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Objective To examine the association of long term intake of gluten with the development of incident coronary heart disease. Setting and participants 64 714 women in the Nurses’ Health Study and 45 303 men in the Health Professionals Follow-up Study without a history of coronary heart disease who completed a 131 item semiquantitative food frequency questionnaire in 1986 that was updated every four years through 2010.

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Exposure Consumption of gluten, estimated from food frequency questionnaires.

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Main outcome measure Development of coronary heart disease (fatal or non-fatal myocardial infarction).

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Compared with participants in the lowest fifth of gluten intake, who had a coronary heart disease incidence rate of 352 per 100 000 person years, those in the hhest fifth had a rate of 277 events per 100 000 person years, leading to an unadjusted rate difference of 75 (95% confidence interval 51 to 98) fewer cases of coronary heart disease per 100 000 person years.

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