Oats and the Gluten-Free Diet: Something for Everyone!
In Honor of Celiac Disease Awareness Month, Gluten Free Watchdog is writing a series of articles (the goal is one per day during the month of May) related to the gluten-free diet–currently the ONLY treatment for celiac disease.
I have written more on oats for both scientific and general audiences than any other issue related to the gluten-free diet. My first article published in the scientific literature in 1997 was on oats and there are at least 27 posts on oats at Gluten Free Watchdog. There isn’t a whole lot more new to say about oats!
The reason oats have received so much attention from me and many others is because this grain is controversial. Whether oats should be included in the diets of folks with celiac disease has been debated since the days of Dicke.
It may help to understand from where this controversy stems…
As I wrote in The Gluten Free Nutrition Guide in 2008 (and yes I keep quoting from this book in this series of articles for CDAM because it contains some great history and it will likely soon be out of print):
“Information contained in their scientific publications suggests that Dicke and colleagues concluded that oats are harmful to patients with celiac disease based on the response to oats of one patient… However, almost as soon as the gluten-free diet became the treatment for celiac disease, some physicians and researchers questioned whether oats should be included on the list of grains to avoid. Early studies that further assessed the safety of oats had findings that were contradictory—some concluding that oats are safe, others that they are harmful. However, many of these studies were not of the quality we expect from scientific studies conducted today. Most of them had to rely on now outdated assessment procedures to determine safety.”
While oats remain controversial, all of the evidence taken as a whole suggests that moderate (up to 50 grams per day) amounts of oats uncontaminated with wheat, barley, and rye can be consumed by the vast majority (but not all) of individuals with celiac disease without causing harm.
Two pivotal articles helped pave the way for this present day view of oats…
The first article published in 2002 entitled, “No harm from five year ingestion of oats in coeliac disease” was the first long-term study to assess the safety of oats. This study found that, “there were no significant differences between controls and those patients consuming oats with respect to duodenal villous architecture, inflammatory cell infiltration, cell infiltration of the duodenal mucosa, or antibody titres after five years of follow-up.” The full study can be accessed at: http://www.nejm.org/doi/pdf/10.1056/NEJM199510193331602
The second article published in 2004 entitled, “The molecular basis for oat intolerance in patients with celiac disease” assessed the intestinal mucosa of a few patients who had previously developed mucosal inflammation while consuming oats. Researchers concluded that, “some celiac disease patients have avenin-reactive mucosal T-cells that can cause mucosal inflammation.” The full study can be accessed at http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0010001
If you eat oats as part of your gluten-free diet, you may want to consider the following…
Choose your oat products based on your comfort level with regard to the amount of information provided to you by manufacturers. You may want to consider the following:
- Does the manufacturer disclose whether they use purity protocol or sorted oats?
- Do they disclose their testing protocols?
- Do they disclose the assay they use to test oats for gluten contamination?
- If a manufacturer refuses to disclose their source(s) of oats, testing protocols, including the assay used for testing or responds to you by saying the information is proprietary, the advice of Gluten Free Watchdog is to move on to another company.
Gluten Free Watchdog’s updated position statement on oats is available at https://www.glutenfreewatchdog.org/news/gluten-free-watchdog-updated-position-statement-on-oats/
Tomorrow’s post: Believe it or not barley has not always been excluded from the gluten-free diet