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The Celiac Disease Oat Conundrum

Celiac.com 06/30/2008 - According to the latest European research, pure oats are safe for most people with celiac disease, and contamination is the main problem facing people with celiac disease who wish to eat oats. The question of whether oats are safe to consume for all people with celiac disease has yet to be adequately resolved. Doubts remain as to whether pure oats are safe for all people with celiac disease, and if so, which oats.

Some studies show that most people with celiac disease can tolerate oats, while some studies show sensitivity. Some people with celiac disease seem to be sensitive to oats, whether they are contaminated or not, but recent studies suggest that contamination is the main problem for most people with celiac disease who wish to eat oats. Anecdotal evidence is equally divided, with some folks reporting no problem with oats, while others report adverse reactions.

A recent editorial by doctors Heather Julia Ellis and Paul J. Ciclitira in the European Journal of Gastroenterology and Hepatology notes that oats could be an important component in a gluten-free diet. They point out that a small segment of the population with celiac disease seem to have adverse T cell responses to oats that can not be explained by contamination. The doctors also point out that only one of the two commercially available kits for testing for the presence of gluten in foods is sensitive to barley. Another problem with oat consumption among people with celiac disease is that some may seem to tolerate oats well, and show no symptoms, but still be suffering damage.

Doctors Ellis and Ciclitira note that people with celiac disease who wish to consume oats need sound advice and regular monitoring for telltale antibodies, and reliable, comprehensive assay techniques, which means access to reliably tested, uncontaminated oats. To that, I would add clear labeling. An article by the Irish gastroenterologist William Dickey in the European Journal of Gastroenterology and Hepatology seems to echo that point. According to Dickey, research supports the idea that most people with celiac disease can tolerate pure oats well, and that only in rare cases do pure oats elicit an adverse reaction. Dickey notes that contamination of commercially viable oats is the cause of most adverse reactions in people with celiac disease. He points out that R5 ELISA accurately detects and measures gluten contamination in oat products. Dickey calls for R5 ELISA testing of all oats, and of all “gluten-free” products containing oats. He points out that contamination levels of all such products should be clearly labeled to help people with celiac disease to avoid products with unacceptable contamination levels.

A recent study made by a team of doctors in Spain set out to measure the levels of wheat and barley contamination of oats from Europe, the United States, and Canada. The research team was made up of doctors Alberto Hernando, Jorge R. Mujico, Mara C. Mena, Manuel Lombardía, and Enrique Méndez. The team used Sandwich R5 ELISA (using either gliadins or hordeins as standards), western blot, matrix-assisted laser desorption/ionization time-of-flight mass spectrometric and quantitative real-time PCR (Q-PCR) techniques to evaluate 134 varieties of “pure,” “uncontaminated” oats from Europe, the United States, and Canada.

Results showed that just 25 of the samples were actually pure, and contained no detectable levels of contamination. The other 109 samples all showed wheat, barley and/or rye contamination. The results also showed that contamination levels vary among oats from the same source.

European Journal of Gastroenterology and Hepatology 20: 492–493; 494–495; 545–554.

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16 Responses:

 
Melia Haywood
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said this on
10 Jul 2008 6:00:05 AM PST
Are you able to reference the 25 sources that were indeed found to be 'pure' when tested for gluten contamination? I have been purchasing 'gluten free' oats as I had been told that both Irish and Scottish Oats were absolutely sure to NOT be cross contaminated as the USA sources were. You make the same references but what do I do to find oats that will be safe for myself?

 
Sarah
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said this on
10 Jul 2008 11:19:30 AM PST
We have had very good luck with the Bob's Red Mill Gluten Free Oats. I'm now using them for oatmeal, granola, granola bars etc. My kids love them and my younger one who has a very sensitive tummy that hurts after even the possibility of cross-contamination, seems fine eating them on a regular basis.
They are expensive, but so nutritious, I really wanted to include them in our gluten-free diet.

 
Phyllis Morrow
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said this on
10 Jul 2008 11:58:05 AM PST
What's the reference for the Spanish study? I'd like to know if Chateau Cream Hill Estates 'Lara's Rolled Oats' were tested. The package claims no cross-contamination (using R5-ELISA batch testing).

 
Luann Brown
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said this on
10 Jul 2008 12:52:05 PM PST
Interesting, but I still would not consider eating oats at this point.

 
Nora

said this on
10 Jul 2008 1:29:15 PM PST
I do tolerate gluten free oats well, whereas I react to even the tiniest amounts of gluten, and the codex wheat starch. What is interesting is that some get problems from oats without symptoms.

 
Bea
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said this on
12 Aug 2008 8:05:39 AM PST
I haven't had any issues with eating oats. I wish people would stop having knee jerk reactions to informative articles such as this. So much misinformation that so many people just cannot let go of even when articles such as this point out the safety of oats.

 
Gloria Brown
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said this on
14 Aug 2008 7:36:48 AM PST
After reading much about the gluten/oat controversy, I dared to try 'Gluten Free Oats' on the hope that the producers (a family of three generations of celiacs) would ensure no contamination. The consequence rated among the most frightening of any food I've eaten, with blood being drawn from my intestine. I have wondered since if damage from oats is related more to the severity of one's sensitivity, and that those reporting no response may be in earlier phases of the disease?

 
Julie
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said this on
13 May 2009 9:13:46 PM PST
I recently have tried gluten-free Oats and have had no adverse reactions. I am excited to have a new grain in my diet!

 
Axel Feldmann
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said this on
22 May 2009 6:04:50 PM PST
I was told by my gastroenterologist that tolerance of oats varies from person to person according to their level of gluten sensitivity. I for one, do not eat oats, because of the risk.

 
kristine
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said this on
29 Sep 2009 12:16:30 PM PST
My daughter is 13 and was told 4 years ago that she has celiac. She happens to be one that can not tolerate oats of any kind. We were taught the phrase: "WHEN IN DOUBT, DO WITH OUT". We still live by this motto. Thank you for a very well written article.

 
Lisa Mims
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said this on
04 Dec 2009 3:51:54 PM PST
I have gluten-sensitive siblings that are fine with oats: I have really reactive Marsh Stage 1 (elevated lymphocytes) celiac even on a gluten-free diet, and can't eat them.

Just a thought? There are different genes that carry celiac--maybe you can eat them if your celiac is from Irish celiac genes, but if your celiac genes are from somewhere else, oats are no good?

 
tlp
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said this on
24 May 2010 7:43:21 AM PST
I love gluten-free oats. The reason oats get contaminated is because regular oats are farmed by the same equipment as wheat is- thus they are contaminated. So a dedicated farm that raises only oats are gluten-free and free of contamination. Most people don't look to see that products will say, ' processed on the same equipment as nuts, wheat, etc... '

Also I must add to women with menopause, like me that you may find that you will have a reaction to starches like oats due to your glucose levels fluctuate during menopause and causes similar reactions you would get from eating gluten's- I get seriously fatigued sometimes when eating starches.

 
Jeanne
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said this on
25 Aug 2010 3:29:20 PM PST
Very helpful. I've decided to continue using oatmeal that's certified as grown on a dedicated field and processed on gluten-free equipment. But I'll give up making occasional exceptions for any other oat product.

 
Doug
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said this on
24 Dec 2011 6:13:18 PM PST
My daughter is very sensitive to gluten and reacts within an hour or two of exposure. She is very careful about her diet and it had been years since she's had a reaction. This evening we tried Bob's Red Mill Gluten-free oats and she is now in the midst of a severe reaction. I am now concerned about the possibility of cross contamination of other BRM products produced in the same facility in which they process oats.

 
steve
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said this on
03 Feb 2012 6:31:23 AM PST
Bob's does process grain containing gluten as well although they supposedly use dedicated equipment for there gluten-free products and test regularly. Valid concern though. I would not allow your daughter to consume oats from any source unfortunately.
One thing that seems clear is some celiac patients are sensitive to oats and some are not. It seems to be the only directly correlated data on this still fuzzy topic!
Hope your daughter recovered quickly and had a great Christmas 2011!

 
Miguel
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said this on
05 Mar 2014 11:12:50 AM PST
I did a 3rd test to make sure that I react to oats (I used Bob's Red Mill Gluten Free Oats); it took only eight hours for the cankers sore to start showing up; I also get kind of pimples in my privates. I love oats but I will pass from now on.




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