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    Oats Not Safe for Some People with Celiac Disease


    Jefferson Adams
    Image Caption: Photo: Wikimedia Commons--Loadmaster

    Celiac.com 12/01/2014 - For years, a debate has raged among researchers and among people with celiac disease about the safety of oats.


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    Photo: Wikimedia Commons--LoadmasterFor American researchers, gluten-free oats have generally been regarded as safe for people with celiac disease, and the decision about whether to include oats in a gluten-free diet has been left to the individual. In Australia, oats are not recommended for people with celiac disease.

    Now, that question looks to be answered, and it turns out, both sides are correct. Oats are generally safe for the vast majority of people with celiac disease. However, Australian researchers recently showed that oats do trigger an adverse immune response in some people with celiac disease. Moreover, they identified the key components in oats that trigger the reaction.

    The 10-year study, published this month in the Journal of Autoimmunity, showed that oats were well tolerated by most people with celiac disease, but that oat consumption triggered an immune response in eight per cent of the participants with celiac disease. The immune responses mirror those caused by eating barley.

    This is somewhat earth-shaking, in that it lends scientific credibility to the idea that some people with celiac disease cannot safely eat oats.

    Dr Jason Tye-Din, head of celiac research at the Walter and Eliza Hall Institute and a gastroenterologist at The Royal Melbourne Hospital, said the study reveals the role of oats in stimulating immune responses in people with celiac disease.

    The fact that the team was able to isolate the specific parts of oat that are toxic to some people with celiac disease should help researchers to develop accurate tests for oat toxicity, and to better tailor dietary treatment for people with the disease.

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    Guest Catherine Becker

    Posted

    I have always had problems with oats. Even as a child before I heard of celiac disease. When I work work in the oat or wheat fields, the next day I would be so sick. My stomach hurt and other things that I know are now are celiac disease related. I can,t eat oats to this day, even gluten free.

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    Guest Uncle Bruce

    Posted

    I'm in the 8%, and that was from a Bob's Red Mill gluten-free oatmeal. Now I stick with their Mighty Tasty Hot Cereal, with brown rice, corn, sorghum, and buckwheat.

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    I have always had problems with oats. Even as a child before I heard of celiac disease. When I work work in the oat or wheat fields, the next day I would be so sick. My stomach hurt and other things that I know are now are celiac disease related. I can,t eat oats to this day, even gluten free.

    I have a reaction when feeding wheat hay, mainly if the wind blows hay back on me or a cow gives a slice of hay a big shake and gets it on me.

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    Oatmeal porridge was breakfast in our house ever since I was born - it made me nauseous just to look at it so I managed to avoid it - but - there were oatmeal cookies which I loved - and got violently sick after - this was long before I was diagnosed - therefore - oat products have been off my diet despite many celiacs telling me they had no problems - thank you for clarifying the situation - I too am a member of the 8% club:)

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    Guest Kristin Jordan

    Posted

    I'm also one of the 8% of celiacs that can't tolerate any oats, and my trigger was also Bob's Red Mill gluten-free oatmeal, which I tried for the first time two years after I was diagnosed with celiac disease. It's difficult to be a no-oats celiac in the U.S., where many gluten-free products that do not contain oats share production lines with "gluten-free" oats. I had residual villous atrophy until I dropped all gluten-free products from Bob's Red Mill (not just oats) and Lundberg Rice (use oats as a cover crop).

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  • About Me

    Jefferson Adams is a freelance writer living in San Francisco. He has covered Health News for Examiner.com, and provided health and medical content for Sharecare.com. His work has appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate, among others.

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  • Related Articles

    Scott Adams
    New England Journal of Medicine
    October 19, 1995 -- Volume 333, Number 16
    Celiac.com 10/25/1995 - According to an article published for the week of October 19, 1995 (Vol. 333, No. 16) in the New England Journal of Medicine, it is not a problem for celiacs to eat oats (non-contaminated, of course!). The article is based on a study conducted in Finland by a group of doctors who did very rigorous testing on adult celiacs and concluded that oats can, and should be included on the celiac diet (The lead doctor for the study is also a celiac).
    The following is a summary of the study: 52 celiacs in remission (on a gluten-free diet for more than a year) were given duodenal-biopsies, and then fed an average of 49.9 grams of oats per day for six months. They were again given biopsies, and none of the subjects were found to have any villi damage.
    There was also a group of 40 newly diagnosed celiacs who underwent the same procedures, except they were studied for 12 months rather than 6. The initial biopsies with this group showed significant villi damage due to the fact that they were still on a gluten-containing diet until they began the study. This group was fed an average of 46.6 grams of oats per day, and were given biopsies at 26 and 52 weeks. Their biopsies were almost normal at 26 weeks, which means their damaged villi were able to heal while eating oats daily. At the end of the year their biopsies showed no damage to their villi.
    The study DID NOT test people who had severe cases of celiac disease, and therefore cannot make recommendations with regard to them. Also, three people with dermatitis herpetiformis withdrew from the study because of an increase of itching, but none of them showed any signs of dermatitis. One person withdrew because of abdominal symptoms, but they did not exhibit damaged villi.
    Their conclusion: Our data suggest that most patients with celiac disease, whether in remission or newly diagnosed, can add moderate amounts of oats to their otherwise gluten-free diets without any harmful subjective side effects or laboratory abnormalities. Furthermore, among the newly diagnosed patients the improvement of mucosal architecture and the disappearance of mononuclear-cell infiltration were similar, regardless of the use of oats. -NEJM
    There is also an editorial from England which cites positive research which has been done there regarding oats. The NEJM is the Bible of medical research, with extensive peer reviews before publication.

    Scott Adams
    CEL-PRO on Oats
    The following is an edited version of some of the opinions of the CEL-PRO, which is a group of doctors who regularly discuss issues concerning celiac disease. Disclaimer - this is NOT medical advise, it is a general discussion of the oats issue. See your own doctor for application to your particular situation.
    Doctor #1:
    I will start off the oats discussion by commenting that this is probably the single most comprehensive study of the effects of a grain on celiacs. The earlier evidence for oats as a deleterious agent in celiac disease was based on a very small number of patients or case studies. Reading the report in the NEJM this week would suggest that oats are safe for most uncomplicated celiacs. There are however some reservations about the study. Severe celiac disease was an exclusion, there were some drop outs in both the oats and the control groups and patients with complications were excluded. If the findings are general to the whole population of celiacs then it would certainly make life a lot easier.
    I have a concern about whether oat flour is reliably free of contamination with barley/ wheat. Also what would happen if we challenged a celiac with high doses of oat flour, greater than the 50g used in this study. Also would oat flour protein produce any of the subtle changes seen in the rectum with enema challenge.
    Doctor #2:
    Here in Finland [where the NEJM study was done] there are mixed feelings about oats. Our colleagues from Kuopio have done a very good study, and in fact the study is on-going. Five year follow-up results will tell us more, the authors are this autumn re-biopsing the coeliacs eating oats. Within our Celiac Disease Study Group we have discussed this, and we are going to discuss the item within the expert team of the Finnish Coeliac Society. At this point I want to say some words regarding children.
    Today we are not going to allow coeliac children to eat oats. We are first going to perform a study, our ethical committee has accepted our protocol. We are also going to look at minor jejunal changes in the normal mucosa revealed by immunohistochemistry. Again, the oats producer will provide us the oats for the study (same deep-frozen tested batch through the whole study). If no harm is seen, oats will be accepted also for children and this is important in our country, we by tradition consume oats. Then another story is whether all oat flour products at our market are clean. This is a real practical problem and we will study this. As you probably know, in Ireland the oats was contaminated, Dr. Conleth Feighery and colleagues used in their study oats from a German producer, tested not to be wheat contaminated (from the fields and mills). The Irish study pointed at the same direction as the Finnish one (9 adult coeliacs challenged with 50 g of oats for 3 months), oats was tolerated. The authors also looked for immunological activation in the mucosa, no changes were seen (paper presented at the 8th International Congress of Mucosal Immunology, San Diego, July 1995, abstract Srinivasan et al. Oats cereal is not immunogenic in coeliac disease. Clin Immunol Immunopathol 1995;76 (part 2):S72).
    Doctor #3:
    The results of Kuopio group published in NEJM are probably changing our dietary recommendations. [The author of #1] has recently discussed the situation in children. The study has been carried out in adults, and in adults the demand to change dietary recommendations is strong, as we have noticed during the last days.
    I think adult celiac patients can switch to oats containing diet under strict follow-up. The amount of oats tolerated, the long-term effect of oats, and the importance of gliadin contamination has to be investigated, however.
    I recommend to my celiac disease patients that they should undergo gastroscopic examination 1-2 years after starting oats-containing diet. Some antecedent information of the mucosal architecture should be available as well. If not, a duodenal biopsy should be taken even before starting of oats. By this way we also can observe possible minor inflammatory changes such as an increase in IEL or alpha-beta T-cell receptor bearing lymphocytes.
    If this arrangement sounds too laborious, at least a strict follow-up by physicians and dietitians are essential. The follow-up comprises general well-being, signs of malabsorption and EmA or AGA analysis.

    Scott Adams
    From an oral report by Dr. Murray; transcribed for the list by Ann Whelan, editor of the bi-monthly newsletter Gluten-Free Living. To subscribe, write to P.O. Box 105, Hastings-on-Hudson, NY 10706. Dr. Joseph Murray, one of the leading USA physicians in the diagnosis of celiac disease (celiac disease) and dermatitis herpetiformis (DH). Dr. Murray (murray.joseph@mayo.edu) of the Mayo Clinic Rochester, MN, is a gastroenterologist who specializes in treating Celiac disease:
    THE DAILY REPORT: The big story today from Finland is oats. There were two talks and several posters presented about the topic.
    In the first talk, Dr. Risto Julkunen spoke about the Finnish five-year follow-up study in which oats were given to a population of well-controlled celiacs. They ingested an average of 34 grams, which is slightly over one ounce, daily for up to five years. The oats used in the study were specially grown and tested to be free of wheat, barley and rye. The researchers claim there was no difference in those allowed the oats and those who were not.
    There was a second study presented from Dublin, and reported by Dr. Conleth Feighery. This 12-week study looked at a small group of patients with healed celiac disease to start with, who were given 50 grams of oats a day. Again, the oats were carefully screened and tested to make sure there was no contamination.
    After 12 weeks, no effect was seen on biopsy or through antibody tests. The researchers also took 2 of the 12 participants and did what they called a micro challenge of 500 milligrams of gluten a day. Both patients got reactions, so the researchers felt that at least two of the participants were sensitive celiacs -- and they still did not respond to the oats.
    A poster from Italy showed biopsies taken from celiacs that had been studied in the culture plate in the presence of oats, which did show some effect on the biopsies. In other words, tissue from biopsies from patients with treated celiac disease were put in a plate and grown in the presence of oat protein, and the oat protein had an effect on the biopsies.
    This sounded odd, so I made sure Id really understood what Joe reported and paraphrased: In other words, theyre seeing no reaction from oats within the body in some studies but this one showed a reaction outside the body? Yes, Joe said, this of course is puzzling. Continuing on the oats issue, a series of short studies from several places also showed what the Finns had shown in the body, i.e., no problem in the short term.
    This is Joes summary on Oats:
    Over the short term, in well-controlled, healed celiacs who are compliant in every other way, it may be safe for them to take oats that have been tested to be free of contamination of other grains. He also mentioned that there were a few studies showing that contamination of commercial oats may be common in several European countries.
    (NOTE: I went to Digestive Disease Week in May, where I met several Irish doctors who have studied oats. I would describe their strong beliefs about oats as very adamant. They are adamant in believing that uncontaminated oats are safe for people with Celiac Disease. If all of this oats talk pans out as being acceptably correct to gluten-sensitive individuals in this country, that would seem to be pretty good news. Then, the next big challenge would be to figure out how gluten-sensitive people are going to get access to contamination-free oats. I, for one, will be all ears.).

    Scott Adams
    The following is a post by Steve Martin (Lucaya@AOL.COM) who has a B.S. in Milling Science, and 10+ years of experience in real world milling, and another 7+ in grain moving and storage.
    I have been reading with some interest the discussion about oats and cross contamination. The grain storage/transporting infrastructure in the US virtually promises cross contamination of grains. Cleaning processes can separate grains with large size and shape differences. For instance, at the flourmill I use to work at, the wheat would come in with about 0.5% corn and soybeans mixed in, but because of the size difference, they were easy to remove. Oats and wheat, on the other hand, are close to the same size, and much more difficult to remove. I have not worked directly at an oat processing facility, and do not know how well they clean the grains before processing. Some mills I have worked at had the equipment to separate wheat and oats and some did not. I would think that oat mills would be the same. I do know that we will not eat any oat products.

    Scott Adams
    I am always amused by the argument that one grain or another is more likely to be contaminated than another, as I believe the real source of danger for contamination is found at mills and processing plants, and is more or less spread out equally for most gluten-free grains. Oats are often cited as having a higher chance of cross-contamination with wheat than other grains because it is often a rotational crop with wheat or barley, and kernels of these gluten-containing grains occasionally get mixed with the non-gluten grains. I do not understand why the same people who make this claim do no also include soy in this category, as it is one of the crops that is most commonly rotated with wheat.
    In any case, from the knowledge that I have gathered over the years about farming and processing grains, I must say that with most grains there is little likelihood of contamination due to the mixing of two different whole grains (i.e., the rotational crop hypothesis). This is due to the different sizes and shapes of different grains, and the machines which sort them after a harvest. If any grains do get mixed together the amount of actual contamination would likely be extremely low.
    In Trevor Pizzeys (Vice President of Operations for Can-Oat Milling) October 30, 1998 letter he expresses his belief that celiacs should avoid oats because he finds between 2.1 and 4.1 kernels of barley or wheat in every 4,000 (0.0525% and 0.1025% respectively). He says that this level can legally go up to a maximum level of 10 kernels per 4,000 (0.25%). In either of these scenarios we are talking about very low amounts. Even at these amounts the likelihood that a celiac eating these grains would eat 1 or 2 kernels of wheat or barley on a given day would be very, very low. Also, since most people who eat oatmeal tend to eat the whole oatmeal as a hot cereal, which means they can take very simple additional precautions to make their chances of eating any kernels of wheat or barley practically zero. The obvious way to do this is to look at the oats before you eat them or mill them and pull out any kernels that are of non-oat type.
    Now we turn to the other part of the argument to scare people away from grains that, taken by themselves, do not cause harm to people with celiac disease. This is the wheat dust in the mill (or during transport, or somewhere else) argument. There are many reasons, both health and safety, why mills take steps to keep dust levels down. Dust contamination is still possible, but I think we are also talking about even lower amounts that we were with the occasional kernel of wheat that pops up in oats, although there is no data that I know of to back this up. I think with whole oats (i.e., oatmeal) people can reduce any possible risk of wheat-dust contamination to almost zero by rinsing off their oats well with water before cooking or milling them.
    The famous oat study that was done in Finland and published in the NEJM used a source of non-contaminated oats to eliminate any possible factors that could ruin the results of their long and expensive study. It is possible that they could have used regular, uncontrolled Quaker oats for their study and gotten the same results, but again, the reasons for not doing so were to eliminate any possible factors that might affect the results of their study. This is the scientific process, and it is important with any study to eliminate any possible factors which could affect the outcome of the study.
    Last, there is a danger of contamination which comes from unclean equipment at mills, and at processing plants. This danger is present with any gluten-free grain, bean, etc., that is milled using the same equipment as is used to mill a gluten-containing grain. In other words we cannot speak of only oats with regard to this issue, as rice flour, soy flour, etc., could be contaminated equally in this way. Aside from legislation to require cleaning between milling runs, those who are worried about this need to buy flours from mills which they have researched and found to be gluten-free, or ones that adequately clean their equipment between runs.
    I think contamination issues are real, but need to be put in perspective with regard to other, perhaps more important issues, like labeling laws and getting agreement between the major celiac organizations in this country with regard to which grains are safe.
    See Also:
    Journal of the American Dietetic Association, Dec. 1997 v97n12p1413(4). Do oats belong in a gluten-free diet? by Tricia Thompson.

    Scott Adams
    J Pediatr 2000;137:356-366
    Celiac.com 10/10/2000 - Dr. Hoffenberg and colleagues from the University of Colorado School of Medicine, Denver report that the short-term consumption of commercially available oat cereal is safe for children with celiac disease new to a gluten-free diet. To determine this they studied 10 children with celiac disease who consumed 24 g of oat cereal per day, and examined small bowel histomorphology and antitissue transglutaminase IgA antibody titer at baseline and at 6 months. According to Dr. Hoffenberg: Compared with start of study, at completion there was a significant decrease in biopsy score, intraepithelial count, antitissue transglutaminase IgA antibody titer and number of symptoms.
    They reported the gluten content of several substances:
    Study oatmeal (%, range) average of 4 samples 0.009 (0.003-0.014)
    Irish Oatmeal 0.006 %
    Quaker oatmeal 0.006 %
    Safeway oatmeal 0.005 %
    Jane Lee oatmeal 0.026 %
    Soy flour 0.001 %
    Brown rice flour 0.000 %
    Pancake mix 0.000 %
    Cornmeal 0.000 %
    Rice flour 0.000 %
    Test was done with RIDASCREEN ELISA test for omega-gliadins. It detects wheat/barley/rye high molecular weight proteins but not oat avenin. The grain scientists tell us that even though oat proteins are different, they do have similar amino acid sequences to the toxic gliadin sequences. Similarly, in vitro (test tube) studies do show that oat proteins trigger the immune response of cells taken from celiac patients.
    The team emphasized, however, that the long-term effects of oat cereal added to a gluten-free diet in children with celiac disease still need to be determined.

    Scott Adams
    Celiac.com 3/14/2003 - After conducting an extensive review of the medical literature concerning the safety of oats for people with celiac disease, the American Dietetic Association recently concluded that even though oats are not yet endorsed as safe for people with celiac disease by doctors and support groups in the USA, they should, however, be safe for celiacs who choose to consume them if they limit their consumption to amounts found to be safe in several studies (approximately one-half cup of dry whole-grain rolled oats per day). Ideally, they also should be advised to consume only those products tested and found to be free of contamination. If this is not possible, patients should be counseled on steps they can take to help reduce their chances of consuming contaminated oat products (e.g., avoiding oats sold in bulk from bins, determining from manufacturers whether a dedicated line or facility is used for processing). In addition, patients should be advised to discuss any dietary changes with their physicians.
    The American Dietetic Associations conditional acceptance of oats as safe for people with celiac disease is another big step forward for celiacs in the USA.
    For more information see:
    Oats and the gluten-free diet
    Journal of the American Dietetic Association
    March 2003 - Volume 103 - Number 3


    Scott Adams
    Gut. 2004 May;53(5):649-654
    A multi-center Swedish study involving eight separate pediatric clinics looked at 116 children with newly diagnosed celiac disease. The group was randomized into two groups, and one group was given a standard gluten-free diet, while the other was given a standard gluten-free diet that also included oats. The study period was one year, small bowel biopsies were performed at the beginning and end of the study, and serum IgA antigliadin, antiendomysium, and antitissue transglutaminase antibodies were monitored at 0, 3, 6, and 12 months. The median intake of oats for the oat-eating group was 15g per day.
    By the end of the study all patients were in clinical remission for celiac disease. Neither group differed significantly from one another with regard to serology markers or small bowel mucosal architecture (including numbers of intraepithelial lymphocytes). Out of the original 116 children 93 finished the study, and significantly more younger patients withdrew from it than older patients.
    The researchers conclude:

    "This is the first randomized double blind study showing that the addition of moderate amounts of oats to a gluten-free diet does not prevent clinical or small bowel mucosal healing, or humoral immunological downregulation in coeliac children. This is in accordance with the findings of studies in adult coeliacs and indicates that oats, added to the otherwise gluten-free diet, can be accepted and tolerated by the majority of children with celiac disease."

    Jefferson Adams
    Celiac.com 05/30/2007 - The results of a study recently published in the Scandinavian Journal of Gastroenterology shows that patients with celiac disease can consume oats with no risk of adverse immunological effects.
    An international research team made up of doctors Tarja Kemppainen (1); Esko Janatuinen (2); Kati Holm (3); Veli-Matti Kosma (4); Markku Heikkinen (5); Markku Mäki (3); Kaija Laurila (3); Matti Uusitupa (1); Risto Julkunen (5), set out to evaluate local cellular immune response after 5 years of oat consumption by adult celiac patients.
    The doctors looked at a group of 42 celiac patients who had previously participated in a 6-12 month oats intervention study.
    22 of these patients already incorporated oats as part of their gluten-free diet. During the 5-year follow-up study, 10 patients who were concerned about the safety of long-term oat consumption stopped eating oats. The 12 remaining patients consumed oats for the whole 5-year period. The remaining 20 celiac patients formed the control group, and followed a strict, conventional, gluten-free diet that excluded oats.
    The team conducted biopsies and counted Intraepithelial CD3, TCR (IEL) and TCR (IEL) T cells to determine corresponding densities.
    No Adverse Effects for Celiac Disease Patients Who Eat Oats
    The results showed no differences in the densities of CD3, IEL and IEL T cells between the oat and the control groups. The researchers concluded that the mucosa of the small intestine show no immunological response in celiac patients who consume oats over a long period of time.
    Scandinavian Journal of Gastroenterology, Volume 42, Issue 1 2007 , pages 54 - 59

    Participating Institutions:
    Department of Clinical Nutrition, University of Kuopio and Kuopio University Hospital. Kuopio. Finland Department of General Medicine, Al Mafraq Hospital. Abu Dhabi, U.A.E. Medical School, University of Tampere and Tampere University Hospital. Tampere. Finland Department of Pathology and Forensic Medicine, University of Kuopio and Kuopio University Hospital. Gastroenterological Unit, Department of Medicine, Kuopio University Hospital. Finland About the Author: Jefferson Adams is a freelance health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.

    Jefferson Adams
    Celiac.com 02/29/2016 - Previous studies have shown that oat proteins trigger an adverse anti-33-mer monoclonal antibody reaction that is proportional to the immune responses in terms of T-cell proliferation.
    Although there has been some research regarding the impact of these varieties on the adaptive response, researchers still don't know very much about the role of the dendritic cells. A research team recently set out to characterize different oat fractions and to study their effect on dendritic cells from celiac patients.
    The research team included Isabel Comino, David Bernardo, Emmanuelle Bancel, María de Lourdes Moreno, Borja Sánchez, Francisco Barro, Tanja Šuligoj, Paul J. Ciclitira, Ángel Cebolla, Stella C. Knight, Gérard Branlard and Carolina Sousa.
    They are variously affiliated with the Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain; the Gastroenterology Unit, Antigen Presentation Research Group, Imperial College London & St Mark′s Hospital, Harrow, United Kingdom; the Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain; the INRA UMR-1095, Clermont-Ferrand, France; the Nutrition and Bromatology Group, Department of Analytical and Food Chemistry, Food Science and Technology Faculty, University of Vigo-Ourense Campus, Ourense, Spain; the Instituto de Agricultura Sostenible (CSIC), Córdoba, Spain; the Division of Diabetes and Nutritional Sciences, King's College London, Gastroenterology, The Rayne Institute, St Thomas' Hospital, London, United Kingdom; and the Biomedal S.L., Sevilla, Spain.
    The team first isolated protein fragments from oat grains and then analyzed them using SDS–PAGE. They then characterized several proteins in the prolamin fraction using immunological and proteomic tools, as well as Nano-LC-MS/MS. These proteins were very similar to α- and γ-gliadin, and showed reactive sequences to anti-33-mer antibody, indicating their potential for causing adverse immune reactions.
    Furthermore, the team found that some of the newly identified oat peptides triggered a range of immune responses on circulating dendritic cells from celiac patients, as compared with healthy controls.
    This is the first study to show that newly identified oat peptides can trigger a range of stimulatory responses on circulating dendritic cells from celiac patients, which highlights the potential of these oat peptides to trigger adverse immune responses in people with celiac disease.
    Source:
    Food & Nutrition Research eISSN 1654-661X

    Jefferson Adams
    Celiac.com 08/31/2016 - Oats are traditionally one of the more commonly contaminated gluten-free grains on the market.
    According to Gluten Free Watchdog, "gluten-free" foods made with oat ingredients are more commonly contaminated than foods made with other "gluten-free" grains. In light of their survey results, people with a high sensitivity to gluten might want to consider taking some extra steps to make sure their oats are truly gluten-free.
    The solution? Know your oats! To be sure that your oats are safe, Gluten Free Watchdog recommends following these easy extra steps:
    1) Make sure you are sourcing oats from a supplier of purity protocol oats, such as gluten-free Harvest, Avena, or Montana Gluten-Free. Currently, Gluten Free Watchdog does not recommend any of the commercial suppliers of mechanically and optically sorted oats, such as Grain Millers or LaCrosse Milling.
    2) Ask for test results. Regardless of where you source oats, ask your supplier to provide you with test results, including how frequently oats are tested and what assay is used for testing.
    3) Test the oats yourself. There is no such thing as too much testing. If you really want to be sure, you can send samples of oats to a third party lab for testing using the sandwich R5 ELISA and cocktail extraction. Labs include Bia Diagnostics and FARRP.
    Read more at Gluten Free Watchdog.

    Jefferson Adams
    Celiac.com 08/03/2016 - As part of its mission, Gluten Free Watchdog performs gluten testing on gluten-free products and shares that information with the gluten-free community. They've tested many gluten-free products over the years, and collected data from their efforts.
    Over the past five years, Gluten Free Watchdog has been testing oat products labeled gluten-free that list oats as the first or second ingredient. In all, they've done professional testing on thirty-five different commercial products. They've recently released their findings, and while they don't name any names, they do offer some good general insight into gluten-contamination levels in general.
    All testing for Gluten Free Watchdog was conducted by Bia Diagnostics, LLC using the sandwich R5 ELISA (Ridascreen Gliadin R7001) and cocktail extraction—Mendez method.
    Based on testing data from Gluten Free Watchdog, oat products labeled gluten-free have an almost three times higher risk of gluten contamination as compared to labeled gluten-free foods as a whole. The results showed 28 of 35 or 80% of oat products testing below 5 parts per million of gluten, and 2 of 35 or 6% of oat products testing at or above 5 ppm but below 20 ppm of gluten. Meanwhile, 5 of 35 or 14% of oat products tested at or above 20 ppm of gluten.
    The good news, of course, is that 86% percent oat products tested below 20 parts per million of gluten, but that's not nearly as good as the 95% of all gluten-free foods tested to date that have tested below 20 ppm of gluten.
    So, the bad news is that the 14% of oat products testing at or above 20 ppm of gluten is nearly three times higher than for gluten-free foods in general.
    Main culprits testing at or above 20 ppm of gluten included "gluten-free" labeled oat breadcrumbs, rolled oats, granola, hot oat cereal, and granola.
    Gluten Free Watchdog's main recommendation for consumers is to know the source of the oats you are eating, and to make sure you're getting your oats form a safe and trustworthy source. If you have a concern, check with the manufacturer to make sure they source ALL oats from a supplier of purity protocol oats, such as gluten-free Harvest, Avena, Montana Gluten-Free.
    Read more at Gluten-free Watchdog.org.

  • Recent Articles

    Jefferson Adams
    Celiac.com 07/21/2018 - These easy-to-make tortilla wraps make a great addition to your lunchtime menu. Simply grab your favorite gluten-free tortillas, a bit of cream cheese, some charred fresh sweet corn, creamy avocado and ripe summer tomato. Add a bit of sliced roast beef and some mayonnaise and hot sauce, and you’re in business. And it's all ready in about half an hour. If you cook the corn the night before, they can be ready in just a few minutes.
    Ingredients:
    12 ounces thinly sliced cooked beef, sliced 6 burrito-sized gluten-free tortillas 1 ripe medium avocado, diced 1 large tomato, diced ½ medium red onion, thinly sliced ¼ cup mayonnaise 2 ears sweet corn, husks and silk removed 1 teaspoon olive oil ¾ cup soft cream cheese spread 1-2 teaspoons gluten-free hot sauce of choice Sprouted pea greens, as desired fresh salsa, as desired Directions:
    Heat grill to medium-hot. 
    Brush corn with olive oil. 
    In a small dish, blend mayonnaise and hot sauce. Adjust mixture, and add fresh salsa, as desired.
    Grill corn for 8 to 12 minutes, turning as it browns and lowering heat as needed until corn is tender and charred in some places. 
    Cool slightly; cut kernels from cobs.
    Spread 2 tablespoons cream cheese on one side of each tortilla to within ½-inch of edge; arrange beef slices to cover.
    Spread beef with mayonnaise hot sauce mixture as desired.
    Place a bit of grilled corn kernels, avocado, tomato and red onion in a 3-inch strip along one edge of each tortilla. 
    Fold ends and roll into a burrito shape, and serve. I like to add sweet, crunchy pea greens for some extra crunch and nutrition.

    Christina Kantzavelos
    Celiac.com 07/20/2018 - During my Vipassana retreat, I wasn’t left with much to eat during breakfast, at least in terms of gluten free options. Even with gluten free bread, the toasters weren’t separated to prevent cross contamination. All of my other options were full of sugar (cereals, fruits), which I try to avoid, especially for breakfast. I had to come up with something that did not have sugar, was tasty, salty, and gave me some form of protein. After about four days of mixing and matching, I was finally able to come up with the strangest concoction, that may not look the prettiest, but sure tastes delicious. Actually, if you squint your eyes just enough, it tastes like buttery popcorn. I now can’t stop eating it as a snack at home, and would like to share it with others who are looking for a yummy nutritious snack. 
    Ingredients:
    4 Rice cakes ⅓ cup of Olive oil  Mineral salt ½ cup Nutritional Yeast ⅓ cup of Sunflower Seeds  Intriguing list, right?...
    Directions (1.5 Servings):
    Crunch up the rice into small bite size pieces.  Throw a liberal amount of nutritional yeast onto the pieces, until you see more yellow than white.  Add salt to taste. For my POTS brothers and sisters, throw it on (we need an excess amount of salt to maintain a healthy BP).  Add olive oil  Liberally sprinkle sunflower seeds. This is what adds the protein and crunch, so the more, the tastier.  Buen Provecho, y Buen Camino! 

    Jefferson Adams
    Celiac.com 07/19/2018 - Maintaining a gluten-free diet can be an on-going challenge, especially when you factor in all the hidden or obscure gluten that can trip you up. In many cases, foods that are naturally gluten-free end up contain added gluten. Sometimes this can slip by us, and that when the suffering begins. To avoid suffering needlessly, be sure to keep a sharp eye on labels, and beware of added or hidden gluten, even in food labeled gluten-free.  Use Celiac.com's SAFE Gluten-Free Food List and UNSAFE Gluten-free Food List as a guide.
    Also, beware of these common mistakes that can ruin your gluten-free diet. Watch out for:
    Watch out for naturally gluten-free foods like rice and soy, that use gluten-based ingredients in processing. For example, many rice and soy beverages are made using barley enzymes, which can cause immune reactions in people with celiac disease. Be careful of bad advice from food store employees, who may be misinformed themselves. For example, many folks mistakenly believe that wheat-based grains like spelt or kamut are safe for celiacs. Be careful when taking advice. Beware of cross-contamination between food store bins selling raw flours and grains, often via the food scoops. Be careful to avoid wheat-bread crumbs in butter, jams, toaster, counter surface, etc. Watch out for hidden gluten in prescription drugs. Ask your pharmacist for help about anything you’re not sure about, or suspect might contain unwanted gluten. Watch out for hidden gluten in lotions, conditioners, shampoos, deodorants, creams and cosmetics, (primarily for those with dermatitis herpetaformis). Be mindful of stamps, envelopes or other gummed labels, as these can often contain wheat paste. Use a sponge to moisten such surfaces. Be careful about hidden gluten in toothpaste and mouthwash. Be careful about common cereal ingredients, such as malt flavoring, or other non-gluten-free ingredient. Be extra careful when considering packaged mixes and sauces, including soy sauce, fish sauce, catsup, mustard, mayonnaise, etc., as many of these can contain wheat or wheat by-product in their manufacture. Be especially careful about gravy mixes, packets & canned soups. Even some brands of rice paper can contain gluten, so be careful. Lastly, watch out for foods like ice cream and yogurt, which are often gluten-free, but can also often contain added ingredients that can make them unsuitable for anyone on a gluten-free diet. Eating Out? If you eat out, consider that many restaurants use a shared grill or shared cooking oil for regular and gluten-free foods, so be careful. Also, watch for flour in otherwise gluten-free spices, as per above. Ask questions, and stay vigilant.

    Jefferson Adams
    Celiac.com 07/18/2018 - Despite many studies on immune development in children, there still isn’t much good data on how a mother’s diet during pregnancy and infancy influences a child’s immune development.  A team of researchers recently set out to assess whether changes in maternal or infant diet might influence the risk of allergies or autoimmune disease.
    The team included Vanessa Garcia-Larsen, Despo Ierodiakonou, Katharine Jarrold, Sergio Cunha,  Jennifer Chivinge, Zoe Robinson, Natalie Geoghegan, Alisha Ruparelia, Pooja Devani, Marialena Trivella, Jo Leonardi-Bee, and Robert J. Boyle.
    They are variously associated with the Department of Undiagnosed Celiac Disease More Common in Women and Girls International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America; the Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom; the Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom; the Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; the Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom; the Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom; and Stanford University in the USA.
    Team members searched MEDLINE, Excerpta Medica dataBASE (EMBASE), Web of Science, Central Register of Controlled Trials (CENTRAL), and Literatura Latino Americana em Ciências da Saúde (LILACS) for observational studies conducted between January 1946 and July 2013, and interventional studies conducted through December 2017, that evaluated the relationship between diet during pregnancy, lactation, or the first year of life, and future risk of allergic or autoimmune disease. 
    They then selected studies, extracted data, and assessed bias risk. They evaluated data using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). They found 260 original studies, covering 964,143 participants, of milk feeding, including 1 intervention trial of breastfeeding promotion, and 173 original studies, covering 542,672 participants, of other maternal or infant dietary exposures, including 80 trials of 26 maternal, 32 infant, or 22 combined interventions. 
    They found a high bias risk in nearly half of the more than 250 milk feeding studies and in about one-quarter of studies of other dietary exposures. Evidence from 19 intervention trials suggests that oral supplementation with probiotics during late pregnancy and lactation may reduce risk of eczema. 44 cases per 1,000; 95% CI 20–64), and 6 trials, suggest that fish oil supplementation during pregnancy and lactation may reduce risk of allergic sensitization to egg. GRADE certainty of these findings was moderate. 
    The team found less evidence, and low GRADE certainty, for claims that breastfeeding reduces eczema risk during infancy, that longer exclusive breastfeeding is associated with reduced type 1 diabetes mellitus, and that probiotics reduce risk of infants developing allergies to cow’s milk. 
    They found no evidence that dietary exposure to other factors, including prebiotic supplements, maternal allergenic food avoidance, and vitamin, mineral, fruit, and vegetable intake, influence risk of allergic or autoimmune disease. 
    Overall, the team’s findings support a connection between the mother’s diet and risk of immune-mediated diseases in the child. Maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitization to food, respectively.
    Stay tuned for more on diet during pregnancy and its role in celiac disease.
    Source:
    PLoS Med. 2018 Feb; 15(2): e1002507. doi:  10.1371/journal.pmed.1002507

    Jefferson Adams
    Celiac.com 07/17/2018 - What can fat soluble vitamin levels in newly diagnosed children tell us about celiac disease? A team of researchers recently assessed fat soluble vitamin levels in children diagnosed with newly celiac disease to determine whether vitamin levels needed to be assessed routinely in these patients during diagnosis.
    The researchers evaluated the symptoms of celiac patients in a newly diagnosed pediatric group and evaluated their fat soluble vitamin levels and intestinal biopsies, and then compared their vitamin levels with those of a healthy control group.
    The research team included Yavuz Tokgöz, Semiha Terlemez and Aslıhan Karul. They are variously affiliated with the Department of Pediatric Gastroenterology, Hepatology and Nutrition, the Department of Pediatrics, and the Department of Biochemistry at Adnan Menderes University Medical Faculty in Aydın, Turkey.
    The team evaluated 27 female, 25 male celiac patients, and an evenly divided group of 50 healthy control subjects. Patients averaged 9 years, and weighed 16.2 kg. The most common symptom in celiac patients was growth retardation, which was seen in 61.5%, with  abdominal pain next at 51.9%, and diarrhea, seen in 11.5%. Histological examination showed nearly half of the patients at grade Marsh 3B. 
    Vitamin A and vitamin D levels for celiac patients were significantly lower than the control group. Vitamin A and vitamin D deficiencies were significantly more common compared to healthy subjects. Nearly all of the celiac patients showed vitamin D insufficiency, while nearly 62% showed vitamin D deficiency. Nearly 33% of celiac patients showed vitamin A deficiency. 
    The team saw no deficiencies in vitamin E or vitamin K1 among celiac patients. In the healthy control group, vitamin D deficiency was seen in 2 (4%) patients, vitamin D insufficiency was determined in 9 (18%) patients. The team found normal levels of all other vitamins in the healthy group.
    Children with newly diagnosed celiac disease showed significantly reduced levels of vitamin D and A. The team recommends screening of vitamin A and D levels during diagnosis of these patients.
    Source:
    BMC Pediatrics