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    Oats Safe for Children with Celiac Disease


    Scott Adams

    J Pediatr 2000;137:356-366


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    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.

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    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.
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    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.

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    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

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    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023

    Jefferson Adams
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    Source:
    Gut. 2017 Feb;66(2):250-257.  doi: 10.1136/gutjnl-2015-310148.