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    Should Celiacs Eat Oats? Depends on the Oat


    Diana Gitig Ph.D.
    Image Caption: New study indicates that the type of oats matters for celiacs.

    Celiac.com 03/14/2011 - It is still a matter of controversy whether or not oats are safe for people with celiac disease. The general consensus at this point seems to be that pure oats are safe for most, but not all, people with celiac. Since oats can easily be contaminated with wheat during harvest, storage, or other stages of processing, it has been stressed that the oats be certified as pure. Although the classic 33-amino acid long oligopeptide that acts as the immunogenic stimulus in gliadin had not yet been found in oats, other peptides isolated from oats do activate T-cells isolated from celiac patients. A new study performed in Spain by Isabel Comino et al. suggests that it is not that some celiac patients can’t tolerate all oats, but rather that all celiac patients can’t tolerate some oats. Their results are reported in the January 2011 issue of GUT: An International Journal of Gastroenterology and Hepatology.


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    Dr. Comina and her colleagues examined nine different cultivars of oats. They exposed each of them to a sensitive monoclonal antibody generated to recognize the toxic 33-mer from gliadin, and also measured if each of the oat varieties could elicit an immune response in peripheral blood mononuclear cells from celiac patients. They wanted to see if they could correlate recognition by the monoclonal antibody to induction of a T-cell response, and found that they certainly could.

    The nine varieties of oats segregated neatly into three groups of three varieties each: those for which the antibody had high affinity, low affinity, and no affinity. This affinity was validated by two different experimental methods, so was not an artifact of the technique chosen. When T cells from patients with celiac were exposed to extracts of the oat variety the antibody bound to strongest, they proliferated the most and released interferon-gamma, an immunostimulatory cytokine whose aberrant expression is associated with autoinflammatory disease. In contrast, the oats that didn’t react with the antibody did not elicit these immune responses. The authors note that the avenin – the storage protein in oats – from even the most immunogenic oats they saw bound to this antibody with 40-400 fold less affinity than gliadin (from gluten – the storage protein in wheat).

    This study thus leaves us with two valuable conclusions. One is that some oats are more toxic than others, regardless of their purity. And the other is that reactivity with this antibody can be correlated to toxicity, making it a potential tool for evaluating the toxic gluten content of other food.

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    Guest Angie Halten

    Posted

    I thought most oats were the same but after reading your article I discovered that some oats are more toxic than others. This sheds a bit more light on the whole controversy concerning eating oats. Thanks!

     

    Angie.

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    The article may answer the question, but as a non-scientific person, I'd prefer a straight, non-scientific answer. So.....specifically what oats are safe and which are not? Just tell me, so I don't have to try and understand the science.

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    Guest Donna

    Posted

    A good start. Now we celiacs need a list of which oats we can try eating, and which to avoid, by brand or at least by some consumer-visible guideline. Looking forward to seeing that, sooner than later. Oats generally can be so good for people, I'd like to resume eating them.

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    This study just confirmed why I have reactions to oatmeal. The oats I purchased from a reputable store were guaranteed gluten free. I tried 2 different manufacturer's of oats and had the same gut reaction. Since I am not willing to keep trying other oat types, oats are out of my diet.

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    Guest Nikki

    Posted

    I too had a terrible reaction to a reputable brand of gluten free oats. If there are specific oats which are less likely to cause a reaction, I'd like to know and would give it one last try. BTW, I get the same reactions from corn and soy.

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    Guest Robin

    Posted

    The researchers in the study cited in the article used an antibody called G12. It is in the Glutentox Kit, now on the market in the United States.

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    Guest Karen

    Posted

    Okay, so some oats are bad and some oats are good. That's great, but what type of oats fall under what category? I guess I don't like wasting my time on something that really doesn't give me any information.

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    Guest Jared

    Posted

    This study may have confirmed why I seem to have no trouble eating all varieties of Nature Valley granola bars. Like Lisa stated, I want to see a list distinguishing between safe and unsafe oats/brands.

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    Guest dappycharlie

    Posted

    nothing said specifically about what defines bad oats even if pure - so of little to no help.

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    She did not say which specific brands of oats are okay to consume- what are we guinea pigs ???

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    Guest Emily Kaufman

    Posted

    The science is still really new, so information about which oats are/are not safe is just not available yet.

     

    For now, the takeaway is still pretty significant -- First, that CC isn't the sole problem with oats / that some are inherently safer than others.

     

    Second, that there's a mistake in the commonly-held belief that some celiacs are just more sensitive to oats than others (even oats labeled gluten-free). This may be true, but it's also likely that some of them are eating oats that aren't gluten-free despite labeling to the contrary. Many of the antibodies used in testing/certifying are only able to recognize CC in oats, not the gluten inside some oats -- these scientists used a different, new antibody (G12) that is so far the only one proven to detect CC-gluten and inherent-gluten.

     

    This is a preliminary study, it paves the way for future studies that will identify safe oats and lead to better testing and labeling.

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    Okay, so some oats are bad and some oats are good. That's great, but what type of oats fall under what category? I guess I don't like wasting my time on something that really doesn't give me any information.

    That is pretty much what I thought. If it doesn't explain the difference in which oat is which, why bother explaining the science behind it. I'm more interested in the bottom line I guess.

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    Guest Robert H. Gibbs MD

    Posted

    It would be good to know just what manufacturers are using when they say they use an 'Elisa' assay for that does not define the epitrope that the testing antibodies have been formed against. Also the author should have noted that the people who did the study treated the proteins prior to assay with enzymes (gut enzymes like we have) and that could make their data more meaningful than the simple testing of an oat slurry.

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    Guest Nicketti

    Posted

    A promising study. However, What's missing is, including the names of the different types of oats that were in the study. Then people can actually use this information.

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    I tried gluten-free oats and had the same symptoms as with wheat. I think that no matter what the general consensus is or what the science says, if there's any question for you personally, oats should be skipped.

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    Guest Brian

    Posted

    Finish with the info on the good oats!

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    Guest Kristin Jordan

    Posted

    Very informative! It's good to see the oat topic and celiac disease still being scientifically explored. I appreciate this article because it informs us that the oats "debate" in the celiac community is not resolved. I had a severe reaction to Bob's Red Mill certified gluten-free oats, two years after my celiac diagnosis and going gluten free. (It was my first time to try gluten-free oats, and I will never get near any type of oats again!) I had tried the oats at this time because the "consensus" out there (what I was reading about celiac disease) was that the gluten-free oats were safe for celiacs, and gluten-free oats are now in so many "gluten-free" products. Now I know better and read more comprehensive studies before attempting anything that might be dangerous to my health.

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    Guest woodchuck64

    Posted

    How much oats can you safely eat per day?

     

    "Catassi et al demonstrated that the ingestion of contaminated gluten should be kept lower than 50 mg/day in the treatment of celiac disease. Based on the reactivity of the G12 antibody against the different oat varieties and gliadin and on the results published by Catassi et al, the tolerance to the most toxic oats might be in the range of 2–20 g/day."

     

    Answer: 2g if you want to be safe, 20g if you're feeling lucky, according to the authors.

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    This study just confirmed why I have reactions to oatmeal. The oats I purchased from a reputable store were guaranteed gluten free. I tried 2 different manufacturer's of oats and had the same gut reaction. Since I am not willing to keep trying other oat types, oats are out of my diet.

    I have such a terrible reaction to regular oats that I am afraid to try the certified gluten-free kind.

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    I feel like I just watched a season ending cliff hanger... Was there something of usable value here that I missed? Why post this article: for people to waste their time? It serves no use.

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    Guest Chris Samuel

    Posted

    To quote from the original paper (linked to above):

     

    "Therefore, three groups of oat varieties could be clearly distinguished depending on their recognition by the moAb G12: a group with high affinity towards the antibody (OM719, OA729 and OE717), a group with intermediate recognition (OH727, OL715 and OC723) and another group comprising oats that were not recognised by moAb G12 (OF720, OR721 and OP722). The alternative anti-33mer moAb A1 also provided equivalent results (data not shown)."

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  • About Me

    Diana received her B.A. in Biochemistry from the University of Pennsylvania, and then a Ph.D. in Cell Biology and Genetics from Cornell. Now she is a freelance science writer and editor in White Plains, New York.  Her son was diagnosed with celiac disease in 2006, at the age of five, and she has been keeping her family healthy by feeding them gluten free treats ever since.

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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).
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    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.
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    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
    The following was written by Donald D. Kasarda who is a research chemist in the Crop Improvement and Utilization Research Unit of the United States Department of Agriculture. If you have any questions or comments regarding the piece, please address them to Don at: kasarda@pw.usda.gov
    The work from Prof. Auricchios laboratory (Troncone et al.) in Naples is certainly of interest and I shall look forward to seeing the details, but I will just point out for the sake of balance that studies with patients who ingest, or have instilled into their intestines, the substance to be tested represent the gold standard and in vitro testing (that is, in glass, or in the test-tube), while valuable, does not carry as much weight. The results from the Finnish group and from Dr. Feigherys group (not yet published), Dublin, Ireland, are very impressive. The results based on in vitro testing would have to be truly exceptional to undermine the excellent work that has been done on the safety of oats. So, we shall have to wait and see, but I doubt there is reason to be overly concerned just yet.

    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.
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    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.

    Dr. Ron Hoggan, Ed.D.
    This article originally appeared in the Winter 2004 edition of Celiac.com's Journal of Gluten-Sensitivity.
    Celiac.com 09/19/2014 - Experts have decreed that pure oats are safe for people with celiac disease(1,2,3).  The definition of this disease is based on a very specific type of injury to the intestinal wall that heals following the removal of gluten from the diet.  This intestinal damage, called villous atrophy, is caused by the interaction between the immune system and certain proteins found in wheat, rye, and barley.  Identical proteins are not found in oats (although there is also some variation between the protein groups found in wheat, rye, and barley).  Further, many newly diagnosed celiac patients have been shown to recover from their celiac symptoms while eating significant quantities of oats and their intestinal biopsies do not show signs of villous atrophy1 (Admittedly, the quantity of oats consumed by these study subjects does not rival the grain protein consumption in a regular, gluten-laden diet, but the quantity is significant).  Therefore, this food is considered safe for celiac consumption.
    Given these facts, it is not surprising that many gastroenterologists are now recommending that their patients eat oats.  Some claim that patients are more likely to follow a gluten-free diet if that diet allows oats.  Others point to the definition of celiac disease, which clearly requires gluten-induced villous atrophy.  Still others insist that since we now know which proteins cause the villous atrophy, oats must be safe for celiac patients to consume.
    There are several problems with these perspectives, beginning with the assumption that patients will be more compliant with the diet if it includes oats.  I have explored the medical literature and have been unable to find a single study that investigates dietary compliance as a function of including oats in the gluten-free diet.  I’d be happy to hear about such a study.  But until the question is investigated, the assumption is just one more opinion afloat in a sea of unfounded beliefs about grains and diet.
    Many celiac patients experience an addictive element in gluten.  I have long suspected that is the result of morphine-like, opioid peptides found in the digests of gluten(4-8).  Are some peptides from oats capable of producing these opioids?  Has anyone investigated that issue?  Again, I can find no evidence that this issue has been studied.
    Reliance on the biopsy to reveal problems with oat consumption is another relevant problem.  As many of us can attest, and the medical literature reports, gluten challenges that intentionally involve ingestion of relatively large quantities of gluten often fail to reveal villous atrophy for weeks, months, and sometimes, years(9).  Many celiac patients will also agree that despite our best efforts at compliance, gluten sometimes manages to sneak into our diets, particularly in the early months of following the diet.  Yet a second biopsy usually shows dramatic healing of the intestinal wall, despite these dietary errors.  Clearly, the intestinal biopsy is a fairly crude tool for measuring intestinal health.  Its use in exonerating oats thus becomes suspect.  An even more troubling element of this issue is that there are gastroenterologists who are recommending that their patients consume breakfast cereals that contain malt flavoring, because patients consuming such small quantities of malt do not show villous atrophy(10).
    Also troubling is the fact that many of the studies that support the safety of oats have not employed the Marsh system for identifying intestinal injury, a refinement that significantly increases the sensitivity of the intestinal biopsy.
    The greatest weakness of the pro-oats position is the underlying assumption that we fully understand celiac disease and gluten sensitivity.  This is simply not the case.  The research shows that some celiacs do develop symptoms when consuming oats.  While most newly diagnosed celiacs experience reduced symptoms and improved health, this may simply be the result of consuming less grain-derived protein.  Researchers have long known that even partial compliance with the gluten-free diet produces health improvements in celiac patients(11).
    The definition of celiac disease that requires villous atrophy followed the discovery of the beneficial impact of the gluten-free diet by more than 20 years (If in doubt about this point, please refer to the English translation of Dr. Dicke’s Ph.D. thesis at http://www.dangerousgrains.com).  Our current understanding of the disease began with the observed benefits of the gluten-free diet.  Intestinal biopsies were a much later development.
    A similar debate arose regarding the inclusion of wheat starch.  It was long held to be a safe nutrient in the gluten-free diet in many European countries.  In fact, the studies that showed a reduced risk of cancer and a variety of celiac-associated conditions were often conducted among patient groups living where wheat starch was deemed acceptable(12, 13).  Yet when wheat starch consumption was studied in Canada, against a back-drop of zero tolerance, most of the subjects developed signs and symptoms of celiac disease(14).
    Many celiacs and gluten-sensitive individuals know that their symptoms do not fit with the conventional view of celiac disease.  Some of us believe that there is a continuum of severity.  Others believe that there are many sub-types of celiac disease.  Still others believe, me included, that it really doesn’t matter whether a person has intestinal damage.  The important, defining characteristic should be whether a person is mounting an immune response against the proteins in the most common substance in our food supply.  
    Whatever our beliefs we turn to the experts when faced with health concerns and crises.  However, those answers often rely on the medical definition of celiac disease, where villous atrophy heals in response to a gluten-free diet.  In cases where the biopsy was improperly taken, or too few samples were taken, or patchy intestinal lesions were missed, or other forms of gluten-induced ailments are causing symptoms, we may not get answers that aid our health.  Many individuals who are gluten sensitive will be, under such circumstances, dismissed with a diagnosis of IBS.
    Given the facts, we have several hurdles to overcome before we can, in my opinion, render an informed judgment about the safety of oats.  We need a much better understanding of gluten-induced disease in all of its manifestations.  We also need a definition of celiac disease that is more useful to the patient who is experiencing symptoms of gluten sensitivity/celiac disease.  As part of this, we also need a test that is more accurate, and can identify celiac disease after beginning the diet––a challenge that many of us face.  Until we have overcome these hurdles, any pronouncement regarding the safety of oats is premature.
    Further research is, in my opinion, the greatest need of the celiac community.  We need to know more, not just about celiac disease, but about the whole range of nutritional and pathological impacts of eating grains. In my own quest, I have learned from the experiences of other celiac patients.  Each new facet of my own experience has been illuminated by someone else’s story.  I have come to understand ADHD as a frequent companion of celiac disease.  Learning disabilities are also common among celiacs.  Behavioral disturbances are the norm, and speech problems are common.  My understanding continues to grow as I hear from others who struggle with gluten sensitivity.
    Despite its usefulness, this patient-to-patient network of information sharing is not enough.  We need well designed, well executed research.  We need a better understanding of our disease and how to protect future generations from the current, inaccurate assumptions about grains.  The oats question is only one facet of a much larger need for more information and better testing methods.
    Sources:
    Storsrud S, Olsson M, Arvidsson Lenner R, Nilsson LA, Nilsson O, Kilander A.    Adult coeliac patients do tolerate large amounts of oats. Eur J Clin Nutr. 2003 Jan;57(1):163-9. Kilmartin C, Lynch S, Abuzakouk M, Wieser H, Feighery C.  Avenin fails to induce a Th1 response in coeliac tissue following in vitro culture. Gut. 2003 Jan;52(1):47-52. Janatuinen EK, Kemppainen TA, Julkunen RJ, Kosma VM, Maki M, Heikkinen M, Uusitupa MI.  No harm from five year ingestion of oats in coeliac disease. Gut. 2002 Mar;50(3):332-5. Teschemacher H.  Opioid receptor ligands derived from food proteins. Curr Pharm Des. 2003;9(16):1331-44. Review. Yoshikawa M, Takahashi M, Yang S. Delta opioid peptides derived from plant proteins. Curr Pharm Des. 2003;9(16):1325-30. Review. Horvath K, Graf L, Walcz E, Bodanszky H, Schuler D. Naloxone antagonises effect of alpha-gliadin on leucocyte migration in patients with coeliac disease. Lancet. 1985 Jul 27;2(8448):184-5. Zioudrou C, Streaty RA, Klee WA. Opioid peptides derived from food proteins. The exorphins. J Biol Chem. 1979 Apr 10;254(7):2446-9. Hoggan R.  Considering wheat, rye, and barley proteins as aids to carcinogens. Med Hypotheses. 1997 Sep;49(3):285-8. Fukudome S, Yoshikawa M.   Opioid peptides derived from wheat gluten: their isolation and characterization. FEBS Lett. 1992 Jan 13;296(1):107-11. Kuitunen P, Savilahti E, Verkasalo M.  Late mucosal relapse in a boy with coeliac disease and cow's milk allergy. Acta Paediatr Scand. 1986 Mar;75(2):340-2. Holmes, et. al. "Malignancy in coeliac disease - effect of a gluten free diet" Gut 1989; 30: 333-338 Holmes GK.  Coeliac disease and malignancy.Dig Liver Dis. 2002 Mar;34(3):229-37 Collin P, Pukkala E, Reunala T.  Malignancy and survival in dermatitis herpetiformis: a comparison with coeliac disease. Gut. 1996 Apr;38(4):528-30. Chartrand LJ, Russo PA, Duhaime AG, Seidman EG.  Wheat starch intolerance in patients with celiac disease. J Am Diet Assoc. 1997 Jun;97(6):612-8.

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    Celiac.com 07/13/2018 - I went to a friend’s home for dinner.  A few days before, she called and asked me what I could eat.  I asked her what she was planning to make, and she said she was grilling meats with side dishes.  I said, “Great.  Please just grill a piece of chicken for me with salt and pepper, and I’ll be happy to bring a side.” She said, “No need to bring a side.  I’ve got this.” When I arrived, she greeted me and said, “I spent all day cooking tonight’s dinner so you can eat it. Hey would you just check this salad dressing to see if it is OK for you?” I looked at the ingredients and it contained gluten and dairy, both of which I cannot eat.  Then I glanced around the kitchen and saw evidence of wheat cross-contamination, including buns being toasted on the grill, and gluten-containing barbeque sauce spilling on the grill where my “clean” chicken was cooking. She had other guests to tend to, and I couldn’t offer instruction or read the ingredients of everything she used in the meal. 
    At social gatherings, I’ve been challenged too by those who ask if I am really “allergic,” or just eating gluten free as a “fad.” I’ve been told many times by hosts and hostesses that, “a little won’t hurt you,” or “everything in moderation,” or “if it is made with loving hands, it is good for you to eat.”  Of course, all of this is bunk for those with food allergies or celiac disease.  A little bit may kill us, and whether made with loving hands or not, it will certainly make us sick. 
    Those of us with food allergies and/or celiac disease walk a tightrope with friends and relatives. The old rules of etiquette just don’t work anymore.  We don’t want to insult anybody, we don’t want to be isolated, and we also don’t want to risk our health by eating foods that may contain ingredients we cannot tolerate.  So what do we do? 
    Etiquette books advise us to eat what is put in front of us when we are guests in someone’s home. They caution us at all costs not to insult our hostess. Rather, we are instructed to compliment the hostess on her good cooking, flavor combinations, and food choices.  But when foods are prepared in a cross-contaminated environment with ingredients we are allergic to, we cannot follow the old social constructs that do not serve us.  We need to work together to rewrite the rules, so that we can be included in social gatherings without fear of cross-contamination, and without offending anyone.
    Let’s figure out how to surmount these social situations together.  
    Each edition of this column will present a scenario, and together, we’ll determine appropriate, polite, and most importantly, safe ways to navigate this tricky gluten-free/food allergies lifestyle in a graceful way.  If someone disagrees with our new behavior patterns, we can refer them to this column and say, “Here are the new rules for those of us with food allergies or celiac disease.”  When we are guests in someone’s home, we can give them links to this column so they understand the plight we are faced with, bite after bite. Perhaps this will help those of us living with us to understand, be more compassionate, and accepting of our adaptations to keep ourselves safe. 
    This column will present a scenario such as the one above, and ask that you comment on how you would navigate it. Let’s talk about it. Let’s share ideas.  Using the example above, here’s the scenario for this issue:
    What would you do?
    Your kind-hearted friend invites you to dinner and insists on cooking for you.  You arrive and the first thing she says is, “I’ve spent all day making this for you. Oh, I bought this salad dressing for you, but you might want to read the ingredients first.”  You do, and it contains malt vinegar.  You look around the kitchen and notice evidence of cross-contamination in the rest of the meal.  What do you do? 
    Please comment below and feel free to share the tricky scenarios that you’ve encountered too.  Let’s discuss how to surmount these social situations.  What would you do?

    Jefferson Adams
    Celiac.com 07/12/2018 - Previous research has shown that the oral administration of Bifidobacterium infantis Natren Life Start super strain (NLS-SS) reduces of gastro-intestinal symptoms in untreated celiac disease patients. The reduction of symptoms was not connected with changes in intestinal permeability or serum levels of cytokines, chemokines, or growth factors. Therefore, researchers suspected that the reduction of symptoms might be related to the modulation of innate immunity.
    To test that hypothesis, a team of researchers set out to assess the potential mechanisms of a probiotic B.infantis Natren Life Start super strain on the mucosal expression of innate immune markers in adult patients with active untreated celiac disease compared with those treated with B. infantis 6 weeks and after 1 year of gluten-free diet.
    The research team included Maria I. Pinto-Sanchez, MD, Edgardo C. Smecuol, MD, Maria P. Temprano,RD, Emilia Sugai, BSBC, Andrea Gonzalez, RD, PhD, Maria L. Moreno,MD, Xianxi Huang, MD, PhD, Premysl Bercik, MD, Ana Cabanne, MD, Horacio Vazquez, MD, Sonia Niveloni, MD, Roberto Mazure, MD, Eduardo Mauriño, MD, Elena F. Verdú, MD, PhD, and Julio C. Bai, MD. They are affiliated with the Medicine Department, Farcombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada; the Small Intestinal Section, Department of Medicine and the Department of Alimentation at Dr. C. Bonorino Udaondo, Gastroenterology Hospital and Research Institute at the Universidad del Salvador in Buenos Aires, Argentina.
    The team determined the numbers of macrophages and Paneth cells, along with the expression of a-defensin-5 expression via immunohistochemistry in duodenal biopsies.
    Their results showed that a gluten-free diet lowers duodenal macrophage counts in celiac disease patients more effectively than B. infantis, while B. infantis lowers Paneth cell counts and reduces expression of a-defensin-5.
    This study documents the differential innate immune effects of treatment with B. infantis compared with 1 year of gluten-free diet. The team calls for further study to better understand the synergistic effects of gluten-free diet and B. infantis supplementation in celiac disease.
    Source:
    J Clin Gastroenterol

    Jefferson Adams
    Celiac.com 07/11/2018 - For people with celiac disease, finding decent gluten-free bread is like searching gold. Many have given up on bread entirely and others begrudgingly relate themselves to the ignominious frozen aisle at their supermarket and content themselves with one of the many dry, shriveled, flavorless loaves that proudly tout the gluten-free label. 
    For these people, the idea of freshly baked bread is a distant, if comforting, memory. The idea of going to Paris and marching into a boulangerie and walking out with a warm, tasty, gluten-free baguette that was freshly baked on the premises that morning, is like a dream. Now, in some Parisian bakeries, that dream is becoming a reality. And the tear of joy from the thankful gluten-free masses are sure to follow.
    These days, a single sign on the awning speaks to hungry customers who peruse the tarts and chou buns, and the loaves that fill the cooling on racks behind a glass pane at Chambelland boulangerie and café in Paris’ 11th arrondissement. The sign lettered in French translates: “artisan baker; flour producer; naturally gluten free.” That’s right. Naturally gluten-free. At a bakery. In Paris. 
    Only the flat, focaccia-style loaves, and the absence of baguettes, tells customers that this bakery is something different. Chambelland opened its doors in 2014 and continues to do a brisk business in delicious, freshly baked gluten-free breads and other goods.
    The boulangerie is the work of Narhaniel Doboin and his business partner, Thomas Teffri-Chambelland. They use flour made of grains including rice, buckwheat and sorghum to make delicious gluten-free baked goods. Doboin says that customers queued in the rain on the first day, hardly believing their eyes, some began to cry. 
    For gluten-free Parisians, there was a time before Chambelland, and the time after. If you find yourself in Paris, be sure to search them out for what is sure to be a gluten-free delight.
    Or maybe book your ticket now.
    Read more at: Independent.co.uk