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    The Celiac Disease Oat Conundrum

    Jefferson Adams

    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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    Guest Melia Haywood

    Posted

    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?

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    Guest Sarah

    Posted

    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.

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    Guest Phyllis Morrow

    Posted

    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).

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    Guest Luann Brown

    Posted

    Interesting, but I still would not consider eating oats at this point.

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    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.

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    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.

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    Guest Gloria Brown

    Posted

    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?

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    Guest Julie

    Posted

    I recently have tried gluten-free Oats and have had no adverse reactions. I am excited to have a new grain in my diet!

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    Guest Axel Feldmann

    Posted

    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.

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    Guest kristine

    Posted

    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.

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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, and science. He previously served as Health News Examiner for Examiner.com, and provided health and medical content for Sharecare.com.

    Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book Dangerous Grains by James Braly, MD and Ron Hoggan, MA.

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