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  • Jefferson Adams
    Jefferson Adams

    The Celiac Disease Oat Conundrum

    Reviewed and edited by a celiac disease expert.

    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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    Very helpful. I've decided to continue using oatmeal that's certified as grown on a dedicated field and processed on gluten-free equipment. But I'll give up making occasional exceptions for any other oat product.

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

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    Bob's does process grain containing gluten as well although they supposedly use dedicated equipment for there gluten-free products and test regularly. Valid concern though. I would not allow your daughter to consume oats from any source unfortunately.

    One thing that seems clear is some celiac patients are sensitive to oats and some are not. It seems to be the only directly correlated data on this still fuzzy topic!

    Hope your daughter recovered quickly and had a great Christmas 2011!

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

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He 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, science, and advanced research, and scientific methods. He previously served as SF Health News Examiner for Examiner.com, and devised 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 "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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