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Oats—Do they Contain Gluten? Are they Safe to Eat?

This article originally appeared in the Autumn 2009 edition of Journal of Gluten Sensitivity.

Celiac.com 02/27/2015 - The answer to the "oats questions" are becoming clearer.

Photo: CC--Matt LavinThe long-asked question is "Can people with celiac disease or gluten sensitivity safely eat oats?" Some people are so sensitive, that even the tiniest bit of gluten makes them feel unwell. So this answer is important because people on a gluten-free diet should not restrict foods unnecessarily. There are several aspects to this question:

  1. 1. Avenin: Oats do not naturally contain gluten ... but there is a similar protein called "avenin" found in oats that has the same properties as gluten (it is the "prolamine storage protein" of oat seeds, that helps protect the dormant seed and nourish it when it begins to grow).

    Fortunately, adverse reactions to this oat protein are rare. A study of 10 pertinent studies, with a total of 165 patients, found only 1 patient who had histological gut damage as a result of eating oats. This condition is now called "avenin-sensitive enteropathy" (ASE). This is documented by Garsed & Scott "Can oats be taken in a gluten-free diet? A systematic review" (Scand. J. Gastroenterol. 2007:42: 171–8.

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    Clinical reports now provide strong evidence that oats very rarely cause damage to the gut mucosa in people with celiac disease. Subsequently, guidelines from many coeliac societies now reflect this new evidence. Moderate amounts of oats (half a cup of oats a day) can be consumed by most celiacs without risk of damaging intestinal villi. However, it is important to emphasise that these oats must be free of other contaminating gluten-cereals.

    What is not reported is whether some of these people experience symptoms (feel unwell) despite the healthy appearance of their gut under a microscope. These people might have an "avenin-sensitivity" similar to gluten-sensitivity without any accompanying gut damage. This question has not yet been investigated.
     

  2. Cross-contamination: The reason that many people apparently react to oats is not because of the avenin, but to inadvertent gluten contamination. In other words, wheat and other gluten-grains accidentally get into the oats.

    Traces of gluten are commonly found in packets of oats–this is from the cross-contamination of oats with other gluten-grains. This contamination can occur during any stage of the life-cycle of oat production: the planting, the harvesting, the transportation, the processing and the refining of oats. It is almost impossible to avoid such cross-contamination unless all this machinery is exclusively devoted to oats production. This requires large-scale production as is seen in the USA.

    One research group analyzed a total of 134 oats samples, comprising grains and commercial oat products collected from Europe, the United States and Canada. This study confirmed that most oats were contaminated with mixtures of wheat, barley and rye (Hernando et al. "Measurement of wheat gluten and barley hordeins in contaminated oats from Europe, the United States and Canada by Sandwich R5 ELISA". Eur J Gastroenterol Hepatol. 2008 Jun;20:545-54.)
     

  3. Level of gluten sensitivity: How intensely people react to gluten varies. Some people can eat moderate amounts of gluten and have no symptoms at all. Whilst many are so sensitive that even the tiniest amount upsets them. Thus, minimal cross-contamination of oats with gluten is a problem for a significant proportion of the gluten-sensitive community.

    It may be that people who have extreme gluten sensitivity are more likely to react to avenin. It is my observation that super-sensitive gluten reactors seldom tolerate oats. However, this subject has not been researched.
     

  4. Asymptomatic gluten damage: Oddly, some people can have the gut damage of celiac disease without experiencing noticeable symptoms. They have severe gut damage but are completely unaware of it. Such a diagnosis is usually discovered by screening blood test. As these people do not get any symptoms from gluten, they would not know if oats are upsetting them either! These asymptomatic celiacs need to be followed up with regular blood tests (and perhaps subsequent biopsy) to ensure that they are healing.
     
  5. Why bother with oats?

    The ability to use oats in your diet gives an important source of fibre as well as other important nutrients. They have a low glycemic index (GI) which makes them satisfying to eat. Also, eating oats will contribute to lower cholesterol levels. And of course, it gives you a valuable additional food to make the topping on apple-crumble, hot oat porridge on a cold morning, and a crunchy, tasty muesli.

    Some companies certify their oats to be gluten-free, which means they are free from any cross-contamination. If you are very sensitive to gluten, then you might not tolerate oats. The best thing to do is try a little and see.
     

  6. Do blood tests: "Get a blood test!" is my mantra. So many people go gluten-free without a blood test. So many people with celiac disease never get follow-up blood tests. It is important to get a firm diagnosis of celiac disease / gluten sensitivity. Then to get more tests a year or two later to make sure that your body is healing. One way to check out how you are tolerating oats in your body is to get regular blood test checks for gluten (IgG-gliadin) and for tissue damage (DGP/tTG)–for more details please visit me at my website.

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9 Responses:

 
Deb
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said this on
27 Feb 2015 2:12:43 PM PDT
Thank you. That was helpful.

 
Carol Sidofsky
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said this on
02 Mar 2015 2:45:41 AM PDT
Very interesting article! There is another gastroenterologist, in Dallas, TX, who has studied and researched non-Celiac gluten sensitivity, extensively over many years. He is Dr. Kenneth Fine, MD. His website is www.finerhealth.com .
Dr. Fine's lab, "EnteroLab" does non-invasive stool sample testing, regarding GLUTEN SENSITIVITY & other protein sensitivities.
His stool sample testing staff does bioassay tests, looking for elevated numbers of IgA antibodies to gluten (&/or milk proteins, &/or soy proteins, &/or yeast proteins, &/or egg proteins, etc.).
However, if a person has an "IgA deficiency", s/he could have a "false negative" result, from his EnteroLab testing, so I've been told that a blood test called "Total Secretory IgA" could be done first, to find out if one is or isn't "IgA deficient".
In Dr. Fine's website (www.finerhealth.com), read his essay called "Before the Villi are Gone".
Dr. Fine avoids all grains, himself, and his health improved greatly. He also found that some people get a Celiac-like condition, as an auto-immune reaction to MILK proteins!

 
Aims
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said this on
02 Mar 2015 9:05:39 AM PDT
After being diagnosed with a biopsy in 1992 - I am one of those people who is extremely sensitive. Even a lot of the products marked gluten-free that have 20 ppm is often too much for me.

Having tried certified gluten-free oats I've discovered that I cannot tolerate them at all. This leaves me with just the memory of some wonderful food.

This is a very interesting article. In fact it has given me the desire to look into these studies and your book!

Thank you so much for writing this. Hearing from someone whose focus, practise and study is gluten is what we really need here on this forum.

 
admin
( Author)
said this on
03 Mar 2015 3:37:29 PM PDT
Products are not "marked 20 ppm"...they can't go over that amount or they are GF. To to use the term on their packaging, the must test below this amount...always. This does not mean that whenever you test such products they contain 20 ppm...most always test much lower, or have no detectable gluten (less than 6 ppm).

 
Teresa
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said this on
02 Mar 2015 11:01:26 AM PDT
Very well researched. Thank you.

 
Jane
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said this on
02 Mar 2015 5:50:50 PM PDT
Thank you for bringing sensitivity to avenin to light. I am one of those 1 in 165, and it took forever for me to figure it out. Now I do not touch oats. In soap it brings out my DH! Keep up the great work, Dr. Ford!

 
Jenica
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said this on
02 Mar 2015 11:52:29 PM PDT
I think I'll pass on them for now, thanks.

 
Cheryl
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said this on
03 Mar 2015 8:23:49 AM PDT
Thanks! I'm not celiac, but I am GF. I can't tolerate even GF oats and I never understood why. Now I think I need to get the blood test, which I never had.

 
Debi
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said this on
26 Jan 2016 1:14:40 PM PDT
I have CD and have tried all kinds of oats. The only one I was able to eat without becoming ill was the Chex oatmeal and they have now removed it from the market due to low sales. So sad! I really miss my oatmeal. So now I am stuck with Cream of Rice!




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Yes the first has wheat gluten in the ingredients, the second via the wheat flour. Here in the UK manufacturers HAVE to highlight gluten sources. Check the ingredients and if WHEAT, BARLEY, or RYE are mentioned *usually highlighted, italicised or underlined, then you will know there's gluten. Most of iceland's processed foods will probably be gluten filled to be honest. Any breadcrumbed or battered foods for instance. Ps, you and me both have another disease, the british one of apologising You don't need to, you're very welcome here and all of your questions are valid and understandable. It's going to get better

Hi, I am deeply sorry for posting on here again. As I am scheduled for an Endoscopy on the 9th May, I wanted to make sure that my gluten intake is being kept the same. I was wondering if the ingredients to these products contain gluten even though dextrose is in one of them? http://groceries.iceland.co.uk/iceland-32-breaded-chicken-nuggets-448g/p/52275 Chicken Breast Fillet (60%), Water, Wheat Flour, Breadcrumbs (Wheat Flour, Dextrose, Salt, Yeast), Rapeseed Oil, Salt, Wheat Gluten, Sugar, Yeast Extract, Garlic Powder, Onion Powder, White Pepper, Dried Sage. http://groceries.iceland.co.uk/iceland-10-breaded-chicken-burgers-550g/p/52276 Chicken Breast Fillet (60%), Water, Wheat Flour, Breadcrumbs (Wheat Flour, Dextrose, Salt, Yeast), Rapeseed Oil, Salt, Wheat Gluten, Sugar, Yeast Extract, Garlic Powder, Onion Powder, White Pepper, Dried Sage. Thank you for all your help so far,

JMG got it down pretty much, the painful and gluten effects from eating it should clear up in a month, damage symptoms you might notice some differences as early as 2-4months but most do not noticed major improvements til about 6 months to a year. I have been gluten-free for over 3 years all my villi have healed according to the doctor on my last scope. It is very important to not cheat and avoid any kind of CC as it can set you back weeks or months. I would suggest a whole foods only diet for the first month or two, no dairy, simple stews, soups, etc. make for easy to digest and simple meals. Check out the 101 thread for some good information. PS a new combo crockpot, steamer, rice cooker combo and liners for a crock pot will be a life saver for making simple meals and easy clean ups. Quick cook microwave ware will also be handy making sure you have gluten-free cooked meals if you can not get new cookware immediately. I normally suggest cleaning out the entire house, scrubbing down knobs, handles, on the drawers, sink, fridge, cubbards etc. throw out condiment jars, checking ingredients on everything in the house including your hygiene and makeup. Putting in drawer organizers for new utensils, throwing out scratched glass, teflon, plastic, and steel cookware. Throwing out any Tupperware, and cutting boards, some utensils that can not be cleaned well. Some times you can save cast iron and stainless steel cook ware if you can run it in your ovens cleaning cycle over 600F. Gluten is a protein like blood if you can not clean a item where a CSI team will not find it give it up, it is not a germ that can be killed with disinfectant. I use freezer paper for clean prep surfaces, also makes clean up a breeze, I tend to use gloves alot also when fixing foods,

Hi Allie and welcome First off, I know 3 years was a long wait, but at 17 you've figured out celiac way before many people do. That should make a big impact on minimising its effects and helping you with the diet, so, bizarrely enough, congratulations! A lot of good advice has been brought together in this thread: Don't worry that your symptoms are bad now. As you follow the diet your body will begin healing itself and you're still very young so hopefully this will go really smoothly. Think in terms of the next 6 months rather than weeks however, recovery will likely take a little time. Eat as healthily as you can, lots of whole foods and try to avoid the gluten free processed substitutes as your digestive system needs all the help it can get at this moment. You may want to avoid dairy as well for now and think about reintroducing it later. This site has been really helpful to me and others. I hope you find it just as useful. Best of luck! ps, your increased reaction to gluten during the challenge phase was perfectly normal. Many find that reintroducing it much worse than the initial affects and take some time to get over the challenge. That's why you'll see lots of posts here urging folks to 'stay on gluten' till their testing is complete! PPS( ) Inasmuch as your post can convey emotion, your's seemed positive Stay that way! At times the diet can be a bit isolating and some friends and family may struggle to understand. I'm sure it will be difficult at times making good choices and staying vigilant when everyone around you doesn't have to think twice. Stick with it, your health is paramount and it will be worthwhile. In time your good friends will get it and those that don't aren't worth worrying about. There are great foods you can eat and if not, learn to cook them yourself

Hi! My daughter is 19 was diagnosed at age 16. It took about 12-18 month s for her to fully heal from the damage and feel "normal" again. Also because of the damage done she had reactions to dairy, so you may want to try no or minimum dairy until youre fully healed. Just a suggestion. Hope you start feeling well soon!