Adult coeliac patients do tolerate large amounts of oats

Abstract

Objective: The aim of the present study was to investigate whether adult patients with coeliac disease in remission could include large amounts of oats in their daily gluten-free diet for an extended period of time without adverse effects. Design, subjects and methods: Twenty adult coeliac patients in remission included large amounts of uncontaminated rolled oats in their daily diet for a prolonged period. The examinations, performed four times during the study period, included small bowel endoscopy with biopsies, blood samples (nutritional status, serological analysis), height and body weight, gastrointestinal symptoms and dietary records. Gastrointestinal symptoms and diet were also investigated through unannounced telephone interviews once a month during the study period. Results: No adverse effects of a large intake of oats were seen in small bowel histology, serology nor in nutritional status in the 15 subjects who completed the whole study period. Two of the subjects dropped out because of gastrointestinal symptoms and three for non-medical reasons. The median intake of oats was 93 g=day and the compliance to the oat diet was found to be good. Examinations of the patients after drop-out did not show any deterioration in small bowel histology or nutritional status nor raised levels of antibodies. Conclusion: Results from this study indicate that adult patients with coeliac disease in remission can include large amounts of controlled wheat-free rolled oats for an extended period of time without adverse effects.

Risk of Celiac Disease Autoimmunity and Timing of Gluten Introduction in the Diet of Infants at Increased Risk of Disease

“…Individuals with celiac disease are also advised to avoid oats because they may be contaminated with wheat (and thus gliadin) through the harvesting and milling process, even though oats themselves are well-tolerated by most individuals with celiac disease. [27][28][29][30][31] We found no association between the development of CDA and the timing of introduction of oats or of rice, suggesting that the association is antigen-specific.…”

Mechanisms underlying celiac disease and its neurologic manifestations

“…Substitute gluten-free grains are available, including corn, rice, teff and millet. Oats are generally regarded as safe for most patients with CD and dermatitis herpetiformis [103,104] because they lack the required toxic amino acid sequences, though there are issues with contamination with other grains. A few patients with celiac disease do mount an immune response to the oats and develop villous atrophy [105].…”

Studies of Mucosal Immune Regulation in Celiac Disease and Type 1 Diabetes

“…The disease-inducing properties of rye and barley are suggested to be due to Tcell cross-reactivity against gliadin-, hordein-and secalin-derived peptides [203]. Pure oats, containing avenin, is nowadays considered to be tolerated by most CD patients, and is therefore allowed in the diet in some countries including Sweden [204][205][206][207][208][209][210]. However, a subset of celiac patients being on a GFD containing oats did not normalize their intestinal immune responses [211].…”