Gluten is a complex protein found in the grains of certain grasses that belong to the Triticeae tribe, which includes wheat, barley and rye. According to Dr. David Nelsen at the University of Arkansas for Medical Sciences, the consumption of alpha-gliadin, a component of gluten, invokes an abnormal immune response in the intestines of people with gluten-sensitive enteropathy, also called celiac disease. Although oats do not contain gluten or alpha-gliadin, many people with celiac disease believe they cannot eat oatmeal or other oat products. If you suffer from celiac disease, always consult with your doctor before making any diet modifications.
Contamination
For people with celiac disease, even small amounts of gluten can trigger symptoms, which can range from mild gastrointestinal upset to full-blown malabsorption and malnutrition. Oats are often milled in the same facilities as other grains, and cross-contamination of oat products is common. A review in "European Journal of Gastroenterology and Hepatology" reported in 2008 that a wide range of commercial products are contaminated with gluten, and consumption of contaminated oats represents one cause of persistent symptoms in celiac patients.
Tolerance of Pure Oats
Most celiac patients experience a resolution of symptoms when they adhere to a gluten-free diet, which usually permits the use of pure oats. In 2007, after consulting with Health Canada, the Canadian Celiac Association disseminated a statement promoting the consumption of contaminant-free oat products by both children and adults with celiac disease. The organization established upper limits for daily oat consumption, recommending that adults and children consume not more than, respectively, 70 g and 25 g.
Not for Everyone
Although essentially corroborating the findings of the Canadian Celiac Association, a 2006 review in "Postgraduate Medical Journal" demonstrated that a few celiac patients still exhibited intestinal inflammation despite gluten-free diets that included oats. In addition, some people with celiac disease still had symptoms even when they strictly avoided gluten and consumed only contaminant-free oats. An intriguing 2006 study in "Journal of Gastroenterology and Hepatology" showed that some varieties of oats--specifically, Astra and Mortlook--contained proteins called avenins that caused effects similar to gluten in tissue culture preparations.
Considerations and Recommendations
Most experts agree that contaminant-free oats and oatmeal are well-tolerated and safe for the majority of people with gluten sensitivity. Rarely, however, oat proteins also may affect some individuals, and some varieties of oats may cause more intestinal inflammation than others. If you suffer from gluten-sensitive enteropathy and wish to consume oats, consider following the Canadian Celiac Association's recommendations, limiting daily consumption to 70 g. In addition, some authorities recommend regular medical checkups, including small bowel biopsy.
References
- "American Family Physician"; Gluten-Sensitive Enteropathy (Celiac Disease): More Common Than You Think; David Nelsen et al.; December 15, 2002
- "European Journal of Gastroenterology and Hepatology"; Making Oats Safer for People with Coeliac Disease; W. Dickey; June 2008
- "Canadian Journal of Gastroenterology"; Consumption of Pure Oats by Individuals with Celiac Disease: A Position Statement by the Canadian Celiac Association; Mohsin Rashid et al.; October 2007
- "Postgraduate Medical Journal"; Coeliac Disease and Oats: A Systematic Review; N.Y. Haboubi et al.; October 2006
- "Journal of Gastroenterology and Hepatology"; In Vitro Tests Indicate That Certain Varieties of Oats May Be Harmful to Patients with Coeliac Disease; Marco Silano et al.; June 16, 2006
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