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Oats, celiac disease gluten

Celiac disease is an immune-mediated disease, triggered in genetically susceptible individuals by ingested gluten from wheat, rye, barley, and other closely related cereal grains. The only treatment for celiac disease is a strict gluten-free diet for life. This paper presents a systematic review of the scientific literature on the safety of pure oats for individuals with celiac disease, which historically has been subject to debate. [Pg.236]

Based on the majority of the evidence provided in the scientific database, and despite the limitations, Health Canada and the Canadian Celiac Association (CCA) concluded that the majority of people with celiac disease can tolerate moderate amounts of pure oats. The incorporation of oats into a gluten-free diet provides high fiber and vitamin B content, increased palatability, and beneficial effects on cardiovascular health. However, it is recommended that individuals with celiac disease should have both initial and long-term assessments by a health professional when introducing pure oats into a gluten-free diet. [Pg.236]

Among the studies conducted with children (Table 6.1), there were 89 children with celiac disease, either in remission (n = 13) or newly diagnosed (n = 76), who were challenged with oats added to an otherwise gluten-free diet. All of the children who were in remission at the time of... [Pg.252]

In addition to the pivotal studies, several publications (Table 6.2) used other methods to test the response of individuals with celiac disease who were introduced to oats. These studies did not fulfill the selection criteria of pivotal studies namely an in vivo oats challenge with an intestinal/skin biopsy to assess the biological response to the introduction of oats into an otherwise gluten-free diet. Instead, they used various in vitro techniques to assess the immune response to avenin, or serology without an intestinal mucosal biopsy. Most of the methods used duodenal mucosal cultures prepared from biopsies or intestinal T cell lines obtained from individuals with celiac disease. Other studies measured the immunogenic reaction in peripheral lymphocytes or measured the presence of various antibodies in individuals with verified celiac disease who included oats in their diet, in comparison with a reference group (Table 6.2). Some of these studies used patients that were previously included in pivotal studies. These studies are identified with an asterisk ( ) in Table 6.2. [Pg.254]

The key limitations of the study designs are the duration of the study and the number of subjects. Since most studies conducted are short term, the potential effect of a lifetime exposure to oats requires further investigation. Long-term compliance to a gluten-free diet is one of the major difficulties in the management of celiac disease, and the collection of longterm data related to the consumption of oats is also very challenging. [Pg.256]

From currently available data, one adult patient (1/170) challenged with oats was reported to have a severe adverse reaction to oats. Approximately 6% of adults and 9% of children withdrew from clinical trials due to reported adverse effects from the inclusion of oats in their diet. This evidence, along with the indication from some in vitro studies of an immunological response to avenin in the absence of clinical manifestations of celiac disease and the limitations of the database (previously discussed), supports a cautionary approach for the introduction of oats into a gluten-free diet until the prevalence of oats intolerance among people with celiac disease is well established (Dickey, 2008 Garsed and Scott, 2007). [Pg.257]

Available scientific data evaluating the introduction of pure oats in the gluten-free diet of patients with celiac disease and dermatitis herpetiformis indicates that moderate amounts of pure oats are well tolerated by the majority of these individuals who are either in remission or newly diagnosed. The term "pure oats" is used to indicate oats uncontaminated with gluten from other cereal grains, like wheat, barley, and rye, as detected by current test methods. Based on pivotal clinical trials in the published literature, the amount of pure oats considered within safe limits is 50-70 g/day for adults and 20-25 g/day for children. [Pg.261]

The benefit of the introduction of oats into a gluten-free diet for adults and children with celiac disease outweighs the possible risk to the few individuals with celiac disease who may exhibit intolerance for oats. However, the previously discussed limitations of the database require the need for some caution when introducing oats into a gluten-free diet. [Pg.261]

Peraaho et al. (2004a) studied 39 patients with celiac disease who consumed gluten-free diets. Patients were randomized to a gluten-free diet with 50 g oats/day (23 patients) or without oats (16 patients)... [Pg.268]

Peraaho, M., Collin, P., Kaukinen, K., Kekkonen, L., Miettinen, S., and Maki, M. (2004a). Oats can diversify a gluten-free diet in celiac disease and dermatitis herpetiformis. J. Am. Diet. Assoc. 104,1148-1150. [Pg.283]


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