Oats, celiac disease intolerance

Limitations identified within the scientific database include limited data on long-term consumption, limited numbers of participants in challenge studies, and limited reporting about the reasons for withdrawals from study protocols. Furthermore, some evidence suggests that a small number of individuals with celiac disease may be intolerant to pure oats and some evidence from in vitro studies suggests that an immunological response to oat avenins can occur in the absence of clinical manifestations of celiac disease as well as suggesting that oat cultivars vary in toxicity. 

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). 

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. 

Arentz-Hansen H, Fleckenstein B, Molberg O, Scott H, Koning F, Jung G, et al. The molecular basis for oat intolerance in patients with celiac disease. PLoS Med 2004 1 84-92. 

In a study introducing oats into the diets of patients with celiac disease, the addition of 50 g of oats daily for 12 weeks was generally well tolerated, although one patient developed partial villous atrophy and a rash after the introduction of oats. Several other patients showed positive levels of interferon gamma mRNA after introduction of oats (Lundin et al. 2003). Other studies have indicated that moderate quantities of oats are safe for persons with gluten intolerance (Janatuinen et al. 1995, 2002 Picarelli et al. 2001 Storsrud et al. 2003). 

Celiac disease (Celiac sprue)— Celiac disease is due to a genetically-inherited intolerance to wheat gluten, a main constituent of wheat flour, which is also present to a small extent in rye, barley, and oats, but not in rice. Such persons develop lesions of the small intestine which lead to diarrhea and malabsorption. It is not known why gluten causes intestinal damage. Symptoms usually arise during the first 3 years of life, but it may affect adults. Fbtients are relieved if gluten is excluded completely from the diet. 

Gluten intolerance Enteropathy syndrome, also known as celiac disease, caused by the ingestion of gluten present in wheat, barley, rye, triticale, and possibly, oat products it is more common in Caucasians. It may be defined as an inflammatory... 

---