Oats on the gluten-free diet – Yes or No?
A gluten-free diet is the only effective way to treat celiac disease. This diet allows for the control of symptoms and avoids several complications associated with this condition.
Wheat, rye and barley and related species should be strictly avoided, but the role of oats is more controversial (1). Therefore, the question often arises whether those who follow a gluten-free diet, and especially those with celiac disease, can eat oatmeal or not.
The answer is… it depends. Because? Let's see next.
How is oat classified by European legislation?
European Regulation 1169/2011, which regulates the information to be presented on food labeling, lists oats as one of the substances that cause allergies or intolerances in the category of Cereals containing gluten. The main reason for this is the fact that oats are often contaminated with other gluten-containing cereals (mainly barley) during their production stages. For this reason, oats must always be highlighted on the label, being safe only when it specifically states that it is gluten-free, that is, that it contains an amount of gluten of less than 20mg/kg. (two)
What does the Portuguese Association of Celiacs (APC) say about oat consumption?
The APC indicates that people with celiac disease, in general, can consume oats, as long as they are pure oats, certified as gluten-free. However, he points out that although studies have shown that oats are not toxic to 95% of celiacs, a small subgroup (<5%) does not tolerate it. (3)
Given this, we did a little more research, and here's a small summary of what we found.
It is first important to understand what gluten is . Gluten includes two types of cereal protein: prolamins and glutenins. Oats, compared to wheat, barley and rye, contain significantly lower amounts of prolamin, avenin. (2, 4)
Pros of eating oats on a gluten-free diet:
- Oats have good nutritional qualities, such as high protein content, presence of biologically active and beneficial substances (fibers, beta-glucans, polyunsaturated fatty acids, essential amino acids, antioxidants, vitamins and minerals). (1)
- The inclusion of gluten-free oats in the celiac diet allows for an increase in the variety of foods that can be accessed, as it is often used in gluten-free products. (4)
- Its pleasant taste, versatility and tolerance by most celiacs make the use of oats popular in gluten-free recipes. (5)
- Studies confirm that pure oats are well tolerated by most celiacs, provided they are in moderate amounts (20-25 g/day of dry oats for children; 50-70 g/day for adults). (4)
Cons of consuming oats on a gluten-free diet:
- One of the problems with oats is the possibility of contamination with other cereal sources during the various stages of production, from cultivation, harvesting, processing and packaging. However, in the case of oats certified as gluten-free, this question does not arise, so it is essential to carefully read the labels to know whether or not the product is gluten-free . (1)
- Even when oats are free from gluten contamination, about 5% of celiacs do not tolerate their consumption. Avenin, an oat protein, is considered to be responsible for triggering the gluten-like immune response. (3)
- It is also necessary to consider that oats include many varieties, therefore containing variations in their proteins. Several studies have shown that immune reactivity to oats varies depending on the variety consumed. (1)
- The risk of prolonged consumption of oats by celiac patients is also a matter of debate among experts, since the risk of sensitization and an adverse immune-mediated reaction is a real threat in some celiac patients. (1)
Expert recommendations:
The introduction of oats into a gluten-free diet for newly diagnosed celiac patients is not appropriate, as strict adherence to a gluten-free and oat-free diet is required for correct recovery. (3, 5)
Only after recovery of symptoms and normalization of the intestine, that is, in patients with celiac disease in remission, oats can be introduced into the diet, but cautiously, gradually and properly monitored by the doctor and nutritionist, due to individual susceptibility to oats. . (3, 4, 5)
If celiacs can consume oats, they must ensure that they are free from contamination, that is, they must purchase only oats marked “gluten-free”. (3)
The safe dose of oats in the diet for celiac patients in remission varies between 20g (for children) and 70g (for adults) per day. (5)
If people with celiac disease belong to the 5% that do not tolerate oats, they cannot consume any oats, even if they are gluten-free, as the problem lies in the avenin and not in the contamination of the product. (3)
Fidu's opinion:
Given the potential for sensitivity to oats in patients with celiac disease and other gluten-related diseases, at Fidu we have chosen not to use oats or derived ingredients in our products.
That's why we developed our Oat-Free Pancake Mix as an alternative to gluten-free preparations from other brands that include oatmeal, so that those with oat sensitivity can also enjoy delicious pancakes.
Discover this and other Fidu products, suitable for celiac, allergic and intolerant people here .
Important Note: The content of this article is merely informative and should not replace medical indications.
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(1) Comino I, Moreno ML, Sousa C. Role of oats in celiac disease. World J Gastroenterol 2015; 21(41): 11825-11831.
(2) NDA, 2016. Scientific Opinion on the evaluation of allergenic foods and food ingredients for labeling purposes. EFSA Journal, 12(11).
(3) APC, 2020. Gluten-Free Diet – FAQS. Available at: https://www.celiacos.org.pt/dieta-isenta-de-gluten-faqs/
(4) Spector Cohen, I., Day, AS, & Shaoul, R. (2019). To Be Oats or Not to Be? An Update on the Ongoing Debate on Oats for Patients With Celiac Disease. Frontiers in Pediatrics, 7, 384.
(5) Hoffmanová, I., Sánchez, D., Szczepanková, A., & Tlaskalová-Hogenová, H. (2019). The Pros and Cons of Using Oat in a Gluten-Free Diet for Celiac Patients. Nutrients, 11(10), 2345.
