Adding oats to gluten-free diet is safe for celiac sufferers, study review suggests

23 Aug 2017 --- No evidence has been found by researchers that addition of oats to a gluten-free diet affects symptoms, histology, immunity or serologic features of patients with celiac disease. This is according to a systemic review and meta-analysis of clinical and observational studies.

Celiac disease is an autoimmune disorder, triggered by gluten and related prolamins in genetically susceptible individuals. The disease mostly affects the proximal small intestine, where it progressively leads to villous atrophy. This means that intestinal villi that line the wall of the small intestine erode away, leaving a virtually flat surface.

The main treatment for celiac disease is a gluten-free diet, note the researchers, and it excludes wheat, barley and rye. This diet enables patients with celiac disease to control their symptoms and avoid intestinal and extra-intestinal complications, including osteoporosis – with an associated increased risk of bone fractures – and development of certain types of cancer.

The researchers’ review, published in the journal Gastroenterology, identifies 433 studies, 28 of which were eligible for analysis. The researchers report that oat consumption for 12 months did not affect symptoms, histologic scores, intraepithelial lymphocyte counts or results from serologic tests.

In addition, the researchers note that subgroup analyses of adults and children did not reveal differences. However, the overall quality of evidence is said to be “low,” and geographic distribution is said to be “limited.”

Giving background reasons for the study, the researchers note that Van de Kamer et al. were the first to suggest that oats may be harmful to patients with celiac disease. The researchers say that although oats are included in the list of gluten-free ingredients specified in some countries’ regulations, such as Canada, the safety for patients with celiac disease remains controversial.

The researchers add that although a gluten-free diet containing oats has been reported to improve celiac symptoms in some studies, others have detected intraepithelial lymphocytosis, and the development of avenin-reactive mucosal T cells in a small proportion of patients. It is noted that the consensus is that pure oats are safe for most patients with celiac disease, but contamination with other cereal sources needs to be avoided.