16th June 03:33
Oats - a UK opinion (gluten-free diet coeliac coeliac disease)
article helps me understand the current state of scientific knowledge
and medical research
click "Medical Info"
click "Guideline on coeliac disease and Oats"
Guidelnes on Coeliac Disease & Oats
The Coeliac Societies' Medical Advisory Council has recently published a
position paper for health professionals, to help them consider the
growing evidence suggesting that oats can form part of the gluten-free
diet for some patients with Coeliac disease and Dermatitis Herpetiformis.
This paper, which includes a comprehensive review of the relevant
medical literature since 1953, has been mailed to all members of the
British Society of Gastroenterologists and the British Dietetic
Association. Dermatologists have also been informed.
The paper concludes that the position of oats in the diet is not yet
entirely clear, as there are some inconsistencies in the facts available.
The study by the Finnish researchers, published in 1995, remains the
most persuasive in suggesting that most adult Coeliacs can tolerate
moderate amounts of oats in their diets, certainly in the short- term,
This was endorsed by the results of a 5-year follow-up study also in
However, reservations include the fact that the amount of toxic protein
- the prolamin called avenin - in oats is relatively small compared with
the amounts of relevant toxic prolamins present in wheat, barley and rye
- hence the quantity of oats consumed may be critical.
Furthermore it is likely that, as with all the harmful substances in
Coeliac Disease, individual reactions will vary as some patients are
much more sensitive than others.
Finally, there is a warning that cross-contamination of cereals can
occur during harvesting, transportation, storage, milling and food
processing, although oats produced by dedicated oat-millers are more
likely to be gluten-free.
The paper ends with the following guidelines for health professionals: -
· Moderate amounts of oats may be consumed by most Coeliacs without
risk. This also applies to people with Dermatitis Herpetiformis, but the
evidence in children is less convincing.
· Severe Coeliacs should probably not be allowed oats.
· With due information and explanation, patient preference must be taken
· Care must be taken to use uncontaminated oat products.
· Careful follow-up is necessary in the present state of knowledge.
Several dietitians and some members have therefore contacted me, asking
for a practical interpretation of these guidelines.
Other members might be interested in the questions being asked and the
answers I am giving: -
Q. What is a Moderate amount of oats?
A. Less than 50g oats per day - i.e. one reasonable serving.
Q Who are Most Coeliacs?
A. Fit and healthy adults, well-established on a strict gluten-free diet.
Q What about Children?
A. Professor John Walker-Smith, our paediatric medical advisor says that
Coeliac children must see their own paediatric gastroenterologist to
discuss the situation in detail.
Q Who are Severe Coeliacs?
A. Definitely, anyone who may be supersensitive or who has not responded
to a strict gluten-free diet. Plus, anyone who appears to react to
gluten or who is unwell.
Q Where can I find suitable Oat products that are gluten-free?
A . Listed in the Appendix section of Coeliac UK's Food and Drink Directory.
The Society would advise members not to make any significant changes in
their diets without prior discussion with their own Consultant
Gastroenterologist and Dietitian, to ensure that they will be under
careful medical and dietetic supervision and can be guaranteed regular
Rae Ward, Consultant Dietitian
You can download the full Position Paper from the Society by clicking
the Icon below. The Report is in Adobe Acrobat format and with the aid
of the free Acrobat reader, it can be read on any type of PC. If you do
not have the reader installed on your computer follow the link to the
Adobe Site for simple instructions.