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oats - are they safe on a gluten free dietOats are commonly recommended for those going on a gluten free diet as a safe substitute food.  The classic or traditional definition of gluten includes only wheat, barley, rye (sometimes oats, sometimes not).  So the big question is – Should you eat oats if you have problems with gluten?

Why All the Confusion?

The common response I hear back from people is – “Dr. Osborne, I don’t feel bad when I eat oatmeal.”  or “My other doctor says that oatmeal is safe.”  or “The package of oatmeal claims to be gluten free.”

Keep in mind the following:  It is not how bad you feel after consumption that tells you whether or not you are having an inflammatory immune reaction.  This type of damage can take years to manifest into symptoms.  That is one of the primary reasons that most people diagnosed with gluten problems don’t get their diagnosis until later in life.  The inflammatory damage builds over time, and is typically not an immediate response.  The food labeling laws don’t include oatmeal because there is not a firm scientific consensus.  Many claim that celiac patients react to oats only because they are cross contaminated with wheat.  And although it is true that many packaged grain products are cross contaminated, non cross contaminated oats have also been shown to cause an inflammatory reaction in patients diagnosed with gluten intolerance.  The bigger problem here is that doctors and the gluten free food industry completely ignore the research on this topic, and continue to claim that oats are a safe substitute food.  But before you make a decision to include oat cereal products into your diet, consider the research studies below:

Current Research on Oats

There have been a number of research studies performed to evaluate the safety of oat consumption.  Many of them report that components in oat proteins cause inflammation and elicit damage in patients with gluten sensitivity.  Most recently, a study published in the European Journal of Nutrition found that some forms of oat protein triggered and antibody reaction.  Another study published in the Scandinavian Journal of Gastroenterology found two varieties of oat proteins were responsible for increased intraepithelial T-cell density and IFN-γ production (both of these are signs of increased inflammation).

In 2012 a research study was published identifying a…

direct correlation of the immunogenicity of the different oat varieties with the toxicity of peptides present in their avenin sequences.

In plain English please – Proteins in oat cereal stimulated an immune response similar to what is seen from wheat.

The studies above were all published after Jan. of 2011.  In medicine, it can take 20-30 years for new information to become common knowledge among doctors.  So I don’t expect that many physicians will be talking about the potential for oat to be a problem for those with gluten sensitivity.  That being said, let’s take a look at a comprehensive review of the medical literature that was published in 2011 compiling 75 studies published on the topic since 1953.  The summary from the authors are quoted below:

Oats in a gluten-free diet increase the diet’s nutritional value, but their use remains controversial. Contamination with prolamins of other cereals is frequent, and some clinical and experimental studies support the view that a subgroup of celiac patients may be intolerant to pure oats. Thus, this issue is more complex than previously suggested. In order to produce oats that are safe for all celiac patients, the following topics should be addressed: selection of oat cultivars with low avenin content, research on such recombinant varieties of oats, development of assay methods to detect avenins in oat products, guidelines for the agricultural processing of oats and the manufacture of oat products, as well as guidelines for following up with celiac patients who consume oats.

Resources:

  1. Silano M, et al.  Diversity of oat varieties in eliciting the early inflammatory events in celiac diseaseEur J Nutr
  2. Maglio M, Mazzarella G, Barone MV, et al.  Immunogenicity of two oat varieties, in relation to their safety for celiac patients.Scand J Gastroenterol. 2011 Oct;46(10):1194-205.
  3. Real A, Comino I, de Lorenzo L, et al.  Molecular and immunological characterization of gluten proteins isolated from oat cultivars that differ in toxicity for celiac disease.  PLoS One. 2012;7(12).
  4. Fric P, Gabrovska D, Nevoral J. Celiac disease, gluten-free diet, and oatsNutr Rev. 2011 Feb;69(2):107-15.

Oat Safety Summary

Oats contain a form of gluten often times referred to as avenin, and this protein represents  12-16% of the total protein found in oats.   This in and of itself makes it virtually impossible for oats to be gluten free.  This number is low compared to the 69% gluten protein composition of wheat, and it may in part account for the fact that people report less negative reactions when consuming oats.  It is well established the 20 ppm (parts per million) – roughly the size of a bread crumb is enough gluten to create and inflammatory reaction in patients with gluten sensitivity.  It has also been shown that many patient embarking on a traditional gluten free diet (avoiding wheat, barley, and rye, but not other grains) continue to remain ill.   The diagram below compares the gluten protein content of different grains:

Gluten composition of grains

The bulk of scientific literature investigating oat safety is in agreement that more research is needed before making a blanket statement that oats are safe for everyone.  Some laboratories now offer limited testing for oat allergy.  These labs are not accurate enough and do not investigate the inflammatory response to oats in a comprehensive manor, and therefor should not be the basis to include oats in the diet.  Because it is currently not possible to extract the forms of oat gluten known to cause damage out of the cereal, avoidance of oats as a substitute food for a gluten free diet is strongly recommended.

Key Points:

  • There is no such thing as a “gluten free” oat.
  • As many as 41% of processed packaged foods labeled gluten free contain enough gluten to cause damage (oats included)
  • 20 ppm exposure can allow for persistent damage
  • Several types of gluten protein in oats have been shown to cause inflammation
  • Although often times labeled gluten free, oats contain gluten.

 

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18 responses on “Are Oats Safe to Eat on a Gluten Free Diet?

  1. Alan says:

    Very useful information. Many of my clients ask me about being able to eat oats. I finally can answer them with confidence. Thank you.

  2. Melvin says:

    What about Spelt and any other substitute for dreads/cereal.

  3. Pedro Colon says:

    The Oats Manufactured by Bob’s Red Mill is really Gluten Free Oats?

  4. Barbara says:

    Hi – I am a senior who wasn’t feeling well for a long while. I decided to just minimally try out eating some gluten free foods – breads, crackers, oatmeal, dry cereal. I watched Dr. Daniel Amen and Dr. David Perlmutter on PBS about Grain Brain – They said to cut out gluten, sugar and bad carbs. I have switched from margarines to butter and olive oil, lots of spinach, mushrooms, etc. olives, humus, nuts, eggs etc. My weight has been going down and I feel much better. Guess its a combination of all this. I don’t eat beef – but I do have chicken and fish. I am in my 80s.

  5. Cindy Bonskowski says:

    Rice used to be my go-to, but noticed a year ago that I was definitely reacting to it. Now I see why. Thank you!

  6. Moranda says:

    What the hell do you do if you’re already vegetarian?

    • Erin says:

      I hear you, Moranda! I’m a vegan who just found out I have celiac disease. If I can’t eat oats, rice, or corn I don’t know what I am going to do…

    • Brad D says:

      If you are type O-Blood you could be struggling from lack of red meat… Look up eat right 4 your blood type! Has changed my life I’m 36 and feel 18. If your type A blood then your on the right track!!!

  7. Julie Vincent says:

    Is there a reliable test to find out what grains are bad for your immune system? There are some health benefits to grain, so hate to totally eliminate them or deprive yourself of them. I’m currently doing Swank Diet for MS and Chronic Kidney Disease so can’t consume too much meat because of the fat content, so rely on grains to fill in the already vegetables and fruit. Help!

  8. Shawna says:

    I was wondering if amaranth and quinoa are truly gluten free? I didn’t see them on the chart above. Thanks.

  9. Glenda Hall says:

    I am now 68, diagnosed with Celiac about 5 years ago. My husband bought land and wants to plant oat “grass” seed on 2 acres which would then be walked upon. He thinks I am out of my mind to object to this! How can I convince him that the oat grass is seriously dangerous to me?

  10. Syn says:

    I’ve read your book Dr Osborne. I’ve cut out all grains except for the occasional buckwheat pancakes I make. however, from what I’m reading on your pages, I should cut that out as well. I recently started getting pain in my wrists, arms and back/neck. I was recently introduced to gluten free ginger stem oat cookies which are delicious and now realise they are possibly the cause of my body pain???? What a blow. I’m off all nightshade food, no dairy, very low sugar, no white potato no legumes, choc, no corn or rice but I do have wild black rice occasionally. It’s all so very difficult and I do crave a bit of sweet. My abdomen is like I’m 6 months pregnant- it feels like it doesn’t belong to me. I’m in my 70s.

  11. chrissie says:

    Cutting out al grains is scared as that just leaves veg and meat and fish. I don’t eat dairy and think hat potatoes have an effect on my stomach. People I hear say, why is she so skinny but has a big stomach. Obviously I am still finding it difficult to digest stuff. Is kaffir wrong as well?

  12. Ray says:

    Hi Dr O.
    Thanks a lot for this article.
    Can I ask what grains then are safe for a gluten free diet especially for children?
    Thanks

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Disclaimer: The entire contents of this website are based upon the opinions of Dr. Peter Osborne, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Osborne and his community. Dr. Osborne encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.

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