Oatmeal – Is It Inflammatory?

Oats 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 – is oatmeal inflammatory for those who have issues 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 following video and research studies below:

Dr. Osborne Breaks Down Why Oats Are A Problem

Current Research on Oats

There have been a number of research studies performed to evaluate the safety of oat consumption and if oats cause inflammation. 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. Therefore, oatmeal is not gluten free.

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 disease. Eur 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 oats. Nutr Rev. 2011 Feb;69(2):107-15.

Oat Safety Summary – Is Oatmeal Inflammatory?

Oats contain a form of gluten often 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 that 20 ppm (parts per million) – roughly the size of a bread crumb is enough gluten to create an inflammatory reaction in patients with gluten sensitivity. It has also been shown that many patients embarking on a traditional gluten free diet (avoiding wheat, barley, and rye, but not other grains) continue to remain ill. That is one of the biggest reasons I wrote No Grain No Pain. 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 manner, and therefore 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 oftentimes labeled gluten free, oats contain gluten.
  • Avoid eating oats because they are a grain – No Grain No Pain

14 thoughts on “Is Oatmeal Inflammatory

  1. L. Barman says:

    Thank you for this information. The only time I feel okay is when I don’t eat any grains. My friends and family think I’m crazy, but this explains a lot. Rice even makes me ill!

  2. Laurie says:

    Question – with respect to this:

    “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)”

    Would you kindly provide your opinion of the company “GF Harvest” (www.GlutenFreeOats.com)? It is an oat manufacturing company owned by a celiac family, and its product is certified to 10 ppm or less.
    _____

    Excerpt from here: http://glutenfreeoats.com/oat-purity-it-matters/

    “We have traceability from planting to package:

    – Dedicated growing fields and equipment isolated from gluten contamination.
    – Testing every truck before entering the mill
    – Double testing in our lab with monthly sample re-verification by an independent lab
    – Making sure each bag of oats is from non-GMO seed
    – Processed in our DEDICATED Gluten Free Mill
    – Packaged and stored in our DEDICATED Gluten Free warehouse and production facility”

    • says:

      Hi Laurie,
      As the testing this company performs is for cross contamination of gliadin, a type of gluten found in wheat, barley, and rye. It is important to understand that oats contain a type of gluten called avenin. This type of gluten is different than gliadin, but it is still a form of gluten. Many with celiac disease and gluten sensitivity will react to avenin.
      Hope this clarifies the issue for you.
      all the best,
      Dr. O

  3. Albert says:

    I found this page because despite eating gluten-free oats my body has the same reaction as if I’m eating a gluten products. I’ve ignored it for months and have been suffering not understanding that it’s likely the oats. Reading this article validated everything I was feeling. I’m seriously angry at oats are labeled gluten free when in fact they can cause such harm to people who are gluten sensitive

  4. N.N. Griff says:

    How come animals who enjoy oats as their favorite food, never show any symptoms of Celiac or other digestion disease or problem? I know their digestion anatomy are different, but they still have to show some inflammatory disease, or a sign of it.
    Could it be the chemicals, Insecticides used for better agricultural products! that have altered the anatomical essence of Oats, wheat or other grains? Or our body has been changed with the style of unhealthy living? I just cannot believe such a beneficial product of nature could be harmful to us. We have to look at other possibilities.

    • ZC says:

      Animals and humans have vastly different digestive systems. Some subsist on only grains and grasses. This is their diet, their original and evolved adaptation. Our diet did not start out with grains, grasses and oats. From Dr. Steven Guyenet: ” Although wheat had its origin around 11,500 years ago, it didn’t become widespread in Western Europe for another 4,500 years. So if you’re of European descent, your ancestors have been eating grains for roughly 7,000 years. Corn was domesticated 9,000 years ago, but according to the carbon ratios of human teeth, it didn’t become a major source of calories until about 1,200 years ago! Many American groups did not adopt a grain-based diet until 100-300 years ago, and in a few cases they still have not. If you are of African descent, your ancestors have been eating grains for 9,000 to 0 years, depending on your heritage. The change to grains was accompanied by a marked decrease in dental health that shows up clearly in the archaeological record. “

  5. KaZ Akers says:

    I have read SO many articles about oats, oatmeal and oat milk that have basically just told us to believe what they say because they say it. (Who are THEY anyway?) BUT you have sited studies, resources, medical and scientific data. I tend to believe you more than any of the others. I have fibromyalgia and gluten is awful for me. SO grateful I found your site.

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