Why are oats a problem in the gluten-free diet?
The vast majority of oats and oats products on the market are contaminated with wheat, rye and/or barley. Processing, such as milling, makes them unsuitable for people with coeliac diseaseA condition where a person is unable to eat gluten as it makes their body attack itself.
The protein found in oats is called avenin, which is similar to glutenA protein that is found in the cereals wheat, barley and rye.
. There is some evidence to suggest that some people with coeliac disease may even react to pure, uncontaminated oats (5, 6).
Oats and oat products that are free fromA range of food that is free from certain allergens - for example gluten or dairy.
contamination i.e. are 'pure' oats, are listed in the oats chapter of our Food and Drink Directory.
The benefits of oats in the diet
Including pure oats in the gluten-free diet can add variety and increase food choice.
Oats are also a useful source of soluble fibre, which has been shown to be beneficial in maintaining healthy bowel function, managing hyperlipideamia and helping glycaemic control in those patients with diabetes, for example.
Where do oats fit into allergen labelling legislation?
Under current food allergen labelling, oats are classed as a gluten-containing cereal. If oats have been used as a deliberate ingredient they must be declared on the ingredients list. If a manufacturer chooses to use an allergy advice box (which is not compulsory) patients will see the term 'contains oat gluten'.
What advice should be given about including oats in the diet?
Including pure, uncontaminated oats should be considered on an individual patient basis. All patients should receive regular follow up. Some people with coeliac disease prefer not to include oats in the diet.
Coeliac UK always refers people enquiring about including uncontaminated oats in the gluten-free diet to their health care team for specific guidance based on an individual's level of sensitivity and ongoing management.
Including oats in your patients’ diets
Many healthcare professionals advise that their patients can include pure, uncontaminated oats in the diet.
One approach may be to exclude all oats initially after diagnosis, so the patient can become symptom free and achieve a 'baseline of wellness', and then to gradually re-introduce pure, uncontaminated oats at a later stage. The British Society of Gastroenterology recommends that it may be helpful to exclude oats in the first six to twelve months of a gluten-free diet before re-introduction.
Monitoring your patients with coeliac serology and symptoms is recommended. Assurance could be measured, for example, if antibody levels remain low months after re-introduction into the diet.
1. Janatuinen EK et al (2002) No harm from five year ingestion of oats in coeliac disease. Gut. 50: 332-335.
2. Garsed, K & Scott-Brian, B (2007) Can oats be taken in a gluten-free diet? A systematic review. Scandinavian Journal of Gastroenterology. 42(2):171-178.
3. Hogberg L et al (2004) Oats to children with newly diagnosed coeliac disease: a randomised double blind study. Gut. 53: 649-654.
4. Thompson T (2005) Contaminated oats and other gluten-free foods in the United States. Journal of the American Dietetic Association. 105:348.
5. Lundin, K et al (2003) Oats induced villous atrophy in coeliac disease. Gut. 52: 1649-1652.
6. Haboubi NY et al (2006) Coeliac disease and oats: a systematic review. Postgraduate Med J. 82: 672-678.
7. British Society of Gastroenterology (BSG, 2010) The management of adults with coeliac disease.