Is it OK for coeliacs to eat oats?
Q: I’m a recently diagnosed coeliac – I’m managing pretty well but I’m confused about oats. Can I have these or not? – Georgie.
A: There’s a lot of confusion around whether or not oats are gluten-free, the sheer volume of conflicting information doesn’t help this.
You may have noticed that oats labelled as ‘‘gluten-free’’ are actually not available in New Zealand (unless imported). Oatcontaining products labelled ‘‘gluten-free’’ overseas are often labelled as ‘‘wheat-free’’ in New Zealand, despite being exactly the same product.
Gluten is the name given to a protein in wheat, rye, barley and oats that affects people with coeliac disease. It is a composite name representing: gliadin in wheat hordein in barley secalin in rye avenin in oats. The current tests for gluten can measure gliadin, hordein and secalin, but not avenin, as it is a slightly different protein. Avenin is an essential part of oats, just as gliadin is with wheat. Oats will never be gluten-free (as in, avenin-free), even if they are described as gluten-free (as in, gliadin-free). About one in five (20 per cent) people with coeliac disease react to pure uncontaminated oats. That is, they react to oat avenin.
While some people with coeliac disease and those who are glutenintolerant can tolerate oats, others can’t. I have found it is therefore unwise to ever ‘‘recommend’’ oats, as I would not want to recommend that 20 per cent of coeliacs get sick.
Since we cannot predict who is the one in five, and we know that damage can occur in the absence of symptoms, I believe the best advice is that oats are not to be consumed without a biopsy before consumption. The practicalities of doing so may prove either challenging or worthwhile.
So when people discuss gluten- free oats (and laboratories advise that oats are gluten-free), a more accurate statement would be is that they are free from wheat (and rye, barley) gliadin. In other words, that there is no measurable contamination. But they still contain avenin.
Those with non-coeliac gluten sensitivity (those with gluten sensitivity who have tested negative for coeliac disease) may experience similar symptoms to those with coeliac disease, while lacking the same antibodies and/ or intestinal permeability that the coeliac disease can create.
Although science does not yet understand all of the mechanisms through which humans can react to gluten (or perhaps other components in grains), the same dietary changes are often required to help alleviate symptoms. This is best guided by an experienced nutrition professional.
But in your case, Georgie, given you have been diagnosed with coeliac disease, the best advice is to avoid oats.
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It is probably best to avoid oats if you have been diagnosed with coeliac disease.