Holm K et al. (2006) Oats in the treatment of childhood coeliac disease: a 2-year controlled trial and a long-term clinical follow-up study. Aliment Pharmacol Ther 23: 1463–1472

Whether oats should be consumed by children with celiac disease who are on a gluten-free diet (GFD) is controversial. Several studies in adults with celiac disease and dermatitis herpetiformis have shown that most can tolerate uncontaminated oats, even in the long-term. There have been few studies of oat tolerance in the pediatric population, however, particularly in the long-term.

Holm and colleagues' 2-year, controlled trial investigated the safety of including oats in the diet of 32 children with celiac disease. Newly diagnosed patients (n = 9) were put on an oat-containing GFD, and patients in remission (n = 23) were randomly assigned to receive either an oat-containing GFD or gluten challenge.

All children who underwent gluten challenge relapsed within 1 year, and were given an oat-containing GFD for the remainder of the study. Encouragingly, all of the newly diagnosed patients and the relapsed patients recovered, and maintained complete remission from the disease whilst consuming a GFD containing oats (a median of 43 g oats per day). In addition, no deterioration (assessed by intestinal histology or serology) was observed in patients in remission who were allocated to an oat-containing GFD on entry to the study. After the 2-year-controlled trial, patients were allowed to eat oats freely, and were followed for up to 7 years, during which none relapsed.

The authors conclude that most children with celiac disease can tolerate oats, and highlight the need for commercial production of oat products that are free from wheat and barley contamination, as oats add diversity to a GFD.