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Adult coeliac patients do tolerate large amounts of oats

Abstract

Objective: The aim of the present study was to investigate whether adult patients with coeliac disease in remission could include large amounts of oats in their daily gluten-free diet for an extended period of time without adverse effects.

Design, subjects and methods: Twenty adult coeliac patients in remission included large amounts of uncontaminated rolled oats in their daily diet for a prolonged period. The examinations, performed four times during the study period, included small bowel endoscopy with biopsies, blood samples (nutritional status, serological analysis), height and body weight, gastrointestinal symptoms and dietary records. Gastrointestinal symptoms and diet were also investigated through unannounced telephone interviews once a month during the study period.

Results: No adverse effects of a large intake of oats were seen in small bowel histology, serology nor in nutritional status in the 15 subjects who completed the whole study period. Two of the subjects dropped out because of gastrointestinal symptoms and three for non-medical reasons. The median intake of oats was 93 g/day and the compliance to the oat diet was found to be good. Examinations of the patients after drop-out did not show any deterioration in small bowel histology or nutritional status nor raised levels of antibodies.

Conclusion: Results from this study indicate that adult patients with coeliac disease in remission can include large amounts of controlled wheat-free rolled oats for an extended period of time without adverse effects.

Sponsorship: This study was supported by Vårdalstiftelsen, Kommunalförbundet Västra Götaland, Stiftelsen Cerealia FoU, and the Swedish Nutrition Foundation. Kungsörnen AB supported the study with rolled oats.

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References

  • Ascher, H, Hahn-Zoric, M, Hanson, LÅ, Kilander, AF, Nilsson, LÅ & Tlaskalova, H (1996). Value of serologic markers for clinical diagnosis and population studies of coeliac disease. Scand. J. Gastroenterol., 31, 61–67.

    CAS  Article  Google Scholar 

  • Baker, PG & Read, AE (1976). Oats and barley toxicity in coeliac patients. Postgrad. Med. J., 52, 264–268.

    CAS  Article  Google Scholar 

  • Brohult, S & Sandegren, E (1954). Proteins: Chemistry, Biological Activity, and Methods: Part B, New York: Academic Press

    Google Scholar 

  • Buzzard, M (1998). 24-Hour Dietary Recall and Food Record Methods, 2nd ed Oxford: Oxford University Press

    Google Scholar 

  • Catassi, C, Rossini, M, Ratsch, IM, Bearzi, I, Santinelli, A, Castagnani, R, Pisani, E, Coppa, GV & Giorgi, PL (1993). Dose dependent effects of protracted ingestion of small amounts of gliadin in coeliac disease children: a clinical and jejunal morphometric study. Gut, 34, 1515–1519.

    CAS  Article  Google Scholar 

  • Chartrand, L, Russo, P, Duhaime, A & Seidman, E (1997). Wheat starch intolerance in patients with coeliac disease. Am. J. Diet. Assoc., 97, 612–618.

    CAS  Article  Google Scholar 

  • Cornell, H, Wieser, H & Belitz, HD (1992). Characterization of the gliadin-derived peptides which are biologically active in coeliac disease. Clin. Chim. Acta, 213, 37–50.

    CAS  Article  Google Scholar 

  • De Vincenzi, M, Luchetti, R, Peruffo, AD, Curioni, A, Pogna, NE & Gasbarrini, G (1996). In vitro assessment of acetic-acid-soluble proteins (glutenin) toxicity in coeliac disease. J. Biochem. Toxicol., 11, 205–210.

    CAS  Article  Google Scholar 

  • Dicke, W (1950). En onderzoek naar de nadlige invloed van sommige graansoorten op de lijder aan coeliakie. Dissertation. University of Utrecht

  • Dicke, W, Weijers, H & van der Kamer, J (1953). Coeliac disease. II. The presence in wheat of a factor having a deleterious effect in causes of coeliac disease. Acta. Paediatr., 42, 34–42.

    CAS  Article  Google Scholar 

  • Hardman, CM, Garioch, JJ, Leonard, JN, Thomas, HJ, Walker, MM, Lortan, JE, Lister, A & Fry, L (1997). Absence of toxicity of oats in patients with dermatitis herpetiformis. New Engl. J. Med., 337, 1884–1887.

    CAS  Article  Google Scholar 

  • Holmes, GK, Prior, P, Lane, MR, Pope, D & Allan, RN (1989). Malignancy in coeliac disease—effect of a gluten free diet. Gut, 30, 333–338.

    CAS  Article  Google Scholar 

  • Janatuinen, EK, Pikkarainen, PH, Kemppainen, TA, Kosma, VM, Jarvinen, RM, Uusitupa, MI & Julkunen, RJ (1995). A comparison of diets with and without oats in adults with coeliac disease. New Engl. J. Med., 333, 1033–1037.

    CAS  Article  Google Scholar 

  • Janatuinen, EK, Kemppainen, TA, Pikkarainen, PH, Holm, KIT, Kosma, VM, Uusitupa, MI, Maki, M & Julkunen, RJ (2000). Lack of cellular and humoral immunological responses to oats in adults with coeliac disease. Gut, 46, 327–331.

    CAS  Article  Google Scholar 

  • Janatuinen, EK, Kemppainen, TA, Julkunen, RJ, Kosma, VM, Maki, M, Heikkinen, M & Uusitupa, MI (2002). No harm from five year ingestion of oats in coeliac disease. Gut, 50, 332–335.

    CAS  Article  Google Scholar 

  • Kaukinen, K, Collin, P, Holm, K, Rantala, I, Vuolteenaho, N, Reunala, T & Maki, M (1999). Wheat starch-containing gluten-free flour products in the treatment of coeliac disease and dermatitis herpetiformis. A long-term follow-up study. Scand. J. Gastroenterol., 34, 163–169.

    CAS  Article  Google Scholar 

  • Kilander, AF, Dotevall, G, Fallstrom, SP, Gillberg, RE, Nilsson, LA & Tarkowski, A (1983). Evaluation of gliadin antibodies for detection of coeliac disease. Scand. J. Gastroenterol., 18, 377–383.

    CAS  Article  Google Scholar 

  • Kluge, F, Koch, HK, Grosse-Wilde, H, Lesch, R & Gerok, W (1982). Follow-up of treated adult coeliac disease: clinical and morphological studies. Hepatogastroenterology, 29, 17–23.

    CAS  PubMed  Google Scholar 

  • Kumar, PJ, Walker-Smith, J, Milla, P, Harris, G, Colyer, J & Halliday, R (1988). The teenage celiac: follow up study of 102 patients. Arch. Dis. Child., 63, 916–920.

    CAS  Article  Google Scholar 

  • Lindberg, T, Nilsson, LA, Borulf, S, Cavell, B, Fallstrom, SP, Jansson, U, Stenhammar, L & Stintzing, G (1985). Serum IgA and IgG gliadin antibodies and small intestinal mucosal damage in children. J. Pediatr. Gastroenterol. Nutr., 4, 917–922.

    CAS  Article  Google Scholar 

  • Lohiniemi, S, Maki, M, Kaukinen, K, Laippala, P & Collin, P (2000). Gastrointestinal symptoms rating scale in coeliac disease patients on wheat starch-based gluten-free diets. Scand J. Gastroenterol., 35, 947–949.

    CAS  PubMed  Google Scholar 

  • Mayer, M, Greco, L, Troncone, R, Auricchio, S & Marsh, MN (1991). Compliance of adolescents with coeliac disease with a gluten free diet. Gut, 32, 881–885.

    CAS  Article  Google Scholar 

  • Moulton, A (1959). The place of oats in coeliac diet. Arch. Dis. Child., 34, 51–55.

    CAS  Article  Google Scholar 

  • Picarelli, A, Di Tola, M, Sabbatella, L, Gabrielli, F, Di Cello, T, Anania, MC, Mastracchio, A, Silano, M & De Vincenzi, M (2001). Immunologic evidence of no harmful effect of oats in celiac disease. Am. J. Clin. Nutr., 74, 137–140.

    CAS  Article  Google Scholar 

  • Reunala, T, Collin, P, Holm, K, Pikkarainen, P, Miettinen, A, Vuolteenaho, N & Mäki, M (1998). Tolerance to oats in dermatitis herpetiformis. Gut, 43, 490–493.

    CAS  Article  Google Scholar 

  • Ripsin, CM, Keenan, JM, Jacobs, DR, Elmer, PJ, Welch, RR & Van Horn, L et al (1992). Oat products and lipid lowering. A meta-analysis. JAMA, 267, 3317–3325.

    CAS  Article  Google Scholar 

  • Schmitz, J (1997). Lack of oats toxicity in coeliac disease. Toxic fractions makes up less of total protein than in other cereals. Br. Med. J., 314, 159–160.

    CAS  Article  Google Scholar 

  • Selby, WS, Painter, D, Collins, A, Faulkner-Hogg, KB & Loblay, RH (1999). Persistent mucosal abnormalities in coeliac disease are not related to the ingestion of trace amounts of gluten. Scand. J. Gastroenterol., 34, 909–914.

    CAS  Article  Google Scholar 

  • Skerrit, JH & Hill, AS (1991). Enzyme immunoassay for determination of gluten in foods. Collaborative study. J. Assoc. Off. Anal. Chem., 72, 257–264.

    Google Scholar 

  • Srinivasan, U, Leonard, N, Jones, F, Kasarda, DD, Weir, DG, O'Farrelly, C & Feighery, C (1996). Absence of oats toxicity in adult coeliac disease. Br. Med. J., 313, 1300–1301.

    CAS  Article  Google Scholar 

  • Swedish National Food Administration (1993). Food Composition Table—Energy and Nutrients, Uppsala: Norstedts Press

  • Thompson, T (1997). Do oats belong to a gluten-free diet?. J. Am. Diet. Assoc., 97, 1413–1416.

    CAS  Article  Google Scholar 

  • Trier, JS (1991). Coeliac sprue. New Engl. J. Med., 325, 1709–1719.

    CAS  Article  Google Scholar 

  • Valdimarsson, T, Löfman, O, Toss, G & Ström, M (1996). Reversal of osteopenia with diet in adult coeliac disease. Gut, 38, 322–327.

    CAS  Article  Google Scholar 

  • Wieser, H (1995). The precipitating factor in coeliac disease. Baillieres Clin. Gastroenterol., 9, 191–207.

    CAS  Article  Google Scholar 

Download references

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Størsrud, S., Olsson, M., Arvidsson Lenner, R. et al. Adult coeliac patients do tolerate large amounts of oats. Eur J Clin Nutr 57, 163–169 (2003). https://doi.org/10.1038/sj.ejcn.1601525

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  • DOI: https://doi.org/10.1038/sj.ejcn.1601525

Keywords

  • oats
  • coeliac disease
  • gluten-free diet
  • nutrition
  • small intestine
  • malabsorption

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