This statement is under review by the CCA Professional Advisory Board, June 2014

Position Statement on Oats

The safety of oats in individuals with celiac disease has been extensively investigated. Clinical evidence from numerous studies indicate that consumption of pure oats, uncontaminated with gluten from wheat, rye or barley, is safe for most individuals with celiac disease in the amount of 50 to 70 grams per day (1/2 – 3/4 cup dry rolled oats) for adults, and 20 to 25 grams per day (1/4 cup dry rolled oats) for children with celiac disease. These studies were up to seven years in length, used uncontaminated oats, but involved a limited number of subjects.

A small number of individuals with celiac disease may not tolerate even pure, uncontaminated oats. To ensure that persons with celiac disease are not intolerant to pure, uncontaminated oats, before incorporating oats into their diet they should be well controlled on a gluten-free diet, with no gastrointestinal complaints.

In Canada and the USA, pure and uncontaminated oats are produced by specialty manufacturers. These oats have been grown on dedicated fields; stored, transported and processed in a dedicated gluten-free facility and tested for gluten. These oats should not exceed the action level of 20 ppm (parts per million) of gluten as detected using current available methods. Individuals s with celiac disease and other gluten-related disorders who wish to add oats or oat products to their diet must ensure that the oats they are eating are free from contamination with gluten from wheat, rye and barley. Oats available in the marketplace labeled as “pure” are not free of gluten contamination and should not be consumed.

The Canadian Celiac Association’s (CCA) position on the safety of pure, uncontaminated oats is supported by Health Canada. Their review entitled Celiac Disease and the Safety of Oats is available on the Health Canada website

The safety of oats in non-celiac gluten sensitivity has not been studied. The CCA will continue to monitor the scientific developments in the area of oats in celiac disease and other gluten-related disorders and will keep its members updated.

by:
Professional Advisory Board
Canadian Celiac Association
April 2013

 

These guidelines under review by the CCA Professional Advisory Board, June 2014

Guidelines for Consumption of Pure and Uncontaminated Oats
by Individuals with Celiac Disease

The Canadian Celiac Association (CCA) has published a position statement on the use of “pure and uncontaminated oats” by individuals with celiac disease (view here). This is supported by Health Canada’s Position on the Introduction of Oats to the Diet of Individuals Diagnosed with Celiac Disease (view here).

Most commercially available oats in North America are contaminated with grains that contain gluten (wheat, rye, barley). Therefore, these oats are not safe for consumption by individuals with celiac disease. Only oats that are pure and uncontaminated and have been appropriately tested should be consumed. These oats should not exceed the action level of 20 ppm (parts per million) of gluten as detected using current available methods.

The following guidelines are recommended when starting pure and uncontaminated oats in the diet of individuals with celiac disease or other gluten-related disorders:

  1. The patient’s disease should be well controlled on a gluten-free diet and he/she should have no gastrointestinal complaints.
  2. It is recommended that adults receive no more than 50-70 grams (1/2-3/4 cup dry rolled oats) and children receive no more than 20-25 grams (1/4 cup) of pure uncontaminated oats per day.
  3. The fiber content of an oat containing diet is often higher than the typical gluten-free diet. When adding oats to the diet, individuals may experience a change in stool pattern or mild gastrointestinal symptoms, including abdominal bloating and flatulence. These symptoms should resolve within a few days.
  4. There are case reports of individuals with celiac disease relapsing from the consumption of pure uncontaminated oats. Individuals should be warned of this possibility. If symptoms occur and/or persist, individuals should discontinue the oats and contact their physician.
  5. Screening with an IgA-tissue transglutaminase (tTG) or IgA-endomysial antibody (EMA) may not identify the rare patient who reacts to oats. These tests are not sufficiently sensitive for detecting mild dietary indiscretions, especially over a couple of months of challenge i.e. <10-1000 mg gluten/day. A positive EMA or tTG will help confirm oats sensitivity but a negative one will not exclude it.
  6. The physician or a dietitian should carefully review the diet to ensure that the patient is not consuming foods that contain gluten.
  7. It is worthwhile rechallenging individuals if they wish to try oats again. Development of symptoms at the time of the second challenge would strongly suggest intolerance to oats. Research suggests that intolerance to oats occurs but is quite rare. The mechanism for this is unknown.

Dr. Mohsin Rashid
for
Professional Advisory Board
Canadian Celiac Association
April 2013