Safety of Oats in Children with Celiac Disease: A Double-Blind, Randomized, Placebo-Controlled Trial

Lionetti, Elena; Gatti, Simona; Galeazzi, Tiziana; Caporelli, N.; Francavilla, Ruggiero; Cucchiara, Salvatore; Roggero, Paola; Malamisura, Basilio; Iacono, Giuseppe; Tomarchio, Salvatore D.; Kleon, Wolfgang; Restani, Patrizia; Brusca, Ignazio; Budelli, Andrea; Gesuita, Rosaria; Carle, Flavia; Catassi, Carlo

doi:10.1016/j.jpeds.2017.10.062

Cited by 40 publications

(24 citation statements)

References 39 publications

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“…Here it should be noted that “gluten” (i.e., avenin) in oats is not CD-inducing (74–76). Therefore, another important aspect to consider why in the late 1980s Sweden experienced 30 times more infants diagnosed with CD before the age of 2 than Finland, is the amount of oats ingested by the infants: at the age of 9 months, Finnish infants ingested significantly more oat protein than Swedish infants (Table 1).…”

Section: Envionmental Factors Behind Changing Patterns Of Celiac Diseasementioning

confidence: 95%

Changing Pattern of Childhood Celiac Disease Epidemiology: Contributing Factors

Popp

Mäki

2019

Front. Pediatr.

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Up until the 1960s and 1970s, diarrhea, malabsorption syndrome, and failure to thrive were the presenting symptoms and signs of celiac disease (CD) in young infants; however this disease was also at the same time reported to be disappearing. Indeed, clinical childhood CD was seen to transform into a milder form, resulting in an upward shift in age at diagnosis during the 1970s (and years later for many countries). This changing pattern of CD presentation then altered the epidemiology of the disease, with major differences between and within countries observed. An awareness of the changing clinical nature of CD and use of case-finding tools to detect even clinically silent CD became an important factor in this changing epidemiology. Countries report both low and high prevalence but it seems to be on the increase resulting in a population-based level of 1–2%. This paper discusses the potential causes and environmental factors behind these observed clinical changes, identifying new clues from different studies published at the time this transformation took place. For instance, it was found that breastfeeding postponed the diagnosis of the disease but did not altogether prevent it. Moreover, gluten introduction at a young age, specifically at the mean age of 2 months, seemed to also have a clear impact in inducing malabsorption syndrome and failure to thrive in young infants in addition to other factors such as gluten intake volume and type of cereal present in the weaning food. Further, the impact of cow's milk and its high osmolarity might have played an important role; humanized milk formulas were not yet invented. Future epidemiological studies on the contributing environmental factors to the shift in CD presentation are thus recommended for countries in which these changing clinical features are still being observed.

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Section: Envionmental Factors Behind Changing Patterns Of Celiac Diseasementioning

confidence: 95%

Changing Pattern of Childhood Celiac Disease Epidemiology: Contributing Factors

Popp

Mäki

2019

Front. Pediatr.

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“…Moreover, patients may prefer to see a dietitian for longterm follow-up. 77 Although pure oats are typically safe for patients with CD to consume, [78][79][80] there is the concern for potential cross-contamination, 81 and it may be reasonable to recommend that oats be withheld for the first year after CD is diagnosed in patients with features of severe malabsorption. 82 Active membership in a CD support group is recommended because it may be beneficial to improve adherence to a gluten-free diet.…”

Section: Management Of CDmentioning

confidence: 99%

Celiac Disease

Oxentenko

Rubio–Tapia

2019

Mayo Clinic Proceedings

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“…Recently, several studies documented the suitability of oat in a gluten-free diet for celiac patients. Pinto-Sánchez et al (2017) [2] and Lionetti et al (2018) [32] postulated that there was no risk associated with the consumption of oat products by both adult and pediatric celiac patients in remission (i.e., patients who had been adhering to a gluten-free diet for an extended period of time). These authors did not find significant pathological changes in intestinal histology and in immune parameters (e.g., seronegativity for antibodies against tissue transglutaminase) in celiac patients consuming oat.…”

Section: Beneficial Effects Of Oat In a Gluten-free Dietmentioning

confidence: 99%

“…These authors did not find significant pathological changes in intestinal histology and in immune parameters (e.g., seronegativity for antibodies against tissue transglutaminase) in celiac patients consuming oat. Additionally, they found no symptomatic manifestation in remitted celiac patients after consuming oat [2,29,32].…”

Section: Beneficial Effects Of Oat In a Gluten-free Dietmentioning

confidence: 99%

The Pros and Cons of Using Oat in a Gluten-Free Diet for Celiac Patients

et al. 2019

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A therapeutic gluten-free diet often has nutritional limitations. Nutritional qualities such as high protein content, the presence of biologically active and beneficial substances (fiber, beta-glucans, polyunsaturated fatty acids, essential amino acids, antioxidants, vitamins, and minerals), and tolerance by the majority of celiac patients make oat popular for use in gluten-free diet. The health risk of long-time consumption of oat by celiac patients is a matter of debate. The introduction of oat into the diet is only recommended for celiac patients in remission. Furthermore, not every variety of oat is also appropriate for a gluten-free diet. The risk of sensitization and an adverse immunologically mediated reaction is a real threat in some celiac patients. Several unsolved issues still exist which include the following: (1) determination of the susceptibility markers for the subgroup of celiac patients who are at risk because they do not tolerate dietary oat, (2) identification of suitable varieties of oat and estimating the safe dose of oat for the diet, and (3) optimization of methods for detecting the gliadin contamination in raw oat used in a gluten-free diet.

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Safety of Oats in Children with Celiac Disease: A Double-Blind, Randomized, Placebo-Controlled Trial

Abstract: ClinicalTrials.gov: NCT00808301.

Cited by 40 publications

References 39 publications

Changing Pattern of Childhood Celiac Disease Epidemiology: Contributing Factors

Changing Pattern of Childhood Celiac Disease Epidemiology: Contributing Factors

Celiac Disease

The Pros and Cons of Using Oat in a Gluten-Free Diet for Celiac Patients

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