Pure Oats as Part of the Canadian Gluten-Free Diet in Celiac Disease: The Need to Revisit the Issue

Abstract

The question about recommending pure, noncontaminated oats as part of the gluten-free diet of patients with celiac disease remains controversial. This might be due to gluten cross contamination and to the possible immunogenicity of some oat cultivars. In view of this controversy, a review of the scientific literature was conducted to highlight the latest findings published between 2008 and 2014 to examine the current knowledge on oats safety and celiac disease in Europe and North America. Results showed that regular oats consumed in Canada are largely contaminated. Overall, the consumption of pure oats has been generally considered to be safe for adults and children. However, it appears that some oat cultivars may trigger an immune response in sensitive individuals. Therefore, further long-term studies on the impact of consumption of oats identifying the cultivar(s) constitute an important step forward for drawing final recommendations. Furthermore, a closer and more accurate monitoring of the dietary intake of noncontaminated oats would be paramount to better determine what its actual contribution in the gluten-free diet of adults and children with celiac disease are in order to draw sound recommendations on the safety of pure oats as part of the gluten-free diet.

Diet, Perceived Intestinal Well-Being and Compositions of Fecal Microbiota and Short Chain Fatty Acids in Oat-Using Subjects with Celiac Disease or Gluten Sensitivity

“…Pure oats suitable for the gluten-free diet are grown, milled and handled without contamination by other cereals. Recently, it was suggested that the current confounding clinical findings on the safety of oat consumption in CeD subjects [32] could be caused by contaminated oats assessed as "pure" [8]. Indeed, a decade ago, gluten cross-contamination was shown to exist in oat supply chains in Europe, the United States and Canada [33].…”

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“…Trata-se, portanto, de tema ainda controverso na literatura. 31,33,40,44,47,48 Quanto à SNCG/T, é incomum a referência à aveia, mas há assinalada ênfase no glúten do trigo como o principal, e talvez único, fator alimentar por trás desta condição. 11,49 Prevalência Uma porcentagem significativa da população geral relata problemas causados por ingestão de trigo e/ou de glúten, mesmo tendo sido devidamente excluídos os diagnósticos de DC e de AT.…”

Sensibilidade não-celíaca ao glúten

“…32 Trabalhos científicos recentes que tratam das doenças relacionadas ao glúten-especialmente a DC-e a Celiac Disease Foundation não incluem aveia entre os alimentos proscritos. 35,36 O risco, porém, de se consumir aveia, se dá pela contaminação por outros grãos, segundo vários autores, [37][38][39][40] o que ajuda a explicar a hesitação em liberar a ingestão de aveia para pacientes com DC. 41 Por outro lado, outros pesquisadores advertem que alguns cultivares de aveia podem exibir imunogenicidade relevante na patogênese da DC.…”

“…Trata-se, portanto, de tema ainda controverso na literatura. 31,33,40,44,47,48 Quanto à SNCG/T, é incomum a referência à aveia, mas há assinalada ênfase no glúten do trigo como o principal, e talvez único, fator alimentar por trás desta condição. 11,49 Prevalência sistêmica em conjunto com um epitélio intestinal comprometido.…”