Why Oats Are Safe and Healthy for Celiac Disease Patients

Overview

Journal Med Sci (Basel)

Specialty General Medicine

Date 2017 Oct 31

PMID 29083384

Citations 27

Authors

Luud J W J Gilissen

Ingrid M van der Meer

Marinus J M Smulders

Affiliations

Soon will be listed here.

Abstract

The water-insoluble storage proteins of cereals (prolamins) are called "gluten" in wheat, barley, and rye, and "avenins" in oat. Gluten can provoke celiac disease (CD) in genetically susceptible individuals (those with human leukocyte antigen (HLA)-DQ2 or HLA-DQ8 serotypes). Avenins are present at a lower concentration (10%-15% of total protein content) in oat as compared to gluten in wheat (80%-85%). The avenins in the genus Avena (cultivated oat as well as various wild species of which gene bank accessions were analyzed) are free of the known CD immunogenic epitopes from wheat, barley, and rye. T cells that recognize avenin-specific epitopes have been found very rarely in CD patients. CD patients that consume oats daily do not show significantly increased levels of intraepithelial lymphocyte (EIL) cells. The safety and the positive health effects of the long-term inclusion of oats in the gluten-free diet have been confirmed in long-term studies. Since 2009 (EC 41/2009) and 2013 (FDA) oat products may be sold as gluten-free in several countries provided a gluten contamination level below 20 ppm. Introduction of oats in the gluten-free diet of celiac patients is advised after the recovery of the intestine. Health effects of oat consumption are reflected in European Food Safety Authority (EFSA)- and Food and Drug Administration (FDA)-approved health claims. Oats can form a healthy, nutritious, fiber-rich, and safe complement to the gluten-free diet.

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References

Wu H, Flint A, Qi Q, van Dam R, Sampson L, Rimm E . Association between dietary whole grain intake and risk of mortality: two large prospective studies in US men and women. JAMA Intern Med. 2015; 175(3):373-84. PMC: 4429593. DOI: 10.1001/jamainternmed.2014.6283. View

Sollid L, Qiao S, Anderson R, Gianfrani C, Koning F . Nomenclature and listing of celiac disease relevant gluten T-cell epitopes restricted by HLA-DQ molecules. Immunogenetics. 2012; 64(6):455-60. PMC: 3349865. DOI: 10.1007/s00251-012-0599-z. View

Salentijn E, Mitea D, Goryunova S, van der Meer I, Padioleau I, Gilissen L . Celiac disease T-cell epitopes from gamma-gliadins: immunoreactivity depends on the genome of origin, transcript frequency, and flanking protein variation. BMC Genomics. 2012; 13:277. PMC: 3469346. DOI: 10.1186/1471-2164-13-277. View

Kaukinen K, Collin P, Huhtala H, Maki M . Long-term consumption of oats in adult celiac disease patients. Nutrients. 2013; 5(11):4380-9. PMC: 3847736. DOI: 10.3390/nu5114380. View

Huang T, Xu M, Lee A, Cho S, Qi L . Consumption of whole grains and cereal fiber and total and cause-specific mortality: prospective analysis of 367,442 individuals. BMC Med. 2015; 13:59. PMC: 4371798. DOI: 10.1186/s12916-015-0294-7. View

Silano M, Pozo E, Uberti F, Manferdelli S, Del Pinto T, Felli C . Diversity of oat varieties in eliciting the early inflammatory events in celiac disease. Eur J Nutr. 2013; 53(5):1177-86. PMC: 4119590. DOI: 10.1007/s00394-013-0617-4. View

Comino I, Bernardo D, Bancel E, Moreno M, Sanchez B, Barro F . Identification and molecular characterization of oat peptides implicated on coeliac immune response. Food Nutr Res. 2016; 60:30324. PMC: 4744869. DOI: 10.3402/fnr.v60.30324. View

Hernando A, Mujico J, Mena M, Lombardia M, Mendez E . Measurement of wheat gluten and barley hordeins in contaminated oats from Europe, the United States and Canada by Sandwich R5 ELISA. Eur J Gastroenterol Hepatol. 2008; 20(6):545-54. DOI: 10.1097/MEG.0b013e3282f46597. View

VAN DE KAMER J, WEIJERS H, DICKE W . Coeliac disease. IV. An investigation into the injurious constituents of wheat in connection with their action on patients with coeliac disease. Acta Paediatr (Stockh). 1953; 42(3):223-31. DOI: 10.1111/j.1651-2227.1953.tb05586.x. View

10.

Fritz R, Chen Y, Contreras V . Gluten-containing grains skew gluten assessment in oats due to sample grind non-homogeneity. Food Chem. 2016; 216:170-5. DOI: 10.1016/j.foodchem.2016.08.031. View

11.

Arentz-Hansen H, Fleckenstein B, Molberg O, Scott H, Koning F, Jung G . The molecular basis for oat intolerance in patients with celiac disease. PLoS Med. 2004; 1(1):e1. PMC: 523824. DOI: 10.1371/journal.pmed.0010001. View

12.

Petersen J, Montserrat V, Mujico J, Loh K, Beringer D, van Lummel M . T-cell receptor recognition of HLA-DQ2-gliadin complexes associated with celiac disease. Nat Struct Mol Biol. 2014; 21(5):480-8. DOI: 10.1038/nsmb.2817. View

13.

van den Broeck H, Cordewener J, Nessen M, America A, van der Meer I . Label free targeted detection and quantification of celiac disease immunogenic epitopes by mass spectrometry. J Chromatogr A. 2015; 1391:60-71. DOI: 10.1016/j.chroma.2015.02.070. View

14.

Hardy M, Tye-Din J, Stewart J, Schmitz F, Dudek N, Hanchapola I . Ingestion of oats and barley in patients with celiac disease mobilizes cross-reactive T cells activated by avenin peptides and immuno-dominant hordein peptides. J Autoimmun. 2014; 56:56-65. DOI: 10.1016/j.jaut.2014.10.003. View

15.

Mitea C, Salentijn E, van Veelen P, Goryunova S, van der Meer I, van den Broeck H . A universal approach to eliminate antigenic properties of alpha-gliadin peptides in celiac disease. PLoS One. 2010; 5(12):e15637. PMC: 3002971. DOI: 10.1371/journal.pone.0015637. View

16.

DICKE W, WEIJERS H, VAN DE KAMER J . Coeliac disease. II. The presence in wheat of a factor having a deleterious effect in cases of coeliac disease. Acta Paediatr (Stockh). 1953; 42(1):34-42. DOI: 10.1111/j.1651-2227.1953.tb05563.x. View

17.

Tapsas D, Falth-Magnusson K, Hogberg L, Hammersjo J, Hollen E . Swedish children with celiac disease comply well with a gluten-free diet, and most include oats without reporting any adverse effects: a long-term follow-up study. Nutr Res. 2014; 34(5):436-41. DOI: 10.1016/j.nutres.2014.04.006. View

18.

La Vieille S, Pulido O, Abbott M, Koerner T, Godefroy S . Celiac Disease and Gluten-Free Oats: A Canadian Position Based on a Literature Review. Can J Gastroenterol Hepatol. 2016; 2016:1870305. PMC: 4904695. DOI: 10.1155/2016/1870305. View

19.

van Herpen T, Goryunova S, van der Schoot J, Mitreva M, Salentijn E, Vorst O . Alpha-gliadin genes from the A, B, and D genomes of wheat contain different sets of celiac disease epitopes. BMC Genomics. 2006; 7:1. PMC: 1368968. DOI: 10.1186/1471-2164-7-1. View

20.

Thompson T . Gluten contamination of commercial oat products in the United States. N Engl J Med. 2004; 351(19):2021-2. DOI: 10.1056/NEJM200411043511924. View