Level 3

This oat section is under revision. For the updated Celiac Center at Beth Israel Deaconess Medical Center Statement on Oats (May 2016), see Following a Gluten-Free Diet (pgs 11-14) under Celiac Center Patient Educational Materials.

KEY POINTS:

  • A small number of people with celiac disease cannot eat oats. 1 They may have an immune reaction to the protein in oats called avenin. It is unclear at this time what causes this reaction. 

    However, most of the reactions that people have had to oats in the past involved contamination with gluten.
  • Oats you find on grocery store shelves that are not labeled gluten-free are highly likely to be contaminated with wheat, barley, and rye. 2
  • Take a look at this chart: Gluten contamination levels of oats not labeled gluten-free: 2

    • Four different lots of each brand of oats were tested. Gluten contamination varied greatly between the lots but none of the three brands of oats could be consistently relied upon to be gluten-free (defined as < 20 parts per million (ppm) gluten). For more information on contamination of oats NOT labeled gluten-free please see: http://www.nejm.org/doi/full/10.1056/NEJM200411043511924 .

GLUTEN CONTENT OF OATS NOT LABELED GF:
BRAND MEAN PPM GLUTEN PER LOT
McCann's Steel Cut Irish Oats < 3, 12, 23, 725
Country Choice Organic Oats < 3, 120 ,131, 210
Quaker Old Fashioned Oats 338, 364, 971, 1807

References: Thompson, NEJM. 351; 19:2021-22

Gluten_Free

  • If you include oats in your diet they should be specially produced labeled gluten-free oats.
  • Producers of labeled gluten-free oats take many precautions to make sure their products are gluten-free as defined by the Food and Drug Administration's proposed rule. These steps may include: 3
    • Checking oat seed for contamination before it is planted and again at harvest.
    • Growing oats in fields that have not grown wheat, barley, or rye for a number of years.
    • Using a dedicated oat mill.
    • Testing oats for gluten contamination using state-of-the-art testing methods, such as the R5 ELISA.

TAKE HOME MESSAGES:

People_In_Field
  • Oats not labeled gluten-free are likely contaminated with gluten.
  • Eat only specially produced labeled gluten-free oats.
  • Manufacturers of specially produced gluten-free oats take extraordinary steps to make sure their products are truly gluten-free.

RESOURCES FOR YOU:

Thompson T. Oats and Wheat Starch. In Real Life with Celiac Disease: Troubleshooting and Thriving Gluten-Free . Eds. Dennis M, Leffler D. AGA Press. Bethesda, MD. 2010.

Thompson T. Gluten contamination of commercial oat products in the United States. N Engl J Med. 2004;351(19):2021-2022. http://www.nejm.org/doi/full/10.1056/NEJM200411043511924 . Accessed November 4, 2011.

Gluten-Free Dietitian. Finding Gluten-Free Oats. http://www.glutenfreedietitian.com/newsletter/dietcom-blog-finding-gluten-free-oats/ . Accessed November 4, 2011.

Research Studies on Oats:

Koskinen O, Villanen M, Korponay-Szabo I, Lindfors K, Maki M, Kaukinen K. Oats do not induce systemic or mucosal autoantibody response in children with coeliac disease. J Pediatr Gastroenterol Nutr. 2009 May;48(5):559-65. 
http://www.ncbi.nlm.nih.gov/pubmed/19412007

Kemppainen TA, Heikkinen MT, Ristikankare MK, Kosma VM, Sontag-Strohm TS, Brinck O, Salovaara HO, Julkunen RJ. Unkilned and large amounts of oats in the coeliac disease diet: a randomized, controlled study. Scand J Gastroenterol. 2008;43(9):1094-101.

Holm K, Maki M, Vuolteenaho N, Mustalahti K, Ashorn M, Ruuska T, Kaukinen K. Oats in the treatment of childhood coeliac disease: a 2-year controlled trial and a long-term clinical follow-up study. Aliment Pharmacol Ther . 2006 May 15;23(10):1463-72.

Janatuinen EK, Kemppainen TA, Julkunen RJ, Kosma VM, Maki M, Heikkinen M, Uusitupa MI . No harm from five year ingestion of oats in coeliac disease. Gut. 2002 Mar;50(3):332-5.

References:

  1. Arentz-Hansen H, Fleckenstein B, Milberg O, et al. The molecular basis for oat intolerance in patients with celiac disease. PLoS Med. 2004;1(1):e1.
  2. Thompson T. Gluten contamination of commercial oat products in the United States. N Engl J Med. 351:19:2021-2022. http://www.nejm.org/doi/full/10.1056/NEJM200411043511924 . Accessed November 4, 2011.
  3. Gluten-Free Dietitian. Finding Gluten-Free Oats. http://www.glutenfreedietitian.com/newsletter/dietcom-blog-finding-gluten-free-oats/ . Accessed November 4, 2011.

Revision Date: 8-29-12 
Author: Tricia Thompson, MS, RD 
Editors: Melinda Dennis, MS, RD, LDN and Daniel Leffler, MD, MS

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