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One of the greatest debates in the world of gluten-free living is whether oats are safe for people with celiac disease to consume. For many years, celiacs were told that the list of grains they should avoid were “wheat, barley, rye and oats.” It was assumed that oats should be avoided as diligently as wheat should.

Only recently has this advice started to change, but the debate still rages. Wrapped up in the argument over oats are many myths and misunderstandings about this humble, fiber-rich grain.

Let’s get to the bottom of this once and for all…

Oats, also known as avena sativa, are an extremely nutritious cereal grain. The portion of the grain used for food is the seed. The seeds can be rolled into the flat shape most familiar to Americans and used for most oatmeal products. Oats can also be ground into flour, or cut to make steel cut oats. Porridge made from steel cut oats is chewier and has more texture than rolled oats, which produces oatmeal that has a mushy consistency.

Unlike other whole grains, oats are processed in such a way that their nutritious bran and germ are not removed, meaning that processed oats are high in fiber and a variety of other nutrients.

 

Gluten-Free Oats Can Cause Problems for Some Celiacs

 

It is believed that in ancient times oats may have originally derived from the same grains that later became wheat and barley. However, oats do not contain the specific proteins we normally refer to as “gluten.” They could, in their pure form, be referred to as “gluten-free.” However, they do contain a protein called avenin.

Although this protein is safe for the majority of celiacs, some celiacs have avenin-reactive mucosal T-cells which cause an inflammatory reaction when oats are consumed. As with gluten, avenin may cause villous atrophy in this subgroup of celiacs.

 

Are Those Oats Really Gluten-Free?

 

A larger issue with oats exists, which affects all celiacs, even the majority who can digest avenin without any danger.

Oats are generally grown, harvested and processed together with gluten-containing grains such as wheat or barley. The rate of cross-contamination is extremely high.

When a leading brand of mainstream oatmeal was studied, some samples had no detectable gluten and some had shockingly high levels of gluten as a result of cross-contamination. Therefore, mainstream oatmeal should be considered an unsafe food for celiacs.

Fortunately, in the celiac-savvy 21st century, we have a new option: certified gluten-free oats. These oats are grown separately from gluten-containing crops and are harvested and processed with equipment used only for gluten-free grains. The final product is then tested for gluten presence and only sold if it is deemed gluten-free by the certifying agency. There are a number of brands that offer certified gluten-free oats on the market now. Bob’s Red Mill sells certified gluten-free oats, and Bakery on Main has fantastic gluten-free breakfast oatmeal.

 

So Can You Eat Oats or Not?

 

Because of the possibility that some celiacs cannot digest avenin, it is suggested that a doctor or dietitian supervise the reintroduction of oats into a gluten-free diet. You will want to introduce them slowly and watch for any reaction. Be aware, also, that because oats have such drastically higher fiber content than most gluten-free foods, you may experience intestinal discomfort as a result of the increase in fiber intake.

This is another reason to introduce oats slowly, and to increase your water intake when you increase your oat intake. Take it slowly and watch for any unusual reactions over time. Your doctor may even advise you that it is wise to get a celiac biopsy done via endoscopy after you begin ingesting gluten-free oats to figure out if avenin is causing any recurrence of celiac-type damage to your gut.

Next time someone asks you if oats are gluten-free, you may find yourself pausing before you give an answer. You’re not alone. The answer to that question is, in fact, complicated. Yes, oats in their pure form are gluten-free. No, most oats available on the retail market are not reliably gluten-free. Yes, gluten-free oats are available in some stores and by mail order. No, not all celiacs can safely consume them as part of their gluten-free diet.

With the advent of certified gluten-free oats, doctors and dietitians are finally able to offer more nuanced answers to their patients about oats so that people with celiac disease can make their own decision about the inclusion of oats in their gluten-free diet.

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