Melbourne researchers have identified why some people with celiac disease show an immune response after eating oats.
The researchers have identified the key components in oats that trigger an immune response in some people with celiac disease. The findings may lead to better tests for oat toxicity, and have implications for new treatments being developed for celiac disease.
As many as one in 60 women and one in 80 men in Australia have celiac disease, an autoimmune condition caused by consuming gluten, a protein found in wheat, rye and barley. The abnormal immune response to gluten damages the small intestine and is associated with gastrointestinal symptoms including vomiting and diarrhea, lethargy, and an increased risk of osteoporosis and cancer. People with celiac disease must adhere to a lifelong gluten free diet that excludes wheat, barley and rye.
The question of whether oats are toxic for people with celiac disease is controversial, but because oats contain proteins, called avenins, that are similar to gluten, oats are excluded from the gluten-free diet in Australia.
Researchers from the Walter and Eliza Hall Institute, Monash University and US biotechnology company ImmusanT, led the 10-year study, published this month in the Journal of Autoimmunity. They revealed that oat consumption triggered an immune response in eight per cent of the 73 participants with celiac disease.
Walter and Eliza Hall Institute researcher Dr Melinda Hardy said the research was the first of its kind to comprehensively profile immune responses to oats in people with celiac disease. “The significance of previous studies performed in test tubes was unclear,” she said. “By studying people with celiac disease who had eaten oats, we were able to undertake a detailed profile of the resultant immune response in their blood stream. Our study was able to establish the parts of oat avenins that cause an immune response in people with celiac disease.”
Dr Jason Tye-Din, head of celiac research at the Walter and Eliza Hall Institute and a gastroenterologist at The Royal Melbourne Hospital, said the study showed oats were well tolerated by most people with celiac disease, but in a proportion of people with celiac disease oat consumption could trigger immune responses similar to those caused by eating barley.
“This study provides specific detail on the parts of oats stimulating immune responses, and highlights the relevance of grains other than wheat in celiac disease,” Dr Tye-Din said. “This is a vital piece of the puzzle that informs the development of targeted tests for oat toxicity and the design of new treatments for people with celiac disease.”
President of celiac Australia, Mr Tom McLeod, said the good health of people with celiac disease depended on strict removal of dietary gluten. “celiac disease is not a dietary fad, but a serious health condition,” he said. “This study adds to our understanding of oats in celiac disease, and sets the scene for definitive evaluation on what can be safely consumed by people with celiac disease.”
Cutting out gluten from your diet may seem like a difficult and limiting task. Fortunately, there are many healthy and delicious foods that are naturally gluten-free! In fact, the most cost-effective and healthy way to follow the gluten-free diet is to seek out these naturally gluten-free food groups, which include:
- Fruits
- Vegetables
- Meat and poultry
- Fish and seafood
- Dairy
- Beans, legumes, and nuts
While grains that contain gluten are out, there are many naturally gluten-free grains that you can enjoy in a variety of creative ways. Many of these grains can be found in your local grocery store, but some of the lesser-known grains may only be found in specialty or health food stores. It is not recommended to purchase grains from bulk bins because of the possibility for cross-contact with gluten. The following grains and other starch-containing foods are naturally gluten-free:
- rice
- cassava
- corn (maize)
- soy
- potato
- tapioca
- beans
- sorghum
- quinoa
- millet
- buckwheat groats (also known as kasha)
- arrowroot
- amaranth
- teff
- flax
- chia
- yucca
- gluten-free oats
- nut flours
There has been some research that certain naturally gluten-free grains may contain gluten from cross-contact with gluten-containing grains through harvesting and processing. If you are concerned about the safety of a grain, purchase only versions that are tested for the presence of gluten and contain less than 20 ppm.
Gluten-Free Substitutes
Many items that usually contain gluten have gluten-free alternatives that are widely available in most grocery stores, and make living gluten-free much easier. Keep in mind, however, that minimally processed fresh foods are a crucial part of a healthy gluten-free diet. It is very important to base your diet around fruits, vegetables, meats, and other healthy food groups listed above.
Many commercially available products are labeled “gluten-free,” but there will be some that are not; this is why proper label reading is important. It is also important to remember that “wheat-free” does not necessarily mean “gluten-free.” Be wary, as many products may appear to be gluten-free, but are not.
As a rule, traditional wheat products such as pastas, breads, crackers, and other baked goods are not gluten-free. However, there are many gluten-free options available that use alternative flours and grains. Health food stores have a wide variety of options, but commercial grocery stores are also beginning to carry a sizeable number of gluten-free products. Often, gluten-free bread can be found in the freezer section. Additionally, there are gluten-free flours and flour blends available, allowing you to bake your own bread.
Cereals
Many cereals contain gluten or wheat-based ingredients, but there are some that do not. Be on the lookout for the “gluten-free” label, but also realize that not all gluten-free cereals will advertise as such, so it is important to check the list of ingredients. Something to watch out for: cornflakes and puffed rice cereal may contain malt flavoring or extract, which contains gluten!
Oats
Oats are often harvested and processed with the same equipment that is used for wheat, and are therefore easily contaminated. Research indicates that pure, uncontaminated oats consumed in moderation (up to ½ cup dry rolled oats daily) are tolerated by most people with celiac disease. Look for oats specifically labeled gluten-free in all products containing oats, including granolas and granola bars.
Soups and Sauces
Soups and sauces are one of the biggest sources of hidden gluten, as many companies use wheat as a thickener. It is always a good idea to read the label of any pre-prepared or canned soups and sauces, paying special attention to those that are cream-based.
Produce
Fresh and frozen fruits and vegetables are naturally gluten-free. However, it is important to read labels on any processed fruits and veggies, as well as dried fruit and pre-prepared smoothies. Additionally, packaged frozen potatoes are not always gluten-free, and labels should be read carefully when considering these products.
Beverages
Most beverages are gluten-free, including juices, sodas, and sports drinks. Alcoholic beverages, including wines and hard liquor/distilled liquors/hard ciders are also gluten-free. However, beers, ales, lagers, malt beverages and malt vinegars that are made from gluten-containing grains are not distilled and therefore are not gluten-free. There are several brands of gluten-free beers available in the United States and abroad.