We advise those with celiac disease to consider adding oats to their diet. Oats are gluten free; they add satiety, nutrient value, fiber and diversity to the gluten-free diet. Multiple studies show that the majority of patients with celiac disease tolerate oats. These studies are from Europe as well as the United States. The study from the United States examined the effect of adding commercially available oats to the gluten-free diet in children who had recently been diagnosed with celiac disease. Over a six month period, those consuming oats did just as well as those who did not.

Oats are a source of fiber. Increasing fiber in the diet has many benefits from lowering cholesterol, helping maintain regular bowel function to added satiety.  However, in adding fiber to the diet it is important to add the fiber slowly.  Increasing the fiber content of the diet all at once can lead to bloating, increased flatulence and abdominal cramps. These side effects can be avoided by adding the fiber (oats) gradually, giving the body a chance to adjust.  A reasonable approach is to start by using a 1/4 portion of oats for a few days then increase to 1/2 then to a full portion. 

There is a potential problem with contamination from other grains. Oats are often grown on the same fields or milled in mills that grow or mill other grains. Therefore although the oat itself may be safe it may have gotten contaminated in the processing.  We recommend using oats from a facility that processes only oats and no other grains. We recommend McCann's's Irish Oats. The company states that their product is produced in factories dedicated to oats. They recognize that some of the batches have shown contamination with gluten. The company is closing down the one factory from which those batches came.

Another issue is that patients may have a sensitivity to the protein portion of oats and develop intestinal inflammation and villous atrophy. This is very rare.  

We recommend the use of oats only after you have stabilized on the gluten-free diet. This would typically involve blood tests for celiac antibodies becoming negative, and may involve a follow-up biopsy. While on the diet, patients should be monitored with celiac serologic-blood tests. If symptoms occur one should be appropriately assessed to determine if the problem is due to the added fiber or a reaction to the protein in oats and aggravation of celiac disease.

If you have any questions, please contact Hal Winfield at 212-342-0251 or email: celiac@columbia.edu.