Coeliac & Oats: Clarifying the Confusion
When it comes to coeliac disease and the gluten free diet, this is the most frequently asked question I get. How can I eat oats when I am a coeliac or how does one find out if they can? I figured now was the perfect time to answer this question as we near the end of Coeliac Awareness Week for 2018. For those who are confused, you are not alone - it is confusing. Keep reading.
What is Gluten?
Gluten is the protein component of wheat, rye, barley and oats. The 'gluten' protein in oats is a slightly different protein to that found in wheat, rye and barely. Oats will never be truely 'gluten free' even if labelled as so from other countries as they do contain a gluten protein.
Oats or any product containing oats are not labelled as gluten free ever, it would be illegal for a company to do this.
People diagnosed with Coeliac Disease are informed to not eat oats or any products containing oats at all.
However, because the gluten protein differs slightly in oats it has been found that only 1 in 5 people with Coeliac Disease react to oats in the way they do wheat, rye and barely (causing intestinal damage). This means 4 out of 5 people with Coeliac Disease can generally tolerate pure, uncontaminated oats.
The problem comes when deciphering those who react from those who don't. There is no simple test, no blood test to tell us and while we think we would know based on our apparent or lack of symptoms, there can still be intestinal damage occurring without symptoms.
Because of this difficulty in knowing who may react and who won't the Australian Food Regulators have said a total ZERO to oats in a gluten free diet. In comparison the UK and USA have said pure, uncontaminated oats are gluten free and disregard that 1 in 5 who is going to experience intestinal damage. So that is why you may find 'gluten free oats' overseas or online. They are just letting that 1 in 5 suffer.
How did I find out that I can tolerate oats and how can you do the same?
To find out if you can tolerate pure, uncontaminated oats (aka if you are one of the 4 out of 5) you need to go through a testing phase. This is not as simple as it sounds.
Firstly, you will need to have a healthy small intestine biopsy to confirm that any damage you had prior to being diagnosed as a coeliac has resolved from your strict gluten free diet you should have been following. For most people this can take up to 12 months of following a strict gluten free diet.
Once you have a healthy biopsy you can now start the challenge. Introduce pure, uncontaminated oats into your diet. It is recommended that you have about 50g per day for at least 8 weeks. At the end of the 8 weeks you will need to head back to your gastroenterologist for a follow up small bowel biopsy (yes you need to go into hospital twice to do this process!)
If your second biopsy comes back healthy and clear - you are free to eat pure, uncontaminated oats! Yay! If not, sorry you are the unlucky 1 in 5. Stop eating oats immediately.
Unfortunately this is the ONLY way to know if you are the 1 in 5 who reacts. Scientists out there I'd love it if you could develop a simple test to see if there is any bowel damage from avenin (the gluten protein in oats).
Remember just because you don't experience gut symptoms doesn't mean you aren't doing damage. You need to follow up and check!
What does pure and uncontaminated mean?
Most oats, especially Australian oats, are grown on farms that also rotate crops with other gluten containing grains like wheat or barley. Oats are also usually processed in factories that are heavily contaminated by other gluten containing grains. Most of the machinery is also used for processing and packaging these gluten containing grains. Because of the small amount of gluten required to trigger intestinal damage in a coeliac, any oats that have been produced on a farm or in a facility like this will not be suitable for any coeliac, not even the 4 out of 5 that can tolerate oats.
Pure, uncontaminated oats on the other hand are sometimes labelled as 'wheat free' because they have been produced on farms that don't rotate crops with other gluten containing grains and have independent gluten free facilities for processing and packaging. Making them suitable for those 4 out of 5 coeliacs who can tolerate pure uncontaminated oats.
Unfortunately pure, uncontaminated oats are bloody difficult to find in Australia and even more expensive. In the USA and EU you will have a lot more success as their rules differ. Note: I always bring back a few kilos every time I make the trip over.
I've included a few links below where I have purchased my oats in the past, these aren't affiliated in any way just want you guys to have some options.
MyProtein - online store
Bobs Red Mill Wheat-Free Oats - I've found these at IGA stores or health food stores
Gloriously Free Oats - Found in health food stores or can purchase online.
Gluten Intolerant Vs Coeliac Disease:
If you are gluten intolerant and not coeliac most oats will be fine. The small amount that may be found in the oats on the Australian market is not likely to be significant enough to trigger a reaction. Eat whatever brand oats you like (I'm jealous - you can buy cheap oats!)
I hope that answers a few questions for you all. If you are a newly diagnosed Coeliac and struggling to find your feet please book in for a consultation with me and we can go over everything you need to know about a gluten free diet. More details here.
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