For many years, oats have been the subject of much controversy in the community of celiac disease sufferers. The majority of celiacs know from bitter experience or doctor's orders that they cannot eat them. (Raise your hand if you learned this the hard way, and yes, my hand is up). But there are always a few people who swear that they have eaten oatmeal without repercussions.
So what's the story?
As anthropod notes, oat flour does not contain gluten, so theoretically oats should be safe for celiacs to eat. Numerous studies have borne this out - in fact, at least one study concluded that a regular diet of uncontaminated oats can actually help the damaged villi in a celiac sufferer's intestine. And yet, when you are first diagnosed with celiac disease, one of the first things you are told is to never eat anything made from the killer quartet of wheat, barley, rye, and oats. There are two main reasons for this.
First, the faces of celiac disease are legion, and no two celiacs display the same symptoms or sensitivity levels. There is no such thing as a standard celiac reaction. Oats do contain proteins that are very similar to gluten, and some celiacs have been found to be sensitive to them. Furthermore, undiagnosed CD can lead to a wide variety of problems that require highly restricted diets. For many celiacs, gluten intolerance is only the tip of the iceberg. If you think not being able to eat wheat, barley, rye and oats is bad, try throwing in lactose intolerance and a corn or soy allergy.
The second reason is more insidious. You'll notice that way up in Paragraph 3 I used the phrase "regular diet of uncontaminated oats". Unfortunately, uncontaminated oats are nearly impossible to find.
According to Trevor Pizzey, Executive Vice President - Operations for Can-Oat Milling,
"Cross contamination of grains in North America is almost a given.... There are a number of points of contamination during the production and manufacturing processes." (Pizzey points out that oats are commonly grown on fields that previously grew wheat, barley or rye, and "volunteer grain" from those crops often sneaks into the oats. The oats are then moved to grain handling facilities that store multiple grains.) "Usually the systems are not cleaned out between receipts or shipments, so residues of one grain are often in equipment when the next batch of grain passes through, resulting in contamination.... Oat flour is more likely to be contaminated with wheat and barley than are oat flakes, although most oat flakes do have a trace of wheat and barley present in them as well."1
I know, small organic farms are the answer to everything, right? Well, dealing with small growers is always good, but our Mr. Pizzey has bad news for those who think organic is the answer:
"We have previously been a certified organic oat processing facility, and have dealt with significant volumes of organic oats. In general terms, we saw both wheat and barley levels to be higher in organic oats than in conventional products."1
(On a side note, I have to point out that, much as I admire the organic ideal, organic has become a marketing buzzword that promises everything and means nothing. If you don't believe me, go down to your local Whole Foods HyperGigaSuperMarket and look at all the certified organic, zero-benefit junk food they stock. And now back to our regularly scheduled programming.)
If there was any doubt left regarding oat contamination, the NEJM recently published the results of a study in which ELISA tests were conducted on oats from three major brands (Quaker, Country Choice and McCann's) and found wheat contamination at levels that could be unsafe for celiacs in all of them. The levels varied from container to container, and some containers would have been safe for consumption. But there was no one brand that was completely uncontaminated.2
The consensus in the celiac community is oats are theoretically safe for most celiacs, but the oatmeal in the stores is almost guaranteed to make you sick. So if you have CD and want oats you have three choices: contact small, individual producers and grill them about their milling process and decontamination procedures, grow your own oats, or get used to grits for breakfast. Me, I like the grits, but I still miss oatmeal cookies.
1: Pizzey, Trevor. Correspondence with www.celiac.com (October 30, 1998 and November 2, 1998)
2: Thompson T. NEJM. 2004;351:2021-2022 (Nov. 4, 2004, Number 19)
quoted on celiac.com:
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