Canadian Celiac Association Professional Advisory Council position statement on consumption of oats by individuals with celiac disease
The safety of oats in individuals with celiac disease has been extensively investigated. Health Canada has reviewed the clinical evidence from numerous international studies and has concluded that the consumption of oats, uncontaminated with gluten from wheat, rye or barley, is safe for the vast majority of patients with celiac disease. A 2014 review entitled Celiac Disease and Gluten-Free Claims on Uncontaminated Oats is available on Health Canada website.
Most commercially available oats in North America are contaminated with gluten-containing grains (wheat, rye, barley). This has been confirmed in various studies including one by Health Canada scientists.
We are fortunate in Canada and the USA that specially-produced pure, uncontaminated oats are available in the marketplace for those with celiac disease. These oats are grown on dedicated fields; and are harvested, stored, transported and processed in dedicated gluten-free facilities. In addition, they are accurately tested for their gluten content to be under 20 ppm.
Health Canada’s Food and Drug Regulations include oats, along with wheat, rye, barley in the list of gluten-containing grains so currently pure, uncontaminated oats cannot be labelled “gluten-free”. To enable pure, uncontaminated oats or foods containing these specialty oats to be labelled “gluten-free”, a Notice of Intent to Issue a Food Marketing Authorization called Proposed Marketing Authorization to allow gluten-free claims for specially produced “gluten-free oats” and products containing such oats under certain condition was issued by theMinister of Health on November 14, 2014.
Health Canada will receive feedback about this Notice of Intent to Issue a Marketing Authorization for oats from consumers, health professionals and other interested persons until January 27, 2015.
The Canadian Celiac Association supports Health Canada’s recommendation to allow a gluten-free claim on specially produced oats.
Also, the Canadian Celiac Association Professional Advisory Board recommends the following guidelines for individuals with celiac disease and other gluten-related disorders who wish to add pure, uncontaminated oats or oat products in their diet:
- The individual should be stabilized on the gluten-free diet and their celiac antibody levels should have normalized. This process may take 6-18 months, although there is considerable variation among individuals.
- The fibre content of an oat containing diet is often higher than the typical gluten-free diet. When adding oats to the diet, individuals may experience a change in stool pattern or mild gastrointestinal symptoms, including abdominal bloating and gas. These symptoms should resolve within a few days. Therefore, it is advised to start with a small amount of oats per day [adults 25-70 grams (1/4-3/4 cup dry rolled oats) and children 10-25 grams (1/8-1/4 cup)] and gradually increase as tolerated.
- There are case reports of individuals with celiac disease relapsing from the consumption of pure uncontaminated oats. Individuals should be aware of this possibility. If symptoms occur and/or persist, they should discontinue consuming oats.
- If a reaction to oats has occurred, it is worthwhile to do a re-challenge if the individual wants to try oats again. Development of symptoms at the time of the second challenge would strongly suggest intolerance to oats. Research suggests that intolerance to oats occurs but is quite rare. The mechanism for this intolerance is unknown at this time.
- A consultation with a dietitian who can carefully review the diet to ensure that the individual is not consuming foods that contain gluten is highly recommended.
- The safety of oats in non-celiac gluten sensitivity has not been studied. The Canadian Celiac Association will continue to monitor the scientific developments in the area of oats in celiac disease and other gluten-related disorders and will keep its members updated.
Professional Advisory Council
Canadian Celiac Association
January 12, 2015