Oats continue to be a confusing and controversial topic in gluten-free land, and social media feeds and Facebook “support” groups are loaded with misinformation and fear-mongering.
In this post, I hope to help you understand who can and can’t eat gluten-free oats and how many people actually have an oat intolerance or experience cross-reactivity to oats.
Disclaimer: I’m not a doctor or dietician; consult a trusted health professional to determine if you can safely consume oats.
Why Are Oats Controversial?
I’ve written about oats in numerous posts, encouraging you to become educated about the controversial grain but not fearful of it.
Please read “Are Oats Gluten-Free? Unpacking Confusing and Contradictory Information and Does an Ingredient Label Have to Say “Gluten-Free Oats” to Be Considered Celiac-Safe? to increase your general knowledge of oats and why they’re controversial.
Here’s a brief overview of the state of oats in the gluten-free community:
Oats are naturally gluten-free. Unlike wheat, rye, and barley, they do not contain gluten protein. However, most oats in the US are grown on shared wheat fields. This means much of the oat supply is cross-contaminated with wheat.
Manufacturers will optically or mechanically sort oats and then wash them to remove gluten dust. This is an effective way to rid oat grains of any gluten remnants.
There are also oats grown on dedicated oat fields. These are called “purity protocol” oats. They are generally safer to consume; however, purity oats are in short supply and more expensive and still need to undergo rigorous testing to ensure they’re celiac-safe.
If a product is labeled “gluten-free” and contains oats, the manufacturer is telling you that it tested its product and it meets the FDA’s gluten-free labeling guidelines. If a product contains oats but does not include a gluten-free claim somewhere on the packaging, the product is NOT gluten-free.
If a product with oats is labeled “certified gluten-free,” a third party or external auditor has verified the product to ensure the company meets the FDA’s regulatory guidelines.
Meghan Donnelly, a registered dietician, said in a presentation about the safety of oats published on the National Celiac Association website, that the gluten-free certification industry is a “big business” and a “wonderful service.”
However, she adds, “There is no difference, from a regulatory perspective, [that] all of these products need to meet the FDA’s standards for gluten-free, whether they have a logo from a third party or just list the words gluten-free.” (See below video starting at 37:54) In other words, oats do not need a third-party certified gluten-free label; they just need to meet the FDA’s regulatory guidelines.
If you’re concerned about oats in your favorite product(s), I encourage you to check the manufacturer’s website (the FAQ section is always helpful) or email the manufacturer to find the source of their oats and determine if their testing protocols meet your standards. These extra steps can help you make an educated choice that works for you.
Why Do So Many Gluten-Free Products Contain Oats?
Oats are delicious. They help gluten-free baked goods taste better and mimic the missing gluten. My bread turns out softer and doughier when I bake with oat flour. Oat flour is an essential ingredient in many gluten-free baked goods, especially if you want your baked goods to taste good.
Oats are also nutritious. They contain more protein than other gluten-free grains and add soluble fiber to your diet, which can aid in symptoms related to celiac disease and gluten intolerance, such as constipation. The gluten-free diet notoriously lacks fiber, so oats end up being a good (and sometimes primary) source of fiber and micronutrients.
How Many People Have an Oat Intolerance?
Whenever I post about a product with oats on Instagram, several people comment that they can’t eat oats. Is an oat intolerance common among people with celiac?
According to information published on the Celiac Disease Foundation website, most people with celiac disease can tolerate moderate amounts of gluten-free oats without triggering any adverse symptoms.
While the protein in oats (avenin) is similar in structure to the gluten protein, research doesn’t support that the protein causes any autoimmune reaction or intestinal damage in people with celiac disease.
In fact, in a systematic review and meta-analysis of over 400 studies, researchers found “no evidence that the addition of oats to a gluten-free diet affects symptoms, histology, immunity, or serologic features of patients with celiac disease.”
Celiac Canada also issued a statement about oats that says, “The safety of oats in individuals with celiac disease has been extensively investigated. Health Canada has reviewed the clinical evidence from numerous international studies. The Association 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.” (Please note that this statement is “sponsored by” Only Oats, a brand name of purity protocol oats in Canada.)
But Some People React to Oats
Some people react to oats, but again, it’s a small percentage of people, not the “majority of celiacs,” as the comment section of my Instagram posts would have you believe.
A study reported by Beyond Celiac investigated this phenomenon. Researchers examined how 30 celiac disease patients, many of whom were already experiencing symptoms after consuming uncontaminated oats, responded to oats.
The subjects were given increasing doses of avenin (the protein found in oats), and then researchers assessed their symptoms and level of IL-2. (IL-2 indicates the activation of T-cells in the body, which offer the first line of defense in fighting diseases.)
They found IL-2 elevation in 40 percent of the participants, and 60 percent experienced pain, diarrhea, and vomiting.
It’s important to note that these results are not representative of the general celiac disease population since a large portion of the participants were chosen due to their sensitivity to oats. If the study participants were more representative of the celiac disease population, researchers suspect the numbers would be much lower.
However, this study can feel validating to someone who has an oat intolerance, and I wanted to share that it is possible, just not common.
The silver lining is that while the participants adversely reacted to the oat protein, researchers found that after six weeks, all the participants still had normal intestinal biopsies.
But Some Oats are Contaminated!
Some oats may be contaminated with gluten, leading many people to question the safety of the oat supply chain.
These fears were heightened in September 2022 when The Gluten Free Watchdog found detectable levels of gluten in purity protocol oats, or oats grown on dedicated oat fields, from GF Harvest and Trader Joe’s.
Ironically, some vocal people in the celiac community insist you should only consume purity oats because they are safe, but the truth is, there are no sacred oats. The Gluten Free Watchdog debunked that myth in seconds with her shocking findings.
Gluten found in oats, especially purity oats, is rare but can happen. All oats, even purity protocol oats, must be tested to ensure they meet the FDA’s gluten-free labeling guidelines and contain less than 20 ppm of gluten.
I encourage you to read The Gluten-Free Watchdog Takes Extreme Stance Against Gluten-Free Oats and consider how to respond to such extreme recommendations.
Oats Still Make Me Feel Sick!
You may be one of the few who cannot tolerate gluten-free oats.
If oats continue to bother you, talk to your doctor or dietician. They can help you implement an elimination diet that tests your tolerance of oats and help you determine if they should be avoided. They can also help you determine what replacements you can make to ensure you get adequate fiber and micronutrients commonly missing in people avoiding gluten.
Also, keep in mind that, for people sensitive to high-fiber foods, oats may cause gastric discomfort. You may need to work towards building a tolerance for them by eating small doses over time.
You may also need to carefully scrutinize food labels. You may be eating products that contain oats that aren’t labeled “gluten-free.”
Finally, if you experience swelling of the lips, face, tongue, or throat, have difficulty breathing, or break into hives when you eat oats, you may have an oat allergy. Oat allergies are extremely rare but possible. An allergy is different than a sensitivity and the two should not be conflated.
Eating Oats Can Build Tolerance
I want to leave you with some interesting findings from researchers in Australia. In 2022, they found that the protein in oats, avenin, “didn’t lead to any harmful effects, and no patients showed damage in their intestinal tissue.”
The researchers also suggested that patients who experience symptoms when eating gluten-free oats could eventually develop a tolerance to them with sustained intake.
In other words, eating a small amount of oats daily may help you build your tolerance so you don’t adversely react to them. Wow!
I encourage you to read the research, watch the following video, and talk with your doctor or dietician.
Where Do You Stand?
An oat intolerance is a rare phenomenon affecting a small number of people with celiac disease and gluten intolerance. The exact number of people affected is unknown.
Most people with gluten disorders can safely enjoy oats, but only when the product containing oats is labeled “gluten-free.” Some still cannot tolerate oats.
The bottom line: Listen to your body, eat what feels good to you, and avoid foods that make you sick. Just be sure to assess any food intolerances with a proper elimination diet prescribed by your doctor or dietician. You don’t want to unnecessarily restrict yourself from your favorite foods based on misinformation you found on social media,
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