A Comparison of Diets with and without Oats in Adults with Celiac Disease

Abstract

Wheat, rye, and barley damage the small-intestinal mucosa of patients with celiac disease; maize and rice are harmless. The effects of a diet containing oats are uncertain. In a randomized trial, we compared the effects of gluten-free diets without oats and with oats (with a goal of 50 to 70 g per day from three sources: two types of wheat-starch flour mixed with an equal amount of oats, muesli containing 60 percent oats, and rolled-oat breakfast cereal). Fifty-two adults with celiac disease in remission were followed for 6 months and 40 with newly diagnosed disease for 12 months. Endoscopy with duodenal biopsy was performed at the beginning and end of the study. The mean (±SD) oat intake in the oat group was 49.9±14.7 g per day at 6 months for patients in remission and 46.6±13.3 g per day at 12 months for patients with newly diagnosed disease. The oat and control groups did not differ significantly in nutritional status, symptoms, or laboratory measures. Patients in remission, regardless of diet, did not have worsening architecture of the duodenal villi or increased mononuclear-cell infiltration. All the patients with new diagnoses were in remission at one year, except for one in the control group. Six patients in the oat group and five in the control group withdrew from the study. Moderate amounts of oats can be included in a gluten-free diet for most adult patients with celiac disease without adverse effects. © 1995, Massachusetts Medical Society. All rights reserved.