Level 2

This oat section is under revision. For the updated Celiac Center at Beth Israel Deaconess Medical Center Statement on Oats (May 2016), see Following a Gluten-Free Diet (pgs 11-14) under Celiac Center Patient Educational Materials.

KEY POINTS:

• Oats are considered a naturally gluten-free grain.
• In most cases specially produced oats that are labeled gluten-free may be included in a gluten-free diet.
• Producers of specially grown and processed labeled gluten-free oats include:
  • Avena Foods
  • GF Harvest
  • It is clear from evidence that up to 1/2 cup of uncooked, rolled gluten-free oats per day does not cause intestinal damage in most people with celiac disease.
  • You should limit your intake of gluten-free oats to about 1/2 cup of uncooked rolled oats or 1/4 cup of uncooked steel cut oats (~50 grams) a day. ^1,2
  • However, if you are tolerating gluten-free oats well you may be able to discuss eating more than 1/2 cup per day under the supervision of your doctor.
• Oats contain a lot of fiber. Add them to your diet gradually and drink plenty of water to help move the fiber through your digestive system.
• A small number of people with celiac disease cannot eat oats.³ They may have an immune reaction to the protein in oats. It is unclear at this time what causes this reaction.
• Before adding oats to your diet, make sure to get the okay from your doctor or dietitian. ¹
• If you experience any new symptoms after adding oats to your diet, stop eating them and call your doctor.
• You should also consider having your celiac blood tests rechecked a few months after adding back gluten-free oats.

ASK YOURSELF:

If you buy oats or products that contain oats, do you make sure the oats are specially produced labeled gluten-free?

1. Yes. Each time I purchase a product with oats I read the label carefully to see that the oats themselves are also labeled gluten-free.
2. No. I just check the front label for the words "gluten-free."

If you answered "No," please remember that manufacturers can use oats that have been contaminated with gluten. To be safe, look for products that are labeled gluten-free AND have made a point to also label their oat ingredients as gluten-free.

TAKE HOME MESSAGES:

• Most people with celiac disease can eat specially produced labeled gluten-free oats.
• A small minority of people with celiac disease may have an immune reaction to oats.
• If you experience any new symptoms after adding oats to your diet, stop eating them and call your doctor. 
  
  CLICK HERE for BIDMC Celiac Center's position on oats in the gluten-free diet.

RESOURCES FOR YOU:

Thompson T. Oats and Wheat Starch. In Real Life with Celiac Disease: Troubleshooting and Thriving Gluten-Free . Eds. Dennis M, Leffler D. AGA Press. Bethesda, MD. 2010.

Thompson T. The Gluten-Free Nutrition Guide. McGraw-Hill. New York, NY, 2008.

References:

1. Celiac Disease Toolkit. American Dietetic Association. Chicago, IL, 2011.
2. Janatuinen EK, et al. A comparison of diets with and without oats in adults with celiac disease. N Engl J Med. 1995;333:1033-1037.
3. Arentz-Hansen H, Fleckenstein B, Milberg O, et al. The molecular basis for oat intolerance in patients with celiac disease. PLoS Med. 2004;1(1):e1.

Revision Date: 8-29-12 
Author: Tricia Thompson, MS, RD 
Editors: Melinda Dennis, MS, RD, LDN and Daniel Leffler, MD, MS

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