Oats on a Gluten-free Diet
Oats have always been controversial on a gluten-free diet. Oats themselves do not contain gluten. However, in recent testing conducted by Gluten Free Watchdog, most samples of Purity Protocol oats tested were found to be contaminated with gluten, including amounts over the FDA limit of 20 parts per million.1
Oats can be contaminated in many ways, including growing wheat or other gluten containing grains in the same fields as oats by accident. This can happen when GCG (gluten containing grain) seeds from GCGs that had previously been planted in the same field or neighboring fields grow and get mixed in with oat crops. Another potential contamination is when companies use shared equipment for oats and GCGs, which happens quite often.
There are two main ways oats can be classified as gluten-free: Purity Protocol and optically sorted oats. Purity Protocol oats are generally thought to be safer than optically sorted oats, however even purity oats have shown significant amounts of gluten during testing by Gluten Free Watchdog and other testing. These findings often exceed what the FDA considers safe for those with celiac disease, which is 20 parts per million. Please note that I do not consider any ongoing level of gluten exposure to be safe for most patients with celiac disease.
My philosophy with celiac disease has been that the home environment should be as free from gluten as possible. I strongly recommend people with celiac disease have no gluten containing foods, ingredients, or body products in their homes. I advise those with celiac disease that their homes should be gluten-free sanctuaries. Most people with celiac disease can eat out safely, however when eating at facilities that are non-dedicated gluten-free, they are likely to encounter at least low levels of gluten cross-contamination. In my personal experience treating patients with celiac disease and with my own family members (my wife and daughter have celiac disease), I have found this approach to be reasonable and generally safe. In other words, if the home is a sanctuary completely free from gluten, the person with celiac disease is otherwise healthy, then the small amounts of gluten cross contamination that may be encountered when carefully selecting what to eat in a restaurant are generally well tolerated.
We love to travel and I am in fact writing this while visiting Argentina. Traveling with celiac disease can be a little complicated, but I have found that celiac disease is widely recognized in many countries now. Hotels and restaurants in these countries are familiar with celiac disease and some are quite familiar with gluten cross-contamination. I have found that Argentina is the most gluten-free country I have been to thus far. There are many excellent dedicated gluten-free restaurants, bakeries, and cafes, and almost every restaurant and hotel we have been to in three different cities are very familiar with gluten and gluten cross-contamination. In Argentina, they label gluten-free items as Sin T.A.C.C. (sin trigo, avena, cebada, centeno or in English without wheat, oats, barley, and rye). Notice that they include oats in their gluten-free labeling.
The National Celiac Association and Gluten Free Watchdog have issued warnings about oats in the past, but recently it has become clear that it is very difficult to ensure that even the more stringent Purity Protocol oats are truly uncontaminated by gluten. This is unfortunate as oats are a good source of fiber and contain compounds beneficial to health. In addition, it is quite difficult to determine which GF Oat containing products use which protocol.
In summary, I have advised all my friends, relatives and patients who have celiac disease to completely avoid oats in any form. This is unfortunate, but I believe it is important. Also, please consider a membership to Gluten Free Watchdog. Neither CCFM nor I have any affiliation with them and do not make a referral/affiliate fee. I have just found it to be a fantastic resource.
References
1. Avena Foods. Purity protocol. Avena Foods. https://www.avenafoods.com/commitments/purity-protocol/
