Pure oats safe in gluten-free diet for coeliac disease children
Pure oats can be safely included in the gluten-free diet (GFD) of children with coeliac disease, concluded researchers at the recent European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) annual meeting held in Athens, Greece.
Coeliac disease requires that afflicted individuals follow a GFD, which excludes proteins from wheat, rye, and barley. However, whether oats should be excluded from the GFD remains controversial.
“The inclusion of oats in the GFD would be beneficial, as they provide a good source of fibres [and] have a higher satiety value than other cereals,” said lead author Dr. Elena Lionetti from the Department of Paediatrics at the University of Catania in Catania, Italy, noting that a low-fibre GFD could induce constipation.
The multicenter, double-blind cross-over study randomized 177 children (median age 8.9 years) with CD who have been on a GFD for ≥2 years to GFD comprising flour, pasta, cakes, biscuits, and crisp toast with either purified oats (group A) or placebo (group B) for 6 months, followed by a 3-month wash-out period with standard GFD before crossing-over to another 6-month diet of group B (treatment AB) or group A (treatment BA), respectively. [ESPGHAN 2016, abstract G-O-006]
Intestinal permeability test (IPT), which was the primary endpoint studied, was not significantly different between treatment AB and BA. Additionally, the upper limit of 95 percent confidence interval of IPT direct treatment effect was found to be lower than the highest difference required for clinical relevance, indicating non-inferiority of GFD containing oats to oats-free GFD.
There was no significant difference found between the two treatment groups for all clinical parameters such as body mass index (BMI) and gastrointestinal symptoms rate scale (GSRS) score.
Serological biomarkers including anti-tissue transglutaminase (tTG), anti-avenin, and anti-deamidated gliadin peptide (DGP) titre were also not significantly different for both groups in both treatment periods.
“CD children can safely add pure oats to their GFD,” said Lionetti. “[Oats also] add texture and flavour to baked goods and could increase compliance with a GFD by providing patients with more alternatives.”
According to Lionetti, although previous studies have supported the safe consumption of oats in a majority of CD patients, these studies were limited by small sample sizes or short follow-up periods.
She said that their study further confirmed that prolonged intake of a considerable amount of daily pure oats could be safely included in the GFD of a large group of CD children.