Oats can’t be called Gluten Free in Australia

Oats can’t be called Gluten Free in Australia

 

It is debated that about 5-8% of people with coeliac disease react to oats1,2. Currently there is no way to predict those people with coeliac disease who will be able to successfully consume oats, therefore oats are not termed gluten free in Australia, nor are they routinely included in a gluten free diet in Australia.

The chemistry of gluten is complex and varies between each of the grains. Gluten is made up of two protein sub-types. One is called a prolamin and the other a glutelin. The chemistry of each of these subtypes vary. Oats are NOT gluten-free, but they are gliadin free: -the part of the wheat gluten molecule that is mostly responsible for activating the disease process in coeliac disease. The prolamin portion of the oat gluten which triggers disease is called AVENIN3,4. Oats are tolerated by the majority because they contain very small amounts of avenin, compared with the proportion of gliadin in wheat. Avenin also has a very different chemical structure to wheat gluten, so it is clumsy at activating small bowel damage. Most people with coeliac disease do not experience symptoms or mucosal damage from limited uncontaminated oats, or as they say overseas, gluten free oat consumption.

 

To date research studies suggest that adults with coeliac disease can consume up to 50-70g pure oats per day and children 25g pure oats per day5,6. Europe, Canada and the United States routinely allow pure oats to be eaten by people with coeliac disease as a part of their gluten free diet. They don’t seem to monitor the quantity eaten.

 

What are gluten free oats?

 

The terms allowed to be used in Australia to describe these are wheat free, uncontaminated or pure oats. Instead of this mouthful of choices, let’s continue with the term uncontaminated. Generally regular oats are grown with barley or wheat as the off-season grain, which leads to contamination of the fields, reaping equipment and storage areas, with gluten containing grains.

Uncontaminated oats are specially produced so that they are grown from pure oat seed, on land that has not grown wheat, rye or barley for at least 2 years, and the crop the farmer grows in the off season must be gluten free. This ensures that at harvest and storage, gluten containing grains do not mix with the oats. Samples of the oats are then tested to ensure there is no contamination of wheat, rye or barley grains within those oats. Only oats produced in this way are considered suitable for those with coeliac disease.

Australia no longer grows uncontaminated oats. Carmans and Uncle Toby’s oats are not uncontaminated. Uncontaminated oats can be obtained from a Queensland Company called GK Gluten Free Foods. They import uncontaminated oats from the USA, retest them, then rebrand and sell them as Gloriously Free Uncontaminated Oats. Overseas companies such as Bob’s Red Mill gluten free oats (USA), Chateau Cream Hill gluten free oats (Canada) & Rude Health gluten free oats (UK) can be purchased online. Currently, unlike Australia, these countries are allowed to certify their oats to be called gluten free. However, to sell these oats in Australia, Bob’s Red Mill Oats cannot use the term gluten free on their product, so when their product is sold here it has been re-labelled as ‘contaminant free oats’.  They will most likely be called gluten free if purchased on-line and brought over individually.

 

Why are oats called gluten free overseas if they contain avenin?

 

At the testing level. The R5 Eliza test that detects gluten, can only detect the chemical structure of the gluten in wheat, rye and barley7. The chemical structure of oat avenin is too different to be detected by this test. When these overseas companies’ say their oats are gluten free they mean that this test did not detect any contamination of wheat, rye or barley grains amongst the oats…and so really they should claim them to be free of contamination, however their governing bodies allow these oats to be called gluten free.

 

Another trap in purchasing these products is that some Companies do not understand the subtlety of PURE vs ORGANIC. Organic oats have not been grown with pesticides, but this in no way ensures they have been grown and harvested in an environment free from the contamination of wheat, rye, barley or triticale grains. So if oats are only certified to be organic, they are not suitable for those with coeliac disease. Be aware that some overseas companies using certified organic oats are calling their products gluten free. There are products overseas that do use certified organic gluten free oats, fulfilling the gluten free declaration of oats in those countries. If you are eating them, it’s imperative that you can correctly interpret the food label.

 

Monitoring Oats in the diet:

 

Because most people with coeliac disease can tolerate oats:- overseas, oats are included in a gluten free diet for the majority and are removed only if an individual is not tolerating them. In Australia tolerance to oats can be ascertained, but it requires short and long-term small bowel biopsy evidence of tolerance.

 

People who do not have many symptoms with their coeliac disease are more likely to not get symptoms if they ate oats. However symptomatic tolerance does not mean that the oats are not damaging the small intestine.  The usual antibody bloods tests cannot monitor how the body is tolerating the oats. ONLY a small bowel biopsy can do this. Trialing uncontaminated oats means your Gastroenterologist must be informed and on board with this decision. It is generally recommended that good health and biopsy markers be restored before commencing a trial with oats.  This country has no official guidelines for monitoring oats beyond the need to biopsy. A review paper on oats suggests that short and long term follow-up is required8, so perhaps biopsies at 3 months and 12 months are good time points to determine tolerance.

 

Research on oats:

Research in 20111 suggested that different varieties, or cultivars of oats, either stimulate or do not stimulate the disease process in the small intestine. As time goes on we may be able to identify specific varieties of oats which are safe to consume by everyone with coeliac disease. Until then, the inclusion of uncontaminated oats in the gluten free diet is not routine in Australia and remains controversial. 

 

References:

 

  1. Comino I, et al. Diversity in oat potential immunogenicity: basis for the selection of oat varieties with no toxicity in coeliac disease. Gut. 2011 Jul;60(7):915-22.
  2. Hardy MY, et al. Ingestion of oats and barley in patients with celiac disease mobilizes cross-reactive T cells activated by avenin peptides and immuno-dominant hordein peptides. Journal of autoimmunity. 2015 Jan;56:56-65.
  3. Ellis HJ, Ciclitira PJ. Should coeliac sufferers be allowed their oats? European journal of gastroenterology & hepatology. 2008 Jun;20(6):492-3.
  4. Arentz-Hansen H, et al. The molecular basis for oat intolerance in patients with celiac disease. PLoS medicine. 2004 Oct;1(1):e1.
  5. Janatuinen EK, et al. No harm from five year ingestion of oats in coeliac disease. Gut, 2002;50:332-335.
  6. M Rashid, et al. Consumption of pure oats by individuals with celiac disease: A position statement by the Canadian Celiac Association. Can J Gastroenterol 2007;21(10):649-651.
  7. Haraszi R, et al. Analytical methods for detection of gluten in food–method developments in support of food labeling legislation. Journal of AOAC International. 2011 Jul-Aug;94(4):1006-25.
  8. Pulido OM, et al. Introduction of oats in the diet of individuals with celiac disease: a systematic review. Advances in food and nutrition research. 2009;57:235-85.