Introduction of oats in the diet of individuals with celiac disease: a systematic review

Adv Food Nutr Res. 2009;57:235-85. doi: 10.1016/S1043-4526(09)57006-4.


Celiac disease is an immune-mediated disease, triggered in genetically susceptible individuals by ingested gluten from wheat, rye, barley, and other closely related cereal grains. The only treatment for celiac disease is a strict gluten-free diet for life. This paper presents a systematic review of the scientific literature on the safety of pure oats for individuals with celiac disease, which historically has been subject to debate. Limitations identified within the scientific database include: limited data on long-term consumption, limited numbers of participants in challenge studies, and limited reporting about the reasons for withdrawals from study protocols. Furthermore, some evidence suggests that a small number of individuals with celiac disease may be intolerant to pure oats and some evidence from in vitro studies suggests that an immunological response to oat avenins can occur in the absence of clinical manifestations of celiac disease as well as suggesting that oat cultivars vary in toxicity. Based on the majority of the evidence provided in the scientific database, and despite the limitations, Health Canada and the Canadian Celiac Association (CCA) concluded that the majority of people with celiac disease can tolerate moderate amounts of pure oats. The incorporation of oats into a gluten-free diet provides high fiber and vitamin B content, increased palatability, and beneficial effects on cardiovascular health. However, it is recommended that individuals with celiac disease should have both initial and long-term assessments by a health professional when introducing pure oats into a gluten-free diet.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Avena / adverse effects*
  • Avena / chemistry
  • Avena / immunology
  • Celiac Disease / diet therapy*
  • Celiac Disease / immunology*
  • Child
  • Clinical Trials as Topic
  • Dermatitis Herpetiformis / diet therapy
  • Dermatitis Herpetiformis / immunology
  • Diet, Gluten-Free*
  • Functional Food / adverse effects
  • Glutens / toxicity
  • Humans
  • Nutritive Value
  • Prolamins / administration & dosage
  • Prolamins / adverse effects
  • Prolamins / chemistry
  • Prolamins / immunology
  • Quality Control
  • Seeds / chemistry*
  • Species Specificity


  • Prolamins
  • Glutens