The Oats Controversy: Why aren't they gluten free in Australia?

Below is an approximation of this video’s audio content:

Hey everyone it’s Kristina Richardson, the Coeliac Disease Dietitian and today I’m going to be talking about OATS.

More specifically, I’m going to discuss why it is that people with coeliac disease in Australia are advised NOT to eat oats, when pretty much the rest of the world considers them gluten free?

Well stay tuned, because I’m going to break it down for you!

It was around the 1950s that oats started being excluded from the the gluten free diet.

Originally this was based on anecdotal data, meaning that Doctors observed some of their coeliac patients getting symptoms after eating oats, so they started advising any new patients with coeliac disease to avoid oats as well as wheat, rye and barley.

So the advice about oats, in Australia, for a long time differed from doctor to doctor.

It wasn’t really until the 1990s and early 2000s that some decent studies started being carried out looking into the toxicity of oats in coeliac disease.

But unfortunately, the results of these studies seemed to always contradict each other.

Many studies have show no apparent ill effects from eating oats, and others observed mucosal damage in their coeliac patients who included oats in their diet.

And that’s why, even 30 years later, the topic of oats and their safety in the gluten free diet remains “controversial”.

In Australia and New Zealand, FSANZ, who regulates our food labelling laws, decided to exclude oats and anything containing oats from the definition of “gluten free” for two reasons:

Because the technology used to detect gluten in foods cannot detect the protein in oats (called avenin) that is potentially toxic in oats….

The ELISA test that is used to detect gluten is primarily designed to detect the gluten proteins in wheat. Its also pretty good at detecting the gluten proteins in barley and rye. But it can’t detect the “gluten” protein in oats, and I’ll explain why a little later.

The second reason FSANZ decided oats could not be labelled “gluten free” is that oat crops are usually contaminated from wheat (and rye) crops.

In the FSANZ assessment report that went on to inform the food labelling standard in Australia, it was estimated that oats would contain approximately 0.004-0.005% gluten contamination. Now that may not sound like much, but it actually translates to around 40-50ppm.

That’s over twice the acceptable threshold for gluten which forms the Codex standard which is used in Europe and America.

But it also, of course, comes nowhere near the “zero detectable gluten” standard that exists in Australia for a product to be labelled gluten free.

So that’s why, even if a food product is tested for gluten and comes up “zilch” it still can’t be labelled gluten free in Australia if it contains oats as an ingredient.

Now since that rule around oats was legislated, there has been some further research done in Australia that’s tried to look further into the oats issue.

The first study, which happened around 2006-2007 in collaboration with researchers in Italy, was just conducted in test tubes.

What they did is they had some white blood cells in a test tube and watched what happened when they added some cereals proteins. So they added:

- gliadin from wheat,

- avenin from a few different varieties of oats; and

- some rice proteins to act as a comparison

What they found was that:

- the rice didn’t do anything,

- the avenin seemed to cause a small amount of activity, but only in two of the oat varieties (the third variety did nothing); and

- the Gliadin from wheat definitely caused a reaction.

Now obviously this isn’t the best evidence, given that it was only done in a test tube, but from this they concluded that some varieties of oats “may” be potentially harmful to people with coeliac disease and therefore oats should remain excluded from the gluten free diet.

So that’s where the advice sat for a while…..

Until nearly 10 years later in 2015 when another Aussie study was published.

In this one, they actual FED oats to people with coeliac disease.

There were 73 people in the study and they ate 100g of oats (that’s just over a cup) for 3 days and measured their immune reaction to the oats by looking at the T cells in their blood.

What they found was that only 8% of the participants had an immune reaction in response to the oats.

They also found that around half the participants developed symptoms from the oats….

The most common symptoms reported were nausea, bloating and lethargy. Some had diarrhoea and constipation, and few people vomited or had reflux.

They noted that many of these symptoms could have just been from eating such a large amount of oats (there’s a LOT of fibre in that amount of oats)!

In my personal option.. the nausea and vomiting was a bit of a concern. But this only happened in around a quarter of the subjects.

The other thing to be aware of is that people who showed an immune response, weren’t necessarily the ones who got symptoms, and vice versa.

Which means, if you’re able to eat oats without any symptoms, you may still be having an immune response, and you could potentially be getting ‘silent’ damage to your villi.

This pretty reflects other research to date about symptoms not predicting intestinal damage when it comes to gluten.

Unfortunately in this study, they didn’t do any biopsies to see whether the immune reactions translated to damaged villi.

Even though this study concluded that small amounts of oats probably wouldn’t do any harm to people with coeliac disease….

The food labelling standard remained unchanged.

Now the reason for that is.... although it’s likely only a small proportion of people with coeliac disease react to pure, uncontaminated oats, it’s impossible to know who these people are.

And…. just because you don’t react symptomatically to gluten, it doesn’t mean you’re free from any damage happening internally.

So right now we’re still taking the quite conservative approach of individual testing for oat tolerance.

That means, that after you’ve been on a gluten free diet for a while and you’ve had the all clear in terms of your intestinal healing and recovery, you can, if you like, do an oat challenge for 3 months, using certified wheat-free oats.

Then you have another biopsy at the end of the 3 months to make sure the oats haven’t done any damage, or caused you to stop absorbing iron or anything like that.

And that’s where we’ve sat in terms of recommendations for quite a while.

But I’m not finished yet…..

The brand new Australian study that has caused quite a stir, was published in the journal “Nature”, which is a very prestigious international journal.

It goes a little bit further towards confirming that oats are probably not as dangerous as we thought, because they contain hardly any of the specific proteins that are toxic to people with coeliac disease (called “prolamins”) when compared to wheat, rye and barley.

You see, wheat is about 10-12% protein, and around 75-80% of those proteins are the “gluten” type which affect people with coeliac disease. That means for every 100g of wheat, there will be approximately 8.5g of gluten.

Oats are also around 12% protein. But only 10-15% of those proteins are the type that could potentially be toxic to people with coeliac disease. So that means for every 100g of oats, there’s only potentially 1.5g of “gluten”.

But what this study also found, which is very exciting is that these storage proteins which they thought were similar to the ones in wheat, are actually more similar to the the proteins in rice. Which we all know is gluten free!

So, that might explain why, around the rest of the world, most people with coeliac disease seem to be able to eat small quantities of oats, around 50g a day, without any ill effects.

Know I know the question you’re all asking is…..

Does this mean Aussies and Kiwis can start stocking up on Uncle Toby’s and eating delicious, delicious porridge and making some decent Anzac biscuits for a change?

Well probably not quite yet… But its looking like this could be a real option in the near future! (fingers crossed)

If you want to see that happen, the researchers at the Walter & Eliza Hall Institute are currently looking for volunteers to take part in their oat feeding study, which we hope, will once and for all clear up the controversy around the inclusion of oats in the gluten free diet.

I’ll put the link in the description if you are interested in helping make that happen.

Until then, if you really want to eat oats, make an appointment with your gastroenterologist and tell them you want to do your own individual oat challenge.

If you DO end up doing this, or have even done this before - I’d love to hear from you. Let me know in the comments about your experience!

That’s it for me today. If you liked today’s video and would like to keep seeing more videos from me, please hit the like button AND subscribe to my channel so that I feel the love!

I’ll talk to you soon!

Kristina Richardson, APD

To participate in the oats study go here:
https://www.wehi.edu.au/people/jason-tye-din/72/jason-tye-din-projects