How safe are they? The scoop on gluten-free oats
When my daughter was diagnosed with celiac disease at age 2, the mandate was clear—no more wheat, rye, barley or oats. Oats, it was explained to us, do not contain gluten but are highly cross-contaminated because they’re often grown and harvested alongside wheat, rye and barley.
Since then, research has shown that most celiacs are able to tolerate pure, uncontaminated oats—but with some limitations. In the past five years, a handful of companies have begun to market specially produced oats that are carefully monitored and tested to prevent any contact with gluten.
Good news for us. Our family had been struggling at breakfast, as the gluten-free cereals our daughter enjoyed weren’t filling enough to carry her through the morning. She would often be distracted in the cafeteria at lunchtime, not eat much of her packed lunch, and come out woozy and whining by the end of the day in first grade.
She also has struggled to inch her way up the growth charts, so her nutritionist advised us to serve more beans and eggs and to give her gluten-free oatmeal made with whole milk. (Fortunately, she can tolerate dairy.)
Oatmeal is now my daughter’s favorite breakfast, especially when it’s punctuated with plump raisins and sweetened with a touch of brown sugar. Hearty and healthy, whole grain oatmeal is full of protein and fiber to get her through those days when she’s too busy chatting in the cafeteria to eat all her lunch.
Over the past 15 years, studies indicate that moderate amounts of gluten-free oats are well tolerated by the majority of people with celiac disease. Current medical consensus is that adults can safely eat ½ to ¾ cup (50 to 70 grams) of uncontaminated dry oats per day. For kids, it’s ¼ cup (20 to 25 grams) per day.
What’s so great about oats?
“Uncontaminated oats are another grain you can add to the gluten-free diet to make it more palatable. They add vitamins and minerals to the diet that you otherwise might be missing,” says dietitian Pam Cureton, RD, LDN, at the University of Maryland Center for Celiac Research.
“I try to reinforce the importance of oats in gluten-free diets because of the lack of fiber in rice flour, tapioca starch and other refined flours found in many popular gluten-free products. Oats are also a good source of whole grain,” agrees Lara Field, MS, RD, CSP, LDN, a pediatric dietitian on the advisory board of the University of Chicago Celiac Disease Center and founder of feedkids.com. “Most patients can consume uncontaminated oats several times a week, adding them to a broad variety of recipes.”
Gluten-free oats are also a good source of protein, iron and manganese, which aids in the utilization of other key nutrients. The soluble fiber in oats helps reduce total cholesterol, along with LDL or “bad” cholesterol. Since oats are low on the glycemic index, they can help control blood sugar.
Pure oats deliver pleasant texture and flavor to foods, in addition to being quite versatile. They can be made into homemade granola, baked in oat bread, cooked into oatmeal cookies and used as a binder in meatloaf. Oat flour added to gluten-free flour blends delivers excellent baking results. Steel-cut oats and rolled oats have a greater nutritional value than instant oats—but they take longer to cook.
“People are busy in the morning and usually don’t have 20 or 30 minutes before breakfast to make longer-cooking oatmeal,” says Cureton. Her time-saving suggestion? “Before you go to bed, put the gluten-free oats in a crock pot with brown sugar and some dried fruit and seeds, so it will be ready in the morning. Make several servings and microwave the leftovers later in the week for breakfast.”
Gluten-free oats should be introduced slowly because some people experience abdominal discomfort, bloating and gas when going from a low-fiber diet to a high-fiber diet. It’s also important to increase your water intake when adding fiber-rich foods.
Most physicians recommend that people wait to introduce pure oats until they are six to 12 months into a gluten-free diet and their antibody levels have returned to normal. Slowly add limited amounts—no more than ¼ cup of uncontaminated dry oats to start—to give your body a chance to adjust to the increased fiber content and to see if you can tolerate gluten-free oats.
A few continue to contend that those with celiac disease should steer clear of gluten-free oats. For example, the Celiac Sprue Association is cautious about endorsing uncontaminated oats.
“We don’t have black-and-white evidence to say that oats are a risk-free choice,” says CSA executive director Mary Schluckebier. “If we include all of the people with celiac disease, there will be oat responders and non-oat responders and there’s no way of knowing what group you are in before consuming oats. There is no oat-specific test. Is it a risk-free choice for everybody? No. Is it risk-free for some? Yes.
“At this time, the only way to know if oats are right for you is to experiment and try them. For those wanting to consider oats in their food plan, we encourage people to build and stabilize their health for at least one year after going on the gluten-free diet. Once health is stable, uncontaminated oats can be introduced a little bit at a time so an individual can personally determine whether they are an oat responder or not,” Schluckebier says.
Kinnikinnick Foods, a Canadian-based manufacturer of a variety of gluten-free foods, has no plans to introduce oats in any of its products.
“Because oats aren’t safe for all celiacs, we don’t intend to use them in any form,” says Jay Bigam, Kinnikinnick’s executive vice president. “Two of the three company owners—my mother Lynne and I—have celiac disease and we won’t eat oats. We haven’t tried oats and don’t intend to. Our diets are healthy without them.”
Bigam also objects to what he says are the small sample sizes of the research studies, the lack of information about long-term consumption and the problem of people surpassing the 50 to 70 grams a day recommended limit.
“If you only eat a bowl of gluten-free oatmeal, that’s manageable,” he says. “But oats are creeping into bars, cereals, cookies and more. Unless manufacturers are required to list the actual amount of oats in each product on the label, there’s no way to monitor your actual consumption.”
In contrast, most physicians, including medical experts who specialize in treating celiac patients, give pure, uncontaminated oats the green light.
“A large body of scientific evidence accumulated for more than 15 years proves that oats are completely safe for the vast majority of celiac patients,” says Stefano Guandalini, MD, director of the University of Chicago Celiac Disease Center. “Oats are not related to gluten-containing grains, such as wheat, barley and rye. They do not have any gluten but rather they contain proteins called avenins that are non-toxic and well tolerated by most celiacs.” Less than 1 percent of celiac patients show a reaction to large amounts of oats in their diet, he adds.
Shelley Case, RD, author of Gluten Free Diet: A Comprehensive Resource Guide, agrees. “The majority of celiac organizations, dietetic associations and medical professionals around the world allow consumption of moderate amounts of pure, uncontaminated oats for people with celiac disease,” she says. Case, a consulting dietitian and member of several celiac medical advisory boards in the United States and Canada, notes that the Gluten Intolerance Group, Celiac Disease Foundation, American Dietetic Association and Dietitians of Canada support inclusion of pure, uncontaminated oats in a gluten-free diet, based on the latest medical research.
According to a 2004 study published in the New England Journal of Medicine, regular oats are highly contaminated with gluten. The study’s author, Tricia Thompson, MS, RD, examined samples from three major brands of oats. Nine of the 12 samples showed gluten levels ranging from 23 to 1,807 parts per million. In contrast, pure oats certified by the Gluten Free Certification Organization must contain less than 10 ppm of gluten, making them a suitable choice for the gluten-free diet.
Pure, uncontaminated oats are farmed, harvested, processed and packed using special methods to avoid cross-contamination with gluten. The oats are watched from the time the seeds are sown to the time they are harvested. They’re then transported on dedicated gluten-free equipment, packaged at gluten-free facilities and tested several times during the process.
Seaton Smith is obsessive when he sows his oats. As president of Gluten Free Oats, a company based in Powell, Wyoming, he takes cross-contamination seriously. The company’s goal of 10 ppm of gluten is also a personal issue for Smith. He has celiac disease, as does his wife, son, mother-in-law, cousin and niece.
Smith says he works hand-in-hand with farmers to select fields that haven’t grown wheat, rye or barley for at least two years. Then he hands over his pedigreed seed stock to the grower.
As the oats mature, Smith says that he and his crew walk through the fields and pull “volunteer plants”—i.e., gluten intruders—that sprout up. Smith explains that if a bird flies over a field and drops a wheat seed, that seed can create three to five stalks of wheat which can then create 250 to 300 new wheat seeds.
“I’m going after every seed,” he says.
The farm equipment is thoroughly cleaned to eliminate cross-contamination, he says. The combine is disassembled, vacuumed and blown out with high-pressure air; trucks are vacuumed, blown out and cleaned with dental picks to dislodge hitchhiker seeds; augers are scrubbed; storage bins are swept and washed down; even tractor tires are inspected to see if they’ve picked up wheat seeds on the road. Smith says he similarly examines the cleaner, flaker and packaging processes, testing for gluten multiple times along the way.
“As celiacs ourselves and as a small company, we can handhold the whole process with controlled steps,” Smith says. “I can’t cut corners because I know that I’ll personally pay for it in the morning with a gluten reaction.”
Everything in Moderation
Dietitian Cureton says she rarely sees anyone who cannot tolerate gluten-free oats.
“If you tried uncontaminated oats once and had a reaction, it might be due to the high fiber. Make sure the product is labeled gluten-free, of course, and then try it again in a smaller amount to see if you can tolerate it,” she advises.
Cureton emphasizes that if people are worried about consuming pure oats as part of their gluten-free diet, they should have follow-up testing after introducing them to see if their antibody levels are normal.
“I eat gluten-free oats almost daily, limiting myself to a half cup a day,” says Stephanie VanSyckel of Hiram, Maine. She bakes extensively since being diagnosed with celiac disease four years ago. “I feel that oats are a really good way to get extra fiber into a diet that tends to be low in fiber because of all the refined flours. Oats have been shown to be good for cholesterol levels. I like their texture and chewiness and I like the variety that they give me. It’s nice to have a few more options.”
VanSyckel’s two adult daughters also have celiac disease. One can tolerate uncontaminated oats but the other cannot and ends up with abdominal distress lasting three to four days.
The bottom line? If you have celiac disease, the odds are in your favor that you’ll be able to safely enjoy a moderate amount of certified gluten-free oats as part of your gluten-free diet. Check with your doctor. Introduce pure oats slowly and watch carefully for adverse reactions.
“Oats can be part of the diet of a celiac patient, provided the oats are selected from sources that can guarantee the lack of contamination by wheat, rye or barley,” sums up Guandalini.
Because gluten-free oats permit a wider choice of foods within a special diet, they are rapidly gaining in popularity. Now most people on a gluten-free diet can feel their oats and eat them, too.
Gluten-Free, Nut-Free Granola
MAKES 4 CUPS
This granola is surprisingly easy to make and is healthier and cheaper than store-bought varieties. Vary ingredients to include your favorite dried fruits, seeds and spices.
2½ cups certified gluten-free rolled oats
½ cup unsweetened shredded coconut
1½ teaspoons ground cinnamon
½ teaspoon ground ginger
¼ teaspoon ground nutmeg
⅛ teaspoon salt
½ cup honey or maple syrup
¼ cup coconut oil, melted
⅓ cup raisins
⅓ cup dried cranberries
⅓ cup dried apricots, diced
1. Preheat oven to 300° F. Grease a rimmed baking sheet.
2. Place oats, coconut, cinnamon, ginger, nutmeg and salt in a large bowl and stir well to combine. Add honey and coconut oil and mix well until the oats are uniformly sticky.
3. Evenly spread the oat mixture on the prepared baking sheet.
4. Place in preheated oven and bake for 15 minutes. Remove baking sheet and stir granola well. Return to oven and bake for another 15 to 20 minutes, until golden brown.
5. While mixture is still warm, stir in raisins, dried cranberries and dried apricots. Cool. Store in airtight container.
Each ½ cup serving contains 294 calories, 11g total fat, 8g saturated fat, 0g trans fat, 0mg cholesterol, 41mg sodium, 49g carbohydrate, 4g fiber, 4g protein.
Gluten-Free Chocolate Chip Oat Cookies
MAKES 5 DOZEN
Blended to a fine powder, oats deliver hidden nutrition and structure to these cookies so they won’t crumble. They can be made with an egg substitute with good results (see instructions below).
2½ cups certified gluten-free rolled oats
1¾ cups All-Purpose Flour Blend or blend
1 teaspoon baking soda
½ teaspoon xanthan gum
½ teaspoon ground cinnamon
¼ teaspoon salt
1 cup (2 sticks) unsalted butter or dairy-free margarine
1¼ cups packed brown sugar
½ cup granulated sugar
2 large eggs or 1 tablespoon arrowroot powder or Ener-G egg replacer
2 teaspoons pure vanilla extract
2 cups (12 ounces) Enjoy Life semi-sweet chocolate chips
1. Put oats in a blender or food processor, blend to a fine powder and transfer to a large bowl. Add gluten-free flour blend, baking soda, xanthan gum, cinnamon and salt and stir to combine. Set aside.
2. Using an electric mixer, beat together butter, brown sugar and granulated sugar until just combined. Beat in the eggs one at a time (or egg substitute), mixing after each addition. Add the vanilla extract and mix. Gradually add dry ingredients, mixing well and scraping the bottom and sides of the bowl with a spatula. Stir in chocolate chips. Refrigerate batter at least 30 minutes to reduce cookie spreading.
3. Preheat oven to 375° F. Line cookie sheets with parchment paper.
4. Drop batter by rounded teaspoons, 2 inches apart, onto prepared cookie sheets.
5. Place cookies in preheated oven and bake 10 to 12 minutes, until lightly browned. Cool 1 minute on cookie sheet before removing to wire rack.
Each cookie contains 110 calories, 6g total fat, 3g saturated fat, 0g trans fat, 15mg cholesterol, 35mg sodium, 15g carbohydrate, 1g fiber, 1g protein.
Gluten-Free Raspberry Oat Squares
MAKES 20 SQUARES
Sweet and satisfying, these squares are packed with whole-grain nutrients from oats, as well from whole-grain teff, amaranth and brown rice flours. They can be made with an egg substitute with good results.
1 cup certified gluten-free rolled oats
¼ cup teff flour
¼cup amaranth flour
¼ cup brown rice flour
¼ cup tapioca starch/flour
½teaspoon ground cinnamon
¼ teaspoon baking soda
¼ teaspoon salt
¼ teaspoon xanthan gum
½ cup (1 stick) unsalted butter or dairy-free margarine, softened
½ cup packed brown sugar
1 large egg or ½ cup mashed ripe banana or 3 tablespoons unsweetened applesauce
mixed with 1 teaspoon baking powder
1 teaspoon pure vanilla extract
1 cup raspberry preserves
½ cup fresh raspberries, more if desired
1. Preheat oven to 350° F. Line an 8-inch square pan with parchment paper, covering the bottom and sides of the pan.
2. In a medium bowl, use a fork to whisk together oats, teff, amaranth, brown rice flour, tapioca starch, cinnamon, baking soda, salt and xanthan gum. Set aside.
3. Using an electric mixer, beat butter and brown sugar until light and fluffy. Add egg (or egg substitute) and vanilla extract and beat to combine. Gradually add flour mixture and continue mixing. Remove ⅓ cup batter and set aside for topping.
4. Press remaining batter into the bottom of prepared pan.
5. In a bowl, mix together raspberry preserves and fresh raspberries. Spread mixture over batter in pan.
6. Scatter clumps of reserved batter on top of the raspberry layer.
7. Place in preheated oven and bake for 30 to 35 minutes, until topping is lightly browned. Cool completely and cut into squares.
Each square contains 146 calories, 5g total fat, 0g saturated fat, 0g trans fat, 23mg cholesterol, 51mg sodium, 24g carbohydrate, 1g fiber, 1g protein.
Eve Becker (glutenfreenosh.com) is a Chicago-based health writer. Her youngest daughter has celiac disease and eats gluten-free oatmeal for breakfast a few times a week.