Hey gluten-free fam!

Let’s get into it: gluten in oats. If you’ve been managing a gluten-free diet, you’ve likely encountered the oats dilemma. It’s one of those foods that leaves many people with coeliac disease scratching their heads.

Can you eat oats or not? Are they a safe option for gluten-free eaters? Or do they trigger a similar reaction to gluten? There’s no clear-cut answer that applies to everyone, and that’s why it’s such a hot topic within the gluten-free community.

For some, oats are a fantastic source of nutrition, while for others, they may need to be avoided altogether. So, what’s the real story behind oats and coeliac disease?

We will dive into the nuances, clear up some of the confusion, and figure out whether oats belong in gluten-free diets. But here’s the twist—we’ll also explore why it’s not such a simple “yes or no” answer.

The Value of Oats Towards a Healthy Diet

First, let’s take a step back and ask: why are oats even part of this discussion? Why are people so keen to include them in their diets with gluten-free products if there’s any potential risk?

It’s simple: oats offer incredible nutritional benefits. They’re packed with fibre, protein, vitamins, and minerals that make them appealing, particularly for those on a gluten-free diet where nutrient variety can sometimes be limited.

You might be familiar with this already, but let’s recap for a second. Oats are a great source of energy and help to keep you feeling full for longer. This is because oats are high in fibre, which is something many gluten-free grains and products often lack.

Health Benefits of Oats — *Adding oats to your weekly diet routine can offer great health benefits. Image: Sheelah Brennan*

If you’re living gluten-free, you’ve probably had moments when you felt like something was missing nutritionally. Maybe you’re not getting enough fibre, or you’ve noticed that gluten-free foods can sometimes be low in protein.

As Associate Professor and Gastroenterologist Jason Tye-Din, a long-time expert in the field, shared on our podcast, "We know that oats is an enormously nutritious cereal. It's got some really good composition of amino acids and sugars in it that are very beneficial." His insight highlights just how important oats can be for those who can tolerate them.

Additionally, the fibre in oats can be beneficial for anyone who struggles with digestion—especially for those with coeliac disease, where maintaining gut health is critical. Fibre is crucial for digestion, and when you cut out gluten, you also cut out sources of fibre - whole wheat, rye & barley, making oats an appealing substitute.

But it’s not just fibre that makes oats stand out. As Tye-Din outlines, “It's an excellent fibre source, but it's also a great source of protein. The idea of adding oats to a gluten-free diet is very appealing.”

And he’s right. There’s a reason why oats are seen as a staple food in many diets, especially for us Aussies—they are nutritious, versatile, and affordable. So, if oats are so beneficial, why the controversy around them when it comes to people with coeliac disease?

The Controversial Relationship Between Gluten and Oats

Here’s where things start to get a bit tricky. You might be wondering, do oats contain gluten? Well, oats don’t actually contain gluten—at least not the type that you find in wheat, barley, and rye. Oats contain a different protein called avenin, which is similar but not identical to gluten.

Now, this is where the confusion sets in. The avenin in oats is generally well-tolerated by most people with coeliac disease. However, for a small group of individuals, this protein can still trigger an immune response, much like gluten does.

It’s rare, but it happens. Tye-Din states, “Oats contain proteins called avenin, which are similar but not the same as the gluten protein found in wheat, rye, and barley. They are like distant cousins.”

So, while oats don’t contain gluten in the traditional sense, they might still be problematic for some people with coeliac disease. The challenge is figuring out whether you’re one of the individuals who can safely consume oats or if you should avoid them entirely.

Complicating matters further is the issue of cross-contamination. Oats are often processed in facilities that also handle gluten-containing grains, like wheat or barley. This means that even if oats themselves are technically gluten-free, they could be contaminated during processing.

In many countries, gluten-free oats are available, but in Australia and New Zealand, things are a bit more complicated. This is where domestic labelling laws come into play.

Domestic Labelling Issues in Australia and New Zealand

One of the reasons why oats are such a controversial food in Australia and New Zealand is because of how they’re labelled. Even if oats are processed in a facility that’s free from contamination, they still cannot be labelled as gluten-free in these countries.

As Tye-Din highlights, “It is very confusing for people. A lot of it (is) because the food standards law at the moment excludes oats from the gluten-free diet in Australia and New Zealand. This is different to many parts of the rest of the world like Europe or the US or the UK, which do allow oats.”

So, what’s going on here? In Australia and New Zealand, oats are considered off-limits for people with coeliac disease, regardless of whether they are contaminated or not. This stems from the fact that oats contain avenin, and some individuals with coeliac disease can still react to it.

*Oats labels for gluten-free consumers is an issue in Australia and New Zealand*

However, in many other countries, including the US, UK, and Europe, oats that are free from gluten contamination are often labelled as safe for people with coeliac disease.

Tye-Din adds, “The labelling laws would not allow Australia or New Zealand to label gluten contamination-free oats as gluten-free oats.” This means that even if the oats are as pure as can be, they still can’t be marketed as gluten-free under Australian and New Zealand laws. This is super frustrating for us Aussies and Kiwis!

It’s important to remember that oats do contain a gluten-like protein even when they’re not contaminated by other grains. So, if you’re living in Australia or New Zealand, oats are generally avoided as part of a gluten-free diet, despite what you might read or see in other countries.

Can Coeliacs Eat Oats? What the Research Says

Here’s the good news: for most people with coeliac disease, oats are considered safe. Research has shown that the majority of individuals with coeliac disease can tolerate oats without any issues, as long as the oats are free from contamination by gluten-containing grains.

Tye-Din notes, “The research around the world to date has been overwhelmingly supportive of the safety of oats in people with coeliac.” That said, it’s important to remember that there’s still a small group of people who may react to the avenin protein in oats.

“When they feed people with oats for long periods of time, most seem to tolerate it well and don't get gut damage and enjoy a better quality of life,” Tye-Din explains. “Having said that, there have been studies that show a small proportion of people may (experience) gut damage or adverse symptoms.”

So, while oats are generally considered safe for most people with coeliac disease, it’s not a one-size-fits-all situation. It’s essential to listen to your body and pay attention to any symptoms you may experience when adding oats back into your diet.

Understanding Your Body’s Symptoms

Let’s talk about symptoms for a moment. If you’re one of the people who reacts to oats, you might experience symptoms similar to those caused by gluten exposure. These can include bloating, stomach cramps, nausea, and even diarrhoea. But here’s the thing: not all symptoms are immediate.

Some individuals might tolerate oats for a while, only to start experiencing issues later on. This is why many experts recommend introducing oats slowly and monitoring your symptoms carefully.

*Coeliac symptoms from oats consumption can be extensive. Image: Towfiqu Barbhuiya*

For some, symptoms like constipation might occur when adding oats back into their diet. This can happen because oats are high in fibre, and for people who are not used to consuming a lot of fibre, this can cause digestive discomfort.

As with any food, it’s important to listen to your body. If you notice symptoms after eating oats, it’s worth having a conversation with your doctor or dietitian. They can help you determine whether it’s the oats causing the issue or something else entirely.

Running the New Coeliac Study

Researchers, including Tye-Din, have been working hard to better understand how oats affect people with coeliac disease. In his study, the gastroenterologist and his team assessed 52 individuals with coeliac disease to see how they reacted to different amounts of oats. The findings were interesting, to say the least.

Tye-Din says, “When you feed oats to people, if you give a lot, you often do get people to (experience) bloating, tummy pain, or constipation. It's often because you're giving massive amounts of fibre that people are not used to. This was an important reason to bring it back to basics to test that.”

What the study revealed is that most people with coeliac can handle oats just fine. However, for those who do experience symptoms, it’s often related to the fibre content rather than the avenin protein itself. It’s worth noting that fibre can be a bit of a double-edged sword—it’s essential for digestion, but too much at once may overwhelm the gut, especially if you’re not used to it.

The Role of Avenin Protein

What makes oats risky for some people with coeliac disease is the avenin protein. This protein is structurally similar to gluten, which is why it can trigger a reaction in certain individuals. But avenin isn’t gluten, and for most people, it’s not problematic.

To get a clearer understanding of how avenin affects those with coeliac, Tye-Din’s team purified the avenin protein from oats and conducted feeding studies. This allowed them to test the effects of pure avenin without the influence of other components in oats.

Avenin in oats is the key for gluten-free study — *Studying the role of avenin has been key in understanding oats for gluten-free consumers. Image: Bermix Studio*

“By purifying that avenin protein from oats, we were able to get large amounts,” Tye-Din recalled. “We started off with more than 200 kilograms of gluten contamination-free oats. So very, very pure oats.”

This process allowed the researchers to test the effects of avenin at different dose levels. What they found was that most people with coeliac disease could tolerate avenin without any issues, but a small subset of individuals experienced adverse symptoms, even at low doses.

Symptom Outcomes Revealed

The results of the study were fascinating. In a small proportion of participants, oats triggered clear symptoms. “Oats did indeed, in a subset of people with coeliac disease, induce a very strong symptom response like diarrhoea, abdominal pain, nausea, and even vomiting in some people. (This) was striking because I never thought that oats would do this to people, but it was (showing that with a) very strong immune response as well,” Tye-Din shares.

Despite these findings, the majority of participants tolerated oats just fine. This highlights the fact that oats are safe for most people with coeliac, but for a small group, they may cause issues.

Research Findings and Practical Advice

So, what’s the bottom line? Should you include oats in your gluten-free diet? The answer depends on your body’s unique response to avenin and whether or not you have access to contamination-free oats.

As Tye-Din’s research shows, “Some people reacted to very, very low doses of avenin, equivalent to a bowl of oats. Whereas (other) people needed around five bowls of oats before they reacted, which is obviously not going to happen in the real world.”

For most people, the research suggests that oats are safe to consume in moderation, provided they are free from gluten contamination. However, for a small group of individuals, even a small amount of oats could trigger symptoms.

Dietician and GP consultancy for oats gluten-free — *Consulting a trusted dietitian or GP is advised*

Tye-Din explains, “The research has helped us understand there is (a) very small group of people who react. (It told) us two things. Number one, it supports the findings from the existing studies about general safety. But secondly, it does give us some cause for pause and not alarm. There is a subset of people with coeliac who do adversely react to oats.”

If you’re thinking about adding oats back into your diet, it’s important to do so slowly and carefully. You might also want to consider having a follow-up biopsy to ensure that your gut isn’t being damaged by the avenin protein.

‘Oats Challenge’ via a Biopsy

Sadly, symptoms aren’t always a reliable indicator of what’s happening inside your body, especially in the gut. Some people tolerate oats without any noticeable symptoms but may still experience gut damage. This is why many healthcare professionals recommend a follow-up biopsy if you decide to add oats back into your diet. This is known as an ‘oats challenge’, similar to a ‘gluten challenge’ which is used to formally diagnose coeliac disease.

“Unfortunately, we do need to use the biopsy as the best way of assessing for damage,” Tye-Din explains. “Symptoms aren't always a reliable readout longer term. We're stuck with that, but a lot of our work is looking at immune readouts. We are working on one that might help facilitate this assessment.”

A small bowel biopsy pre and post oats challenge remains the gold standard for arriving at a conclusive outcome. To have clarity about any decision like this, it’s always advised to speak with your trusted dietitian or GP to see how you can gauge your tolerance for the protein.

Using the Body as a Guide for Information

Should you include oats in your gluten-free diet? The answer is a personal one. For most, the answer is yes—gluten-free oats can be a healthy and nutritious addition. But if you notice any symptoms after eating oats, it’s important to consult with your doctor or dietitian to make sure that they’re safe for you.

*Your body is your best guide to recognising potential oats symptoms*

As Tye-Din points out, “Generally we say symptoms are not always a good readout of what's happening inside your body. When it comes to this oats reaction, they are a fairly good reflection because people who develop acute symptoms to the oats (that) didn't resolve were likely to have that very strong immune response.”

Individual Approaches to Oats

When it comes to oats and coeliac disease, it’s not a one-size-fits-all approach. Coeliac Australia Health Advocacy Officer, Penny Dellsperger highlighted that fact during our episode, "We need an individual approach." For some, oats can be a valuable addition to their diet, while for others, they may need to be avoided.

The inclusion of oats has shown to improve overall quality of life for many individuals who can tolerate them. As she noted, “The inclusion of oats in certain studies has also been associated with enhanced quality of life.” This means that for people who can safely eat oats, they’re not only benefiting nutritionally, but they’re also potentially experiencing a greater sense of well-being and dietary satisfaction.

Dellsperger also emphasised the importance of making informed decisions about which oats to trust. "We don't recommend any particular brand," she explained, but there are ongoing efforts to provide clarity for consumers.

Exciting Oats Developments Still to Come

As a Dietitian & Health Advocacy Officer for Coeliac Australia, Dellsperger understands how much of a minefield this whole area can be. With her expert feedback on the ‘may contain gluten’ label topic, she recognises that her organisation can play a role in educating and guiding gluten-free consumers with the product.

Coeliac Australia is working to gather more information on trusted gluten-free oat brands to ensure people can make confident choices. “We are putting together a survey which we will circulate to those oat producers just to get information from them about the different steps that they take to make sure that their oats are contamination-free,” Dellsperger said.

This survey will eventually lead to a publicly accessible resource where consumers can review the practices of different producers and make their own informed decisions. “We plan to put that on our website so that consumers can come and have a look all in one place at what is done by each of those producers and make their own decision about which oat they would like to use for their own diet,” she added.

Reflecting on My Personal Oats Experience

As you can now understand gluten free fam, this is a very nuanced & controversial discussion. Whenever oats are brought up on my podcast, when we’re chatting with others on our Instagram account or on various Facebook groups it definitely causes controversy.

Opinions can get nasty quickly. With Coeliac Australia’s new approach & advice around the consumption of oats for people living with coeliac disease and following a 100% strict gluten free diet, many are interested to try an oats challenge or reintroduce oats into their diet by themselves.

Personally, I have been considering whether to do this, but what holds me back is simply the thought of having to deal with the symptoms if I do begin to react. I used to love having oatmeal each morning before diagnosis but, like many gluten-containing foods from that time, I have an association in my mind of those types of foods to the gluten challenge.

To be honest, I consume enough fibre and nutrients which fuel my body to make me feel well through a varied and balanced diet. I make my own Buckwheat & Tapioca loaf using a super easy recipe by Helen Tzouganatos. I make two of these a week. Buckwheat has a tonne of fibre and many nutritional benefits.

In fact, buckwheat flour beats oat flour in protein, dietary fibre, B vitamins and is a fantastic source of both potassium & essential amino acids. This is a great option if you aren’t willing or just don’t see the point in stirring the pot (pun intended) with oats right now.

Another great gluten free substitute I’ve found lately is including quinoa flakes for my morning brekky. I was previously making my own recipe which was okay but a little strong tasting with a bitter quinoa aftertaste staying in the mouth. Recently Bask & Co has released two alternative gluten free porridges - one is Almond & Cinnamon Gluten Free Porridge & the other is the Traditional Gluten Free Porridge.

Take it from me - these porridges are fantastic, especially after attempting to make my own over the past few years! Bask & Co also stock delicious Gluten Free Granola and Granola Bars.

Check out our Discount page for a Bask & Co discount among others!

Important Podcast Insights and Takeaways

I get asked so much about what the go with oats is in Australia and why we take it so seriously. I have been pointing people towards my conversation with Professor Jason Tye-Din and so many have clarity after listening. However, I appreciate it’s still a very complicated discussion.

As Tye-Din and Dellsperger say - it all comes down to your own personal situation. You have to make the decisions that are right for you and your own unique life. For many, oats will be safe, but please make sure you’re being guided in your decision with a GP or dietitian. It is hard to find uncontaminated oats in Australia. Do your own research and make your own call.

I regularly make my two girls oat-porridge for breakfast in the morning and I am jealous as the smell takes me back to when I was able to consume it. However, I have found great gluten-free alternatives which suit me in taste, texture and nutritional benefits.

Trust me, I know it sucks seeing other countries around the world who are a lot more lax about oats in their gluten-free diets, especially for those with coeliac. With this being said, Australian perspectives are changing and once we have further guidance and information from Coeliac Australia, our choices will become much more clear. I too wish I could try Gluten Free Oreos but alas, they do contain oat flour which, as you will now understand from reading this far, cannot be deemed gluten-free in Australia right now.

Taking Practical Steps Forward

If you’ve removed oats from your diet and are thinking about reintroducing them, it’s essential to do so gradually. Start with small amounts and monitor your symptoms carefully. It’s also a good idea to check with your healthcare provider to make sure that you’re on the right track.

Oats Compatibility Gluten-Free — *Try oats and see if you're compatible*

A dietitian or GP should be across all of this relevant information. From coeliac disease, non-coeliac gluten sensitivity to wheat allergy, adding dietary fibre and exploring gluten-free oat products, the goal is to be informed with specialist support.

For those who can tolerate oats, the benefits are clear. Oats are a great source of fibre, protein, and essential nutrients that can support a healthy diet. But for a small subset of people, oats can cause issues. It’s all about finding what works for you and making informed decisions about your health.

Closing Take

The good news? You have options. You may wish to plan an oat challenge with specially produced oats free from contamination of gluten. If you find these types of oats and other alternative gluten-free grain sources, this could be the perfect time to introduce the ingredient into a breakfast, lunch or snack routine. How does the body react? Do you feel like you’re gaining nutritional value, or are the symptoms from oat products causing more harm than good?

While oats can be a nutritious and beneficial addition to many people’s diets, it’s important to listen to your body and take the necessary precautions if you’re living with coeliac disease. Whether you choose to include oats or not, making informed choices and working with your healthcare team will help ensure your gluten-free diet is both safe and healthy.

Are Oats Safe for Coeliacs? What You Need to Know