Oats in the treatment of childhood coeliac disease: a 2-year controlled trial and a long-term clinical follow-up study.
BACKGROUND
The exclusion of oats from the diet in coeliac disease is controversial.


OBJECTIVE
To study the long-term safety of oats in the treatment of children with coeliac disease.


METHODS
Altogether 32 children with coeliac disease were enrolled in a 2-year controlled trial. Twenty-three children in remission were randomized either to oats or gluten challenge; when small bowel histological relapse was evident after gluten challenge, a gluten-free diet including oats was started. Furthermore, nine newly detected coeliac patients adopted an oat-containing gluten-free diet. Small bowel mucosal morphology, CD3+, alphabeta+ and gammadelta+ intraepithelial lymphocytes, human leucocyte antigen (HLA) DR expression and coeliac serology were determined. After the trial, the children were allowed to eat oats freely; follow-up was extended up to 7 years.


RESULTS
In coeliac children in remission, oats had no detrimental effect on intestinal histology or serology during the 2-year trial. In contrast, the gluten-challenge group relapsed after 3-12 months. Complete recovery from the disease was accomplished in all relapsed and newly detected patients on an oat-containing gluten-free diet. After the trial, 86% of the children preferred to consume oats and they all remained in remission.


CONCLUSIONS
In most children with coeliac disease, long-term consumption of oats is well tolerated, and it does not result in small bowel mucosal deterioration or immune activation.
Holm
K
K
Department of Paediatrics, Tampere University Hospital, University of Tampere, Tampere, Finland.
Mäki
M
M
Vuolteenaho
N
N
Mustalahti
K
K
Ashorn
M
M
Ruuska
T
T
Kaukinen
K
K