Urinary nitric oxide during one year of gluten-free diet with or without oats in children with coeliac disease.
OBJECTIVE
Although in both adults and children with coeliac disease (CD) it is now recommended that oats be added to their gluten-free diet, there is still some controversy concerning the possible harmful effects of oats in some individuals. In this study concentrations of nitric oxide metabolites were repeatedly measured in the urine of children under investigation for CD, when on a gluten-free diet with or without oats.


METHODS
The study included 116 children, randomized to a standard gluten-free diet (GFD-std) or a gluten-free diet supplemented with wheat-free oat products (GFD-oats), over a one-year period. Small-bowel biopsy was performed at the beginning and end of the study. Morning urine samples were collected from 87 children and urinary nitrite/nitrate concentrations were monitored at 0, 3, 6, 9 and 12 months.


RESULTS
All patients were in clinical remission after the study period. There was a rapid decline in urinary nitrite/nitrate concentrations in both groups as early as after 3 months. No differences were seen between the study groups at any of the checkpoints. However, at the end of the study, the nitrite/nitrate values of 9 children in the GFD-oats group and 8 children in the GFD-std group had not normalized.


CONCLUSIONS
Children with CD on a gluten-free diet with oats display a similar reduction in urinary nitrite/nitrate as those on a traditional gluten-free diet. Some children, however, still demonstrate high nitrite/nitrate excretion after one year on either diet, indicating that long-term follow-up studies of children on an oats-containing diet are needed.
Hollén
Elisabet
E
Division of Medical Microbiology, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Sweden. eliho@imk.liu.se
Forslund
Tony
T
Högberg
Lotta
L
Laurin
Pia
P
Stenhammar
Lars
L
Fälth-Magnusson
Karin
K
Magnusson
Karl-Eric
KE
Sundqvist
Tommy
T
D000293:Adolescent; D018554:Avena; D001706:Biopsy; D002446:Celiac Disease / Q000178:diet therapy* / Q000473:pathology / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D004311:Double-Blind Method; D005069:Evaluation Studies as Topic; D005260:Female; D005983:Glutens; D006801:Humans; D007223:Infant; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D009566:Nitrates / Q000652:urine; D009569:Nitric Oxide / Q000652:urine*; D009573:Nitrites / Q000652:urine; D013548:Sweden
D009566:Nitrates; D009573:Nitrites; D009569:Nitric Oxide; D005983:Glutens