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SSCD Position Statement: Consuming Oats on a Gluten-Free Diet

SSCD Position Statement: Consuming Oats on a Gluten-Free Diet

Oats are a whole grain that can provide important nutritional benefits when someone is following a gluten-free diet. They are a natural source of dietary fiber, complex carbohydrates, protein, unsaturated fatty acids, vitamins, minerals, and bioactive compounds, including beta-glucan and polyphenols. Dietary fiber is important for gastrointestinal health and has been associated with lower risk of cardiovascular disease, type 2 diabetes, and premature mortality. 8,9 In a long-term observational study of adults with celiac disease, individuals who consumed oats had higher daily fiber intake than those who did not consume oats. 1

Unlike wheat, barley, and rye, oats do not contain the gluten proteins that trigger intestinal damage in people with celiac disease. The primary concern regarding oats for individuals with celiac disease is cross contact with wheat, barley, or rye during growing, harvesting, transportation, storage, processing, or manufacturing.

For individuals with celiac disease who wish to consume oats, SSCD recommends consuming only oats and oat-containing products that are labeled gluten-free.

This recommendation is based on the potential for gluten cross contact from other cereals. A systematic review and meta-analysis of 28 studies found no evidence that consumption of gluten-free oats adversely affected symptoms, histology, immunity, or serologic findings in individuals with celiac disease.4 However, multiple studies of commercial oat products have demonstrated gluten levels above the 20 ppm standard for gluten-free.2,3 Because the clinical evidence supporting oat consumption is based on gluten-free, uncontaminated oats, selecting products with a gluten-free label provides a regulated means of identifying products that meet the established gluten-free standard.

In the United States, “gluten-free” is a regulated labeling claim with an FDA-defined standard.⁷ Some manufacturers also use the term “purity protocol” to describe practices intended to minimize cross contact; however, this is not a regulated or standardized labeling claim, and the term may represent different practices among manufacturers.

Avenin, the principal storage protein in oats, can elicit a response in a small number of individuals with or without celiac disease. Recent studies have reported avenin-specific immune responses and symptoms in a subset of individuals with celiac disease.5,6 However, long-term oat consumption did not result in histological damage.6 Thus, while some individuals may experience symptoms or immune reactivity to avenin, current clinical evidence has not demonstrated that consumption of gluten-free oats causes intestinal damage in individuals with celiac disease.

Gluten-free oats can therefore be considered a nutritious option for individuals with celiac disease. For patients who experience symptoms with gluten-free oats, evaluation by a dietitian with expertise in celiac disease is recommended. A dietitian-led evaluation can determine if symptoms are due to change in fiber, or potential gluten exposure, or other potential explanations for symptoms. When gluten-free oats are included in the diet, consideration can also be given to the frequency, the portion, and the type of products consumed.

When concerns about gluten-free oat consumption persist, particularly in individuals with ongoing symptoms, persistently elevated celiac serology, or evidence of ongoing enteropathy, collaboration with the patient’s medical team can help determine whether additional evaluation is appropriate. Gluten-free oat consumption should be individualized based on the patient’s symptoms, dietary preferences, and clinical picture.

 

References:

  1. Kaukinen K, Collin P, Huhtala H, Mäki M. Long-term consumption of oats in adult celiac disease patients. Nutrients. 2013;5(11):4380-4389. doi:10.3390/nu5114380.
  2. Thompson T. Gluten contamination of commercial oat products in the United States. N Engl J Med. 2004;351(19):2021-2022. doi:10.1056/NEJM200411043511924.
  3. Rodríguez JM, Estévez V, Bascuñán K, Ayala J, Araya M. Commercial oats in gluten-free diet: a persistent risk for celiac patients. Front Nutr. 2022;9:986282. doi:10.3389/fnut.2022.986282.
  4. Pinto-Sánchez MI, Causada-Calo N, Bercik P, et al. Safety of adding oats to a gluten-free diet for patients with celiac disease: systematic review and meta-analysis of clinical and observational studies. Gastroenterology. 2017;153(2):395-409.e3. doi:10.1053/j.gastro.2017.04.009.
  5. Hardy MY, Tye-Din JA, Stewart JA, et al. Ingestion of oats and barley in patients with celiac disease mobilizes cross-reactive T cells activated by avenin peptides and immuno-dominant hordein peptides. J Autoimmun. 2015;56:56-65. doi:10.1016/j.jaut.2014.10.003.
  6. Hardy MY, Russell AK, Henneken LM, et al. Purified oat protein can trigger acute symptoms linked to immune activation in coeliac disease patients but not histological deterioration. Gut. 2025;74(6):906-917. doi:10.1136/gutjnl-2024-333589.
  7. US Food and Drug Administration. Questions and Answers on the Gluten-Free Food Labeling Final Rule. Updated September 2023. Accessed October 5, 2026. https://www.fda.gov/food/nutrition-food-labeling-and-critical-foods/questions-and-answers-gluten-free-food-labeling-final-rule
  8. Lebwohl B, Cao Y, Zong G, Hu F B, Green P H R, Neugut A I et al. Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study BMJ 2017; 357 :j1892 doi:10.1136/bmj.j1892
  9. Reynolds A, Mann J, Cummings J, Winter N, Mete E, Te Morenga L. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet. 2019;393(10170):434-445. doi:10.1016/S0140-6736(18)31809-9.