B Tjellström, L Stenhammar, T Sundqvist, K Fälth-Magnusson, E Hollén, K-E Magnusson, E Norin, T Midtvedt, L Högberg
Journal: Alimentary pharmacology & therapeutics 2014;39(10):1156-60
PMID: 24661128
Oats have been allowed in the gluten-free diet of patients with coeliac disease (CD), however concerns have been raised that they may not be safe to eat in a subset of these patients. Short chain fatty acids (SFCAs) have been identified as a marker of inflammation and gut metabolism. Recent studies have found that children with CD often have elevated SCFA levels, indicating a disturbance in the gut microflora. The aim of this study was to identify the effect of consuming oats in children recently diagnosed with CD by examining faecal SCFAs. 116 children were treated with or without oats in their gluten-free diet for one year to see if oats affect the gut microflora. The findings of this study indicate that the children consuming oats had higher faecal SCFA concentration after one year than those not consuming oats. Based on this study, the authors’ conclude that oats do affect the gut microflora metabolism and that some coeliac children consuming oats may develop gut mucosal inflammation, leading to further future complications.
BACKGROUND
Faecal short chain fatty acids (SCFAs) are produced by the gut microflora. We have previously reported high faecal SCFA levels in children with coeliac disease (CD), indicating alteration in gut microfloral metabolism. Data accumulated over recent decades by us and others suggest that wheat-free oats can safely be included in a gluten-free diet (GFD). However, concerns have been raised with respect to the safety of oats in a subset of coeliacs.
AIM
To describe faecal SCFA patterns in children with newly diagnosed CD treated for 1 year with a GFD with or without oats.
METHODS
This report is part of a randomised, double-blind study on the effect of a GFD containing oats (GFD-oats) vs. a standard GFD (GFD-std). Faecal samples were received from 34 children in the GFD-oats group and 37 in the GFD-std group at initial diagnosis and/or after 1 year on a GFD. Faecal SCFAs were analysed.
RESULTS
The GFD-std group had a significantly lower total faecal SCFA concentration at 12 months compared with 0 months (P < 0.05). In contrast, total SCFA in the GFD-oats group remained high after 1 year on the GFD. The children in the GFD-oats group had significantly higher acetic acid (P < 0.05), n-butyric acid (P < 0.05) and total SCFA concentration (P < 0.01) after 1-year diet treatment compared to the GFD-std group.
CONCLUSIONS
Our results indicate that oats do affect the gut microflora function, and that some coeliac children receiving oats may develop gut mucosal inflammation, that may present a risk for future complications.
© 2014 John Wiley & Sons Ltd.
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