Gluten Free Oats on Prescription An update on the inclusion of oats in the gluten free diet


CHRISTINE BAILEY MSc PGCE MBANT CNHC


INTRODUCTION


The only treatment for coeliac disease is a life-long exclusion of gluten from the diet and a selected range of staple foods is available on prescription to aid compliance.


Historically breakfast cereals have not been included on prescription, despite being a key staple within the UK diet, and the regular consumption of wholegrain cereals has been shown to have a number of health benefits, being naturally rich in many vitamins and minerals and lower in fat than many other types of breakfasts.


For coeliac patients, the lack of suitable healthy gluten free cereals has long been a problem. Many cereals on offer are highly processed, low in fibre and key nutrients and high in sugar and fail to contribute significantly to the increased nutritional needs of coeliac patients.


Now for the first time the Advisory Committee on Borderline Substances has approved Gluten Free Oat Porridge on prescription, with the approval of Nairn’s Gluten Free Oat Porridge available on prescription from March 2012.


Recent studies have emphasised that the inclusion of gluten free oats can increase the nutritional profile of the diet for those with CD, as well as increasing variety of food eaten. The approval of gluten free oats on prescription now enables patients to benefit from the proven additional health benefits that oats provide.


Christine Bailey is a renowned Nutritionist, Speaker, Chef, Food and Health Consultant and Author with over 16 years of experience. A specialist in allergy free food she was awarded Coeliac Chef of the Year 2009. She is a member of BANT (The British Association for Applied Nutrition and Nutritional Therapy), CNHC (Complementary & Natural Healthcare Council) and is a Graduate member of the Institute of Functional Medicine (IFM).


BENEFITS OF OATS


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For further information on the latest research and guidance on inclusion and monitoring please visit: www.nairns-oatcakes.com/gluten-free/ health-care-professionals


Coeliac UK will be issuing new guidelines to confirm how gluten free oats can be included within patients monthly prescription allowances. For further information visit: www.coeliac.org.uk


References available on request from Nairn’s – telephone: 0131 620 7000


100% wholegrain – Oats can contribute to the recommended 3 servings of whole grains per day.


Low glycemic index – Oats provide a sustained energy source to help maintain healthy blood sugar levels and aid weight reduction. Beta-glucans found in oats have been shown to possess beneficial effects in diabetes supporting more even blood sugar levels through the day.


High in fibre – Oats provide a rich source of insoluble and soluble fibre essential for healthy digestion and of particular importance for coeliac patients who are at greater risk of certain cancers especially gastrointestinal cancers.


Heart Friendly – Oats have been proven to reduce LDL and total cholesterol, help lower high blood pressure, and reduce the risk of cardiovascular disease. Studies show that in individuals with high cholesterol (above 220 mg/dl), consuming just 3 grams of soluble oat fibre per day (an amount found in one bowl of oats) typically lowers total cholesterol by 8-23%.


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Oats are rich in calcium, phosphorous, magnesium, selenium, and are a good source of zinc and B vitamins. Regular consumption of oats (especially when served with milk or fortified milk alternative) may assist in the maintenance of healthy bone mass and reduce the risk of osteoporosis, the incidence of which is 50% amongst coeliac patients.


SUITABILITY OF OATS FOR COELIAC DISEASE


At the nutritional level, oats are an important source of slow releasing carbohydrates, protein, vitamins, minerals, phytonutrients and fibre and could therefore be beneficial for people with CD. In addition, the palatability of oats could contribute to the acceptability of a diet without wheat, barley and rye.


Oats do not contain gluten but a similar protein to gluten called avenins. Current research and clinical studies suggest that pure oats are safe for the majority of people with CD and can be tolerated without signs of intestinal inflammation. However a major concern is the contamination of oats with wheat, rye or barley and for that reason only certified gluten free oats should be considered for inclusion in a coeliac diet.


To ensure suitability it is important that all patients wishing to include gluten free oats be considered on an individual basis and should seek the support of their health care practitioner.


INTRODUCING GLUTEN FREE OATS


It is recommended that patients avoid all oats in the first six months to a year after they have been diagnosed with CD.This will assist with healing of the gut and absorption of nutrients as well as ensuring they are free of symptoms.


Prior to introducing gluten free oats it is recommended that antibody levels are measured and if sufficiently low a trial introduction of gluten free oats undertaken. It is recommended that patients are carefully monitored with coeliac serology and signs and symptoms to ensure that they are appropriate for the patient. Suitability could be ascertained if inflammatory markers and antibody levels remain low months after re- introduction into the diet.


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