Nutrition and Celiac Disease

Celiac disease affects about 1% of the European and North American population. The classical clinical presentation is with symptoms of malabsorption. Serologic studies demonstrate that most celiac patients present with oligosymptomatic (silent), latent, potential, and extraintestinal forms. The disease is defined as an immune-mediated systemic disorder of genetically disposed individuals (HLA-DQ2/8) induced by the alcohol-soluble fractions of cereals and characterized by gluten-dependent symptoms, celiac-specific antibodies (against tissue transglutaminase 2), and a Marsh 2-3 enteropathy. In the last 60 years, a strict and lifelong gluten-free diet has been demonstrated to be effective and safe, preventing most potential complications of the disease, including autoimmune disease, osteoporosis, infertility, prematurity, and malignancy. Among patients with celiac disease, the toxicity of oats seems to be less than wheat, barley, and rye. The introduction of oats into the diet of patients with celiac disease should increase taste, fiber content, diversity, compliance with the diet, and quality of life. The clinical studies provide limited results in favor of a general harmlessness of oats for celiac disease patients. Patients with celiac disease who consume oats (20-25 g/d for children, 50-70 g/d for adults) need proper follow-up.