Who else gets an occasional hankering for oats at breakfast? Slow cooked, steel cut oats used to be a breakfast staple in my pre-paleo days. And I always thought I was safe---after all, they don't contain the proteins found in wheat, barley, or rye that elicit an immunological response in celiac disease---right?
WRONG. Because grains are grown, harvested, transported, and stored together, cross-contamination of oats with gluten is rampant (Fric et al., 2011). Moreover, there is a sizable subset of celiac patients who are intolerant to oats---and for which oats may be cross-reactive (in other words, the body identifies oats and gluten as one in the same, and oats perpetuate autoimmune tissue destruction to the degree that gluten does) (Fric et al., 2011).
It turns out, that the peptides contained in wheat, rye, barley, and oats (gliadin, secalin, horedin, and avenin, respectively) all resist digestion in the upper gastrointestinal tract and elicit an immune-mediated enteropathy (Sapone et al., 2012; Pietzak, 2012). Cultivars of oats low in avenin may be tolerated by celiac patients; however, these cultivars are not currently distinguished commercially (Thompson, 2003; Janatuinen et al., 2002).
The subset of celiac patients who do not tolerate oats (presumably studies where high avenin oats have been used) develop villus atrophy (flattening of the "shag carpet" in your small intestine that absorbs nutrients), skin rash, gut symptoms, and increased transcription of IFN-gamma, a marker of small intestinal inflammation (Fric et al., 2011).
So, to be safe, oats are a no-go for most celiac patients. Even if you are asymptomatic upon consuming them, silent inflammation and destruction could be brewing in your gut, or you could experience delayed extra-intestinal (systemic) symptoms that you fail to associate with oat consumption.
So what's an oat loving girl to do? If you crave a bit of sweetness in the morning with a porridge-like texture, try this Cinnamon Apple Quinoa Bake---combined with some animal protein and healthy fat for satiation and blood sugar stability, this is a great heat-and-go breakfast.
Quinoa is a wonderful re-introduction on the autoimmune paleo protocol if you can tolerate it. The ancestral practice of soaking and sprouting this grain-like seed minimizes anti-nutrient content and liberates nutrients for better bioavailability.
Fric, P., Gabrovska, D. & Nevoral, J. 2011. Celiac disease, gluten-free diet, and oats. Nutrition Reviews, 69, 107-15.
Janatuinen, E. K., Kemppainen, T. A., Julkunen, R. J. K., Kosma, V.-M., Mäki, M., Heikkinen, M. & Uusitupa, M. I. J. 2002. No harm from five year ingestion of oats in coeliac disease. Gut, 50, 332-335.
Pietzak, M. 2012. Celiac Disease, Wheat Allergy, and Gluten Sensitivity. Journal of Parenteral and Enteral Nutrition, 36, 68S-75S.
Sapone, A., Bai, J. C., Ciacci, C., Dolinsek, J., Green, P. H., Hadjivassiliou, M., Kaukinen, K., Rostami, K., Sanders, D. S., Schumann, M., Ullrich, R., Villalta, D., Volta, U., Catassi, C. & Fasano, A. 2012. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine, 10, 13.
Thompson, T. 2003. Oats and the gluten-free diet. Journal of the American Dietetic Association, 103, 376-379.
1 cup of sprouted uncooked quinoa
2 pasture-raised organic eggs
2 cups of unsweetened almond milk
2 honey crisp apples, peeled and diced
1/3 cup of raw, sprouted almonds, chopped
1.5 teaspoons organic ground cinnamon
1/2 teaspoon organic ground nutmeg
2 tablespoons of raw honey (mine contained fall spices including ginger, allspice, nutmeg, and cinnamon), melted (or substitute 1/4 cup of maple syrup)
optional add ins - 1/8th teaspoon of clove
1) Grease an 8 x 8 inch pan with coconut oil
2) Mix uncooked quinoa and the spices in a bowl and evenly distribute the mixture into the greased pan
3) Add peeled and diced apples on top of the mixture
4) In the same bowl that you mixed the quinoa, whisk two eggs, two cups of almond milk, and the honey
5) Pour the egg, milk, and honey mixture over the top of the fruit and quinoa in the pan
6) Sprinkle chopped almonds on top
7) Bake for one hour until mostly set
8) Allow the casserole to cool and serve
9) Eat alone or with a dollop of unsweetened almond milk yogurt or coconut yogurt