# Presentation: 746117

## Pekka CollinUniversity of TampereGreenbelt, MD July 14, 2005

- Rationale of a retrospective analysis of gluten levels in gfd
- Gluten exposure in gfd
- Variability of sensitivity to gluten in celiac disease patients –Northern European view

## Gluten-free diet n=52Kaukinen et al Scand J Gastroenterol 1999;34:163

**Naturally gfd**

**Wheat starch gfd**

**Dietary lapses**

## Intolerance to cereals Kaukinen et al Scand J Gastroenterol 2000;35:942-6

**Celiac disese**

**IBS (?)**

**Wheat allergy**

**N=88**

## Kaukinen et al 1999

**0**

**1.0**

**2.0**

**3.0**

**4.0**

**5.0**

**Villous height / crypt depth ratio**

**CD children**

**CD adults**

**DH adults**

**CD adults, **
**occasional gluten**

_**Short-term GFD**_
**      ****CD adults**

_**Untreated**_** **
**       ****CD adults**

_**Long-term GFD**_

**Kaukinen et al 1999**

## Gluten content (ppm)

**60**

**80**

**100**

**120**

**Gluten content (ppm)**

**Naturally gluten-free flours**
**   **

**Wheat-starch- based gluten-free  flours**

**40**

**20**

**140**

**160**

**180**

**200**

**<10**

**10**

**Collin et al**
** ****Aliment Pharmacol Ther **
**2004;19:1277-83**

## Consumption of floursCollin et al Aliment Pharmac Ther 2004

## Slide 7

## Recovery of small bowel mucosa

**GFD**

**Long GFD**

**ShortGFD**

**Lapses**

**USA**

**Finland**

**Recovery of small bowel mucosa**

## I           II

- <date/time>

**0**

**1.0**

**2.0**

**3.0**

**4.0**

**Villous height / crypt depth**

**Naturally GFD**
**   **

**Wheat starch- based GFD   **

**I           II**

**I           II**

**Peräaho et al**
** ****Aliment Pharmacol Ther **
**2003;17:587-94**

##  IELs /100 enterocytes

- <date/time>

**20**

**40**

**60**

**80**

**Naturally GFD**
**   **

**Wheat starch- based GFD   **

**I           II**

**I           II**

**10**

** ****IELs /100 enterocytes**

**Peräaho et al**
** ****Aliment Pharmacol Ther **
**2003;17:587-94**

## How coeliac disease patients consent to include oats in their gluten-free diet 

- How coeliac disease patients consent to include oats in their gluten-free diet

## The use of oatsn=1000 (710 responded)

**Taking currenly**

**Never used**

**Stopped**

## Oats and quality of lifePeräaho et alScand J Gastroenterol 2004;39:27-31

- Oats and quality of lifePeräaho et alScand J Gastroenterol 2004;39:27-31

- Randomized study, gfd with and without oats; 1 year; n=39
- No difference in quality of life
- Patients taking oats suffered more often from diarrhea
- Mucosal architecture similar, more IELs in the oat-group

## Conclusions (’Northern European view’)

**Conclusions ****(’Northern European view’)**

- Trace amount of residual gluten are well tolerated (100 ppm)
- A good dietary compliance is essential
- The majority of celiac disease patients appreciate oat products

## Are oats safe?

**Are oats safe?**

**+++++++**
- Janatuinen 1995
- Shrinivasan. 1996
- Shrinivasan 1999
- Janatuinen 2000
- Janatuinen 2001
- Hardman 1998
- Reunala 1998
- Hoffenberg 2000
- Holm 2000
- Picarelli 2001
- Kilmartin 2001

**+++++++**
- Högberg 2004
- Störsrud 2002
**- - - - - - - -**
- Lundin 2003
- Arentz-Hansen 2003

**Notes:**
aare oats definitely safe