Celiac disease affects about 1 in 100 people. In addition, about 6% of people are gluten-sensitive, meaning, they do not have classic celiac disease, but feel much better when they eliminate gluten from their diets. On top of those, there is an even larger group of individuals who believe avoiding gluten is simply better for you.
Food manufacturers have seized on this great economic opportunity and large numbers of gluten-free products have been popping up on store shelves everywhere. Unfortunately, this has created more of a dietary trap than a path to eating better. Fat is gluten-free. Sugar is gluten-free. And the next thing you know, that White Chocolate Iced Mocha Latte gets stamped with a gluten-free label – all 500 calories of it.
This may be one of the reasons why people with celiac disease face a higher risk of heart disease risk. Celiac disease is associated with high levels of inflammation – which predisposes to heart disease because inflammation is also a central component of plaque formation. But if you just substitute inflammation from gluten with inflammation from unhealthy foods, you’re no further ahead in terms of preventing heart disease.
Eating healthfully while eating gluten-free can therefore be a tricky business – and you need to go far beyond just avoiding gluten. Because unless you’re really conscientious about your diet, you could end up deficient in the 4 critical nutrients for heart disease prevention – whole food fiber, omega 3 fatty acids, antioxidants and plant sterols while over-consuming counterproductive nutrients such as saturated fats and processed/simple carbs.
But there’s another layer of food quality that is especially relevant to celiac sufferers. It has to do with oats, which are naturally gluten-free and may be present in gluten-free products.
According to the Academy of Nutrition and Dietetics, “Oats are considered naturally gluten-free. But they are likely to be contaminated with wheat, barley, or rye. This is because of the way oats are grown, harvested, transported, and processed.” The resultant gluten contamination can be relatively minor and random, and depending on which batch of oats is used for testing, can be missed entirely. For individuals with gluten sensitivity, this is not a problem. For patients with celiac disease, this can mean the difference between staying healthy and experiencing a disease flare.
Which is why patients with celiac disease should favor using only products that contain purity protocol oats. Purity protocol oats come from pure and uncontaminated seeds grown on fields without wheat, rye or barley in the crop rotation for at least 3 years. They are seeded and harvested using dedicated machinery and transported using thoroughly cleaned equipment. They are processed in a dedicated gluten-free facility and extensively tested for gluten contamination.
Most gluten-free food manufacturers do not use purity protocol oats. And, there is no rule or mandate that dictates that manufacturers need to disclose where their oats come from – on their packaging or their websites. So it takes extra sleuthing to be sure.
Fortunately, Gluten Free Watchdog keeps track of companies that have committed to purity protocol oats and lists them on their website. You can access the listing here.
Elizabeth Klodas, MD, FACC, is a cardiologist and founder of Preventive Cardiology Consultants in Minneapolis. She is also the founder and chief medical officer of Step One Foods, a company dedicated to helping patients minimize their dependence on medications through strategic dietary changes.