Janatuinen E K, Pikkarainen P H, Kemppainen T A, Kosma V M, Järvinen R M, Uusitupa M I, Julkunen R J
Department of Medicine, Kuopio University Hospital, Finland.
N Engl J Med. 1995 Oct 19;333(16):1033-7. doi: 10.1056/NEJM199510193331602.
Wheat, rye, and barley damage the small-intestinal mucosa of patients with celiac disease; maize and rice are harmless. The effects of a diet containing oats are uncertain.
In a randomized trial, we compared the effects of gluten-free diets without oats and with oats (with a goal of 50 to 70 g per day from three sources: two types of wheat-starch flour mixed with an equal amount of oats, muesli containing 60 percent oats, and rolled-oat breakfast cereal). Fifty-two adults with celiac disease in remission were followed for 6 months and 40 with newly diagnosed disease for 12 months. Endoscopy with duodenal biopsy was performed at the beginning and end of the study.
The mean (+/- SD) oat intake in the oat group was 49.9 +/- 14.7 g per day at 6 months for patients in remission and 46.6 +/- 13.3 g per day at 12 months for patients with newly diagnosed disease. The oat and control groups did not differ significantly in nutritional status, symptoms, or laboratory measures. Patients in remission, regardless of diet, did not have worsening architecture of the duodenal villi or increased mononuclear-cell infiltration. All the patients with new diagnoses were in remission at one year, except for one in the control group. Six patients in the oat groups and five in the control group withdrew from the study.
Moderate amounts of oats can be included in a gluten-free diet for most adult patients with celiac disease without adverse effects.
小麦、黑麦和大麦会损害乳糜泻患者的小肠黏膜；玉米和大米则无害。含燕麦饮食的影响尚不确定。
在一项随机试验中，我们比较了不含燕麦和含燕麦的无麸质饮食的效果（目标是每天从三种来源摄入50至70克燕麦：两种小麦淀粉面粉与等量燕麦混合、含60%燕麦的什锦早餐、燕麦片早餐谷物）。52名缓解期的成年乳糜泻患者随访6个月，40名新诊断患者随访12个月。在研究开始和结束时进行十二指肠活检的内镜检查。
缓解期患者在6个月时，燕麦组的平均（±标准差）燕麦摄入量为每天49.9±14.7克，新诊断患者在12个月时为每天46.6±13.3克。燕麦组和对照组在营养状况、症状或实验室指标方面无显著差异。无论饮食如何，缓解期患者的十二指肠绒毛结构没有恶化，单核细胞浸润也没有增加。除对照组的一名患者外，所有新诊断的患者在一年时均处于缓解状态。燕麦组有6名患者、对照组有5名患者退出研究。
对于大多数成年乳糜泻患者，无麸质饮食中可包含适量燕麦，且无不良影响。
