Thompson T
J Am Diet Assoc. 1997 Dec;97(12):1413-6. doi: 10.1016/S0002-8223(97)00341-6.
Celiac disease is an intolerance to protein fractions in wheat, rye, barley, and possibly oats. When these grains are consumed by a person with celiac disease, they damage the mucosa of the small intestine, which eventually leads to malabsorption of nutrients. Patients are therefore advised to remove these grains from their diet, with lifelong adherence generally suggested. Although many dietitians and physicians consider this dietary prescription to be standard protocol, it is actually quite controversial. Whether oats can safely be consumed by persons with celiac disease has been debated since the gluten-free diet was first advocated more than 40 years ago. Historically, there have been several reasons for this debate, including the difficulty in identifying the precise amino acid sequence in gliadin that is responsible for toxicity; the differences in cereal chemistry between wheat and oats; and the lack of well-designed studies to assess the toxicity of oats. A growing body of evidence now suggests that moderate amounts of oats may be safely consumed by most adults with celiac disease. If further research continues to find no adverse effects from oat consumption, a consensus may emerge on the place of oats in the gluten-free diet. In the meantime, individual dietary prescriptions, routinely assessed for appropriateness using histologic and/or serologic studies, may be warranted to prevent unnecessary dietary restrictiveness and undesirable medical complications.
乳糜泻是对小麦、黑麦、大麦以及可能还有燕麦中的蛋白质成分不耐受。当患有乳糜泻的人食用这些谷物时，它们会损害小肠黏膜，最终导致营养物质吸收不良。因此，建议患者从饮食中去除这些谷物，通常建议终身坚持。尽管许多营养师和医生认为这种饮食处方是标准方案，但实际上它颇具争议。自从40多年前首次倡导无麸质饮食以来，患有乳糜泻的人是否能安全食用燕麦一直存在争议。从历史上看，这场争论有几个原因，包括难以确定麦醇溶蛋白中导致毒性的确切氨基酸序列；小麦和燕麦在谷物化学方面的差异；以及缺乏评估燕麦毒性的精心设计的研究。现在越来越多的证据表明，大多数患有乳糜泻的成年人可以安全食用适量的燕麦。如果进一步的研究继续发现食用燕麦没有不良影响，那么对于燕麦在无麸质饮食中的地位可能会达成共识。与此同时，可能有必要根据组织学和/或血清学研究定期评估个体饮食处方的适宜性，以防止不必要的饮食限制和不良的医疗并发症。
