Gluten-free oats and diet quality in children and youth with celiac disease.

Abstract

Objectives: Celiac disease (CD) requires lifelong adherence to a strict gluten-free diet (GFD). The GFD is associated with higher intakes of fat, added sugars, and glycemic index (GI) and lower diet quality (DQ) in youth with CD. Gluten-free oats (GF-oats) are safe for CD youth, but few studies have studied the nutritional contribution of GF-oats consumption on DQ in children with CD. We hypothesized that youth with CD who consume GF-oats as part of their GFD will have higher DQ, micronutrient and fiber content, and lower GI than a GFD without GF-oats.

Methods: A case-control analysis using age-sex matched controls was performed in youth (ages 3-18 years) with CD in a 1:2 (N = 16 GF-oats cases: N = 32 Oat-free cases) ratio to compare differences in macro- and micronutrient (Canadian nutrient file), GI (mixed-method approach), DQ (healthy-eating index) between case-controls using validated methodologies. Dietary adequacy was determined by comparisons to dietary reference intakes (DRI) and to gluten free food guide (GFFG) recommendations.

Results: GF-oats did not significantly improve DQ (68.5 ± 16 [cases] vs. 64.3 ± 13 [controls], macro- and micronutrient, fiber intake, or the percentage of children meeting DRIs (p > 0.05). Children consuming GF-oats had lower dietary GI than children not consuming GF-oats (50.6 ± 2.4 [+GF-oats] vs. 56.1 ± 7.4 [-GF-oats]; p = 0.05). No differences in DQ occurred (±GF-oats) when following GFFG recommendations.

Conclusions: GF-oats are not a major determining factor of overall DQ in CD youth. Regardless of the oats in the GFD, following the pediatric GFFG was more important to DQ.