The safety of oats for people with coeliac disease is controversial. Australia and New Zealand exclude oats from the gluten free diet due to safety concerns, but many other countries do not. Oat is a nutritious grain that is high in fibre and may have a range of health benefits, but it is important to determine if they can be safely consumed by people with coeliac disease.

We have shown that almost 10 per cent of people with coeliac disease have T cells that target peptides within oats, potentially putting them at risk of adverse effects. This study aims to definitively determine if people with coeliac disease are at risk of oats toxicity, whether this can be predicted by an immune blood test or food test, and whether a specific type or dose of oats can be consumed safely.

This study will involve the consumption of contamination-free oats, immune blood tests and for some, gastroscopy and biopsy of the small bowel.

The gluten-free diet is the main treatment for coeliac disease, yet many patients continue to have intestinal damage or experience symptoms despite many years on the diet. Ongoing intestinal damage is concerning as it is associated with a higher rate of complications such as osteoporosis, infections, refractory coeliac disease and cancers such as lymphoma.

This project is investigating the reasons why the gluten-free diet fails in some patients despite their best attempts to exclude gluten. While it is assumed that low amounts of inadvertent gluten exposure is responsible for dietary failure, the actual causes for this have not been systematically addressed. This study is exploring the role of gluten contamination in commercial gluten-free foods and gluten-free products sold in food outlets, examining food handling, labelling and testing practices in industry, and looking at patient factors that contribute to knowledge and compliance to the diet.

The findings will inform targeted strategies to improve gluten-free diet outcomes for people with coeliac disease.