Skip to main content Accesibility Help
×
×
Home

Oats and bowel disease: a systematic literature review

  • Frank Thies (a1), Lindsey F. Masson (a2) (a3), Paolo Boffetta (a4) (a5) and Penny Kris-Etherton (a6)
Abstract

Whole-grain foods such as oats may protect against colorectal cancer and have benefits on inflammatory bowel disease and coeliac disease. The present study aimed to systematically review the literature describing intervention studies that investigated the effects of oats or oat bran on risk factors for bowel disease. A literature search was conducted using Embase, Medline and the Cochrane library, which identified 654 potential articles. Thirty-eight articles describing twenty-nine studies met the inclusion criteria. Two studies carried out in participants with a history of colorectal adenomas found no effects of increased oat-bran intake on indirect risk makers for colorectal cancer. One of two interventions with oat bran in patients with ulcerative colitis showed small improvements in the patients' conditions. Most of the eleven studies carried out in adults with coeliac disease showed no negative effects of uncontaminated oat consumption. The fourteen studies carried out in volunteers with no history of bowel disease suggest that oats or oat bran can significantly increase stool weight and decrease constipation, but there is a lack of evidence to support a specific effect of oats on bowel function compared with other cereals. A long-term dietary intake of oats or oat bran could benefit inflammatory bowel disorders, but this remains to be proven. A protective effect on colorectal adenoma and cancer incidence has not yet been convincingly shown. The majority of patients with coeliac disease could consume up to 100 g/d of uncontaminated oats, which would increase the acceptability of, and adherence to, a gluten-free diet.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Oats and bowel disease: a systematic literature review
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Oats and bowel disease: a systematic literature review
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Oats and bowel disease: a systematic literature review
      Available formats
      ×
Copyright
Corresponding author
* Corresponding author: F. Thies, fax +44 1224 554761, email f.thies@abdn.ac.uk
References
Hide All
1 World Cancer Research Fund/American Institute for Cancer Research (2007) Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective. AICR Washington, DC.
2 Cancer Research UK (2012) Bowel cancer incidence statistics. http://www.cancerresearchuk.org/cancer-info/cancerstats/types/bowel/incidence/uk-bowel-cancer-incidence-statistics#geog (accessed May 2013).
3 Aune, D, Chan, SM, Lau, R, et al. (2011) Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose–response meta-analysis of prospective studies. BMJ 343, d6617.
4 Slavin, JL, Martini, MC, Jacobs, DRJ, et al. (1999) Plausible mechanisms for the protectiveness of whole grains. Am J Clin Nutr 70, S459S463.
5 Molodecky, NA, Soon, IS, Rabi, DM, et al. (2012) Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 142, 4654.
6 Vernia, P (2007) Butyrate in the treatment of ulcerative colitis. Dig Liver Dis Suppl 1, 2730.
7 Di Sabatino, A, Cazzola, P, Ciccocioppo, R, et al. (2007) Efficacy of butyrate in the treatment of mild to moderate Crohn's disease. Dig Liver Dis Suppl 1, 3135.
8 Reilly, NR & Green, PHR (2012) Epidemiology and clinical presentations of celiac disease. Semin Immunopathol 34, 473478.
9 Verdu, EF, Armstrong, DA & Murray, JA (2009) Between celiac disease and irritable bowel syndrome: the “no man's land” of gluten sensitivity. Am J Gastroenterol 104, 15871594.
10 The Coeliac Society, United Kingdom (2011) Guidelines on coeliac disease and oats. http://www.coeliac.org.uk/healthcare-professionals/healthcare-professional-newsletters/october-hcp-exg/oats-in-the-gluten-free (accessed May 2013).
11 Ciclitira, PJ, Dewar, DH, McLaughlin, SD, et al. (2010) The Management of Adults with Coeliac Disease. British Society of Gastroenterology, High Wycombe.
12 Hoffenberg, EJ, Haas, J, Drescher, A, et al. (2002) A trial of oats in children with newly diagnosed celiac disease. J Pediatr 137, 361366.
13 Janatuinen, EK, Kemppainen, TA, Julkunen, RJ, et al. (2002) No harm from five year ingestion of oats in coeliac disease. Gut 50, 332335.
14 Halpern, SH & Douglas, MJ (editors) (2005, 2007) Appendix: Jadad scale for reporting randomized controlled trials. pp. 237238 (2005, 2007) Evidence-Based Obstetric Anesthesia. Blackwell Publishing Limited, Oxford.
15 Kashtan, H, Stern, HS, Jenkins, DJ, et al. (1992) Colonic fermentation and markers of colorectal-cancer risk. Am J Clin Nutr 55, 723728.
16 Macrae, FA, Kilias, D, Selbie, L, et al. (1997) Effect of cereal fibre source and processing on rectal epithelial cell proliferation. Gut 41, 239244.
17 Hallert, C, Bjorck, I, Nyman, M, et al. (2003) Increasing fecal butyrate in ulcerative colitis patients by diet: controlled pilot study. Inflamm Bowel Dis 9, 116121.
18 Zhang, JX, Hallmans, G, Andersson, H, et al. (1992) Effect of oat bran on plasma cholesterol and bile acid excretion in nine subjects with ileostomies. Am J Clin Nutr 56, 99105.
19 Baker, PG & Read, AE (1976) Oats and barley toxicity in coeliac patients. Postgrad Med J 52, 264268.
20 Dissanayake, AS, Truelove, SC & Whitehead, R (1974) Lack of harmful effect of oats on small-intestinal mucosa in coeliac disease. Br Med J 4, 189191.
21 Kemppainen, TA, Heikkinen, MT, Ristikankare, MK, et al. (2008) Unkilned and large amounts of oats in the coeliac disease diet: a randomized, controlled study. Scand J Gastroenterol 43, 10941101.
22 Kemppainen, T, Heikkinen, M, Ristikankare, M, et al. (2009) Effect of unkilned and large amounts of oats on nutritional state of celiac patients in remission. e-SPEN 4, e30e34.
23 Kemppainen, TA, Heikkinen, MT, Ristikankare, MK, et al. (2010) Nutrient intakes during diets including unkilned and large amounts of oats in celiac disease. Eur J Clin Nutr 64, 6267.
24 Lundin, KEA, Nilsen, EM, Scott, HG, et al. (2003) Oats induced villous atrophy in coeliac disease. Gut 52, 16491652.
25 Reunala, T, Collin, P, Holm, K, et al. (1998) Tolerance to oats in dermatitis herpetiformis. Gut 43, 490493.
26 Hardman, CM, Garioch, JJ, Leonard, JN, et al. (1997) Absence of toxicity of oats in patients with dermatitis herpetiformis. N Engl J Med 337, 18841887.
27 Janatuinen, EK, Pikkarainen, PH, Kemppainen, TA, et al. (1995) A comparison of diets with and without oats in adults with celiac disease. N Engl J Med 333, 10331037.
28 Janatuinen, EK, Kemppainen, TA, Pikkarainen, PH, et al. (2000) Lack of cellular and humoral immunological responses to oats in adults with coeliac disease. Gut 46, 327331.
29 Kemppainen, T, Janatuinen, E, Holm, K, et al. (2007) No observed local immunological response at cell level after five years of oats in adult coeliac disease. Scand J Gastroenterol 42, 5459.
30 Peraaho, M, Kaukinen, K, Mustalahti, K, et al. (2004) Effect of an oats-containing gluten-free diet on symptoms and quality of life in coeliac disease. A randomized study. Scand J Gastroenterol 39, 2731.
31 Srinivasan, U, Leonard, N, Jones, E, et al. (1996) Absence of oats toxicity in adult coeliac disease. BMJ 313, 13001301.
32 Feighery, C, Srinivasan, U & Carolan, J (1998) Oats challenge in vivo does not activate coeliac disease as determined by immunohistological markers. In Changing Features of Coeliac Disease, pp. 103108 [Lohiniemi, S, editor]. Tampere: The Finnish Coeliac Society.
33 Størsrud, S, Olsson, M, Arvidsson Lenner, R, et al. (2003) Adult coeliac patients do tolerate large amounts of oats. Eur J Clin Nutr 57, 163169.
34 Størsrud, S, Hulthen, LR & Lenner, RA (2003) Beneficial effects of oats in the gluten-free diet of adults with special reference to nutrient status, symptoms and subjective experiences. Br J Nutr 90, 101107.
35 Abrahamsson, L, Goranzon, H, Karlstrom, B, et al. (1994) Metabolic effects of oat bran and wheat bran in healthy women. Scand J Nutr Naringsforsk 38, 510.
36 Anderson, JW, Story, L, Sieling, B, et al. (1984) Hypocholesterolemic effects of oat-bran or bean intake for hypercholesterolemic men. Am J Clin Nutr 40, 11461155.
37 Hosig, KB, Shinnick, FL, Johnson, MD, et al. (1996) Comparison of large bowel function and calcium balance during soft wheat bran and oat bran consumption. Cereal Chem 73, 392398.
38 Judd, PA & Truswell, S (1981) The effect of rolled oats on blood lipids and fecal steroid excretion in man. Am J Clin Nutr 34, 20612067.
39 Kirby, RW, Anderson, JW, Sieling, B, et al. (1981) Oat-bran intake selectively lowers serum low-density lipoprotein cholesterol concentrations of hypercholesterolemic men. Am J Clin Nutr 34, 824829.
40 Kretsch, MJ, Crawford, L & Calloway, DH (1979) Some aspects of bile acid and urobilinogen excretion and fecal elimination in men given a rural Guatemalan diet and egg formulas with and without added oat bran. Am J Clin Nutr 32, 14921496.
41 Calloway, DH & Kretsch, MJ (1978) Protein and energy utilization in men given a rural Guatemalan diet and egg formulas with and without added oat bran. Am J Clin Nutr 31, 11181126.
42 Kristensen, M & Bugel, S (2011) A diet rich in oat bran improves blood lipids and hemostatic factors, and reduces apparent energy digestibility in young healthy volunteers. Eur J Clin Nutr 65, 10531058.
43 Marlett, JA, Hosig, KB, Vollendorf, NW, et al. (1994) Mechanism of serum cholesterol reduction by oat bran. Hepatology 20, 14501457.
44 Noakes, M, Clifton, PM, Nestel, PJ, et al. (1996) Effect of high-amylose starch and oat bran on metabolic variables and bowel function in subjects with hypertriglyceridemia. Am J Clin Nutr 64, 944951.
45 Sturtzel, B & Elmadfa, I (2008) Intervention with dietary fiber to treat constipation and reduce laxative use in residents of nursing homes. Ann Nutr Metab 52, Suppl. 1, 5456.
46 Sturtzel, B, Mikulits, C, Gisinger, C, et al. (2009) Use of fiber instead of laxative treatment in a geriatric hospital to improve the wellbeing of seniors. J Nutr Health Aging 13, 136139.
47 Sturtzel, B, Dietrich, A, Wagner, KH, et al. (2010) The status of vitamins B6, B12, folate, and of homocysteine in geriatric home residents receiving laxatives or dietary fiber. J Nutr Health Aging 14, 219223.
48 Valle-Jones, JC (1985) An open study of oat bran meal biscuits (‘Lejfibre’) in the treatment of constipation in the elderly. Curr Med Res Opin 9, 716720.
49 Arffmann, S, Hojgaard, L, Giese, B, et al. (1983) Effect of oat bran on lithogenic index of bile and bile acid metabolism. Digestion 28, 197200.
50 Kestin, M, Moss, R, Clifton, PM, et al. (1990) Comparative effects of three cereal brans on plasma lipids, blood pressure, and glucose metabolism in mildly hypercholesterolemic men. Am J Clin Nutr 52, 661666.
51 Payler, DK, Pomare, EW, Heaton, KW, et al. (1975) The effect of wheat bran on intestinal transit. Gut 16, 209213.
52 Burkitt, DP (1973) Some diseases characteristic of modern Western civilization. BMJ 1, 274278.
53 Lipkin, M, Reddy, B, Newmark, H, et al. (1999) Dietary factors in human colorectal cancer. Annu Rev Nutr 19, 545586.
54 Schatzkin, A, Mouw, T, Park, Y, et al. (2007) Dietary fiber and whole-grain consumption in relation to colorectal cancer in the NIH-AARP Diet and Health Study. Am J Clin Nutr 85, 13531360.
55 MacDonald, TT (1995) Breakdown of tolerance to the intestinal bacterial flora in inflammatory bowel disease (IBD). Clin Exp Immunol 102, 445447.
56 Prantera, C (2008) What roles do antibiotics have in the treatment of IBD? Nat Clin Pract Gastroenterol Hepatol 5, 670671.
57 Parkes, M, Barrett, JC, Prescott, NJ, et al. (2007) Sequence variants in the autophagy gene IRGM and multiple other replicating loci contribute to Crohn's disease susceptibility. Nat Genet 39, 830832.
58 Strober, W & Fuss, IJ (2011) Proinflammatory cytokines in the pathogenesis of inflammatory bowel diseases. Gastroenterology 140, 17561767.
59 Fuss, IJ, Heller, F, Boirivant, M, et al. (2004) Nonclassical CD1d-restricted NK T cells that produce IL-13 characterize an atypical Th2 response in ulcerative colitis. J Clin Invest 113, 14901497.
60 Heller, F, Florian, P, Bojarski, C, et al. (2005) Interleukin-13 is the key effector Th2 cytokine in ulcerative colitis that affects epithelial tight junctions, apoptosis, and cell restitution. Gastroenterology 129, 550564.
61 Kruis, W, Fric, P, Pokrotnieks, J, et al. (2004) Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut 53, 16171623.
62 Tursi, A, Brandimarte, G, Papa, A, et al. (2010) Treatment of relapsing mild-to-moderate ulcerative colitis with the probiotic VSL#3 as adjunctive to a standard pharmaceutical treatment: a double-blind, randomized, placebo-controlled study. Am J Gastroenterol 105, 22182227.
63 Vivas, S, Ruiz de Morales, JM, Fernandez, M, et al. (2008) Age-related clinical, serological, and histopathological features of celiac disease. Am J Gastroenterol 103, 23602365.
64 Ludvigsson, JF, Ansved, P, Fälth-Magnusson, K, et al. (2004) Symptoms and signs have changed in Swedish children with coeliac disease. J Pediatr Gastroenterol Nutr 38, 181186.
65 Rampertab, SD, Pooran, N, Brar, P, et al. (2006) Trends in the presentation of celiac disease. Am J Med 119, 355.e9355.e14.
66 Bergamaschi, G, Markopoulos, K, Albertini, R, et al. (2008) Anemia of chronic disease and defective erythropoietin production in patients with celiac disease. Haematologica 93, 17851791.
67 Meyer, D, Stavropolous, S, Diamond, B, et al. (2001) Osteoporosis in a North American adult population with celiac disease. Am J Gastroenterol 96, 112119.
68 Chin, RL, Latov, N, Green, PH, et al. (2004) Neurologic complications of celiac disease. J Clin Neuromuscul Dis 5, 129137.
69 Thompson, T (2003) Oats and the gluten-free diet. J Am Diet Assoc 103, 376379.
70 Haboubi, NY, Taylor, S & Jones, S (2006) Coeliac disease and oats: a systematic review. Postgrad Med J 82, 672678.
71 Arentz-Hansen, H, Fleckenstein, B, Molberg, O, et al. (2004) The molecular basis for oat intolerance in patients with celiac disease. PLoS Med 1, e1.
72 Thompson, WG, Longstreth, GF, Drossman, DA, et al. (1999) Functional bowel disease and functional abdominal pain. Gut 45, 11431147.
73 Kojima, M, Wakai, K, Tokudome, S, et al. (2004) Bowel movement frequency and risk of colorectal cancer in a large cohort study of Japanese men and women. Br J Cancer 90, 13971401.
74 Watanabe, T, Nakaya, N, Kurashima, K, et al. (2004) Constipation, laxative use and risk of colorectal cancer: the Miyagi Cohort Study. Eur J Cancer 40, 21092115.
75 Park, JY, Mitrou, PN, Luben, R, et al. (2009) Is bowel habit linked to colorectal cancer? – results from the EPIC-Norfolk study. Eur J Cancer 45, 139145.
76 Simons, CCJM, Schouten, LJ, Weijenberg, MP, et al. (2010) Bowel movement and constipation frequencies and the risk of colorectal cancer among men in the Netherlands Cohort Study on Diet and Cancer. Am J Epidemiol 172, 14041414.
77 Sengupta, S, Muir, JG & Gibson, PR (2006) Does butyrate protect from colorectal cancer? J Gastroenterol Hepatol 21, 209218.
78 Lupton, JR (2004) Microbial degradation products influence colon cancer risk: the butyrate controversy. J Nutr 134, 479482.
79 McBain, JA, Eastman, A, Nobel, CS, et al. (1997) Apoptotic death in adenocarcinoma cell lines induced by butyrate and other histone deacetylase inhibitors. Biochem Pharmacol 53, 13571368.
80 Rouet-Benzineb, P, Aparicio, T, Guilmeau, S, et al. (2004) Leptin counteracts sodium butyrate-induced apoptosis in human colon cancer HT-29 cells via NF-kappaB signaling. J Biol Chem 279, 495502.
81 Andoh, A, Tsujikawa, T & Fujiyama, Y (2003) Role of dietary fiber and short-chain fatty acids in the colon. Curr Pharm Des 9, 347358.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed