A COMPARISON OF DIETS WITH AND WITHOUT OATS IN ADULTS WITH CELIAC-DISEASE
A COMPARISON OF DIETS WITH AND WITHOUT OATS IN ADULTS WITH CELIAC-DISEASE
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DOI：
10.1056/nejm199510193331602
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发表时间：
1995-10-19
影响因子：
158.5
通讯作者：
JULKUNEN, RJK
中科院分区：
文献类型：
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作者：
JANATUINEN, EK;PIKKARAINEN, PH;JULKUNEN, RJK
背景。小麦、黑麦和大麦损害乳糜泻患者小肠黏膜；玉米和水稻是无害的。含有燕麦的饮食的效果是不确定的。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50至70克，有三种来源：两种小麦淀粉面粉混合等量燕麦，含有60%燕麦的什锦麦片和燕麦卷早餐麦片）。52名乳糜泻缓解期的成年人随访6个月，40名新诊断的乳糜泻患者随访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。燕麦组的平均（+/-SD）燕麦摄入量为缓解期患者6个月时每天49.9+/-14.7 g，新诊断疾病患者12个月时每天46.6+/-13.3 g。燕麦组和对照组在营养状况、症状或实验室测量方面没有显著差异。缓解期患者，无论饮食如何，均未出现十二指肠绒毛结构恶化或单核细胞浸润增加。除了对照组的一名患者外，所有新诊断的患者一年后病情都有所缓解。燕麦组的6名患者和对照组的5名患者退出了研究。对于大多数乳糜泻成年患者来说，在无谷蛋白饮食中加入适量燕麦不会产生不良反应。
Background. 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.Methods. 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.Results. 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 group and five in the control group withdrew from the study.Conclusions. Moderate amounts of oats can be included in a gluten-free diet for most adult patients with celiac disease without adverse effects.