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Does oatmeal interfere with medications?

Interactions. Oat bran may decrease absorption of medications. There are reports of decreased absorption of HMG-CoA reductase inhibitors and iron with oat bran ingestion.

drugs.com - Oats Uses, Benefits & Dosage - Drugs.com Herbal Database
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Oats

Scientific Name(s): Avena sativa L.

Common Name(s): Avena (Spanish), Hafer (German), Ma-karasu-mugi (Japanese), Oats

Medically reviewed by Drugs.com. Last updated on Sep 30, 2021.

Clinical Overview

Use

Oats and oatmeal are used primarily as a food source. Use in celiac disease is debated. Benefits in dermatology, hypercholesterolemia, cardiovascular conditions, and diabetes mellitus remain controversial.

Dosing

The recommended intake of beta-glucan for reduction of cholesterol is 3 g/day, an amount found in approximately 90 g of oats.

Contraindications

None well documented.

Pregnancy/Lactation

US Food and Drug Administration (FDA) generally recognized as safe (GRAS) status when used as food. Avoid dosages higher than those found in food because safety and efficacy are unproven.

Interactions

Oat bran may decrease absorption of medications. There are reports of decreased absorption of HMG-CoA reductase inhibitors and iron with oat bran ingestion. Oat bran increases the bulk of stools and frequency of defecation, which may result in distention, flatulence, and perineal irritation. Oat sensitization and allergy have been described.

Toxicology

Data are lacking.

Scientific Family

Gramineae

Botany

Oats grow as hardy annual grasses able to withstand poor soil conditions in which other crops are unable to thrive and are best adapted to areas with a cool, moist climate; Russia, the United States, Finland, and Poland are the world's major oat-producing countries. The plant grows to approximately 61 to 91 cm in height and has straight, hollow, blade-like leaves. The flowers contain 2 or 3 florets and are clustered at the top of the plant. Oat grain grows enclosed in 2 hulls that protect it during development. It contains 3 main structures: the bran, endosperm, and the germ containing embryonic structures that can grow into a new plant.1, 2, 3

History

Derived from wild grasses, the oat evolved into today's cultivated plant. The oldest known oat grains were found in Egyptian remains dating from approximately 2,000 BC. Scottish settlers introduced oats into North America in the early 17th century. Before being used as a food for humans, oats were used as a livestock feed in the form of grain, pasture, hay, or silage. Traditional medicinal uses of oats include the treatment of rheumatism, depression, chronic neurological pain, atonia of the bladder, and, externally, as a skin cleanser and emollient.2, 3

Chemistry

The dietary value of oats is very high compared with that of other cereals in the Gramineae family. Oats are a good source of soluble and insoluble fiber, manganese, selenium, phosphorous, tryptophan, thiamine, and vitamin E (mainly as alpha-tocopherol). The protein content is 15% to 20% higher than that of other cereal grains3 with approximately 10% consisting of storage proteins known as avenins.4 These proteins belong to the prolamin group and are related to the gluten found in wheat.4 Oat bran contains the soluble dietary fiber beta-glucan, a highly viscous soluble polysaccharide with a linear, unbranched structure composed of 4-O- and 3-O-linked beta-D-glucopyranosyl units. Other polysaccharides in oat include starch, araban, and xylan gums. Lipid content is high, especially in unsaturated triglycerides. Lipase, lipoxygenase, and superoxide dismutase are enzymes present in oats.3 Phenolic esters, including avenacins, phenols (hydroxycinnamic, ferulic, p-coumaric, and caffeic acids), and other phenolic compounds (benzoic and cinnamic acids, quinones, flavones, flavonols, chalcones, flavanones, anthrocyanidines, aminophenolics, avenanthramides) have been identified.3, 5, 6, 7

Uses and Pharmacology

The widespread use of oats and oatmeal preparations makes the findings of animal experiments largely redundant. An extract of oats is used in traditional Ayurvedic medicine to cure opium addiction, but a few older trials were conducted on the potential of oats in treating addictions with conflicting results.(50, 51, 52) A study in rats receiving increasing alcohol doses up to 8 g/kg/day demonstrated a protective effect of oats on gut leakiness associated with endotoxemia and liver injury.(53)

Cancer

The avenanthramides from oats have been investigated for potential anticancer applications.(54, 55)

Cardiovascular

The FDA recognizes that beta-glucan may play a role in reducing the risk of coronary heart disease.(8) In vitro experiments using human aortic endothelial cells showed reduced monocyte adherence and decreased production of cytokines involved in inflammatory response with oat phenolic avenanthramide pretreatment. A role in reducing the risk of atherosclerosis has been suggested.(5)

Clinical data

In a trial of overweight dyslipidemic adults (N = 30), oats had no effect on endothelial dysfunction over a 6-week period compared with placebo. Subgroup analysis (not powered for) suggested a beneficial effect.(9) A pilot study showed a reduction in systolic and diastolic blood pressure in 18 patients with mild or borderline hypertension who received oat cereal. Beta-glucan content of the cereal was standardized to 5.52 g/day.(10) However, these results were not confirmed by another small trial that showed no change in blood pressure despite a similar daily intake of beta-glucan.(11) In a larger trial of 97 patients with hypertension, beta-glucan administered for 12 weeks did not affect blood pressure except in subgroup analysis, which was not powered for in the study design.(12) A decrease in systolic pressure (but not diastolic) was reported in a 12-week trial of 206 healthy middle-aged volunteers who consumed three 30 to 40 g portions of whole grain foods daily. No changes in markers of inflammation were noted.(13)

Celiac disease

The role of oats in the diet of patients with celiac disease is controversial and possibly compounded by results of older, uncontrolled trial data or the use of contaminated oats.(14) A smaller proportion of immunogenic storage proteins is found in oats than in wheat, barley, and rye, and oat-derived proteins are more readily digested by the protease enzymes in the gut. In addition, the proline found in oat avenin is more readily digested by protease enzymes, which results in rapid degradation of potentially harmful peptides and may help to prevent the initiation of an immune response against oats in the small intestine.(4, 15) Some people with celiac disease possess avenin-reactive mucosal T cells that can cause mucosal abnormality.(16, 17) A long-term study of oat ingestion in adults with celiac disease showed no effect on duodenal villous architecture, inflammatory cell infiltration of the duodenal mucosa, or antibody titers after 5 years.(15, 21) Similar results were obtained in children with newly diagnosed celiac disease.(20, 22) Two systematic reviews, as well as the World Gastroenterology Organisation, and the Finnish, United Kingdom, and Canadian celiac associations consider that uncontaminated oats can be consumed by most patients with celiac disease. Because of the possibility for oat intolerance in some people, the reviewers suggest eliminating oats initially and only adding moderate amounts in well-established, gluten-free diets. The American Celiac Sprue Association regards the use of oats as not risk-free.(16, 19, 23) Studies suggesting that oats are safe in patients with dermatitis herpetiformis have also been published.(4, 15, 24, 25, 26)

Dermatology

Despite their promotion for management of dry, itchy skin conditions, claims about the benefits of colloidal oat-containing preparations are largely based on older trials(3, 56) but the popularity of colloidal oatmeal in the management of pruritus is increasing.(56, 57, 58) Although listed in the United States Pharmacopeia, the FDA has added a caution to the skin protectant monograph regarding over-drying that may occur from prolonged soaking in colloidal oatmeal.(59) Additionally, the use of oatmeal-containing products may cause sensitization in children with atopic dermatitis.(60)

Diabetes mellitus

Meals high in soluble fiber have been shown to reduce the rise in postprandial blood glucose and insulin concentration, attributed in part to an increase in the viscosity of the contents of the stomach and small intestine, with a subsequent reduction in the rate of absorption of digested nutrients.(27, 28) The results of studies of oats in diabetic patients are conflicting. As a component of medical nutrition therapy for patients with type 1 or type 2 diabetes, the American Diabetes Association Standards of Care (2014) recommend an increase in foods containing n-3 fatty acids (EPA and DHA; from fatty fish), viscous fiber (eg, oats, legumes, citrus), and plant-based stanols or sterols to help treat dyslipidemias in most diabetic patients (ie, those who do not have severe hypertriglyceridemia) (high-quality evidence).(76)

Clinical data

Fasting plasma glucose, insulin, and glycosylated hemoglobin (HbA 1c ) were unaffected by a dietary regimen containing oat bran (beta-glucan 3 g) concentrate in a number of trials. Dosages of beta-glucan in these trials ranged from 2.25 to 6 g/day over 6 to 12 weeks.(12, 29, 30, 31, 32, 33) A slight effect on the glucose response curve was shown in a trial in healthy adults.(34) In a small trial of patients with mild type 2 diabetes, oat bran flour produced a lower glycemic response than glucose.(28) Similar responses were obtained in a few additional trials.(35, 36, 37, 38) The use of a beta-glucan–enriched bedtime snack to reduce the prevalence of silent nocturnal hypoglycemia in children with diabetes mellitus has been investigated.(39) Children receiving the enriched snack experienced flattening of the blood glucose curve before midnight, but the incidence of hypoglycemia after 2 AM remained unchanged. The ability of a variety of oat and barley food products to lower postprandial blood glucose was evaluated in a 2013 meta-analysis of 34 human studies; patients with type 2 diabetes mellitus (including NIDDM) were excluded as were trials that employed low viscosity extracts or deliberately depolymerized beta-glucan. A dose of at least 3 g beta-glucan per meal of intact oats or barley (cooked or fermented), or at least 4 g soluble beta-glucan (with a molecular weight greater than 250,000 g/mol) in processed oat and barley food products, which provided 30 to 80 g of available carbohydrate, was sufficient to produce a physiologically relevant reduction (at least −27 mmol min/L) in postprandial blood glucose. Glycemic response was greater for intact grains than for processed foods. The efficacy rate and average reduction in area under the curve (AUC), respectively, were as follows: intact kernel foods (96%, −99 mmol min/L); raw flours, flakes, and bran in beverages or puddings (75%, −75 mmol min/L); muffin batter (92%, −60 mmol min/L); dry cereal products (82%, −32 mmol min/L); and breads (64%, −29 mmol min/L). Oat and barley products were not significantly different with respect to average reduction in AUC or glycemic index.(73) Data from studies assessing oat and barley beta-glucan effects on blood glucose levels, as well as cholesterol levels, were analyzed in a 2011 meta-analysis that included subjects with or without health conditions. Of the 126 eligible studies, 82 studied oat beta-glucan; daily beta-glucan doses ranged from 2 to 14 g/day. Analysis revealed a significant reduction in blood glucose (−2.58 mmol/L); heterogeneity was high. A beta-glucan dose of 1 g/day resulted in a change in blood glucose of −0.084 mmol/L, but showed uncertain changes in blood glucose levels with changes in beta-glucan dosage.(74) A meta-analysis of randomized controlled trials has assessed the effect of beta-glucan extract on glycemic control and insulin sensitivity in patients with or without diabetes. A total of 18 trials met inclusion criteria; 7 trials (N=423) utilized beta-glucan extract. All 7 studies used beta-glucan extracted from cereals (oats, oat bran, barley) and the dose of the extract ranged from 3 to 10 g/day for up to 8 weeks. Significant heterogeneity was observed among the studies and subgroup analysis found the variability in study results to be impacted by study location (significant benefit associated with studies conducted in Asian but not Western countries), type of study (benefit in parallel but not crossover designs), participant health status (benefit in type 2 diabetics and hyperlipidemics), and duration of intervention (less than 8 weeks vs 8 weeks). Overall, beta-glucan extract was not as effective as whole oats in reducing HbA 1c , fasting blood glucose, or insulin sensitivity.(79)

GI effects

The American College of Gastroenterology (ACG) clinical guideline for the management of irritable bowel syndrome (IBS) (2021) suggests that soluble fiber like that found in oat bran, but not insoluble fiber, be used to treat global IBS symptoms (Strong; moderate).(81)

Hyperlipidemia

Oat fiber produces modest reductions in cholesterol levels and may exert a small positive effect on the risk of coronary artery disease, but the mechanism is unclear. Although evidence suggests that some soluble fibers bind with bile acids or cholesterol, resulting in an increased clearance of low-density lipoprotein (LDL) cholesterol, this action may be insufficient to account for the observed cholesterol reductions. Other proposed mechanisms include inhibition of hepatic fatty acid synthesis, changes in intestinal motility, and reduction in absorption of macronutrients, resulting in increased insulin sensitivity and satiety, with a consequent overall reduction in total energy intake.(32, 40, 41, 42) Other factors to be considered when interpreting trial data include the solubility and molecular weight of beta-glucan, unfavorable changes during commercial preparation, storage conditions, and cooking processes.(41, 43)

Clinical data

A large number of studies have been conducted to evaluate the effect of oat bran supplementation on blood lipid levels, with results included in several meta-analyses.(40, 41, 74, 77) Substantial heterogeneity among individual studies suggests that the effects of fiber are not uniform, possibly as a result of inconsistent dosages. Many, but not all, trials show reductions in LDL-cholesterol.(30, 31, 32, 33, 37, 38, 40, 41, 43, 44, 45, 46, 47, 48, 49, 74, 77) In addition, nonlinearity was observed at higher doses (eg, above 3 g/day), suggesting a possible diminished adherence or biological maximum being reached at these doses.(37, 40, 41, 74) In a 2011 meta-analysis that included subjects with or without health conditions, significant reductions occurred in total cholesterol, LDL, and triglycerides/triacylglycerol after beta-glucan consumption. Of the 126 eligible studies, 82 studied oat beta-glucan; daily beta-glucan doses ranged from 1.2 to 10 g/day in total cholesterol studies. Analysis revealed a significant dose-response reduction in total cholesterol with 1 g/day yielding a −0.079 mmol/L change, but no significant dose-response relation was noted for LDL, high-density lipoprotein, or triglycerides/triacylglycerol. (74) A 2014 meta-analysis of data from 28 randomized clinical trials on the consumption of at least 3 g/day of oat beta-glucan for at least 2 weeks in generally healthy normo- or hypercholesterolemic adults found significant reductions in LDL and total cholesterol (P = 0.0001 each) but not high-density lipoproteins or triglycerides.(77) A small, uncontrolled study in AIDS patients on highly active antiretroviral therapy (n = 31) failed to produce any clinically or statistically significant improvement in cholesterol parameters or uricemia with daily supplementation of 20 g of oat bran contained in a formulation that also contained flaxseed and soy protein (10 g/day each).(75) Dietary supplementation with a commercially available beta-glucan product (Betaglucare; 3 g/day for 8 weeks) was observed to reduce LDL cholesterol by 0.3 mmol/L (P=0.0002) compared to baseline in patients with myasthenia gravis in a prospective, uncontrolled study. Patients with an initial baseline LDL of at least 3 mmol/L experienced a slightly greater reduction. LDL was reduced equally regardless of diabetes diagnosis or baseline BMI. Mean HbA 1c was not significantly affected.(78) The FDA has endorsed the relationship between inclusion of beta-glucan soluble fiber in the diet and a decrease in serum cholesterol, and advises a dosage of beta-glucan 3 g/day soluble fiber. A causal relationship with decreased cardiovascular disease has not been demonstrated.(41) The 2017 joint position statement of the Italian Society of Diabetology (ISD) and the Italian Society for the Study of Arteriosclerosis (ISSA) on nutraceuticals for the treatment of hypercholesterolemia strongly recommends the use of fiber (eg, oat beta-glucan, chitosan, glucomannan, guar gum, HPMC, pectin, psyllium) to lower LDL in the general population that fails to increase dietary fiber; in patients with mild hypercholesterolemia and low to moderate cardiovascular risk; or in patients with mild hypercholesterolemia and metabolic syndrome (Level I, Strength A).(80)

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Nutrition in the elderly population

Studies have shown that the addition of oats into diets of elderly persons increases bioavailability of vitamin B 12 , reduces laxative use, and supports the maintenance of body weight.(61, 62)

Weight loss

Clinical trials evaluating the effect of adding oats to energy deficient diets have largely found no additive effect.(46, 49, 63) Satiety is increased with the addition of fiber in some, but not all, studies.(64, 65, 66)

Dosing

The recommended intake of beta-glucan for reduction of cholesterol is 3 g/day, an amount found in approximately 90 g of oats.40, 41, 46 An estimate of decreases in LDL by 5 mg/dL (0.13 mmol/L) is produced by inclusion of 3 g/day beta-glucan in the average American adult.46 Moderate dietary amounts of oats, 20 to 25 g/day in children and 50 to 70 g/day in adults, are suggested in celiac disease.15

Pregnancy / Lactation

Generally recognized as safe when used as food. Avoid dosages above those found in food because safety and efficacy are unproven.

Interactions

Oat bran may decrease absorption of medications. In 2 patients with hypercholesterolemia, concomitant ingestion of 50 to 100 g of oat bran and lovastatin 80 mg resulted in an increase in LDL compared with taking lovastatin alone.(67) Absorption of iron is decreased with concomitant consumption of oats, attributed to the presence of phytic acid in the fiber fraction of cereals.(68) Oat bran increases stool bulk, which may cause discomfort, and more frequent defecation may result in perineal irritation.69 The increase in stool bulk has been used to advantage in stoma reversal.70 Digestion of fiber by colonic bacteria may cause gaseous distention and flatulence. Adequate fluid intake is recommended to ensure hydration and dispersion of fiber in the GI tract. Contact dermatitis from oat flour has been reported.71 A study linking life-threatening, recurrent, exercise-induced anaphylaxis with gliadin-containing grains, including oats, has been published.72 A higher than expected incidence of oat sensitization in children with atopic dermatitis has been reported.60

Toxicology

Data are lacking.

References

Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product. This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

More about oats Related treatment guides Dietary Supplementation

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Soluble fibre oat and barley beta-glucan enriched products: can we predict cholesterol-lowering effects? Br J Nutr. 2007;97(6):1049-1050.17381959 42. Ellegård L, Andersson H. Oat bran rapidly increases bile acid excretion and bile acid synthesis: an ileostomy study. Eur J Clin Nutr. 2007;61(8):938-945.17251929 43. Kerckhoffs DA, Hornstra G, Mensink RP. Cholesterol-lowering effect of beta-glucan from oat bran in mildly hypercholesterolemic subjects may decrease when beta-glucan is incorporated into bread and cookies. Am J Clin Nutr. 2003;78(2):221-227.12885701 44. Karmally W, Montez MG, Palmas W, et al. Cholesterol-lowering benefits of oat-containing cereal in Hispanic Americans. J Am Diet Assoc. 2005;105(6):967-970.15942550 45. Robitaille J, Fontaine-Bisson B, Couture P, Tchernof A, Vohl MC. Effect of an oat bran-rich supplement on the metabolic profile of overweight premenopausal women. Ann Nutr Metab. 2005;49(3):141-148.15942159 46. Maki KC, Beiseigel JM, Jonnalagadda SS, et al Whole-grain ready-to-eat oat cereal, as part of a dietary program for weight loss, reduces low-density lipoprotein cholesterol in adults with overweight and obesity more than a dietary program including low-fiber control foods. J Am Diet Assoc. 2010;110(2):205-214.20102847 47. Ulmius M, Johansson A, Onning G. The influence of dietary fibre source and gender on the postprandial glucose and lipid response in healthy subjects. Eur J Nutr. 2009;48(7):395-402.19415409 48. Wolever TM, Tosh SM, Gibbs AL, et al. Physicochemical properties of oat beta-glucan influence its ability to reduce serum LDL cholesterol in humans: a randomized clinical trial. Am J Clin Nutr. 2010;92(4):723-732.20660224 49. Beck EJ, Tapsell LC, Batterham MJ, Tosh SM, Huang XF. Oat beta-glucan supplementation does not enhance the effectiveness of an energy-restricted diet in overweight women. Br J Nutr. 2010;103(8):1212-1222.19930764 50. Anand CL. Treatment of opium addiction. Br Med J. 1971;3(5775):640.5569993 51. Anand CL. Effect of Avena sativa on cigarette smoking. Nature. 1971;233(5320):496.4939551 52. Bye C, Fowle AS, Letley E, Wilkinson S. Lack of effect of Avena sativa on cigarette smoking. Nature. 1974;252(5484):580-581.4431518 53. Keshavarzian A, Choudhary S, Holmes EW, et al. Preventing gut leakiness by oats supplementation ameliorates alcohol-induced liver damage in rats. J Pharmacol Exp Ther. 2001;299(2):442-448.11602653 54. Guo W, Kong E, Meydani M. Dietary polyphenols, inflammation, and cancer. Nutr Cancer. 2009;61(6):807-810.20155620 55. Guo W, Nie L, Wu D, et al. Avenanthramides inhibit proliferation of human colon cancer cell lines in vitro. Nutr Cancer. 2010;62(8):1007-1016.21058188 56. Meydani M. Potential health benefits of avenanthramides of oats. Nutr Rev. 2009;67(12):731-735.19941618 57. Matheson JD, Clayton J, Muller MJ. The reduction of itch during burn wound healing. J Burn Care Rehabil. 2001;22(1):76-81.11227690 58. Cerio R, Dohil M, Jeanine D, Magina S, Mahé E, Stratigos AJ. Mechanism of action and clinical benefits of colloidal oatmeal for dermatologic practice. J Drugs Dermatol. 2010;9(9):1116-11120.20865844 59. Food and Drug Administration, HHS. Skin protectant drug products for over-the-counter human use; astringent drug products; final monograph; direct final rule. Direct final rule. Fed Regist. 2003;68(114):35290-35293.12807133 60. Boussault P, Léauté-Labrèze C, Saubusse E, et al. Oat sensitization in children with atopic dermatitis: prevalence, risks and associated factors. Allergy. 2007;62(11):1251-1256.17919139 61. Sturtzel B, Dietrich A, Wagner KH, Gisinger C, Elmadfa I. The status of vitamins B6, B12, folate, and of homocysteine in geriatric home residents receiving laxatives or dietary fiber. J Nutr Health Aging. 2010;14(3):219-223.20191257 62. Sturtzel B, Mikulits C, Gisinger C, Elmadfa I. Use of fiber instead of laxative treatment in a geriatric hospital to improve the wellbeing of seniors. J Nutr Health Aging. 2009;13(2):136-139.19214342 63. Beck EJ, Tapsell LC, Batterham MJ, Tosh SM, Huang XF. Increases in peptide Y-Y levels following oat beta-glucan ingestion are dose-dependent in overweight adults. Nutr Res. 2009;29(10):705-709.19917449 64. Willis HJ, Eldridge AL, Beiseigel J, Thomas W, Slavin JL. Greater satiety response with resistant starch and corn bran in human subjects. Nutr Res. 2009;29(2):100-105.19285600 65. Lyly M, Liukkonen KH, Salmenkallio-Marttila M, Karhunen L, Poutanen K, Lähteenmäki L. Fibre in beverages can enhance perceived satiety. Eur J Nutr. 2009;48(4):251-258.19306033 66. Peters HP, Boers HM, Haddeman E, Melnikov SM, Qvyjt F. No effect of added beta-glucan or of fructooligosaccharide on appetite or energy intake. Am J Clin Nutr. 2009;89(1):58-63.19056555 67. Richter WO, Jacob BG, Schwandt P. Interaction between fibre and lovastatin. Lancet. 1991;338(8768):706.1679514 68. Bering S, Suchdev S, Sj⊘ltov L, Berggren A, Tetens I, Bukhave K. A lactic acid-fermented oat gruel increases non-haem iron absorption from a phytate-rich meal in healthy women of childbearing age. Br J Nutr. 2006;96(1):80-85.16869994 69. Valle-Jones JC. An open study of oat bran meal biscuits ('Lejfibre') in the treatment of constipation in the elderly. Curr Med Res Opin. 1985;9(10):716-720.3000692 70. Saunders RN, Thomas WM. Antegrade porridge enema to assess anorectal function after severe perineal sepsis. Ann R Coll Surg Engl. 2006;88(1):74-75.16468137 71. Calzavara-Pinton PG, Tosoni C, Carlino A, Cattaneo R. Contact eczematous dermatitis caused by wheat and oats [in Italian]. G Ital Dermatol Venereol. 1989;124(6):289-291.2534305 72. Varjonen E, Vainio E, Kalimo K. Life-threatening, recurrent anaphylaxis caused by allergy to gliadin and exercise. Clin Exp Allergy. 1997;27(2):162-166.9061215 73. Tosh SM. Review of human studies investigating the post-prandial blood-glucose lowering ability of oat and barley food products. Eur J Clin Nutr. 2013;67(4):310-317.23422921 74. Tiwari U, Cummins E. Meta-analysis of the effect of β-glucan intake on blood cholesterol and glucose levels. Nutrition. 2011;27(10):1008-1016.21470820 75. Ferreira Rdos S, Cassaro DC, Domingos H, Pontes ER, Aiko PH, Meira JE. The effects of a diet formulation with oats, soybeans, and flax on lipid profiles and uricemia in patients with AIDS and dyslipidemia. Rev Soc Bras Med Trop. 2013;46(6):691-697.24474009 76. American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care. 2014;37(suppl 1):S14-S80.24357209 77. Whitehead A, Beck EJ, Tosh S, Wolever TM. Cholesterol-lowering effects of oat beta-glucan: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2014;100:1413-1421.25411276 78. Haggård L, Andersson M, Punga AR. β-glucans reduce LDL cholesterol in patients with myasthenia gravis. Eur J Clin Nutr. 2013;67(2):226-267.23187951 79. He LX, Zhao J, Huang YS, Li Y. The difference between oats and beta-glucan extract intake in the management of HbA1c, fasting glucose and insulin sensitivity: a meta-analysis of randomized controlled trials. Food Funct. 2016;7(3):1413-1428.26840185 80. Pirro M, Vetrani C, Bianchi C, Mannarino MR, Bernini F, Rivellese AA. Joint position statement on "Nutraceuticals for the treatment of hypercholesterolemia" of the Italian Society of Diabetology (SID) and of the Italian Society for the Study of Arteriosclerosis (SISA). Nutr Metab Cardiovasc Dis. 2017;27(1):2-17.27956024 81. Lacy BE, Pimentel M, Brenner DM, et al. ACG Clinical Guideline: Management of irritable bowel syndrome. Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.000000000000103633315591 1.L. USDA, ARS, National Genetic Resources Program. Germplasm Resources Information Network - (GRIN) [Online Database]. National Germplasm Resources Laboratory, Beltsville, Maryland. URL: http://www.ars-grin.gov/cgi-bin/npgs/html/tax_search.pl. (07 July 2008)2. Gibson L, Benson G. Origin, history, and uses of oat () and wheat (). Iowa State University. Department of Agronomy. January 2002. http://www.agron.iastate.edu/courses/agron212/readings/Oat_wheat_history.htm. Accessed January 11, 2012.3. Kurtz ES, Wallo W. Colloidal oatmeal: history, chemistry and clinical properties.. 2007;6(2):167-170.173731754. Vader LW, Stepniak DT, Bunnik EM, et al. Characterization of cereal toxicity for celiac disease patients based on protein homology in grains.. 2003;125(4):1105-1113.145177945. Liu L, Zubik L, Collins FW, Marko M, Meydani M. The antiatherogenic potential of oat phenolic compounds.. 2004;175(1):39-49.6. Chen CY, Milbury PE, Kwak HK, Collins FW, Samuel P, Blumberg JB. Avenanthramides and phenolic acids from oats are bioavailable and act synergistically with vitamin C to enhance hamster and human LDL resistance to oxidation.. 2004;134(6):1459-1466.151734127. Chen CY, Milbury PE, Collins FW, Blumberg JB. Avenanthramides are bioavailable and have antioxidant activity in humans after acute consumption of an enriched mixture from oats.. 2007;137(6):1375-1382.8. Food and Drug Administration, HHS. Food labeling: health claims; soluble dietary fiber from certain foods and coronary heart disease. Final rule.. 2003;68(144):44207-44209.128848769. Katz DL, Evans MA, Chan W, et al. Oats, antioxidants and endothelial function in overweight, dyslipidemic adults.. 2004;23(5):397-403.1546694610. Keenan JM, Pins JJ, Frazel C, Moran A, Turnquist L. Oat ingestion reduces systolic and diastolic blood pressure in patients with mild or borderline hypertension: a pilot trial.. 2002;51(4):369.1197826211. Davy BM, Melby CL, Beske SD, Ho RC, Davrath LR, Davy KP. Oat consumption does not affect resting casual and ambulatory 24-h arterial blood pressure in men with high-normal blood pressure to stage I hypertension.. 2002;132(3):394-398.1188056112. Maki KC, Galant R, Samuel P, et al. Effects of consuming foods containing oat beta-glucan on blood pressure, carbohydrate metabolism and biomarkers of oxidative stress in men and women with elevated blood pressure.. 2007;61(6):786-795.1715159213. Tighe P, Duthie G, Vaughan N, et al. Effect of increased consumption of whole-grain foods on blood pressure and other cardiovascular risk markers in healthy middle-aged persons: a randomized controlled trial.. 2010;92(4):733-740.2068595114. Delaney B, Nicolosi RJ, Wilson TA, et al. Beta-glucan fractions from barley and oats are similarly antiatherogenic in hypercholesterolemic Syrian golden hamsters.. 2003;133(2):468-475.1256648515. Pulido OM, Gillespie Z, Zarkadas M, et al. Introduction of oats in the diet of individuals with celiac disease: a systematic review.. 2009;57:235-285.1959538916. Garsed K, Scott BB. Can oats be taken in a gluten-free diet? A systematic review.. 2007;42(2):171-178.1732793617. Lundin KE, Nilsen EM, Scott HG, et al. Oats induced villous atrophy in coeliac disease.. 2003;52(11):1649-1652.1457073718. Kemppainen TA, Heikkinen MT, Ristikankare MK, Kosma VM, Julkunen RJ. Nutrient intakes during diets including unkilned and large amounts of oats in celiac disease.. 2010;64(1):62-67.1975602719. Fric P, Gabrovska D, Nevoral J. Celiac disease, gluten-free diet, and oats.. 2011;69(2):107-115.2129474420. Koskinen O, Villanen M, Korponay-Szabo I, et al. Oats do not induce systemic or mucosal autoantibody response in children with coeliac disease.. 2009;48(5):559-565.1941200721. Janatuinen EK, Kemppainen TA, Julkunen RJ, et al. No harm from five year ingestion of oats in celiac disease.. 2002;50(3):332-335.1183971022. Högberg L, Laurin P, Fälth-Magnusson K, et al. Oats to children with newly diagnosed coeliac disease: a randomised double blind study.. 2004;53(5):649-654.1508258123. Haboubi NY, Taylor S, Jones S. Coeliac disease and oats: a systematic review.. 2006;82(972):672-678.1706827824. Reunala T, Collin P, Holm K, et al. Tolerance to oats in dermatitis herpetiformis.. 1998;43(4):490-493.25. Hardman CM, Garioch JJ, Leonard JN, et al. Absence of toxicity of oats in patients with dermatitis herpetiformis.. 1997;337(26):1884-1887.940715526. Picarelli A, Di Tola M, Sabbatella L, et al. Immunologic evidence of no harmful effect of oats in celiac disease.. 2001;74(1):137-140.1145172927. Würsch P, Pi-Sunyer FX. The role of viscous soluble fiber in the metabolic control of diabetes. A review with special emphasis on cereals rich in beta-glucan.. 1997;20(11):1774-1780.935362228. Tapola N, Karvonen H, Niskanen L, Mikola M, Sarkkinen E. Glycemic responses of oat bran products in type 2 diabetic patients.. 2005;15(4):255-261.1605454929. Kabir M, Oppert JM, Vidal H, et al. Four-week low-glycemic index breakfast with a modest amount of soluble fibers in type 2 diabetic men.. 2002;51(7):819-826.1207772430. Cugnet-Anceau C, Nazare JA, Biorklund M, et al. A controlled study of consumption of beta-glucan-enriched soups for 2 months by type 2 diabetic free-living subjects.. 2010;103(3):422-428.1978112031. Chen J, He J, Wildman RP, Reynolds K, Streiffer RH, Whelton PK. A randomized controlled trial of dietary fiber intake on serum lipids.. 2006;60(1):62-68.32. Queenan KM, Stewart ML, Smith KN, Thomas W, Fulcher RG, Slavin JL. Concentrated oat beta-glucan, a fermentable fiber, lowers serum cholesterol in hypercholesterolemic adults in a randomized controlled trial.. 2007;6:6.1738609233. Hallikainen M, Toppinen L, Mykkänen H, et al. Interaction between cholesterol and glucose metabolism during dietary carbohydrate modification in subjects with the metabolic syndrome.. 2006;84(6):1385-1392.1715842134. Tuomasjukka S, Viitanen M, Kallio H. The glycaemic response to rolled oat is not influenced by the fat content.. 2007;97(4):744-748.1734908735. Behall KM, Scholfield DJ, Hallfrisch J. Comparison of hormone and glucose responses of overweight women to barley and oats.. 2005;24(3):182-188.1593048436. Weickert MO, Möhlig M, Schöfl C, et al. Cereal fiber improves whole-body insulin sensitivity in overweight and obese women.. 2006;29(4):775-780.1656781437. Biörklund M, van Rees A, Mensink RP, Onning G. Changes in serum lipids and postprandial glucose and insulin concentrations after consumption of beverages with beta-glucans from oats or barley: a randomised dose-controlled trial.. 2005;59(11):1272-1281.1601525038. Liatis S, Tsapogas P, Chala E, et al. The consumption of bread enriched with betaglucan reduces LDL-cholesterol and improves insulin resistance in patients with type 2 diabetes.. 2009;35(2):115-120.1923073739. Rami B, Zidek T, Schober E. Influence of a beta-glucan enriched bedtime snack on nocturnal blood glucose levels in diabetic children.. 2001;32(1):34-36.1117632140. Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis.. 1999;69(1):30-42.992512041. Poppitt SD. Soluble fibre oat and barley beta-glucan enriched products: can we predict cholesterol-lowering effects?. 2007;97(6):1049-1050.1738195942. Ellegård L, Andersson H. Oat bran rapidly increases bile acid excretion and bile acid synthesis: an ileostomy study.. 2007;61(8):938-945.1725192943. Kerckhoffs DA, Hornstra G, Mensink RP. Cholesterol-lowering effect of beta-glucan from oat bran in mildly hypercholesterolemic subjects may decrease when beta-glucan is incorporated into bread and cookies.. 2003;78(2):221-227.1288570144. Karmally W, Montez MG, Palmas W, et al. Cholesterol-lowering benefits of oat-containing cereal in Hispanic Americans.. 2005;105(6):967-970.1594255045. Robitaille J, Fontaine-Bisson B, Couture P, Tchernof A, Vohl MC. Effect of an oat bran-rich supplement on the metabolic profile of overweight premenopausal women.. 2005;49(3):141-148.1594215946. Maki KC, Beiseigel JM, Jonnalagadda SS, et al Whole-grain ready-to-eat oat cereal, as part of a dietary program for weight loss, reduces low-density lipoprotein cholesterol in adults with overweight and obesity more than a dietary program including low-fiber control foods.. 2010;110(2):205-214.2010284747. Ulmius M, Johansson A, Onning G. The influence of dietary fibre source and gender on the postprandial glucose and lipid response in healthy subjects.. 2009;48(7):395-402.1941540948. Wolever TM, Tosh SM, Gibbs AL, et al. Physicochemical properties of oat beta-glucan influence its ability to reduce serum LDL cholesterol in humans: a randomized clinical trial.. 2010;92(4):723-732.2066022449. Beck EJ, Tapsell LC, Batterham MJ, Tosh SM, Huang XF. Oat beta-glucan supplementation does not enhance the effectiveness of an energy-restricted diet in overweight women.. 2010;103(8):1212-1222.1993076450. Anand CL. Treatment of opium addiction.. 1971;3(5775):640.556999351. Anand CL. Effect ofon cigarette smoking.. 1971;233(5320):496.493955152. Bye C, Fowle AS, Letley E, Wilkinson S. Lack of effect ofon cigarette smoking.. 1974;252(5484):580-581.443151853. Keshavarzian A, Choudhary S, Holmes EW, et al. Preventing gut leakiness by oats supplementation ameliorates alcohol-induced liver damage in rats.. 2001;299(2):442-448.1160265354. Guo W, Kong E, Meydani M. Dietary polyphenols, inflammation, and cancer.. 2009;61(6):807-810.2015562055. Guo W, Nie L, Wu D, et al. Avenanthramides inhibit proliferation of human colon cancer cell lines in vitro.. 2010;62(8):1007-1016.2105818856. Meydani M. Potential health benefits of avenanthramides of oats.. 2009;67(12):731-735.1994161857. Matheson JD, Clayton J, Muller MJ. The reduction of itch during burn wound healing.. 2001;22(1):76-81.1122769058. Cerio R, Dohil M, Jeanine D, Magina S, Mahé E, Stratigos AJ. Mechanism of action and clinical benefits of colloidal oatmeal for dermatologic practice.. 2010;9(9):1116-11120.2086584459. Food and Drug Administration, HHS. Skin protectant drug products for over-the-counter human use; astringent drug products; final monograph; direct final rule. Direct final rule.. 2003;68(114):35290-35293.1280713360. Boussault P, Léauté-Labrèze C, Saubusse E, et al. Oat sensitization in children with atopic dermatitis: prevalence, risks and associated factors.. 2007;62(11):1251-1256.1791913961. Sturtzel B, Dietrich A, Wagner KH, Gisinger C, Elmadfa I. The status of vitamins B6, B12, folate, and of homocysteine in geriatric home residents receiving laxatives or dietary fiber.. 2010;14(3):219-223.2019125762. Sturtzel B, Mikulits C, Gisinger C, Elmadfa I. Use of fiber instead of laxative treatment in a geriatric hospital to improve the wellbeing of seniors.. 2009;13(2):136-139.1921434263. Beck EJ, Tapsell LC, Batterham MJ, Tosh SM, Huang XF. Increases in peptide Y-Y levels following oat beta-glucan ingestion are dose-dependent in overweight adults.. 2009;29(10):705-709.1991744964. Willis HJ, Eldridge AL, Beiseigel J, Thomas W, Slavin JL. Greater satiety response with resistant starch and corn bran in human subjects.. 2009;29(2):100-105.1928560065. Lyly M, Liukkonen KH, Salmenkallio-Marttila M, Karhunen L, Poutanen K, Lähteenmäki L. Fibre in beverages can enhance perceived satiety.. 2009;48(4):251-258.1930603366. Peters HP, Boers HM, Haddeman E, Melnikov SM, Qvyjt F. No effect of added beta-glucan or of fructooligosaccharide on appetite or energy intake.. 2009;89(1):58-63.1905655567. Richter WO, Jacob BG, Schwandt P. Interaction between fibre and lovastatin.. 1991;338(8768):706.167951468. Bering S, Suchdev S, Sj⊘ltov L, Berggren A, Tetens I, Bukhave K. A lactic acid-fermented oat gruel increases non-haem iron absorption from a phytate-rich meal in healthy women of childbearing age.. 2006;96(1):80-85.1686999469. Valle-Jones JC. An open study of oat bran meal biscuits ('Lejfibre') in the treatment of constipation in the elderly.. 1985;9(10):716-720.300069270. Saunders RN, Thomas WM. Antegrade porridge enema to assess anorectal function after severe perineal sepsis.. 2006;88(1):74-75.1646813771. Calzavara-Pinton PG, Tosoni C, Carlino A, Cattaneo R. Contact eczematous dermatitis caused by wheat and oats [in Italian].. 1989;124(6):289-291.253430572. Varjonen E, Vainio E, Kalimo K. Life-threatening, recurrent anaphylaxis caused by allergy to gliadin and exercise.. 1997;27(2):162-166.906121573. Tosh SM. Review of human studies investigating the post-prandial blood-glucose lowering ability of oat and barley food products.. 2013;67(4):310-317.2342292174. Tiwari U, Cummins E. Meta-analysis of the effect of β-glucan intake on blood cholesterol and glucose levels.. 2011;27(10):1008-1016.2147082075. Ferreira Rdos S, Cassaro DC, Domingos H, Pontes ER, Aiko PH, Meira JE. The effects of a diet formulation with oats, soybeans, and flax on lipid profiles and uricemia in patients with AIDS and dyslipidemia.. 2013;46(6):691-697.2447400976. American Diabetes Association. Standards of medical care in diabetes--2014.. 2014;37(suppl 1):S14-S80.2435720977. Whitehead A, Beck EJ, Tosh S, Wolever TM. Cholesterol-lowering effects of oat beta-glucan: a meta-analysis of randomized controlled trials.. 2014;100:1413-1421.2541127678. Haggård L, Andersson M, Punga AR. β-glucans reduce LDL cholesterol in patients with myasthenia gravis. Eur J Clin Nutr. 2013;67(2):226-267.2318795179. He LX, Zhao J, Huang YS, Li Y. The difference between oats and beta-glucan extract intake in the management of HbA1c, fasting glucose and insulin sensitivity: a meta-analysis of randomized controlled trials. Food Funct. 2016;7(3):1413-1428.2684018580. Pirro M, Vetrani C, Bianchi C, Mannarino MR, Bernini F, Rivellese AA. Joint position statement on "Nutraceuticals for the treatment of hypercholesterolemia" of the Italian Society of Diabetology (SID) and of the Italian Society for the Study of Arteriosclerosis (SISA).. 2017;27(1):2-17.2795602481. Lacy BE, Pimentel M, Brenner DM, et al. ACG Clinical Guideline: Management of irritable bowel syndrome.. 2021;116(1):17-44. doi:10.14309/ajg.000000000000103633315591

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