A 20 year old male college student is diagnosed with celiac disease based on serologic and histologic evaluation. He is started on a gluten-free diet that he has taken great pains to follow despite his busy schedule. He notes that he only buys grains and cereals, including oatmeal, which are labeled as gluten free even when dining in the school cafeteria. However, his symptoms continue to persist. Which of the following items in his diet is least likely to be contaminating his gluten-free diet?
A. Béchamel sauce
B. Buckwheat pancakes
C. Strawberry milk
D. Herbal tea
Answer:B
A 20 year old male college student is diagnosed with celiac disease based on serologic and histologic evaluation. He is started on a gluten-free diet that he has taken great pains to follow despite his busy schedule. He notes that he only buys grains and cereals, including oatmeal, which are labeled as gluten free even when dining in the school cafeteria. However, his symptoms continue to persist. Which of the following items in his diet is least likely to be contaminating his gluten-free diet?
A. Béchamel sauce B. Buckwheat pancakes C. Strawberry milk D. Herbal tea
Explanation: Buckwheat pancakes are made from buckwheat, which does not contain gluten and does not exacerbate celiac disease. Béchamel sauce, as well as other sauces and marinades, may contain thickeners that contribute gluten to the diet. This is not always obvious, especially given that he likely eats part of the time in the college cafeteria. Strawberry milk, as well as other flavored milks, may contain thickeners, and/or other additives that could contribute gluten to his diet. Some herbal teas may also contain gluten, depending on their composition. Thus, the current American College of Gastroenterology guidelines for the management of celiac disease, recommends that all patients with non-responsive celiac disease meet with a dietician to ensure that their diets are devoid of gluten given not all products are necessarily labeled for this purpose. Key Point: All patients with celiac disease need to meet with a dietician in order to be adequately educated regarding dietary sources of gluten.