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Hospitals that serve our food to patients:
-Children's National Medical Center; Washington, DC in-patient and cafeteria meals.
-Anne Arundel Medical Center; Annapolis, MD; in-patient meals.
Celiac Disease (CD) and Gluten Sensitivity (GS):
CD affects about 1.3 % of the population and is an IgA Autoimmune disease where gluten protein (wheat, rye, barley) causes damage to the intestines and can cause many complications. GS affects about 6% of the population. However, even with all of the knowledge that we have now; it is believed that 85% of those with CD are not yet diagnosed! CD often presents with intestinal symptoms and villous atrophy of the small intestine. Those with GS may have similar symptoms but they don't have villous atrophy or antibodies for CD. Sometimes those with CD and GS don't complain of gastrointestinal symptoms at all and they just present with neurological or psychological symptoms. (see link to 300 symptoms below)
Both CD and GS are diagnosed by the same tests. However, GS is a diagnosis of exclusion. Below are the five criteria used for a Celiac Diagnosis and the patient only needs to meet 4 of the 5 criteria and testing is done while patient is still consumng gluten:
1) The presence of signs/symptoms compatible with Celiac Disease
2) Positive serology screening (high levels of anti TTG and/or EMA), 5 Tests:
-AGA (anti gliadin antibodies)- IgA
-tTG (anti-tissue transglutaminase)-IgA
-EMA (anti-endomysial antibodies)-IgA
-Total Serum IgA
-Note: there is a 70% False Negative in the US on the Antibody Blood Tests (GlutenFreeRN). That is why the intestinal biopsy is still the Gold Standard Test!
3) Presence of pre-disposing genes HLA DQ2 and/or HLA DQ8
4) Histological evidence of auto insult of jejunal mucosa typical of Celiac Disease (biopsy)
5) Resolution of symptoms and normal serology test following implementation of GF Diet
If a patient meets 4 or 5 criteria, they are given a diagnosis of Celiac Disease. If the patient meets 3 or less of the criteria they are put on a gluten-free diet. If symptoms are relieved, they are given a diagnosis of GS.
If you think you or your child has a gluten related disorder, please make sure you see a Gastroenterologist who is well versed in Celiac Disease and Gluten Sensitivity. 70% of patients test negative on blood work and positive on intestinal biopsy.
(sources: Gluten Freedom by Dr. Alessio Fasano; Director, The Center for Celiac Research, MassGeneral Hospital for Children. National Institute of Health).
Dermatitis Herpetiformis; DH is often misdiagnosed as eczema and is the specific IgA skin manifestation of Celiac Disease; seen in 25% of those with Celiac Disease. It presents as an itchy skin rash that can show up anywhere on the body. This is diagnosed by a dermatologist (experienced with this) via a skin biopsy of unaffected skin directly adjacent to an IgA deposit and they must perform a very specific process called direct immunoflourescence. (The reason the biopsy is taken from skin adjacent to the lesion is that inflammation in the lesion can destroy IgA deposits) Often, those with DH show no gastrointestinal symptoms or damage and have negative blood serum for Celiac Disease. Again, DH is the skin manifestation of Celiac Disease! (Source: Dr. Daniel Leffler, Director The Celiac Center, Beth Israel Deaconess Medical Center) For more information from NIH Click Here
For more information see our Blog (click tab on top of page) or:
There are more than 300 signs and symptoms of Celiac Disease.
To learn more, Gluten Free Works Celiac Disease Symptom Guide
Food Allergies affect about 12% of the population and are IgE Reactions. That can be severe and life threatening. If you think you or your child has a food allergy, please see an allergist for appropriate medical testing prior to dining with us. Make sure your doctor tells you what is safe to consume and always carry a food allergy card. If you are "challenging" an allergen, please do so under your physicians care and not here. Always carry your Epinephrine with you. Contact FARE for support and educational materials and see our FAQ Page. For more information Click Here
EoE: If you or your child has EoE (Eosinophilic Esophogitis); IgA inflamation and swelling in the esophogus caused by an allergic/immune condition, we consider that a life threatening food allergy, because reactions can be severe. For more information from the American Partnership for Eosinophilic Disorders; Click Here
FPIES: Food Protein-Induced Enterocolitis: If you or your child suffer from this please let us know! We treat that just like an anaphylactic food allergy. FPIES is a non-IgE-mediated type of food allergy that is usually triggered by Cow's Milk or Soy but it can be caused by cereals like rice or oats. It can cause vomitting, diarrhea and often reactions can be delayed by two or three hours. FPIES Foundation: Click Here
Alpha Gal Meat Protein Allergy: Please let us know if you have this as well and we treat this just like an anaphylactic food allergy because reactions can be severe. This is a delayed reaction IgE food allergy often brought on after a tick bite from a lone star tick. The tick bite releases a carbohydrate into the victim and then when they ingest red meat, there is an IgE reaction to the meat carbohydrate. Often it is a delayed reaction. Click Here for More Info
Galactosemia: This is a rare genetic disorder due to digestive enzyme deficiency causing the person to not be able to break down the sugars galactose and lactose. Just like in Celiac Disease, the only treatment is complete avoidance of galactose and lactose. All infants are screened for this in the US. Severe complications are: enlarged liver, renal failure, cataracts, seizure, hypoglyxemia, lethargy, brain damage, ataxia, ovarian failure, speech deficits, diminished bone density. Click Here for More Info
Dysautonomia: is not really rare, actually, more than 70 million people worldwide suffer from this. "Dysautonomia" is and umbrella term used to describe several different medical conditions that cause a malfunction in the autonomatic nervous system. The Autonomatic Nervous System controls the temperature, metobolic and endocrine systems and participates in the regulation of our gastrointestinal, urinary and cardiovascular systems. Basically, the functions in the body that we don't need to think about in order for our body to perform them. Examples of these functions would be our heart rate, digestion, kidney function, temperature control and the dilation and constriction of the pupils in the eyes. Those with one or several forms of dysautonomia will have trouble regulating these systems.
Dysautonomia can occur secondary to other medical conditions such as Celiac Disease, Diabetes, Multiple Sclerosis, Parkinson's Disease, Lupus, Rheumatoid Arthristis and Sjogren's Syndrome. Some forms of Dysautonomia are: POTS (Postural Orthostatic Tachycardia Syndrome), NCS (Neurocardiogenic Syncope), MSA (Multiple System Atrophy), EDS (Ehlers Danlos Syndrome), Gastroparesis and Mast Cell Activation Disorders.
For More Information on the above, please click on my Blog tab at the top of this page, scroll down and click on Rare Diseases.
Above and Beyond Rare International (facebook page): Click Here
Mast Cell Disorders: The Mastocytosis Society
Ehlers-Danlos Society: Click Here
Dysautonomia International: Click Here
Dysautonomia Youth Network of America, Inc. www.dynainc.org.
ADHD and Autism: 5% of children with Autism have Celiac Disease and 95% have some level of gluten sensitivity. (Dr Allessio Fasano) There are many great local and national support groups available such as Talk About Curing Autism, Pathfinders for Autism and Autism Speaks that offer support on all things related to Autism and ADHD. TACA has extensive information about the GFCFSF Diet and local support meetings.
Food Sensitivities and Food Preferences:
We know that food sensitivities are very real and we urge everyone to see a doctor if you suspect gluten issues or food allergies. Please see a doctor to find out exactly what the problem is; instead of just "self diagnosing". Remember, our first job is to make sure that those with life threatening Food Allergies or Celiac Disease can eat safely.
After ruling out Celiac Disease and Food Allergies, often there is diagnosis of food sensitivities; which are a minor reaction to food and are not life threatening. These sensitivities are said to cause inflammation in the body. Often, the person affected does not even know what food they may have an issue with. These sensitivities are (IgG) ususally diagnosed by a non-traditional doctor via specific blood tests, stool samples, etc.; and are not covered by insurance because the testing is not approved or validated by the FDA. These tests do not test for Celiac Disease!
We ask that you not claim a food allergy if you just have a sensitivity (IgG Cyrex Labs type testing) to a food or just don't like a certain food or ingredient. Serious and life threatening food allergies to an item that we have in our kitchens will mean that we have to completely shut down and clean a kitchen line in order to safely serve that guest. This means that no other food can come or go from that kitchen until the allergy meal is delivered to the customer. This extreme steps puts us in a shut down mode and delays all orders from that kitchen line. Therefore, we don't like being told someone is "allergic" to something when they really just "don't like it” or just have a minor sensitvity because that does not warrant this type of extreme measure. We know what is in our food and we can tell if someone is not being honest with us by the way they answer our questions!
We are very conscious of your wants and needs and want to accommodate you. However, claiming an allergy when it is just a minor sensitivity or preference is what makes it very difficult for those with Celiac Disease and life threatening food allergies to eat out safely and causes us NOT be taken seriously when dining out. When you dine at One Dish Cuisine Cafe, Deli and Bakery it is not like going to any other restaurant!
Because so many people use the term “Food Allergy” incorrectly, we often need to ask customers many very specific questions in order to make sure that we completely understand their situation. We have detailed ingredient lists and know what is in our food. Those with Food Allergies, EoE and Celiac Disease count on us to clearly understand their situation so we can safely serve them. We have to be correct when we make their food, therefore, they don't get upset with us for asking clarifying questions in order to keep them safe. For more information please see our FAQ page: "What is the difference between Food Sensitivities, Food Allergies and Celiac Disease?".
When a customer is misrepresenting their situation; they are never "right" because it is disrespectful to us and to those with Life Threatening Food Allergies and/or Celiac Disease.
Special thanks to Erin Tapley at Creative Fuze for website design: firstname.lastname@example.org and Jennifer Hughes for Website Photos: http://jenniferhughes.com/ and Colleen Feehely for exterior cafe shot on home page.
OPEN 6 DAYS A WEEK: Closed on Tuesdays
Bakery Opens Daily at 10 am - For coffee, donuts muffins, etc.
Mon: 10 am - 7:30 pm | Wed - Sat: 10 am - 7:30 pm | Sun: 10 am - 3 pm
We are always closed on the following days:
New Years Day, Easter Sunday, Memorial Day, 4th of July, Labor Day, Thanksgiving Day and Christmas Day.
We close early on the following days:
Halloween, Thanksgiving Eve, Christmas Eve & New Years Eve