Dietetics — Advice Letter to a Patient Newly Diagnosed with Coeliac Disease
A dietitian writes an advice letter to a 34-year-old woman newly diagnosed with coeliac disease, explaining the lifelong gluten-free diet, what foods to avoid, the cross-contamination risk, and how to read food labels. A beginner case with a single dietary change and clear, actionable instructions.
Letter type
Advice
Write to
Patient
Target length
180–200 words
The case notes
Patient: Ms Lauren Collins, 34 years old; recently confirmed coeliac disease on biopsy (Marsh III)
Gluten-free diet: Strictly lifelong — no wheat, barley, rye, or any product containing them; oats are tolerated by most coeliacs but avoid initially and reintroduce after gut healing under dietitian supervision
Cross-contamination: A tiny amount of gluten can cause damage — use a separate toaster, separate butter/jam spreads, separate chopping boards; inform restaurants (coeliac, not preference); check soy sauce, stock cubes, ready meals, processed meats (common hidden gluten sources)
Naturally gluten-free foods: Rice, potatoes, corn, quinoa, fresh meat and fish, eggs, legumes, all fresh fruit and vegetables, plain dairy
Label reading: Look for the crossed-grain (Coeliac UK) symbol or gluten-free label (EU standard: <20 ppm); 'wheat-free' does NOT mean gluten-free — barley malt extract and rye can still be present
Follow-up: Anti-tTG antibody blood test in 3 months to monitor diet compliance; annual dietitian review
Task: Write an advice letter to Ms Collins explaining how to follow a gluten-free diet safely.
Writing task
Write an advice letter to Ms Collins explaining how to follow a gluten-free diet safely.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
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The four grains to avoid: wheat, barley, rye — and the provisional oat avoidance with supervised reintroduction
Patients frequently believe coeliac disease is only about wheat. Barley (beer, malt) and rye are equally harmful and less obvious. The oat nuance is a clinically accurate instruction the patient cannot derive from a simple no-grains rule.
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The cross-contamination risk and the practical household measures
Cross-contamination is the most common reason a diagnosed coeliac continues to have symptoms. The toaster, shared spreads, and shared chopping board are the most important household vectors.
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That wheat-free does not mean gluten-free
This is the labelling trap that most commonly causes inadvertent gluten exposure in newly diagnosed patients.
Leave out
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A complete list of every gluten-containing food
The patient needs principles and the highest-risk examples, not an exhaustive inventory. The Coeliac UK App provides comprehensive food lists; the letter provides the framework.
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Nutritional deficiency management in detail
A brief mention — 'your GP will check your blood count and vitamin levels' — covers it. Detailed supplementation advice belongs in a separate consultation.
Criterion in focus · Language
A coeliac disease advice letter requires precise, unambiguous language because mistakes cause real harm. 'Try to avoid gluten' is not accurate — even trace amounts cause gut damage; 'avoid gluten strictly' is correct. 'Most soy sauces contain gluten — always check the label' is more useful than 'be careful with processed foods'. Precision in food language is a Language criterion requirement in dietetic letters.
Now write the letter — and find out what is blocking your Grade B
Write a 180–200 words advice letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.