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Clinical Alimentary

Know your guts, love yourself.

Feta, orange and pine nut salad

It’s time to get back to fresh ingredients, I always crave fresh salad after the Christmas excess. This salad is a tasty low Fodmap salad that will fill you up for lunch, it also contains one of your fruit portions. Remember to separate your fruit portions through the day if you have fructose malabsorption.

Ingredients

1 navel orange.

100g of feta cheese.

3 radishes.

1 slice of red cabbage.

1 tablespoon of pine nuts.

A small handful of rocket.

8 little gem lettuce leaves.

A Sprinkling of poppy seeds.

Method

Simple really, lay the little gem lettuce on the plate, peel and slice the orange and add the other ingredients to this. Serve – or add to your lunch box for the next day!

navel_trans1What are navel oranges? They are oranges with a belly button! Navel oranges are always sweet and delicious I always look out for them at this time of year.

It’s Seville Orange Season

Seville oranges are oranges that are in season around January and are a taste experience that has both sweet and bitter overtones. They are not oranges for eating but do make an excellent marmalade and this is what most people in the UK use them for. They are suitable for a low FODMAP diet. I purchased mine from a local farmers market, which meant that they were reasonably good value. I have made this marmalade a couple of times now and for both I have used jam sugar developed for high pectin containing fruits. The high pectin in these oranges comes from using the pith, pips and skin of the oranges during the marmalade production. Be aware that some sources of pectin can be apple based. Whether you tolerate apple pectin depends on how much was used to make the jam and how much you eat at the time. Remember the low FODMAP diet is just that – low – not fodmap free – fodmap free would be impossible to follow! I don’t like too much of the shredded peel in my marmalade but you could use more in yours if you wish. I needed two bags of jam sugar and twelve oranges, plus 50ml of lemon juice to make the marmalade and the result was four 500g jars. I was a little disappointed that I didn’t get more but I suspected that I could have added more sugar and peel to make more jam. But less sugar and more fruit has to be better – right?

Using a jam pan, the first thing to do is to wash the fruit then boil them in a little water, just to cover the fruit, till they are soft. Remove the oranges and keep the water in the pan. Once cool, cut each orange in half and juice each one then save the pith and seeds. Boiling the fruit whole has the advantage of getting more juice from the fruit and allowing you to scrape some of the pith from the peel before you chop it and add it to the marmalade. Scrape the pith off the skin and slice and chop it to your desired shred size. Add an additional 500mls of water to the pan, the orange juice, shredded peel, jam sugar and lemon juice. Using a muslin bag add the remaining pith and pips to the bag and tie the top. Add the bag to the pan. Bring the marmalade to a boil and keep a rolling boil till the marmalade reaches it’s setting point. This is likely to be more than one hour but keep a check on it. Check it’s setting point by adding a small amount of marmalade to a cold plate and it should wrinkle when pushed with a spoon. Sterilize four to five jam jars, add the marmalade and seal the lids. If they are sealed correctly the marmalade will last sealed in the jar for at least a year. Serve a small amount on gluten free or sourdough spelt bread for a low fodmap breakfast treat.

Lemon drizzle spiced bundt Christmas cakes – low fodmap

When baking with gluten free flour the recipes are improved by a ‘drizzle’- to add moisture to the cake. Plus, for this special time of year, I have used best butter! Yes – B…U…T…T…E…R you heard that right . Consumed once a year in the Thompson household but it is really worth it for Christmas as butter does make a difference to the flavour of these cakes. These are special cakes for Christmas eve supper.

Ingredients

130g caster sugar

45g brown sugar

2 heaped teaspoons powdered ginger

1/2 teaspoon mixed spice

175g of best butter

220g gluten free self raising flour

3 eggs

3 tablespoons table sugar

2 tablespoons of lemon juice and 2 tablespoons of water

Cream together the butter and sugar till the mix is pale. Add each egg and beat the mixture well in between adding the eggs. If the mix appears to separate add a tablespoon of flour. When all the ‘wet’ ingredients have been added slowly fold in the flour and spices. Using a greased bundt tin add the mixture and cook in a moderate oven for approximately 30 minutes.

Add the lemon juice, water and sugar to a pan and dissolve. Remove the cakes and whilst still warm drizzle the cake well. Serve.

Serves 6 depending on the size of baking tin. You can make a ring of the houses like a traditional bundt and fill the centre with treats, if you wish.

Finally it’s snowing heavily at the bundt village – but not too much to spoil the fun!

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How to survive the holiday season without too many gut problems

The holiday season means many different things to different people, it is supposed to be a period of joy but often it really doesn’t live up to all those expectations that we often have. The media portray images of idealistic families around the Christmas tree having all their dreams come true. For some people the reality is somewhat different, Christmas can be a traumatic time and managing with all the family can be challenging, but it can also be a time when some people are alone too. Here are some tips to help you navigate your way through the period and avoid your gut spoiling the fun.

1. Tis the season to be jolly – really? You have my permission to be a Grinch too if you wish. You should not be expected to see people and be jolly, especially people who you never get along with during the rest of the year. If you don’t get on with someone then Christmas is not a time that somehow the ‘magic’ will make a difference, and likely if your inhibitions are lowered with the odd glass of Advocaat (add your choice of tipple here!) it will not end well! Suggest that you have other plans this year, make your apologies for not seeing them if you wish.

2. Scenes on TV cookery shows promote the domestic goddess, but don’t forget all those well choreographed scenes take time and lots of other people to help, likely months of planning too. Not so much of a goddess then! So don’t try to live up to this myth of being able to manage it all, you will only end up frazzled and this will likely make symptoms worse. You could have a Jacobs join – were everyone brings a different part of the dish. Or you could ask people to bring dishes from around the world, and think of others or you could go out to eat on Christmas day. Consider inviting someone who might be on their own on Christmas day. It really doesn’t have to be a traditional day – make new traditions!

Click on here to see what Nigella really thinks
Click on the image to see what Nigella really thinks.

3. Ensure you eat regularly on Christmas day – leaving hours between meals will not help, plan to have a light breakfast before your Christmas lunch – this doesn’t mean grazing all day either. Manage your portion sizes – use a smaller plate if you like your plate full and you will be just as satisfied and not over full and unable to move!

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4. Don’t slouch on the sofa eating snacks whilst watching those Christmas movies, let gravity help you gut and try to sit up when eating – or don’t snack, you will eat more than you realise if you are not being mindful about what you are eating. Alternatively plan how much you are going to eat and put it in a bowl so you know when you have had enough. Your body will thank you for it.

Seriously – not a good idea!!

5. Include some light activity mid afternoon if you are able – a gentle walk in the park perhaps or some games to get you moving around.

6. Family dynamics can be a rich source of conflict during the season, this can lead to arguments in the period leading up to Christmas and especially on the day itself. Arguments at mealtimes are really not advisable, this will do nothing to help your digestion. Stress causes your body to produce adrenaline, the fight or flight hormone, this is a response to conflict or dangerous situations, originally utilised so you can escape from predators. Your body is therefore NOT concentrating on digesting lunch. In the distant past a dose of indigestion was a very small price to pay to avoiding being eaten. So you might need to be assertive and lay down some ground rules for everyone to follow so that the meal can be as calm as possible.

7. Budget as much as you can. Planning is the key here and Christmas is for thinking of others, but not at the expense of experiencing anxiety at not being able to live up to their expectations. Again tell people in advance what you are planning, say that you are only going to be able to afford to do certain things – you may find that people are relieved that they don’t have to meet these expectations either.

8. Stick rigidly to your Low Fodmap foods (or other tolerated foods) before the day, so if you eat something that you react to, you possibly won’t have as severe symptoms as you would have with eating as you please for the full season.

9. Drink plenty of fluids through the day – a least six to eight cups of non carbonated drinks and if you do drink alcohol, match every alcoholic drink with a non alcoholic one – this will mean you drink less and stay hydrated at the same time. Drinking whilst eating slows the absorption of alcohol into the body. Stay within the healthy drinking guidelines (no more than 2-3 units per day) and watch mixers for fodmaps and fizz. Make a glass of water the final drink before going to bed to counteract the dehydrating effects of alcohol. Remember alcohol is a gut stimulant and hangovers won’t help your IBS symptoms although some people can tolerate small amounts. Try not to over indulge – intoxication can remove your resolve and you might be tempted to have more than you planned. Check out Drink Aware for details of how much alcohol is in your favourite tipple. https://www.drinkaware.co.uk/understand-your-drinking/unit-calculator

The true toll of Christmas tipple how excess plays havoc with mind and body

10. The best tip is – remember to enjoy yourself – it is not money that makes the difference but being in the presence of friends, family and company on the day – spending time with others.

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Happy Holiday!

Chicken liver and rosemary stuffing – low fodmap Christmas recipes

Sage and onion stuffing is a classic accompaniment to Christmas dinner, however for people following a low fodmap diet this is not an option because it does contain lots of onion. Perhaps this recipe might be a good alternative and uses up some of the parts of meat that often go to waste, such as liver. I do save gluten free bread to freeze when I have the odd slice, or perhaps the bread crumbles because it is a little stale. Although freezing and reheating can increase the resistant starch content. Most people who get improvements on the low fodmap diet don’t seem to have problems with resistant starches – but if resistant starch does affect you, it might be better to use fresh breadcrumbs and only have a small piece, perhaps.

Serves 8

Ingredients

1 pack of chicken livers

1 tablespoon of garlic infused oil

1 teaspoon of asafoetida

100g of celeriac (gives a flavour of celery)

100g of chopped white cabbage

200g of gluten free breadcrumbs

4 sprigs of fresh rosemary.

Salt to flavour

Method

Trim the chicken livers (remove the tougher membrane that runs between the livers lobes). Add oil to the pan and fry the asafoetida and livers till cooked. Process the cabbage, rosemary and celeriac till a fine texture is achieved and then add the cooked liver and gluten free breadcrumbs. Process till smooth. Add to a loaf tin and cook for 1 hour at gas mark 5 or you could make stuffing balls or sausages depending on your preference but his will affect the cooking time. This stuffing tastes between a stuffing and pate and goes particularly well with Turkey.

I do not put my stuffing mix in the turkey body as this will not reach the temperature needed to cook either the stuffing or the turkey. Do take care when cooking Christmas lunch – do not wash the turkey and ensure any juices from the turkey run clear. Prevention of food poisoning during the festive season is really important!

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Christmas bread & butter pudding low fodmap

Yes it’s still November and thoughts are turning to Christmas🎄. I apologize now 😃 for posting this recipe but you do need to be planning and perhaps trialing recipes before the big day so here is one for consideration. Bread and butter pudding is not one of my favourite dishes as I have nightmarish visions of being offered this at school and school lunches were not to my liking. However it is a great option for a lighter pudding on Christmas day when spiced or perhaps thanksgiving if you are in the USA. If you can’t get Schar brioche rolls in the USA gluten free croissants will also be suitable. It is very easy to make and contains low fodmap ingredients, so should be a safe option for those of you following a low fodmap diet.

Ingredients

1 pack of Schar* brioche rolls (gluten & wheat free)

500mls of lactose free milk

3 eggs and one egg yolk

50g pecan nuts

1/4 teaspoon of allspice and 1 teaspoon of cinnamon

2 tablespoons of 100% maple syrup

1 tablespoon of raisins

butter or spread

Dark brown sugar for sprinkling on the top

Method

Slice the brioche rolls length-ways

Chop the pecan nuts reasonably finely

Measure the lactose free milk and add the eggs, maple syrup and spices – mix well

Line the dish with butter and spread butter thinly on both sides of the bread.

Dip each slice into the chopped nuts to coat them.

Line the bread into the dish.

Pour in the milk mixture, then scatter the raisins and sugar on the top and grate over nutmeg.

Cook in the centre of an oven at gas mark 5 temperature 190 deg.C after 30 minutes check and if the edges of the bread or sultanas look a little over done cover with foil for the last 10 minutes. Enjoy!!

*Schar brioche rolls were purchased for this recipe.

Vegetable tart

This vegetable tart was made using frozen gluten free pastry bought at the Allergy & Free From Show over the weekend. It is a quick and tasty recipe for a weekday evening. Serve with some green salad.I used coloured carrots for effect but orange ones will do just fine.

Ingredients

5 carrots

spray oil

4 pieces of frozen spinach

2 eggs

60g of hard cheese sliced thinly

One pack of frozen gluten free pastry*

Method

Slice the carrots length ways so they will lie flat, spray with oil and roast.

Roll out the pastry between cling film and when shaped line a flan tin or suitable oven resistant tin. The pastry should then be pricked with a fork and baked blind for 10 minutes at gas mark six.

Defrost the spinach and squeeze to remove as much moisture as possible. This is important to avoid a soggy base to the flan.

Break the eggs and mix with a fork, then brush the pastry with the egg wash to seal it from moisture. Place back in the oven to seal the flan for 2 minutes. Remove from oven and add ingredients.

Lay the spinach on the base of the flan, add thin slices of cheese over the top and then the roasted carrot.

Pour over the rest of the egg wash and bake for twenty minutes at gas mark 5, 190 deg. C.

Serves four for lunch. It should be suitable for people with #IBS following a low fodmap diet and people with coeliac disease.

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Hot roasted vegetables

I adore roasted vegetables – I have said this before but I can’t get enough of them at the moment. These choices are low fodmap and packed with fibre, really filling and comforting. The spice mix I chose to use was a Japanese mix called Togarashi- a seven spice mix. It is really fiery so if you have IBS and are sensitive to chilli, I would probably give this recipe a miss. Although the mix is suitable for a low fodmap diet. The spices are mixed chilli powder, black & white sesame seed, orange zest, ginger, sichuan pepper and seaweed. Sichuan pepper is contained in Chinese five spice mix which Monash have stated is suitable for the low fodmap diet. Monash is based on the Australian diet and in the UK if you wish to try Chinese five spice check the ingredients – some manufacturers add onion and garlic to their mixes. The manufacturer of this mix is Taste Gourmet Spice Company some of their mixes are gluten free. The website mentions Paleo and ‘clean’, which I don’t endorse for IBS – but I will forgive them that indiscretion for the fact that some of these mixes are onion and garlic free (I have not had time to check them all so it is worth a further look.) I purchased this mix and I might be tempted to buy more to test for you. I used a flat teaspoon of the mix and it was as hot as I could take – so you could use less if you wish.

Ingredients

Half a small pumpkin

1 carrot

1 Parsnip

200g swede

1 Aubergine

1 tablespoon sesame seeds

1 tablespoon of pinenuts

1 tablespoon of oil

1 flat teaspoon of Togarashi

Method

Peel and chop the vegetables

Add the spice to the oil and mix then rub on to all the surfaces of the vegetables.

Roast in a hot oven for 20 minutes or until the vegetables are soft.

Roast the sesame seeds and pinenuts for a one to two minutes till golden – watch them closely as they can burn easily.

Add the vegetables to a plate and sprinkle with sesame seeds and pinenuts.

A great Halloween treat and posted just in time for you to make for meatless Monday!

Serves 2-3

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Pumpkin and chocolate tea loaf

Ingredients

175g of roasted pumpkin

175 muscovado sugar

175g caster sugar

125g of low fat margarine

3 eggs

2 tablespoons cocoa powder

300g plain gluten free flour

1/2 teaspoon bicarbonate of soda

1 tablespoon of baking powder (use gluten free if non coeliac gluten sensitive.)

1 teaspoon of cinnamon

1/4 clove of nutmeg grated

150g of dark chocolate

100ml lactose free milk

(makes 2 loaves in 12 x 20 cm loaf tin.)

Method

Roast the pumpkin in an oven till soft – allow to cool.

Measure out the dry ingredients.

Add the margarine and sugar to a mixing bowl, cream till the mixture is pale.

Add one egg and a tablespoon of dry ingredients and beat into the mixture.

Repeat the above till all three eggs are used.

Melt the chocolate over a pan of hot water and add to the mix.

Blend the cooled pumpkin with milk and add to the mix.

Use 2 loaf tins and spay with oil and add the mix

Cook for 1 hour at gas mark 4 180 deg C.

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