Vegan ‘chicken’ and pumpkin couscous – low fodmap

An autumn favourite is pumpkin and numerous varieties can be found. When I was young pumpkin in the UK was unheard of – in fact we used to make Halloween lanterns with a swede! That certainly was a recipe for injury – although the pumpkin isn’t always easy to carve.

I have also decided to venture into a vegan recipe using vegan ‘chicken’ low FODMAP suitable products are based on soya protein or alternatively you could use Quorn ‘chicken’ pieces.

This was a fairly easy recipe to make and was lightly spiced – if you want a heavier spice then you can add more Ras El Hanout. Do check your spice mix has no high fodmap ingredients such as onion or garlic. Enjoy!

Ingredients

  • 200g Pumpkin
  • 30g Pumpkin seeds
  • 30g Pine nuts
  • 20g Sunflower seeds
  • 30g Course peanut butter
  • 200ml Water
  • 1 teaspoon of Ras El Hanout Spice
  • 200g Soya protein based chicken pieces
  • 250g Corn couscous
  • Spray oil
  • 30g mint leaves
  • Seasoning (salt and pepper) to taste

Method

  • Chop the pumpkin and boil in water till soft.
  • Spray oil into a frying pan and add the Ras El Hanout and fry gently with minimal oil to release the flavours, add the chopped mint leaves.
  • Add the peanut butter, seeds and water to the frying pan and cook till thickened
  • Add the ‘chicken’ pieces and cooked pumpkin
  • Weight the couscous and pour over the same amount of boiling water (250 ml) and leave to cook – run a fork through the mix to give texture to the couscous
  • You can either serve the ‘chicken’ sauce and couscous separately or mix the ‘chicken’ sauce through the couscous, as I have done.
  • Serves 5-6 enjoy!

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Autumn jacket potatoes

It’s Autumn, I love this time of year but as the dark nights role in thoughts of wholesome, warm filling meals arrive. What could be more sustaining than a jacket potato for people following the low fodmap diet? This is also married with carrot and celeriac, oregano and thyme and of course mixed with cheese – not so much – but enough to provide ample calcium.

However food means more than sustenance – it is family, experience, love – in fact food ripples throughout life and our lived experiences. Many of us have stories to tell about food – both negative and positive. There are two considerations for people who wish to follow a low fodmap diet, what benefits might there be? Much longed for reduction in symptoms? The benefits are often the driving consideration. But what about negatives – how is changing the way that I eat going to affect my quality of life? You might be somewhat surprised at this suggestion – negatives in quality of life? But this diet is supposed to improve my situation, surely?

Consider cooking for the family, going out for a meal with a treasured friend, traveling on holiday and having a suitable option for lunch at work. How much additional planning and work is it going to take to follow this diet – can I afford to have additional work when I already have a very busy schedule to follow? These are all considerations that should be taken into account when deciding to follow an elimination diet – these are considerations that the dietitian can help you with and are what your dietitian will be contemplating as part of the assessment process. This is also another reason that the reduction phase of the diet should be as short as possible. The re-introduction phase will provide some freedom and release from some of the restrictions the low fodmap diet instills.

There are options for people who may not wish to follow a complete exclusion and would find that following the low fodmap diet too much to plan – because planning is what you will need to do, to be successful. There is a shorter low FODMAP version that the dietitian may consider if the full diet is too challenging and a wheat free or lactose free diet if these food types are considered to be the main issue from a diet history.

It hasn’t gone unnoticed by me how people with IBS try hard with regards to treatments – sometimes unfortunately too hard and continue far too long when diet treatments are not working. People then should explore other treatments and often need help or a nudge to move onto other options. To some extent this hard effort is why I work in the area of digestive illness, because I know my patients will often try their upmost to make changes, more than in other areas of dietetics and when this works, it is satisfying – although, truly, it is their hard work that has produced dividends. Symptoms of IBS really are the great motivator, I would suggest that their may be no greater drive towards change than these symptoms provide – imagine what could be achieved with such an instigator, if it was a positive driver rather than a negative one?

But, enough of the musings and lets get back to the recipe…

Ingredients

  • 3 jacket potatoes
  • 3 carrots
  • 2cm of celeriac (tip here: keep some blanched celeriac ready cut in your freezer for any recipes that ask for celery)
  • 150g grated cheese
  • 1 teaspoon oil
  • 1/2 tablespoon of chopped fresh oregano or 1 teaspoon of dried
  • 3 sprigs if thyme or 1 teaspoon of dried
  • Seasoning

Method

  • Warm the oven to 200 degrees C and then wash and prick the three jacket potatoes, place them on a baking tray and add to the oven. Depending on the size cook for 1 hour to 1 hour 20 minutes.
  • Whilst the potatoes are cooking add the oil to a pan and add the herbs and cook for 2-3 minutes.
  • Slice the carrots and celeriac and boil in a pan of hot water till soft. Mash and add the herbs and seasoning.
  • Grate the cheese.
  • When the potatoes are cooked scrape out the potato leaving the skins intact. Mash the filling with the carrot mix and add 100g of the grated cheese and mix. Add back to the potato skin shells and top with the remaining cheese.
  • Grill till the cheese has melted and then serve (serves 3)

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Oyster mushrooms – a umami low fodmap option for IBS

It is autumn and the evenings are becoming darker. It is the season for mushrooms and many people really miss mushrooms when following the low fodmap diet. But if you are following the Kings College Low FODMAP diet oyster mushrooms are suitable. They are not as available as a few years ago and are now usually found in the section labelled up as wild mushrooms – so perhaps suitable for a treat only.

Mushrooms have an umami flavour – an earthy, complex meaty flavour that is very important particularly if you are vegan and missing the deep, rich flavour that meat offers. Mushroom also offers a texture that is robust, filling and satisfying. This is the flavour provided by glutamate (the natural variant of mono-sodium glutamate – MSG, a food additive) a chemical that in the past has been implicated in Chinese or Asian food intolerance or ‘Chinese restaurant syndrome’. It might be the FODMAP content rather than the glutamate that lead to perhaps some gastrointestinal upset in some people and not specifically the glutamate content – we have no evidence that ‘Chinese restaurant syndrome’ exists from eating food where MSG has been added (see the Compound Interest info-graphic above.) Some foods containing glutamate listed above also contain histamine, which also is implicated in developing symptoms such as palpitations, chest pain, headaches, asthma, flushing and gastrointestinal upset. They are cheese, fermented foods such as miso and tomato. These foods are possibly the foods which might have lead to Chinese Restaurant syndrome, although this reaction is likely to occur infrequently. If you do suspect a histamine intolerance and have the symptoms above see a dietitian who will provide help for you to check if you have. Please avoid information from the internet on histamine intolerance, as it is usually far too restrictive and might lead to nutritional deficiencies. Although actually we have no evidence that most people with IBS have histamine intolerance – in my opinion we need much more research in histamine reactions.

Who wouldn’t want to have this fantastic flavouring naturally found in mushroom, parmesan and soy sauce? I have developed a recipe for you. You can replace the parmesan with a vegan alternative, if you wish, and it really doesn’t change the flavour. Risotto is such a tasty filling meal for autumn evenings this recipe contains lots of umami from white miso, oyster mushrooms and parmesan cheese. Do enjoy it!

Ingredients

  • 160g Oyster mushrooms
  • 1 tablespoon oil
  • 250g arborio (risotto) rice
  • 15g white miso diluted with 700ml boiling water
  • 20g vegan or standard parmesan
  • 50g toasted pine nuts
  • 3-4 sprigs of thyme
  • additional grated parmesan

Method

  • Now the only rule really in making risotto is that you shouldn’t leave it alone for a second! It takes time to prepare but it is worthwhile putting that additional work in – you get out what you put in.
  • Grate the parmesan and set aside.
  • Toast the pine nuts in a drizzle of oil until they are brown -watch them closely as they can easily burn. Set aside to cool and then add the thyme (chopped) and mix well.
  • Add the oil to the pan and gently fry the mushrooms for 5 minutes. Then add rice to the pan and cook to 2 minutes.
  • Start to incorporate the miso based stock slowly to the pan over 10-15 minutes and keep stirring – this will prevent the rice from sticking to the pan.
  • The rice is ready when it is al dente (slightly firm to bite)
  • You may need additional liquid – water is suitable – depending on the rice you use.
  • At this point stir in the grated parmesan and serve topped with toasted pine nuts and extra grated parmesan to taste (you shouldn’t need any seasoning as the flavours are deep but add some at this point after tasting the dish if you wish.)
  • Enjoy!

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A nice cup of tea

There is nothing more quintessentially English than a nice cup of tea. We debate the nuances of how to make it properly – milk before the tea or after, warm the pot before adding the hot water and tea or not, or how much tea to add to the pot. Tea also has lots of reported health benefits but does it help people with IBS? If you are interested, please read on…

Tea is culture, it’s refreshing, herbal tea is reported to be calming, relaxing – we all could do with a little of that, surely? Well perhaps all is not as it first appears.

Standard tea (black, white, green, yellow and oolong) are the true teas

Tea contains caffeine, a stimulant, not as much as coffee but certainly enough to have a systemic effect if sufficient is consumed. It is worth changing to decaffeinated if you have IBS, caffeine can not only stimulate the gut causing diarrhoea type symptoms it also disrupts sleeping patterns and poor sleep can be a symptom of IBS for some people. Some individuals with IBS also have overactive bladders, symptoms which can be influenced negatively by caffeine intake. Tea has lower levels of caffeine than coffee and certainly less than energy drinks, but do consider reducing or slowly swapping to decaffeinated if you drink caffeinated versions.

Oolong tea is high fodmap so will need to be avoided for the low FODMAP diet and tested as part of a re-introduction protocol, if you wish to drink it.

One study reported hard stools for tea in people with IBS (Simren et al 2001) but this was a prospective self reported study and has not been tested directly by a true randomized controlled study. This probably should be investigated but there are fewer studies in people with IBS with constipation for all treatments, unfortunately.

Rooibos

Rooibos is not a true tea and as such does not contain any caffeine and lower levels of tannin’s than true teas. It does however contain some of the poly-phenol compounds found in true tea. For the Monash version of the low fodmap diet it is categorized as low in FODMAP.

Herbal teas

Peppermint

Peppermint has been widely investigated for IBS symptoms. It acts as a smooth muscle relaxant so it can reduce those lower digestive tract spasms. Many people use the tea for the same effect. A number of people with IBS will also experience reflux, or upper gastrointestinal symptoms. Peppermint may also relax the sphincter (a ring of muscle) that prevents stomach acid from traveling up the food pipe (oesophagus). If someone has reflux it is probably not a good idea to drink peppermint tea. However it is good to help with lower abdominal pain so feel free to try it for that. If you want to read more about peppermint and IBS see my other blog post here:

https://clinicalalimentary.blog/2018/01/21/peppermint-and-ibs/

Camomile

Camomile is often stated as a treatment for IBS and ‘helps’ abdominal pain and induces sleep. Camomile acts as a neuroendocrine modulator so it has been suggested as a possible treatment to help with anxiety, insomnia and stress. This does suggest that it could be helpful for IBS type symptoms however Camomile contains FODMAP sugars therefore for those people with fodmap intolerance it is probably best avoided. Camomile also interacts with some drugs – please discuss this with you doctor or pharmacist before trying camomile tea. Common interactions are suggested with sedatives, blood thinners, anti-platelet drugs, aspirin, NSAID painkillers like ibuprofen and naproxen, but also others too (source: WebMD)

Fennel

Fennel is another herbal tea that is suggested to be a good option for those people with IBS. It again, also contains FODMAPs so if you are following the diet, perhaps this is one to avoid.

Dandelion tea

This tea has lot’s of anecdotal suggestions that it helps digestive symptoms, from increasing appetite, soothing minor digestive ailments and relieving constipation. There is no evidence that any of these symptoms are improved. Dandelion tea is another tea that it high in FODMAP so this might be the reason for the anecdotal reports of improving constipation, as lots of FODMAP containing foods are prebiotic (food for gut bacteria) and can help increase bowel function. Dandelion tea has also implications for drug interactions so it is best avoided for people taking diuretic medications, lithium and ciprofloxacin (an antibiotic.) Discuss this with your doctor or pharmacist before considering dandelion tea.

Fruit teas

Many people love fruit teas – they are naturally low in caffeine, however for me, they always promise more than they give. The odour of them is very tempting and I always feel disappointed that they are not more highly flavoured when drunk. If you like them though fruit teas should be fine to use. Use flavours suitable for the low FODMAP diet, if you are following it.

Testing tolerance to teas

For people following the low fodmap diet if you want to test the tea’s above which are high in FODMAP, to see if you can tolerate them, you can. Everyone has an individual tolerance to teas high in fodmap. Once your symptoms are reduced to a good level you could re-introduce the teas above and see how you get on. Use a standard cup as a portion and increase to three over three days, monitoring your symptoms as you go.

Following a Low FODMAP diet and adding milk to tea?

If you are following the low FODMAP diet then lactose is a problem for some people and if you need to exclude lactose then you can use lactose free cows milk – this is suitable for the low fodmap diet and the calcium it contains is slightly better absorbed than from milk alternatives. If you have been tested for lactose intolerance and you are not intolerant, you can use standard milk. Lactose free cows milk also marries with tea very well and you will not notice a difference in taste. This also means that Chai tea (milky tea with spices also added) is not suitable for people following the Low FODMAP diet, as it will contain lactose. You could make your own Chai tea with lactose free milk, if you wish.

Needing a milk free diet and have milk in tea? Which is the best option?

Well, for tea without sugar the best option is cashew milk, and for those who have sugar in their tea then coconut or almond milk are the better choices, according to people who have to follow milk free diets. I can attest to the cashew milk being suitable for tea without sugar, I tried it and really couldn’t taste a difference. Please ensure that your milk alternative is fortified with calcium, as cow’s milk forms a very good source of calcium in the diet and changing to milk alternatives may reduce your calcium intake. You could choose ones that are also fortified with B12 if you are following a vegan diet.

Image by Pexels from Pixabay

Image by congerdesign from Pixabay

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Orecchiette con Cima de rape – Low FODMAP

This recipe was in a newspaper supplement but wasn’t really Low FODMAP friendly so I decided to give it an update and make it suitable for those with food intolerances. It is a traditional Puglian recipe using broccoli tops (Cima de Rape), which is a winter vegetable in Italy but is a really refreshing recipe for spring in the UK using broccoli tops makes it a suitable low FODMAP version.

The other problem is that there is no suitable gluten free Orecchiette pasta that is available in the UK, so fresh gluten free pasta has to be made if you want an authentic dish. The other point to note is that only if you find cooking relaxing should you attempt to made home made gluten free pasta. An important factor is not making more work for yourself if you don’t find cooking relaxing and dried pasta is suitable for this dish.

I have decided to make a longer recipe today as it is Bank Holiday weekend and the forecast suggested that it was going to rain although it hasn’t done yet. I have also posted some bluebell images from this weekend – bluebells are everywhere at the moment and are quite a spectacle.

Ingredients

Pasta (wheat free)

250g Pure maize flour (wheat contamination free if you are coeliac)

50g Gluten free bread flour

2 Eggs

Salt

1/2 Teaspoon xanthan gum

Enough water to bring the dough together

Stock

1 Ladle of pasta cooking water – top up to 500ml with water

20g Carrot chopped

30g Celeriac

1 Bay leaf

Small amount of salt and 6 peppercorns

Sauce

1 Head of broccoli (250g) stalks removed

1 Anchovy

1 Lemon

20g Parsley

20 Bay leaves

20g Rocket

30g Parmesan

3 Tablespoons of garlic infused olive oil

25g Butter

100ml White wine

Salt to taste

Method

Pasta

Weigh the flours into a bowl and add salt and xanthan gum. Mix the dry ingredients well before adding any liquid to the mix. Add the eggs and start to mix the flour, then add water to bring the flour together into a dough. Add just enough to ensure a soft mix – it is not possible to give a volume as this will depend on the fineness the flour mix you use. Once the dough is formed work it well to incorporate it together and make a smooth mix. This will take time, don’t worry about over working – this is not the same as making standard pasta. Roll out logs of the dough to the thickness of you thumb and then slice finely. To make the orecchiette shape press your finger into the centre of the disc. Bring a pan of water to boil and add salt and the pasta. Cook till the pasta rises in the pan remove and drain.

Zest the lemon and juice.

Chop the broccoli tops, celeriac, carrot, anchovy finely and add to separate bowls.

Then chop the basil, rocket and parsley and add to a bowl with the rest of the lemon juice.

Make the stock adding the pasta cooking liquor, carrot, celeriac, bay leaves and pepper to a pan and cook for 10 minutes, drain and save the stock. You could add the carrot and celeriac to the main dish but remove the bay leaf and peppercorns.

Add the olive oil to a pan and add the broccoli, anchovy and the zest of 1/2 the lemon and cook for four minutes then add the stock, wine, 1/2 the parmesan and butter and simmer for 10 minutes until the broccoli is soft.

Add the herbs and the rest of the lemon zest to the pan and then gently mix in the pasta to warm through. Serve and finish with a tablespoon of the lemon juice and the rest of the parmesan.

Serves two

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Lemon – Low FODMAP

http://www.compoundchem.com

The words of the song the Lemon Tree, the words are undeniable “Lemon tree very pretty, and the lemon flower is sweet, but the fruit of the poor lemon is impossible to eat.” Many people with gastro-oesophageal reflux (GORD) and IBS avoid all citrus fruit due to reporting of them making symptoms of reflux worse. Yet, citrus fruits are allowed on the low FODMAP diet. I actually love lemon, the flavour is sharp and strong but has to be handled carefully in recipes to prevent is tasting like a popular cold remedy.

One point to mention here is that the National Institute of Health and Clinical Excellence (NICE) guidance on reflux does not specify a reduction of citrus fruit consumption as part of lifestyle GORD treatment. The reduction of coffee, chocolate, alcohol and fatty foods are the main focus of dietary lifestyle factors. Although the date of the review of this lifestyle advice is 2004 – so somewhat old data, but this is fine if no new developments have come to light. It is also worth noting that the measure of acidity, pH, is very low for stomach acid (2-3), for lemon Juice, it is 2, so not much different than the pH of gastric juices anyway. But people do report problems, so we do treat everyone as an individual and they can be reduced to a tolerable level, when needed.

Reduction of acidic foods also can reduce the amount of vitamin C in the diet, as ascorbic acid is found in higher levels in citrus fruits. Vitamin C full deficiency is rare in the UK, although arguably becoming more common due to fad diets, such as complete carnivore diets. Our bodies cannot make it, unlike other animals. Not much data is available on low vitamin C intake and GORD, but the effects of deficiency include damage to skin and likely the GI tract, which has a fast turnover of cells, not that helpful for those who have sensitive guts. The requirement for vitamin C might be increased in people who have diarrhoea – although caution is advised as vitamin C supplements above 3g/day (three times the amount of a standard over the counter supplement) will increase symptoms of abdominal pain and diarrhoea. As ever, it is better to get your nutrition from food, so once your symptoms have reduced, re-introduce those low FODMAP foods you have stopped eating, try them again, you might find that you can eat them after all.

Lemon butter drops

These little biscuits are only a mouthful – just a bite – but are a divine melt in the mouth treat. Especially nice for this time of year, Spring and Easter, (when Easter does arrive in April).

Ingredients

100g butter

200g rice flour

1/2g zanthan gum

Grated rind of 2 unwaxed lemons

1 egg

50g of gluten free self-raising flour plus extra for rolling out.

Filling (lemon curd)

4 wax free lemons – juice and rind

350g castor sugar

200g butter

1 1/2 tablespoons of corn flour

4 eggs

Method

Add the butter and sugar and cream (mix) together well.

Then add the grated lemon rind and egg, mix well

Add the flour and bring together into a dough, if it doesn’t bind together add a little more flour till it does.

Roll thinly and cut out small rounds (I made 40 with the mix)

Cook for 10 minutes at gas mark 6.

cool

Make the curd

Whisk together 4 eggs

Juice and grate the lemons and weigh out the other ingredients

Warm the eggs whilst adding the other ingredients and cook till thickened

Cool and add to the jars

(This is based on a Delia Smith recipe but with additional cornflour to make the curd thick enough to sandwich between the biscuits.)

Recipe makes enough for 20 small sandwich biscuits and enough curd to add to a litre and a half volume – more than enough to add to sterilized jam jars and they will keep for a few weeks.It does go a long way so you don’t need to use much for a sweet and sharp lemon flavour.


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