An alternative low fodmap Christmas cake

If you have fructose malabsorption and/or fructans malabsorption and you are really missing a Christmas celebration cake – look no further. Christmas cake is exceptional – like the Wedding cake, but in recent years the heavy fruit cake has gone out of favour somewhat. It is also not really suitable for the low fodmap diet despite only a small slice being recommended, being packed with dried fruit and made using wheat flour. This alternative has ingredients that provide a Christmas taste and is packed full of flavour.

This is a spiced whiskey ginger and chestnut cake

Ingredients

225g Dairy free margarine

340g Dark muscovado sugar

2 eggs (or 40g egg alternative if you have an egg allergy)

240g Self-raising gluten free flour

100g Chestnut flour

1/2 teaspoon of salt

1 1/2 Teaspoons of nutmeg

1 1/2 Teaspoons of ground cloves

2 Teaspoons of ground cinnamon

2 Teaspoons of ginger

100g of crystallised ginger pieces

Method

Weigh out the dry ingredients and sieve them well into a bowl.

Cream the butter and sugar in another bowl. Add the eggs to a measuring jug and beat them with a fork, then slowly add the egg to the wet mix while beating.

If the mix looks slightly curdled (grainy) than add a tablespoon of flour to the wet ingredients and continue to mix it well.

Add the dry ingredients to the wet mix and stir them in using a metal spoon and a cutting and folding action, to not lose the air you have already added.

Chop up the ginger pieces finely and add to the mix. 

Place the mix into a greased 18cm cake tin.

Cook in an oven for 2 hours at gas mark 4 or 180 degrees C or until a cake skewer comes out of the mix clean (the surface of the cake was dry, and this might give a false  reading with the skewer, ensure you pierce the surface with a wider hole to allow wet mix to come out.)

I soaked the cake with whiskey to give it an added depth of flavour!

Meat free Sausages – Low fodmap

This recipe was devised as a result of trying to find low fodmap meat-free sausages and failing to find a suitable option easily. They are very tasty – although they do not taste the same as standard sausages – perhaps they are better as a result, give them a try and see! Just in time for meat-free Monday.

Ingredients

100g walnuts

2 slices of vegan gluten free bread

90g celeriac

190g roasted peppers

1/4 teaspoon of asafoetida

1/4 teaspoon of paprika

salt & pepper to taste

Method

Add all the ingredients into a food processor and blitz till fine. This should be a thick paste texture, but it will depend on the size of the slice of bread, just add more bread if it is too thin. Dust gluten-free flour on your hands then roll handfuls of this mix into a sausage shape, or they can also be rolled into balls if preferred. Shallow fry in vegetable oil and serve. It couldn’t be easier really!

This recipe was made at the end of a day out at The Piece Hall at Halifax – as the pictures show below, we had a great day out, but it was freezing!

🎆Bonfire bangers and mash low fodmap

Gravy, mmm, this is what most low fodmapers miss the most. I have found a ready-made beef stock from Atkins & Potts  https://www.atkinsandpotts.co.uk/products/stocks-gravies/17-stocks-and-gravies/P2724-beef-stock it does contain lemon juice concentrate, but as the stock ingredients consist of only 5% of the end product, this is unlikely to prove problematic. Not all of their products are suitable for the low fodmap diet, but this beef stock is handy and not too expensive compared with other specific low fodmap products. Some of you may notice there are only five sausages in the picture – hubby couldn’t wait and ate one of then during the preparation!

Ingredients

Gravy

1 pack of Atkins and Potts beef stock

2 teaspoons of gluten-free flour

Sausages

6 Gluten-free sausages (check other ingredients for fodmaps such as onion)

Vegetables

80g carrots

80g swede

80g celeriac

Spray oil

1 teaspoon of Italian mixed herbs

Salt to season

Potatoes

300g potatoes

salt to season

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Method

Prick and grill the sausages for 20-25 minutes until cooked

Peel, season and boil the potatoes in salted water for 20 minutes and mash

Mix the 2 teaspoons of gluten-free flour with water to make a paste and add this to the beef stock in a pan, keep stirring and cook until thickened to your preferred thickness, add hot water if it is too thick for your taste.

Peel and chop the vegetables and spray in oil. Add the peppercorns and herbs and roast in the oven – gas mark 6, 200 degrees C until soft.

Combine and enjoy before venturing out into the cold for bonfire night!

 

 

 

 

🎃Maple + ginger Halloween cupcakes 👻

OK – what has grandma got on her scary doily-covered table for you? Yes, these small cupcakes are a great low fodmap treat for Halloween! Just don’t scare your gut by eating too many 😉

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Ingredients

175g gluten-free self-raising flour

50g butter

45mls oil

80g dark muscovado sugar

35g maple syrup (golden syrup can be used if you can’t get any pure maple syrup)

1 teaspoon ginger

1/2 teaspoon of nutmeg

1 egg

a pinch of salt

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Method

Weight out the dry ingredients into a bowl

Add the sugar, maple syrup, butter and oil to a pan and melt slowly (do not boil)

Cool the mix slightly and add the egg

Beat with a whisk until mixed

Add the wet ingredients to the dry ingredients

mix well

Add to a preheated oven at 170 degrees C until a skewer pierced into the cake comes out clean.

Decorate with buttercream, orange and black icing and decorative bats

recipe makes 10-12

Enjoy!

 

 

 

Chocolate & IBS – what’s the deal?

It’s National Chocolate week this week! Chocolate is a complex food for people with IBS, as it contains more than one ingredient that could make IBS symptoms worse – high-fat content, lactose in milk chocolate and caffeine. Yet it is allowed in the low fodmap diet in small amounts, plus specific chocolate types such as dark chocolate are better for those who respond to a low fodmap diet. In this post we look at chocolate in more detail:

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What is the link with higher fat content of chocolate and IBS symptoms?

Foods high in fat can trigger symptoms, particularly in respect of abdominal pain for people with functional gut problems. Reducing foods high in fat is not explicitly part of the low fodmap diet. Fat is a symptom trigger, where a reduction is often advised by dietitians. Sometimes just a reduction in the foods we consume that have a higher fat content can lead to an improvement in symptoms for some people with IBS. Not everyone needs to go on a low fodmap diet, and the importance of other symptom triggers shouldn’t be underestimated.

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Is it lactose in milk and white chocolate?

Yes, for some people with IBS – the government standard and the European directive (2000/36/EC) for milk and white chocolate state that these types of chocolate should not contain less than 14% dry milk solids. Therefore a 100g bar contains at least 14g dry milk solids, which can provide significant amount of lactose (possibly around to 50% of lactose content in non fat milk powders, Lomer, Parkes and Sanderson 2017.) 7g of lactose per 100g is likely to induce symptoms with people who have lactose intolerance when milk or white chocolate is consumed. Dark chocolate is suitable for the low fodmap diet – but it still contains fat and caffeine and might need to be consumed in moderation, if it continues to result in symptoms of IBS.

What about the caffeine?

Caffeine is a trigger for gut symptoms, and this may be the cause. The caffeine content of chocolate is as follows:

Dark chocolate contains 20mg per 25g

Milk chocolate contains 10mg per 25g

If chocolate is your only source of caffeine, you would probably have to have more than 100g per portion to induce symptoms, but if you eat chocolate alongside coffee, energy drinks and tea, it might be worth reducing your intake. Don’t go cold turkey as this can induce withdrawal symptoms – reduce your consumption slowly. This is another example where it is not the fodmap content that induces symptoms.

Check out the chemistry!

Tryptophan and serotonin link – the content of tryptophan is not likely high enough to reduce symptoms at all. Theobromine – the same applies here, no evidence that this chemical, found in chocolate, induces symptoms in IBS.

Chocolate can contain high fat, lactose and caffeine which can produce IBS symptoms. But don’t despair, if you respond to the low fodmap diet then dark chocolate is fine – everything in moderation is a good idea, and you might be able to manage a small amount as a treat during chocolate week, perhaps!

 

 

Do you have a problem with lactose?

The-chemistry-of-milk

The following script is based on an article I wrote for the Allergy & Free From show magazine last year. With some updates!

What is lactose?

Lactose is a sugar, for this sugar to be used by us, the walls of our lower digestive system produce a digestive enzyme called lactase. This enzyme helps to break down the sugar so it can be made small enough to be taken into the body and used as energy. See the above infographic.

What causes lactose intolerance?

Congenital lactose intolerance occurs because of the gut not being able to produce any lactase enzyme from birth – this is very rare. Primary lactose intolerance is where the gut loses the ability to create the lactase enzyme over time. Secondary lactose intolerance can occur with a digestive disease, gastrointestinal infections and food poisoning, which may or may not be short term.

Some people’s ethnic background puts them more at risk of lactose intolerance because in South America, Africa and Asia, over half of the indigenous population have primary lactose intolerance and in some Asian countries almost everyone can have primary lactose intolerance.

What symptoms might I have?

The symptoms from lactose intolerance can be unpleasant and embarrassing and range from loose, watery poo, wind, bloating and a distended tummy. Some people get stomach cramps, loud digestive gurgling noises, feeling sick and occasionally are sick. These symptoms occur because undigested lactose in the bowel pulls fluid from the body as it moves through the lower digestive tract, causing diarrhoea. Then lactose is then used for energy by the bacteria usually found in the bowel – this causes bloating and wind.

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When do I need to see my doctor?

Usually, digestive symptoms because of food poisoning are often quick to resolve (lactose intolerance after a digestive system infection usually resolves after six weeks), if you still struggle with symptoms, see your doctor, don’t be tempted to self-diagnose. Don’t be shy in talking about your symptoms – doctors have heard them all before. You can always write down your symptoms before you go if you just find them too difficult to talk about.

The following symptoms are not expected with lactose intolerance if you have swelling of your lips, mouth or face; rashes or wheezing within minutes to a few hours of drinking milk. This might suggest an allergy – see your doctor. Or, alternatively, blood mixed in your poo with a temperature and feeling unwell. These are not symptoms generally associated with lactose intolerance and may be due to another medical problem.  Contact your GP and don’t make drastic changes to your diet.

All children should be seen by their doctor and lactose intolerance because of cow’s milk protein allergy should be considered. Because babies and young children are more vulnerable, any symptoms of blood or mucus in poo, green vomiting, a temperature and severe tummy pain in young children call NHS 111 for advice or discuss with your doctor urgently.

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What tests are available for lactose intolerance?

No blood tests can identify lactose intolerance. Sometimes your doctor might advise a test called a hydrogen breath test – but often they will recommend following a full lactose-free diet for one month and then introduce lactose to test that symptoms return, which is usually very useful in identifying this intolerance. Testing food is also essential to find your own level of lactose tolerance. Most people can have a small amount without having any symptoms at all, and this knowledge can make following a lactose-free diet a little bit easier. A registered dietitian can help you do this effectively and check you are getting the correct nutrition from your modified diet.

Might symptoms be caused by something else?

Occasionally, it’s possible to have lactose intolerance along with other digestive complaints, such as:

Coeliac disease (autoimmune gluten enteropathy) this is because gluten, a protein in wheat, barley and rye, damages the bowel surface so it cannot make the lactase enzyme very well. See your doctor, and your doctor will complete tests for coeliac disease if it is suspected. It is vital to continue to eat food containing gluten to make quite sure that the tests used can identify coeliac disease well. Lactose intolerance usually resolves with treatment for coeliac disease.

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A few people with inflammatory bowel disease (IBD – Crohn’s disease and ulcerative colitis), which causes the bowel wall to become swollen and ulcerated, can also occasionally have problems digesting lactose. Due to inflammation of the bowel wall sometimes it cannot make the lactase enzyme very well. This lactose intolerance can resolve with treatment for IBD.

People with irritable bowel syndrome (IBS) can have problems digesting lactose, this might occur because of the gut microbe fermentation of some foods (called FODMAPs.) Lactose is a FODMAP. FODMAPs are sugars found widely in the diet that are poorly digested and result in symptoms for people with IBS. If you wish to try a low fodmap diet ask your doctor for a referral to a registered dietitian to help you. Don’t be tempted to exclude all carbohydrates from your diet. Wholegrain starchy carbohydrates are essential for long-term gut health.

Where is lactose found?

In animal milk, some cheeses, some yoghurts, processed foods made from animal milk and some medications. Most medications contain tolerable amounts so don’t stop taking them. Discuss alternatives with your doctor or pharmacist if you are taking a few medicines containing lactose, as this might be enough to cause symptoms.

Lactose-containing ingredients can be recognised on the food package ingredients list by the following words – milk, lactoglobulin, milk solids, buttermilk, lactose, artificial cream, whey powder, cheese, condensed milk, curd, skimmed milk powder, cream cheese, modified milk, evaporated milk, margarine and butter. As milk is an allergen, it will be listed as bold, in italics or in a different font or colour on the ingredients list. But lactose is not an allergen as such, so it doesn’t need to be listed separately to milk. Lactose-free animal milk products will be explicitly stated on the packaging by the manufacturer.

Where can I find lactose free products?

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Much lactose-free milk and alternative milk products can be found at larger supermarkets and can also be sourced online. Some manufacturers are Lactofree (Arla), Candia, supermarket home brands, free from milk (Alpro, Oately, Rice Dream, Good Hemp, Koko and Provamil.) Please note rice milk should not be given to children under 4 ½ years of age.

Other products, due to the processing methods used, might be lower in lactose naturally and some people can eat them with no problem such as standard hard cheeses and some yoghurts. Many other foods are typically free of lactose.

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The new ‘alternative’ on the block:

Tiger nut milk is a new marketed product trend, and I really don’t see the point of having this milk, unless you are from Spain and have Horchata as a cultural drink. Tiger nuts are tubers, and you can buy tiger nut milk ready made – but often making your own is advocated by bloggers and companies alike. Marketed as paleo – with little other nutritional content in the milk except for carbohydrate this marketing ploy seems a bit odd. Neither has it been tested for fodmap content.

So, people who have food intolerances and IBS, or those with inflammatory bowel disease, who may have associated conditions that result in extreme lethargy are required to make their own milk? You have to be kidding, right? There is no advantage to having this product nutritionally over and above other milk, and it does not naturally contain reasonable levels of calcium. This is exploitative of vulnerable patients in my opinion and risks long-term low calcium intake.

Is animal milk bad for me?

poison milk

No, quite the opposite in fact – lactose-free animal milk contain good levels of calcium iodine and vitamin B12. Unless you have any religious, cultural or ethical reasons to avoid it, you could just swap to lactose-free animal milk products. These products contain the same level of nutrition found in regular animal milk and have the added advantage of tasting the same. We also know that the calcium found in animal milk is slightly more readily absorbed into the body than the calcium used to fortify plant-based milk.

The internet is full of alternative articles scaremongering around the consumption of cows milk. While I have no issues at all with people who decide to avoid animal products for ethical, cultural or religious reasons, scaremongering others to avoid cows milk due to spurious health risks and unevidenced harms is unacceptable.

You might have heard that animal milk leaches calcium from the bones, this is just untrue, and stories of milk being ‘too acidic’ for the body has no basis in science. Neither does milk cause excessive mucus production in the body or inflammatory bowel disease.

However, if you have changed to plant-based milk for religious, ethical, cultural or personal choice, do ensure these are fortified with calcium and ideally vitamin D (plus vitamin B12 if you are vegan.)

Another nutritional consideration for those avoiding animal milk is that milk and dairy products are the primary sources of iodine for most people. So, avoiding cows milk and/or fish can also risk low levels of iodine in the body. Adults need 150 micrograms per day, pregnant and nursing mothers slightly higher at 200 micrograms, most milk alternatives are rarely fortified, too much-added iodine can also be problematic so ask your dietitian if you feel you are not getting adequate amounts.

What about raw milk?

Raw milk contains lactose and is therefore unsuitable for people with lactose intolerance and can risk gastroenteritis (food poisoning) if it is not properly treated. I would not take the risk of drinking raw milk, particularly if you have any other digestive complaints.

Can I buy a supplement to help me digest lactose?

Yes, they are available online or from health food shops. However, the effectiveness of them varies. But they might be useful to have to hand when eating out and travelling when it might be a little more challenging to avoid lactose.

Does having lactose intolerance affect my future health?

Not generally, but not getting adequate calcium in your diet because you have stopped having all milk products long term can lead to weakened bones. Adults should ensure they have at least three portions of lactose-free dairy or calcium-fortified alternatives a day (a portion size is a glass of lactose-free milk, a small matchbox size of hard cheese, or a yoghurt.) People with bowel diseases and teenage boys need more than this, and other children less. Discuss with your doctor or dietitian. A useful calcium information sheet can be downloaded free from the British Dietetic Association website under ‘food facts’.

I do not have any affiliations with the dairy industry and have never been funded or paid by them.