Snapshot – love your gut!
Author: Jules_GastroRD
I am a state registered dietitian. My speciality is dietary treatment of gut disorders such as irritable bowel syndrome, crohns disease, ulcerative colitis, coeliac disease, lactose & fructose malabsorption and multiple food intolerances. I have had lots of experience in other areas of dietetics and I wished to start this blog to spread the word about evidence based dietary treatments and dispel much of the quackery that is common with these diseases. All information on this site is of a general nature and is based on UK based treatments and guidelines. Please see your healthcare practitioner should you need more country specific information.
Easter meal – roast spring lamb
The first thing to do in the preparation for this Easter meal is to marinade lamb steaks for 1-2 hours.
Marinade
1 freshly squeezed lemon
1 tablespoon of garlic infused oil
Sprinkle of salt
3 sprigs of rosemary
chop the rosemary and add to a bowl with 2 lamb steaks, oil, lemon juice and a small amount of salt to taste.
Leave to refrigerate for 1-2 hours before adding the lamb to a roasting tin with vegetables (I chose parsnips, these were what I had in the fridge, but you could choose carrots if you wish.)
Place in the oven at gas mark 4 and cook for 2-3 hours or until the lamb is very soft and falls apart. Keep checking it as you don’t want it to become too dry. Cooking the lamb long and slow will ensure that some of the marbling of fat it contains will liquefy and can be skimmed off the meat juices once cooked.
The next dish to make is a greek salad – we had this as a starter to our easter meal.
Ingredients
1 large tomato
1/2 cucumber
10-12 black olives
1 teaspoon of dried oregano
100g of feta cheese.
Chop the tomato, feta and cucumber and add to a bowl with olives. Mix well, as the feta and olives are quite salty there should be no need to add salt to season this dish. Serve before the main meal or have it as a side dish – whatever you prefer to do is fine.
The next thing to make is the mint dressing for the potatoes.
Minted Charlotte Potatoes
2-3 potatoes per person.
2-3 sprigs of mint
1 tablespoon of garlic infused oil
1 tablespoon of white wine vinegar
Salt to taste
Chop the mint and add it to a bowl with the olive oil and white wine vinegar, salt and mix well.
Chop the potatoes into 2-3 cm wide slices. Boil the potatoes for 10-15 minutes, drain the pan of water, add the dressing and shake the pan well.
Keep potatoes warm.
Prepare the lamb
Trim the fat from around the lamb and place on a serving dish with the roasted vegetables.
Drain off the cooking juices and strain off the fat which floats on the surface, drizzle this liquid over the meat and allow it to rest (if you wish to make a gravy add a heaped teaspoon of cornflour and heat in a pan until thickened.)
Serve up and enjoy! This meal is gluten-free and Low FODMAP (a small amount of tomato is included in the salad, which shouldn’t be too much for those excluding fructose from their diet) however the salad does contain milk protein. The meal is a celebration and has been prepared with some effort to reduce the fat levels in the roast lamb, however lamb is still quite a fatty meat therefore it is probably better to eat it occasionally. It serves 2-3 people (ensure a lamb steak per person.)
Easter with food intolerance
What is Simnel cake? Simnel cake is a cake that is traditionally consumed on Easter Sunday, it is a light fruit cake with a toasted marzipan topping. The Lancashire version is a particularly fine version – recipes I have found don’t contain saffron, you can leave it out if you wish but I felt it added a nice flavouring and colour to the cake. It is a festival cake once used for mothering Sunday – see a history of the cake here
http://www.timetravel-britain.com/articles/taste/easter.shtml
I hope you have a happy holiday this weekend – despite the cold weather!
Ingredients
240g of self-raising wheat free/gluten-free flour
1 flat tsp of cinnamon*
1/4 of grated nutmeg
1/4 tsp of ground cloves*
1 teaspoon of gluten-free dairy free** cocoa powder
50g of pecan nuts
50g of sultanas
4 eggs
200g of milk free margarine
Large pinch of saffron
200g of golden caster sugar
Method
Pour approximately 1 tablespoon of boiling water on to the saffron and set aside to cool.
Weigh all other ingredients into a mixing bowl, add saffron and liquid mix, mix well.
Place in a paper lined seven-inch baking tin and bake till a cake skewer comes out clean when inserted into the centre of the cake.
Trim the top of the cake flat and turn upside down to give an even working surface. Cover with rolled out marzipan* (or ready roll icing sugar* if you are following a low FODMAP diet – you can colour it pale yellow to simulate marzipan if you wish!) Roll 11 equal balls of marzipan or icing sugar to represent the disciples (minus Judas) and if you are using marzipan place the cake under a grill to brown the marzipan.
Enjoy a small piece with a nice cup of tea!
**Milk free see http://lucysfriendlyfoods.wordpress.com/2012/07/05/dairy-and-nut-free-cocoa-powder-found-at-last/ , lactose free, wheat free, gluten-free, Low FODMAP (without marzipan.) *Ensure these ingredients are not contaminated with wheat or gluten.
Reflection on a year of blogging.
I have just had my anniversary of my blog, I started the site a year ago and did wonder how it would go, but I have been really hooked on writing and cooking recipes. Watching my stats I am also surprised at the breadth of countries who are interested in looking at my site, plus an interest in which countries have not viewed my site yet – so, come on guys I want to complete the full globe this year, as sure as anything you can bet that someone has some digestive complaint that would benefit.
I have experienced writers block for the last month and a paucity of recipes too. I am hoping that IBS Awareness Month spurs me on with writing more and I would also appreciate some ideas about what people would like to read on digestive disorders. The plans for the next twelve months include more book reviews and recipes, I hope to expand the blog to a website – and perhaps most exciting of all I hope to be running a clinic for patients who have intolerances, allergy and low FODMAP dietary requirements very soon, email me if you are interested.
I have attended The IBS Networks AGM today, my third one and the future in IBS is looking really positive, new ideas, treatments (including the Low FODMAP diet) and new research into the gut microbiome (bacterial population) and it’s effects on health and disease have made IBS more of an attractive area for research and medical management. If you are interested in getting involved, maybe you would be interested in running a support group in your area, The IBS Network can provide support if you do.
So watch this space and any ideas on what you would want to read are gratefully appreciated!
Valentines Day approaches – love me, love my gut – even if it misbehaves sometimes.
Now, I’m not a counsellor or psychologist but I am able to give you some advice around dining out and reducing the anxiety this can cause around safe foods to eat. If you are going out with a new partner Dr Barbara Bolen has some really useful advice around dating and functional bowel problems (IBS.) She advises that you should be open about having digestion problems and it is OK to describe them as such, you don’t need—and probably
wouldn’t wish to go into detail. She also provides some good examples of how to describe your GUT problems so check out her website. An explanation will also help to reduce your anxiety about needing to go to the loo frequently during a meal and this might help reduce the actual visits required. Dr Bolen also has some really good information on her website about how to tell someone about your IBS, relationships and how to enjoy a healthy sex life with functional bowel problems, check out her site here –
http://ibs.about.com/od/livingwithibs/tp/IBSandDating.htm
Dr Bolen has also posted a link about this post and she does also appreciate Valentines Day is not a day that everyone celebrates and it can be a time that can be difficult psychologically – see the link here:-
http://ibs.about.com/b/2013/02/14/ibs-and-valentines-day.htm
If you are going on a date you may want to go to an establishment that you know well and ask for a table to be reserved in a good position, making it easier should you need to visit the toilet. Making a suggestion about where to go on a date shouldn’t cause a problem, just be a little assertive and ensure that you explain about your IBS at some point—if someone wishes to go out with you this really shouldn’t be an issue. You could also a look at the menu before your visit and telephone the chef to ask if they can cook your food without ingredients that may cause problems if this helps. See if your partner also wishes to look at the menu before arriving, this will leave more time for conversation and getting to know each other. Looking at the menu is easier to do these days as most restaurants post menus on-line.
Eating out on the Low FODMAP diet can be challenging, as onion and garlic are widely used, don’t forget to ask about sauces and stock. Having dietary intolerances shouldn’t stop you going out – some ideas for choosing food are grilled chicken breast, fish fillets, steak—in other words plain meat or fish without sauce. Egg dishes are also a possibility, omelette or frittata, check the dishes are onion and garlic free, if they are a problem for you. Choices for the starchy component are plain rice, freshly cooked potato or you could ask for wheat or gluten-free dishes (depending on your intolerance,) but again check for other FODMAPs. Establishments are now better at labelling their menus, or providing separate gluten-free menus, since a recent change in regulations. Or you could try sushi, if you like it but again check any vegetables for FODMAPs. Always remember that it might not be the food you have just eaten that causes symptoms. If you are through the exclusion phase stick to your known low FODMAP foods for the day and possibly the evening before your date depending on your GUT motility (knowing the time it takes food to pass through your digestive system.)
If foods high in fat are a problem for your digestion then ask for the meat grilled or cooked on a griddle which will allow the majority of the fat to drain away. Vegan options are a little more challenging as they often contain foods high in fermentable carbohydrates, but a risotto based on Low FODMAP vegetables or rice stuffed peppers would be an option here, not forgetting to ask about use of onion and garlic in the dish, should you need too.
Some people find alcohol is a problem, if you want to have alcohol and it does give you symptoms, limit the amount that you have. You could have a glass of wine, for example with your main meal, or ask for a spritzer to make a longer drink. Order a spritzer with your starter and allow it to go a little flat before drinking it, if you suffer from bloating. Using an implement such as a straw or cocktail stirrer to mix your drink will help to disperse the gas it contains, but don’t be tempted to drink from the straw. You could try a little seduction and gaze into your partners eyes, whilst stirring your drink! Watch the amount of fruit cocktails you have, if you have fructose intolerance—one small glass (100 ml) of pure fruit juice containing low FODMAP fruits is usually the maximum advised. So ensure your cocktail has no more than this amount and drink it with the main dish or sweet.
Check out The IBS Network Self-Care Plan for medications that are helpful.
I would really encourage you to eat out this Valentines Day if you are invited, you may have some symptoms because it can be difficult to avoid all FODMAPs, but the most important factor is that you go out and enjoy the experience. You might find a life partner by going on the date, what more could you wish for? If you don’t have a partner, you could plan to do something special with friends or family for the day.
Most of the advice has been about functional gut problems (IBS) but if you have inflammatory bowel disease IBD, some of the advice posted may be useful but I would strongly advise you to go on-line and check out Crohns & Colitis website (link to the main site is found to the right) as they have some really useful advice on relationships and IBD, or the link for The Ileostomy and Internal Pouch Association for advice.
Check out the living with IBD leaflet here
http://www.nacc.org.uk/content/services/infoSheets.asp
Now for the bah humbug ;-), this advice also applies to the rest of the year! Valentines Day is very commercialised, expensive and anticipation of events occasionally can prove to be disappointing if you spend lots of money on the day. You could always suggest going out at another time, if you wish and there are other ways of showing your affection than an expensive card and some petrol station bought carnations! If you know what your partner likes, try making your own gifts, some baking perhaps (and I do include you gentlemen readers here too)—invest some time and personalise your gift, this will be really appreciated as it shows your love and understanding.
Related articles
- What To Eat/Drink/Do/Make on Valentine’s Day/Fat Tuesday (aliciatasteslife.wordpress.com)
- Confessions of a Reluctantly Picky Eater (circleoffood.com)
Change is not made without inconvenience, even from worse to better – (Samuel Johnson 1755)
Happy New Year to our my readers and I hope you will have a year of gut calmness in 2013. January is a natural time for contemplating change and you might be wondering how successful New Year resolutions are, I am sure the majority of people have attempted to make changes in the New Year. I know I have joined gyms and weight loss groups in January, signed up for twelve months only to lapse and end up wasting my money. So what is the trick here? Can we be successful in what we choose to renew? Looking into the actual evidence one study that compared New Years resolvers with those who wanted to change later in the year, the authors found that 46% of those choosing to change in the New Year were successful compared with 4% of those choosing to change later on. The reasons for their success were that they were contemplating change, really thinking about how it can be achieved and feeling confident of being successful. It might have been possible that the study was biased, those choosing to take part were more likely to be successful because of being more proactive for example, but even if the figures are an overestimation this is still pretty impressive. Other surveys have suggested that New Year isn’t the time to plan changes; a very large survey by Richard Wiseman suggested that 88% of people fail but the details of this survey were difficult to access.
After the Christmas indulgence in rich foods it is perhaps natural to want to look after your body and wipe the slate clean, this is a time of year when detox diets or programmes are promoted to help you cleanse your body, in general but also for people with IBS. I know from personal experience I always crave fresh foods after Christmas, fruit for example never gets eaten at Christmas in our home – I often wonder about the reason, every year in fact! Detox is the process of removing toxins from the body and I’ll let you into a little secret, we have a fantastic organ in our body called the liver, it really is a wondrous organ, it is our bodies detox machine and it normally works very effectively in removing toxins from inside our body, helped by our kidneys. But there is a natural need to look after our body this time of year and there is no harm in pampering it by eating a more healthy diet, within the restrictions of your IBS symptoms, of course. For example higher fibre is not advisable for everyone; check out the IBS Network Self Care Plan for more advice on changes to help changing to a healthier lifestyle. Perhaps getting back to your normal pattern of eating after the Christmas splurge might be a good goal to begin with, then choosing one more change to a healthier lifestyle to keep things manageable. Personally and professionally the problem I have with detox diets and regimens is that they don’t do what they propose to do. Sometimes they can be very expensive and are, in the main, just a very restrictive diet – which will result in rapid weight loss initially, making you feel lighter, less bloated and fresher, but this feeling is unlikely to be maintained. So what do you do to fulfil the need for a fresh new you? Your body will thank you if you make changes to make your life generally healthier and you can feel really positive that you are helping in the long-term. Being a little more active can help your digestion and changing to eating perhaps a little more healthily for your IBS, check out the Self Care Plan for advice about how to eat and manage your IBS. Perhaps all that is needed is planning to include some ‘me time’ in your life, this will be helpful, if you find your life is very busy. A thought to changes to help your well-being is also a possibility – the overriding consideration is that whatever you decide to do it has to be your choice and shouldn’t harm you in any way.
Here are some tips to help make those changes more permanent.
1. Think carefully about what you wish to change, I mean REALLY think, not just a transient ‘light-bulb’ moment, put the kettle on, get a pen and paper or use your laptop, deliberate and plan what you are going to do.
2. On your paper write a heading of positive and negative or pros and cons. How is changing helpful? What positive benefits are there to what you are planning? The more you can think of here the better.
3. What are the negative aspects of your change? These are very important to consider as we all choose to live the way we do as it is somehow easier for us, what makes it easier? The content of this list is possibly what is going to stop you changing or result in a relapse. How are you going to manage this aspect? Write a plan of action for if you lapse, remember lapses are likely and if you plan for the possibility, it’s less likely to become a fully blown relapse.
4. How are you going to put your plan into action? What exactly are you going to do? You need to be specific here.
5. You might find that thinking about your change results in deciding that it really isn’t the best time to do it, this is acceptable, maybe keep the pros and cons list somewhere safe and come back to it sometime in the future. Ensure your choice is an easy goal for you to achieve; being successful will help you make other changes. Goals need to be realistic and achievable deciding that it is perhaps not the right time to change is a positive step. Changing one aspect of you life at a time is more manageable.
6. How will you know whether you have made a positive change? It is important to measure this aspect as this is your motivation to continue, write it down or draw a graph, use the symptom tracker or there are lots of apps available to help with this and never forget to congratulate yourself on your achievements.
7. How long is it going to take to see an achievement? Measuring daily might not be helpful, weekly might be better. It depends on what you choose to do, but if you measure too much you might not see a change and this can be disheartening.
8. What do you do when you lapse? Well look at your measurements – what you have already achieved, congratulate your self for all that effort, use that motivation to continue. Also review your list of positive reasons you wrote at the start to refresh yourself on why you decided to change that aspect of your life.
If we live our lives without considering changing then we will carry on having to manage the negative aspects of what we choose to do. New Year is a really good time for people to consider what it is about our lifestyles can be improved and as such it is a really useful time, also getting others involved can also help people to keep up with resolutions.
J. C. Norcross, M. S. Mrykalo, M. D. Blagys (2002) Auld Lang Syne : Success Predictors, Change Processes, and Self-Reported Outcomes of New Year’s Resolvers and Nonresolvers Wiley Periodicals, Inc. J Clin Psychol 58: 397–405, 2002.
http://richardwiseman.wordpress.com/2009/12/29/how-to-keep-your-new-years-resolution/
Clinical Alimentary 