Uncategorized – Page 25 – Clinical Alimentary

When making snow dragons and other mythical creatures, keep your energy up with chestnut biscuits!

These delightful biscuits have a crisp crunchy outside and a cake textured middle. They are so easy to make and do taste very sweet – ideal served with a sweet wine at Christmas, after walking in the snow (doing some exercise to burn off the calories, obviously!) Or after expending energy making snow men/creatures in the cold like the dragon in the picture above, we made him about 3 years ago. I often wondered what people thought of him, we made him along a country walk near to where we live, I think he probably lasted two or three days. The biscuits are wheat, dairy, egg and gluten-free and should be suitable for most people following a low fodmap diet – as long as you tolerate almonds, as almonds can be rather high in fodmaps but obviously, this also depends on how much you add to a recipe and you could always use more gluten/wheat free flour to replace the almonds if you are following the exclusion phase of the Low fodmap diet.

Ingredients

250g dairy free margarine

100g icing sugar

40g soft brown sugar

260g of wheat and gluten-free plain flour

40g of ground almonds

1 x 250g tin of sweet chestnut spread

Icing sugar to dust

Method

It couldn’t be easier – add all ingredients in to a bowl and mix with an electric mixer till all the ingredients have been incorporated into a stiff batter.

Spoon about a tablespoon size drop on a greased baking tray and cook at gas mark 6/200 degrees C, till nicely browned.

Place on a cooling rack and sprinkle with icing sugar, I’m not sure if they are really a cake or a biscuit – I suppose this depends on whether it goes hard or soft on standing (cake goes hard once stale, biscuits go soft.) Will have to let you know.

December 12, 2012December 12, 2012

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Christmas Eve special supper – spicy saffron red pepper and courgette/zucchini Quiche

Low Fodmap, low lactose, wheat free + gluten-free.

Ingredients

200g of gluten free wheat free flour mix.

90g of milk free margarine

Pinch of salt

(or 1 packet pastry mix for gluten free, wheat free pastry – this can contain chickpea flour, so make your own if you have problems with lentils and chickpeas)

pinch of saffron

4 tablespoons of water

1-2 red peppers

1 courgette/zucchini

1 red chilli

4 eggs

1/4 teaspoon of turmeric

1/4 teaspoon of chilli powder

1/2 teaspoon of smoked paprika

1 oz of finely grated fresh parmesan.

Salt to taste.

Method

Place a tablespoon of just boiled water into a cup and add the saffron, leave for approximately half an hour to release the colour and flavour.

Weigh out the flour, add salt (if not a packet mix) and rub in the margarine, add the water and saffron mix to the pastry. Bring the dough together, work it well – the better it is worked in, the easier you will find it to use.

Roll out the pastry on a well floured (gluten and wheat free!) board or roll between two sheets of cling film. Line the base of a flan ring/dish. Cut out circles or shapes for the top of the flan.

http://animatedtoast.blogspot.co.uk/2007/12/santa-imposter-gallery.html

Break the four eggs into a bowl and mix well, add chilli powder, salt and turmeric, mix well.

Use a small amount of the egg mix as a wash for the base of the flan and the cut out shapes. Bake these for 15-20 minutes in an oven set a gas mark 5 or 190 degrees C. Also add to the oven a baking tray containing sliced pepper, finely chopped chilli, sprinkled over smoked paprika and spray oil. Place the peppers at the top of the oven till roasted.

Slice the courgette.

Cool the pastry, grate the parmesan. add the courgette to the base of the flan, then layer on the pepper. Pour over the egg mix, decorate with the pastry discs and sprinkle over the cheese. Cook at gas mark 6 or 200 degrees C, for approximately 20 minutes. Exclude the chilli if you find it too much for your digestion. Check your spices are wheat and gluten free if you need to.

December 9, 2012December 7, 2013

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Marilyn and the #IBS Myth

I have recently been interested in celebrity and IBS – would someone famous divulge that they have IBS? Would they want to act as an advocate, perhaps? My twitter followers would tell you I do hold a certain amount of disdain for celebrity culture, but I also appreciate the good work a role model can have to support a cause. I am not averse to sidelining my principles to help. Having a role model would be really beneficial as in my view we certainly need some support for this condition. Could any of these people be a real role model to help with promotion of the cause?

http://www.topnews.in/people/marilyn-monroe

There appear to be a number of famous people who clearly have not, or would ever be able to give consent to discuss this very private aspect of their lives. Whilst looking into celebrity and IBS I can across the following article. It appears Marilyn was reported to have had IBS, she was also reported to have been ‘unhygienic’, eating in bed and pushing the remnants of her meal under the bedclothes when she had finished. This was reported to have been disclosed by Clarke Gable (in a biography by David Brett) – who had a cleanliness fetish, she has also been classed as one of the top 15 filthiest people.

http://www.standardmedia.co.ke/?id=2000012098&cid=349&articleID=2000012098

So – it was reported by a person who ‘had’ an issue with dirt – is this a good scale to use to measure someone’s cleanliness? Possibly not, but it is a good titbit to sell a publication, however.

http://www.huffingtonpost.com/2012/08/01/marilyn-monroe-fbi-files-_n_1730017.html

It is always reported, after describing her apparent less than desirable cleanliness habits – oh by the way, just so you can know this, alongside her obnoxious habits, she also had ‘a form of IBS.’ I am not sure what ‘a form of IBS’ means as a diagnosis – it either is or it clearly isn’t. Marilyn always held a fascination for me, I am not sure why, perhaps it was her ethereal qualities, the fact that she died young and had a pretty hard life. Her beauty is indisputable, even in the first picture in this post, windswept and ruffled she appears alluring. Yet she was also vulnerable, courting nurturing – one of her reported virtues. She does not deserve to have her memory belittled by gossip about her personal life, the worst of it is she cannot defend herself.

http://jamiemalanowski.com/blogwp/2012/01/page/2/

She had a tragic life and fifty years after her death we still are enthralled by her story but we really should apply the Socrates triple filter test to this – do we know this is true? Well, Clarke Gable cannot confirm that he said it, let alone prove that it was in fact true. Is this something good? – the reported slovenliness no, obviously not. She may have been ill at that time, the circumstances are never included in the short internet reports. Do we, therefore, have a right to report this information, assuming it were true? It is a piece of useful information? Well the fact that she had IBS might be an interesting fact that would be useful to inform people IBS can affect anyone, but did she consent to us knowing? However, when reporting someone’s health status to help others it is vital HOW you inform – discussing it whilst also reporting a range of spurious unappealing habits clearly does not shed IBS in a good light. An incorrect association of IBS with unappealing habits may have been made by the report authors, this is damaging to what we want to ultimately achieve and the association is so far wide of the mark – simply false, but in fact, we don’t know if she had IBS at all. We clearly don’t know if what has been said is fact and neither does it pass any of the triple filter test. We cannot ask Marilyn for her consent so we should respect her memory and not gossip about something that we know little real facts about.

December 5, 2012March 11, 2018

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Inviting Salmonella to your festive dinner this year? A dietetic holiday lecture (you were warned!)

This post is about how to keep your gut healthy this christmas and avoid an infection of your digestive tract. What do I mean by this? Well, you might be at risk of an infection resulting in severe diarrhoea, abdominal pain and sickness during the holiday if you are not observing some food hygiene tips when preparing or eating food. No one would want this and we do have evidence that some people have a legacy of functional gut symptoms (irritable bowel syndrome) after such infections – worth a little bit of care then, to avoid.

Here is what the Food Standards Agency and NHS choices advises: (mercilessly ripped from their websites – but they are the experts!! Thank you to both organisations, see below for links)

Understanding ‘use by’ and ‘best before’ dates
‘Use by’ dates appear on foods that go off quickly. It can be dangerous to eat food past this
date, even though it might look and smell fine.
Check the ‘use by’ dates on the food in your fridge on a regular basis and be sure to use (eat, cook or freeze) food before its ‘use by’ to help you avoid throwing food away unnecessarily.

You can freeze food anytime up until the ‘use by’ date. Check the packaging to make sure
it’s suitable for freezing.
Once food with a ‘use by’ date has been opened, follow any storage instructions such as ‘eat
within 3 days of opening’, but not if the ‘use by’ date is tomorrow.
‘Best before’ dates appear on food with a longer shelf life. They show how long the food will
be at its best quality. Using food after the ‘best before’ doesn’t mean it will be unsafe. The
exception to this is eggs, providing they are cooked thoroughly, they can be eaten a day or
two after their ‘best before’ date.

Fridge looks like this at Christmas? Seriously - asking for an infection! http://www.heritageradionetwork.com/programs/13-Let-s-Get-Real.xml — Fridge looks like this at Christmas? Seriously – asking for an infection! http://www.heritageradionetwork.com/programs/13-Let-s-Get-Real.xml

http://www.youtube.com/watch?v=ULuaf7mWgyI&playnext=1&list=PL43290765924EDEAE&feature=results_video

Use leftovers safely
Eating leftovers can be a good way of making food go further.
If you are going to store leftovers in the fridge, cool them as quickly as possible (ideally
within 90 minutes) cover them and eat them up within two days.
If you are going to freeze them, cool them before putting them in your freezer. Once food is
in the freezer, it can be safely stored for a considerable time – but the quality will

Eurgh! Cover your food – even if close to serving! http://hulenhills.com.s96387.gridserver.com/blog/

deteriorate so it’s best to eat it within three months.
Make sure you defrost leftovers properly before reheating. Defrost them in the fridge
overnight, or in the microwave if you intend to cook them straightaway.
Eat leftovers within 24 hours of defrosting and do not refreeze. The only exception is if you
are defrosting raw food, such as meat or poultry, once it’s cooked it can be refrozen.
Cook leftovers until steaming hot throughout.
Don’t reheat leftovers more than once.

Plan your meals
Before you go shopping check what’s in the fridge and freezer.
Think about what you are going to eat that week, plan your meals and write it down.
Make a list of what you need to buy and stick to it! Impulse buys can be expensive and, if not part of your plans, could lead to something else being wasted.
If you do get tempted by special offers in the shop, such as ‘buy one get one free’, think
about adjusting your meal planner for the week to add it in, or freeze the extra pack before
the ‘use by’ date, ensuring that it is possible to freeze the food. Or you could cook larger
portions and save some for another time.
Label food and date it before it goes in the freezer, so you know what it is and how long it’s
been frozen for.

Preparing and cooking your turkey here is what NHS Choices recommend:

Defrosting your turkey

If you buy a frozen turkey, make sure that the turkey is properly defrosted before cooking it. If it’s still partially frozen, it may not cook evenly, which means that harmful bacteria could survive the cooking process.

Defrosting checklist:

Work out defrosting time in advance, so you know how much time to allow – it can take at least a couple of days for a large turkey to thaw.
When you start defrosting, take the turkey out of its packaging, put it on a large dish and cover. The dish will hold the liquid that comes out of the thawing turkey.
Remove the giblets and the neck as soon as possible to speed up the thawing process. Wash your hands thoroughly after handling raw turkey, giblets or any other raw meat.
Before cooking, make sure there aren’t any ice crystals in the cavity. Test the thicker parts of the turkey with a fork to tell whether the meat feels frozen.
Turkey (and any other poultry) is best defrosted in a covered dish at the bottom of the fridge so that it can’t drip onto other foods.
Pour away the liquid that comes out of the defrosting turkey regularly to stop it overflowing and spreading bacteria. Be careful not to splash the liquid onto worktops, dishes, cloths or other food.
If the bird is too big for the fridge, put it somewhere out of reach from animals and children, and where it won’t touch other foods. For example, a cool room, shed or garage.
If you’re not using the fridge, watch out for sudden changes in room temperature as they could prevent the turkey from thawing evenly.

Defrosting times

To work out the defrosting time for your turkey, check the packaging for any guidance first. If there aren’t any defrosting instructions, use the following times to work out roughly how long it will take to thaw your turkey.

In a fridge at 4ºC (39ºF), allow about 10 to 12 hours per kg, but remember that not all fridges will be this temperature.
In a cool room (below 17.5ºC, 64ºF), allow approximately three to four hours per kg, or longer if the room is particularly cold.
At room temperature (about 20ºC, 68ºF) allow approximately two hours per kg.

When your turkey is fully defrosted, put it in the fridge until you’re ready to cook it. If this isn’t possible, make sure you cook it immediately.

Preparing the turkey

Wash you hands before preparing or touching food.

Keep the uncooked turkey away from food that’s ready to eat. If raw poultry, or other raw meat, touches or drips onto these foods, bacteria will spread and may cause food poisoning.

Bacteria can spread from raw meat and poultry to worktops, chopping boards, dishes and utensils. To keep your Christmas food safe, remember the following things:

After touching raw poultry or other raw meat, always wash your hands with warm water and soap, and dry them thoroughly.
There’s no need to wash your turkey before your cook it. If you do, bacteria from raw poultry can splash onto worktops, dishes and other foods. Proper cooking will kill any bacteria.
Always clean worktops, chopping boards, dishes and utensils thoroughly after they have touched raw poultry or meat.
Never use the same chopping board for raw poultry or meat and ready-to-eat food without washing it thoroughly in warm soapy water. If possible, use a separate chopping board just for raw meat and poultry.
Cooking times The cooking times below are based on an unstuffed bird. It’s better to cook your stuffing in a separate roasting tin, rather than inside the bird so that it will cook more easily and the cooking guidelines will be more accurate.If you cook your bird with the stuffing inside, you need to allow extra time for the stuffing and for the fact that it cooks more slowly. Some ovens, such as fan-assisted ovens, might cook the bird more quickly – check the guidance on the packaging and the manufacturer’s handbook for your oven if you can.As a general guide, in an oven preheated to 180ºC (350ºF, Gas Mark 4):
- Allow 45 minutes per kg plus 20 minutes for a turkey under 4.5kg.
- Allow 40 minutes per kg for a turkey that’s between 4.5kg and 6.5kg.
- Allow 35 minutes per kg for a turkey of more than 6.5kg.
Cover your turkey with foil during cooking and uncover for the last 30 minutes to brown the skin. To stop the meat drying out, baste it every hour during cooking. There is some debate over the cooking times so have a look at the Live Well website comments below – and also check out the time for other birds.
http://www.nhs.uk/Livewell/Healthychristmas/Pages/cooking-turkey.aspx

http://www.youtube.com/watch?v=2shb5aahLGs

Best not to watch this next one if you have a sensitive disposition! I don’t remember this video being released – very good though!

http://www.youtube.com/watch?v=Zu-fD8m9vxU

http://www.food.gov.uk/news-updates/campaigns/germwatch/#.UKjCo2e0N8V

December 2, 2012

Jules_GastroRDLeave a comment

LOFFLEX how to manage a #crohn’s flare up during the festive season

It probably isn’t very good to be following the LOFFLEX diet during the festive season but crohn’s is no respecter of holidays and it may be that you have had to return to a very bland diet during the festive season. You can eat food during this time – here are some recipes I developed to help you to have at least a Christmas lunch, or you could use this recipe for thanksgiving too.

Turkey is suitable for stage one of the lofflex diet, so are carrots and boiled potatoes (no skins.)

Roast potato

Peel potato and wash with clean water.

Cut into pieces and par boil in salted water for five minutes.

Drain off cooking liquor

Shake the pan to roughen the edges of the potato

Spray with a small amount of vegetable oil.

Cook in the oven for minutes at gas mark 7/220°C

Have 1-2 pieces.

Stuffing

3oz/75g Rice crumbs

1 teaspoon of sage

1 teaspoon of mixed herbs

100mls/4 fluid ounces of boiling water

Spray with rapeseed oil

Salt to taste

Method

Add sage and herbs to a cup; pour on water and leave to brew.

Sieve herb liquor to remove solids and retain liquor.

Weigh out rice crumbs and add herb liquor till a consistency of stuffing is achieved, add salt to taste.

Place stuffing into a ramekins and flatten the surface, spray oil on the top.

Put into an oven at gas mark 6/200 degree celsius for approximately 20 minutes or until the surface has browned.

Gravy

Use turkey stock – drain off the fat from the surface and thicken with rice flour.

Cranberry sauce with no alcohol added – sieve out skin and seeds.

Pear or apricot crumble with soya custard

Serves two

50g/2 oz Rice crumbs

12g/½ oz granulated sugar

2 tablespoons sieved, or skin free apricot jam

2 pears

Spray rapeseed oil

Peel and remove the stalk and core from the pears

Slice the pear and add to two ramekins.

Add one tablespoon of sieved apricot jam to each one, (warm the jam in a pan till the jam is runny and sieve off skins, or purchase skin free apricot jam, available for Christmas cake decorating.)

Mix rice crumbs and sugar and sprinkle on the top of the apricot and pear

Spray surface with spray oil

Cook in the oven for 15 minutes gas mark 6/200°C – take care when serving as it can be very hot! Serve with soya custard.

Christmas can be a difficult time if you have restrictions on your diet, so try to keep focused and think of some treats that are not food related, such as going to see a movie at the cinema, watching your local football team on boxing day, going to see a play or pantomime or inviting friends round to watch a Christmas DVD.

Keep well hydrated and if you experience severe symptoms seek help from your healthcare provider. Everyones intolerances can be different so if you have noticed that some of the ingredients in the above recipes make your symptoms worse it’s probably best to avoid them, discuss this with your dietitian.

December 2, 2012December 2, 2012

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Have IBS food intolerances and only eating gruel? How to avoid a Dickensian diet this holiday!

Christmas and the holidays are a time of celebration and food usually takes a central role, so what if you need to avoid certain foods to prevent having symptoms over the Christmas/holiday period? You can eat food and take some steps to reduce the effects, should you wish. It is possible to eat nice food and prevent spending boxing day never off the loo and with a covered hot water bottle strapped around your stomach. You just need to plan ahead – a reason why this post is going to be published early. First lets talk about Christmas lunch – skinless turkey, carrots, parsnips (use spray oil to roast) and potatoes are fine to have. When making gravy use stock from the turkey and spoon off or pour off the fat that settles on the top of the stock, thicken with corn or rice flour to make a nice gut-friendly gravy. For roast potatoes you could parboil the potatoes for about 5 minutes and then drain off the water, keeping the potatoes in the pan, shake the pan to soften the potato surface – spray with oil and then place in the oven to roast. Trimmings such as cranberry sauce is OK – only have a small portion, wheat free stuffing is also possible using herbs and wheat free bread crumbs (see the LOFFLEX Christmas post for the recipe – although you can use whole fresh herbs) or rice crumbs (available from larger supermarkets.) Again it might be better to trim any bacon fat and grill bacon to reduce the fat levels and prevent diarrhoea, and grill wheat free sausages. These are ideas to help, but of course, if you know your IBS well, you may want to eat normally, it may possibly be uncomfortable for a short while but won’t necessarily do any lasting harm. The following recipe is for Low FODMAP christmas cakes, hope you enjoy!

Ingredients

150g dairy free margarine

150g soft brown sugar

3 eggs (room temperature)

1 cap full (1/2 tsp of vanilla essence)

150g of the wheat free self-raising flour blend.

1tsp of mixed spice

1 flat tsp of cinnamon

1 flat teaspoon of ginger

2 tablespoons of chopped roasted pecan nuts

5 tablespoons of lactose-free milk.

Icing sugar, ready-made fondant icing sugar (check label for fructose) and water to decorate.

Method

Cream together the butter and sugar till the mix is pale in colour.

Add one egg at a time and one tablespoon of flour, mix well till all three eggs have been incorporated. Add vanilla essence.

Sieve the spices and flour into the mix and fold in till well incorporated, add the milk and nuts and mix well.

Spoon mix into paper cases.

Bake in a preheated oven gas mark 6/200 C until risen and browned.

Allow to cool, add some water to icing sugar to make a thin coating. Using ready prepared icing, roll out and cut shapes. ‘Stick’ the icing sugar shape to the cake with runny icing made from icing sugar and water and decorate as wished.

Eat one – (or maybe two if you must! ;-))

I hope all my readers have an enjoyable Christmas (or holiday) and here are some tips that might help –

You DON’T have to be a domestic goddess this Christmas, plan ahead and remember that having time with your family is the most important thing – they will appreciate you just being there, not frazzled or tired after trying to be perfect. Remember that being a perfect ‘housewife’ or ‘househusband’ is a marketing concept and these concepts are usually impossible to attain, no matter how you try (or, in fact, how much you spend!) Children, in particular, appreciate time with their parents more than anything.

Plan ahead if you can – now is the time to take a break and sit and plan your shopping and meals for over the holiday period. Shop online if you don’t like large crowds.

Plan a short walk with the family after Christmas lunch – will help constipation and stop the slump in energy levels after lunch.

Don’t slouch on the sofa eating snacks whilst watching the afternoon or evening movie, try to keep your posture and sit up straight if you can.

Moderate your alcohol intake – who wants to spend boxing day with diarrhoea, abdominal pain and a hangover?

Eat slowly and chew your food well, savour your meal – you have worked hard for it!

Christmas can be a stressful time and this won’t help your gut, IBS is not ‘all in your head’ but stress produces hormones that affect your gut, this can make symptoms worse. Avoid arguments over the dinner table, this may be difficult if you have critical family members. Tell them beforehand that arguing or criticising is NOT acceptable, you are making an effort for them and that should be appreciated, if it is not, then perhaps they are not welcome at the lunch? Be assertive and stay calm!

Don’t have unrealistic expectations, setting yourself up for disappointment, do what you can – nobody will or should expect more.