Gluten free bread woes?

The one anxiety people have when they are diagnosed with coeliac disease is the bread. People complain about the texture, the taste, the fact that sandwiches ‘are just not the same’, the slices are too small and they struggle with choices at lunchtime. In my experience most people find a solution to the bread ‘problem’ and this can be achieved by trying all different types, most

http://sammisofties.blogspot.co.uk/2011/09/miss-marples-bread-woes.html

companies will allow you to sample the products. Free From shows are ideal venues to visit as most companies exhibit and will allow you to taste. It can be argued that the popularity of the gluten-free diet as a lifestyle choice is not ideal, but one thing is for sure, choices for gluten-free foods are improving all the time. Although free market competition and following price reductions due to market competition does not seem to have followed with the increasing choice available.

The fresh breads that are marketed are good options and if you can tolerate codex wheat (wheat that has had the gluten removed) but you may need to have freezer storage as if these are ordered on prescription (for people with coeliac disease only) they are delivered in larger batches. Try to choose ones with added fibre or seeds to increase wholegrain options in your diet. Some breads can be freshened by warming in an oven or microwave – this is usually stated on the packet and some versions have humectants (an additive that holds on to water) added to keep them moist, such as psyllium husk flour, which can also act as a bulking laxative! Useful for most people but you might want to limit the amount of these types of bread if you have irritable bowel syndrome and you suffer from diarrhoea and bloating.

lunch day 2

Most types of bread are available in gluten-free varieties, such as baguettes, rolls, fruit loaf, pita and naan, a new wrap has even been introduced recently. If you use artesian bread outlets or farmers markets, please ensure contamination with gluten has been avoided and the seller is aware that spelt flour is not gluten-free. One clear problem with the gluten-free bread is that the slices are often smaller – but do be cautious as these slices may contain the same calories as a standard sized loaf. Those people who have weight management requirements need to review the labels when choosing bread as sometimes ingredients that are used to improve the texture increase the calories the bread contains. Some of the more common breads and there fat and calorie contents are below.

————–Energy per Slice/per 100g (Kcal)              Fat Content per slice/per 100g (g)

Juvela Fibre Fresh                           73/229                                                     1.3/4.2

Glutafin Select Fibre Fresh             88/252                                                     2.2/6.1

Genius brown original                      82/304                                                    3.8/14.3

Warburtons Brown                           73/229                                                    2.2/6.1

Yes You Can (fibre)                          83/221                                                    1.4/3.7

Wellfoods (fibre)                               –/216                                                     –/2.3

Ener-G (rice brown loaf)                  –/334                                                     –/15

Fria Fiber                                            83/265                                                   2.1/7.0

Barkat Brown                                      –/221                                                   — /3.2

Dietary Specials                                68.5/249                                                 1.7/6.2

Biona rice brown bread                       –/200                                                  –/2.0

Asda Brown                                            86/234                                                1.2/3.3

Sainsbury’s Brown  (slice = 36g)         86/302                                                3.6/12.5

Tesco Brown                                         105/285                                                3.1/8.6

Only two of the above products would be classed as a low fat product if you go by grams of fat per 1oog only, but this is complicated, as slices are different thicknesses and sizes and calorie content is also important. Concentrating on the fat level might not be that helpful (and the calorie content of the rest of the diet too is clearly important – it’s no good complaining about the calorie content of the bread, if you consume lots of gluten free cake, biscuits and pastries!) Those examples above without per slice options may be unsliced, therefore the calorie content depends on how generous you are, thin slices or ‘door stop’ slices, as my Lancashire family would describe. Some companies are now producing loaves that have larger slices to address the issue of small slices, but again caution might need to be taken for those who struggle to maintain a healthy weight.

gluten free bread loaf 3 4-23-12 w

As can be seen above we now have lots of options for choices for bread – so those who are newly diagnosed should ideally try each version to see which they prefer, this choice can be as different as chalk and cheese! You can make your own using breadmakers and baking by hand, mixes are available to help and they are usually very good in my experience. Making your own can take some time to get used too but home-made can taste much nicer – you could add dried fruit, a source of iron and fibre. Other options are gluten-free crackers and crispbreads, good options for lunchtime and eating away from home. Toasting the bread can also make the bread more tolerable for some.

If you are following the Low FODMAP diet ensure you check ingredients.

If you have any tips for people please share!

No funding or free samples were provided to faciliate writing of this post.

Easter meal – roast spring lamb

IMG_1673The 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.

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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.

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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.IMG_1680

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.)

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Easter with food intolerance

Simnel Cake

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!

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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.

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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.

IMG_1650I 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.

http://www.arikhanson.com/wp-content/uploads/2010/08/InspirationPoint.jpg

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.

ibsnetwork

So watch this space and any ideas on what you would want to read are gratefully appreciated!

Change is not made without inconvenience, even from worse to better – (Samuel Johnson 1755)

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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/

Happy New Year! Clinical Alimentary blog awards 2012

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Will you sing this tonight on the strike of midnight, to being in the new year?

Should auld acquaintance be forgot

And never brought to mind

Should auld acquaintance be forgot

For the sake of auld lang syne.

For auld lang syne my dear

For auld lang syne

We’ll take a cup of kindness dear

For the sake of auld lang syne – Robert Burns

So as not to forget times long past and new friendships found – with a special thanks to all my followers – in particular (in no order of preference)

Dr Gary Lum author of Yummy Lummy, who consistently likes my posts and has so far provided my only reblog http://garydavidlum.com/

John Thompson (not a relation!) author of Sybaritica, for comments http://sybaritica.me/

Alex Gazzola author of Food Allergy and Intolerance, for support and always making me think ‘out of the box’ http://foodallergyandintolerance.blogspot.co.uk/

Dr Barbara B. Bolen author of About IBS, http://ibs.about.com/ and Patsy Catsos author of IBS free http://ibsfree.net – for driving the most views to my site

Nina and all at IBS Impact http://www.ibsimpact.com/about_us.htm http://ibsimpact.wordpress.com/ for supporting the IBS community and driving some very interesting discussions.

I hope the New Year brings all of my followers good luck, new opportunities and most of all a calm gut.

My most popular posts of 2012

https://clinicalalimentary.wordpress.com/2012/04/18/surely-these-digestive-enzymes-ive-found-can-help-or-are-they-money-down-the-toilet/

https://clinicalalimentary.wordpress.com/2012/03/27/lofflex-recipes/

https://clinicalalimentary.wordpress.com/2012/09/30/low-fodmap-on-a-budget-how-to-make-the-diet-more-affordable/

The WordPress.com stats helper monkeys prepared a 2012 annual report for this blog.

Here’s an excerpt:

600 people reached the top of Mt. Everest in 2012. This blog got about 6,900 views in 2012. If every person who reached the top of Mt. Everest viewed this blog, it would have taken 12 years to get that many views.

Click here to see the complete report.