FODMAP – Clinical Alimentary

Chestnut pies – an alternative to mince pies (low FODMAP)

Mince pies are quintessentially Christmas. Normally mince pies have a large amount of dried fruit which can cause problems for people with fructose malabsorption if enough are eaten, plus they are made from pastry, a source of fructans. This is the reason I decided to develop a nut based pie instead and chestnut was just the right choice (along side the fact I had 1/2 tin of chestnut puree left from the previous recipe!) I am probably going all out to trash the traditional mince pie – but needs must!

Again this is a Christmas recipe and not one necessarily for health – the addition of lard really should be part of a true shortcrust pastry, the recipe standard is 1/2 fat to flour and 1/2 lard to butter/margarine. The lard in the pastry is also traditional in mince pie but usually added as suet to the filling. This recipe is made a rich shortcrust with the addition of an egg and the sugar. A recipe for a treat occasionally and when else can you have a treat except Christmas?

Ingredients

Pie filling
50g Candied Ginger
½ Can chestnut puree
¼ teaspoon Vanilla
40g pecan nuts
¼ teaspoon Cinnamon
3 tablespoons maple syrup
Pastry
200g gluten free plain flour
½ teaspoon xanthan gum
50g margarine
50g Lard
1 medium egg
1 tablespoon sugar
1 egg beaten for egg wash

Method

Sieve the flour into a bowl add the xanthan gum and mix well.
Add the sugar.
Cut the margarine and lard into small pieces and add to the flour.
Rub the fat into the flour until it forms a small crumb.
Add the egg and bring the crumb together into a pastry – you may need to add a small amount of water if it is too dry but be cautious – you can always add more but you can’t remove too much!
Chill the pastry whilst you make the filling.
Chop pecan nuts and add the filling ingredients into a pan and warm through till blended well, chill.
Roll out the pastry and cut out the pie bases and tops
To a well oiled pie tin add the pastry base, some filling (don’t overfill) and then add the top and glaze with beaten egg wash (it will not brown without this addition.
Cook at gas mark 6/200 degrees C for 15-20 minutes.
Serve with sprinkled icing sugar.

November 9, 2019

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Lemon – Low FODMAP

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.

March 7, 2019

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Is ginger useful for treating IBS?

Chemistry-of-Ginger-1024x724 — http://www.compoundchem.com/2014/11/27/ginger/

The next ingredient to be reviewed is ginger. Ginger has many studies into its use to treat vomiting in pregnancy and to treat nausea during treatments such as chemotherapy or reducing sickness after surgery. Ginger has a long history of being used as a natural treatment for nausea, so one might expect that it could be used to reduce some of the symptoms of IBS. It is one of the most common herbal treatments used by patients to attempt to ameliorate symptoms of IBS (1). The action of ginger on the digestive tract is suggested to be an increase in prokinetic action of the tract (increasing movement or contractions without disrupting the rhythm) and it has also been suggested to be useful in pain reduction. The active ingredients in ginger can be seen in the diagram above and a placebo-controlled RCT parallel study in IBS (2) used the pharmaceutical grade ginger containing 2.29 mg/g of gingerols and 6-shogaols. Raw and cooked ginger contain different chemical compounds and may have different modes of action on the digestive tract.

The study had a good choice of placebo (brown sugar) tolerated by most patients with IBS. Study numbers were small – a larger trial with at least 100 patients per group would give a chance of better results. Larger doses appeared to give poorer results from this study, but the numbers in each group were small. We are aware that IBS is a very heterogeneic condition (wide variation in symptoms between people) and studying those people reporting more upper GI symptoms of IBS such as nausea and reflux plus constipation might improve results if the mode of action is to increase stomach emptying and increase digestive tract motility. The study, unfortunately, did not show that ginger was effective compared with placebo so we have therefore no evidence that ginger is an effective treatment for IBS.

Does it cause harm?

Side effects in the study chosen were greater in the placebo group, the relevance for this is unknown – IBS is a challenging condition to treat with relapsing-remitting symptoms – no significance can be seen in regard to side effects as no statistics were applied to check whether this was significant in the study reviewed. Ginger is thought to be a safe treatment – ginger is also suitable to be used for the Low fodmap diet. So a great tasting low fodmap ingredient – but don’t expect it will stop your IBS symptoms.

Just the ticket for a recipe then!

This is a very easy recipe to prepare and these biscuits can be stored in an airtight tin. They may go soft if not stored correctly.

Ingredients

325g Gluten Free self-raising Mix (I used Doves Farm)

1 tsp. xanthan gum

a beaten egg

75g muscovado sugar

75g golden syrup

75g butter

2 tsp. ground ginger

Method

Melt the butter, sugar and golden syrup in a pan then cool till the mix is only just warm

Beat the egg

Add the dry ingredients to a bowl and ensure the xanthan gum is mixed into the flour.

Add the wet ingredients to the dry and mix well till the mixture forms a dough.

Work this well.

Roll out the pastry dough into a thin sheet on grease-proof paper or a Teflon sheet and cut out the biscuits.

Add the biscuits to a greased baking tray and cook till golden brown in a moderate temperature oven – gas mark 4 or 180 degrees C

Makes around 30 biscuits (depending on what size cutter is used.)

1.Van Tilburg MA, Palsson OS, Levy RL, et al. (2008) Complementary and alternative medicine use and cost in functional bowel disorders: a six month prospective study in a large HMO. BMC Complement Altern Med. 2008; 8:46.

2. VAN TILBURG MA, PALSSON O S, RINGEL Y and WHITEHEAD WE (2014) Is ginger effective for the treatment of Irritable Bowel Syndrome? A double blind randomized controlled pilot trial Complement Ther Med. 22(1): 17–20. doi:10.1016/j.ctim.2013.12.015

February 25, 2018March 11, 2018

Jules_GastroRD2 Comments

Chicken goujons – low fodmap

What are goujons? They are small chicken fillets that are coated in breadcrumbs. They are fairly easy to make using gluten free breadcrumbs but it is important to use the correct ones for the low fodmap diet. Clearspring rice crumbs are probably the best option. Some gluten free breadcrumbs use a blend including gram flour – this is chickpea flour and is a source of GOS, it might be OK for some people with IBS because of the small portions of crumbs used to coat ingredients – but pure rice crumbs are better and they are wholegrain too – bonus for those with constipation! Hale and Hearty breadcrumbs contain inulin so this should not be used for a low fodmap diet. You can make your own breadcrumbs with gluten free bread if you wish, again choosing wholegrain bread to give the dish added fibre – a way of using up stale gluten free bread and fibre is great for gut health! For health this is a recipe to have occasionally as it is a fried dish – but suitable for those who are underweight as frying adds additional calories to the dish. Mayonnaise is another addition but take care with ones that say low fat mayo as these can have increased amount of skimmed milk powder – a source of lactose. So it has to be full fat and a small portion! The dish includes making your own garlic infused oil at the start of the process – follow this part of the recipe closely, slicing the garlic makes it easier to remove it all before frying the goujons, so you remove all the fructans included in the clove. Don’t be tempted to use a garlic crusher as you cannot then remove all the pieces. I have added the goujons to a gluten free pitta bread with salad leaves.

Ingredients

Gluten free four (100g)

1 egg

Gluten Free Breadcrumbs (1/2 pack)

seasoning

1 pack of chicken mini breast fillets

Rapeseed oil – enough for frying

1 pack of gluten free pitta breads

Salad leaves of your choice (I used chard and radicchio but lettuce leaves are another option.)

1 clove of garlic.

Method

Wash Hands.

Wash and chop the salad leaves and prepare the pitta bread and put these on a plate away from the work surface you are using to prepare the goujons. If you have work surfaces on either side of the oven this is good, you can use one side for raw chicken preparation and one for cooked. Do this before handling the raw chicken fillets.

Open the packet of chicken fillets and use immediately – please do not wash them, they don’t need it, plus washing raw chicken is a food poisoning hazard – it can easily spread bacteria around the kitchen.

Place the flour and seasoning on a plate, crack the egg and mix well with a fork on a plate and breadcrumbs on separate plates. Dip the chicken fillets into the flour first, then egg and then the breadcrumbs – coat each fillet well and don’t forget the edges.

When coated, pile them on a dish for frying later.

Clean work surfaces down and wash your hands again after handling raw chicken.

Slice the garlic clove (this is better than crushing as it makes it easier to remove the pieces before frying the chicken.)

Add oil to the pan and fry the clove quickly then remove all the pieces of garlic from the pan.

Add the chicken goujons and fry till golden. Don’t overload the pan as this will lead to steaming instead of frying and soggy breadcrumbs.

Add 2 slices of goujons to each pitta – makes 5.

Serve with green salad.

OLYMPUS DIGITAL CAMERA

February 18, 2018

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Celebration trifle – low fodmap

It’s New Years eve and if you want a celebration dessert that can help people following a low fodmap diet but is also tasty for all your New Years Day party guests, this is ideal – it is made with lactose free mascarpone and lactose free creme fraiche (you can buy these at Tesco) plus gluten free sponge. Whilst this trifle is low fodmap it is not low in fat – if you have issues with foods high in fat resulting in symptoms take care – a small portion only is probably best!

Ingredients

Sponge

100g gluten free self raising flour

2 eggs

100g margarine

100g castor sugar

Rhubarb

250g rhubarb

2 tablespoons of maple syrup

1/2 teaspoon of orange oil

1 tablespoon of granulated sugar

100ml of water

Topping

50g chopped pecan nuts

Cream

200g lactose free mascarpone

100g of lactose free creme fraiche

1 tablespoon of icing sugar

Method

Sponge

Make the sponge – this is better prepared the day before to allow it to stale a little

Add the margarine and castor sugar to a bowl and using a hand mixer mix until light and creamy

Add one egg and beat till incorporated into the mix – if it curdles or separates just add a little of the flour to the mix.

Repeat with the other egg.

Add the flour and mix it in slowly with a metal spoon.

Pour into a 7 inch lined cake tin and put in an oven to cook at gas mark 5 190 degrees C for 45 minutes – or until a metal skewer inserted into the cake comes out clean.

Cool and slice length ways into two circles

Rhubarb

Wash slice and cook the rhubarb with the water, maple syrup and sugar and orange oil until soft – cool and save the cooking liquor. I like my rhubarb quite sharp to counteract the sweetness – add sugar or syrup to your preference here.

Cream

Mix the mascarpone with the creme fraiche and icing sugar – keep in the fridge

and build….

Build the trifle, one layer of rhubarb, then sponge – add some of the rhubarb cooking liquor to the sponge, then mascarpone – repeat until all the mixes are used up ending with a layer of mascarpone. Add chopped nuts to the top of the cake to decorate.

Serves 8

🎇🎊 Wishing all my followers a Happy New Year!🎊🎇

December 31, 2017

Jules_GastroRD1 Comment

Mini chocolate orange panettone – low fodmap

This is an ideal Christmas recipe for low fodmappers who want to have a festive bread without marzipan and probably one of the only bread recipes that I have managed to produce that has risen well! It is based on an enriched bead dough mix produced using a standard purchased bread flour.

Recipe

250g gluten free bread flour

150g dark chocolate chips

2 teaspoons of orange oil

2 eggs

1 tablespoon of oil

1 teaspoon of vanilla

1 pack of fast acting yeast

1 pinch of salt

1 small pinch of cream of tartar

50g of castor sugar

1 teaspoon of cinnamon

1/4 teaspoon of cloves

1 teaspoon of ginger

1 teaspoon of mixed spice

400ml of warm water

Method

Add the flour, spices salt and dark chocolate chips to a bowl, mix.

Separate the yolk from the white of the eggs.

To the white add a pinch of cream of tartar and whisk till peaks are formed, adding 25g of sugar half way through, then add the rest when soft peaks are formed.

To the yolks add the oil, vanilla and orange oil

Start adding the water to the dry ingredients and mix with a hand mixer. Then add the yolks.

Fold into the mix half the beaten egg whites quickly to slacken the mix. The gently fold in the rest of the egg white.

Add to bread tins and leave in a warm place for 30 minutes to rise. Cook in a warm oven (200˚C, Fan 180˚C, 400˚F, Gas 6) for 30 minutes until cooked.