Low FODMAP sausage rolls

Christmas party food is important for people who need to follow a free from diet. Here is a popular choice for most parties and the pastry worked out really well and was fairly easy to make.

Ingredients

  • 200g Plain flour
  • 150g butter
  • 1/2 teaspoon Xanthan gum
  • 1 teaspoon of baking powder
  • 50mls water
  • Flour to use to roll out the pastry
  • 500g low fat pork mince
  • 2 Sprigs parsley
  • 2 Sprigs thyme
  • 1 Sprig rosemary
  • 2 sprigs oregano
  • Egg
  • Salt to taste

Method

  • Sieve flour, Baking powder, xanthan gum and salt into a bowl, mix.
  • Weigh out the butter and divide into three.
  • Rub 1/3 of the butter into the flour and then add the water.
  • Bring the ingredients together and roll into a rectangle, mark out into three sections – to the bottom 2/3 and add blobs of butter to the dough.
  • Bring the bottom 1/3 of the pastry over the middle third and then fold over the top third. Rotate a quarter turn, roll and repeat the above at least three times.
  • Rest for 30 minutes before use.
  • Add the pork to a bowl and season.
  • Chop the herbs and add to a blender with the pork mince,
  • Remove the pastry from the fridge and roll out. Add a line of pork mince and fold over the pastry.
  • Cut the pastry and wash with egg wash before using.
  • Cook in an oven gas mark 6, 220 degrees C.
  • Better served warm.

Enjoy!

Oyster mushroom soup low FODMAP

Mushroom soup is really very tasty and oyster mushrooms are the only suitable mushrooms for the low FODMAP diet. I love mushrooms and I went on a foraging course to help identify them but I haven’t picked any as yet – to nervous about picking the wrong ones I suppose. I would love to come across an oyster mushroom in the wild and they may be sold as wild mushrooms but I suspect they rarely are – I found the ones I used in this recipe in an Tesco store and they weren’t too costly.

I have written about the umami flavour before here and I have just read a really interesting article in the Guardian newspaper online here. I was astonished to read that glutamate the flavour that is responsible for the meaty rich flavour is also found in human breast milk and our tongue has a specific receptor for it – no wonder we like it! So much for MSG and the reports of it being ‘toxic’ according to some who like to say all ‘chemicals’ are bad – spoiler alert – all food are based on chemicals!

Ingredients

  • 300g of oyster mushrooms.
  • 2 teaspoons white miso (check the label for other high fodmap ingredients).
  • 2 teaspoons of Tamari sauce.
  • 1 teaspoon of ginger.
  • 1 tablespoon of oil.
  • 2 tablespoons of lactose free cream.
  • 1 and a half pints of water.

Method

  • Chop mushrooms and add oil to a pan.
  • Fry the ginger and add the chopped mushrooms and cook for 10 minutes.
  • Add some hot water to the miso and dissolve then add the water, miso and Tamari sauce to the pan.
  • Cook for 10 minutes
  • Blend till smooth

Serve with cheese on toast floats for an additional umami flavour! It really couldn’t be easier.

Here is a picture of me and my mum on our foraging course in the Lake District – lots of mushrooms here but they were foraged by an expert!

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.

Lemon – Low FODMAP

http://www.compoundchem.com

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.


IBS digestive distress – is there a problem with bread?

Many people with IBS state that bread is a real issue in provoking symptoms. Is this true? What is it about bread that is the problem? This post aims to discuss the provocateurs of digestive distress in IBS (Irritable Bowel Syndrome).

Cited as sustenance – for example, the line ‘give us this day our daily bread’ in the Lord’s prayer – having access to bread was life for the poor in the past and bread is a staple food in the United Kingdom. The first piece of toast dripping in butter and a cup of tea after a period of fasting through having surgery is one time I recall, and bread was all the food I desired. How wonderful it tasted. The mouthfeel of gluten is undeniable and can be identified by those who do need to follow gluten, wheat or fructans free diet. I have identified it when I have infrequently made a mistake, as in ‘wow, this gluten-free bread tastes GREAT’ only to later realise my mistake at a cost and in fact it was the standard wheat based bread I had consumed!

The-Chemistry-of-Bread-MakingIn the past bread was made locally and bakers were part of the local community. When industrialisation arrived, bread, needed in large quantities as a staple food, soon was produced in factories, one of the possible reasons was because it was terrible work – bakers had to rise early and work hard to provide the daily loaf for their community. Is industrialisation the cause of bread symptoms? Many blame the Chorleywood bread making process and fast fermentation – but harking back to the bread of the past does not always leave a rosy glow. Adulterating food with cheap ingredients was commonplace in Victorian history, alum (aluminium salt) was added to the dough to improve it’s colour and was thought to be one cause of Rickets, by reducing the availability of phosphorus, leading to decreasing its absorption from the diet.

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So, let’s take a look at bread more closely. There are possibly a few protagonists for digestive discomfort after eating bread, and the reason may be different for individuals – we will now discuss some of those possible causes:

Resistant starch content

‘Resistant’ starch does what its name suggests – it resists digestion and is a component of fibre.  Produced by heating/cooling treatment, these resistant carbohydrates are based on wheat (and other) grains. Now for a little bit of chemistry, not too complicated, I promise. Starch is a crystalline polymer (think of a chain of a necklace containing many small beads, each small bead representing a sugar molecule, the necklace representing a polymer chain – a starch). Chains of the starch molecules closely line up on cooling, forming crystals within the bread matrix, links (imagine two or more necklace strings joined together) or bridges between the starch chains makes the structure a tightly packed area, where our digestive enzymes (amylases) can’t penetrate. The speed and repetition in cooling and heating will affect the amount of the resistance formed. Exposed to up to 20g of resistant starch per day from our diet some of the bacteria (amylolytic) in our large intestine may be able to ferment these crystalline resistant areas more successfully . IBS has alterations in the gut microbes, meaning that gut fermentation is a possible consequence and symptoms likely, in those people with IBS.

Research has shown that only certain types of bacteria are capable of digesting resistant starch of the form Bifidobacterium spp. and Clostridium butyricum but these types of study are limited. Consumption of these starches enriches the gut microbial populations with more of the microbes capable of breaking down the starch. We know that people with IBS have different populations of gut bacteria than the general public – a changing diet to improve symptoms is a possible cause of this difference.

Similar mechanism to the mechanism that causes issues from resistant starch – in other words poorly absorbed starch components causes these starches to be fermented in the large bowel resulting in symptoms when the colon is overly sensitive in IBS.

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Gluten

Gluten is a different component, and it is a protein, not a starch. Different mechanisms occur with proteins. During bread mixing initially, the gluten is softened by adding water to the flour, then kneading the bread with the salt that is added strengthens the gluten bonds gives a stretchy mixture, which traps air giving a better rise. Proteins tend to solidify when heated during baking, producing the tight structure or links between the protein molecules. Some research has found by blinding during trials that it does appear to be the fructans in wheat that result in the majority of problems for people with IBS. However is it still possible for individuals to have an issue with gluten? It does make you wonder, for those people who can tolerate all other fodmaps except wheat, whether this is, in fact, a non-coeliac gluten sensitivity. In my experience, most people following a low fodmap diet will go utterly gluten-free despite the fact that small amounts of wheat are tolerated well. Or perhaps the problem is a non-IgE wheat allergic reaction, or maybe natural toxins developed by the wheat is the problem…

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Wheat ATIs

Wheat amylase-trypsin inhibitors are proteins that are found naturally in wheat and are resistant to digestion and were developed by the plant to act as a defence against parasites and insects. They are activators of innate immunity and are suggested to lead to digestive symptoms by activating an immune reaction in the gut mucosa resulting in low levels of inflammation. Bioactivity of these proteins was found to be lower in spelt flour – often stated to be tolerated better for digestion. Is it possible that these ATI’s or gluten activate an immune response that then sensitises the colon leading to reactions to fodmaps?

The processing of wheat to produce bread, however, reduced ATI’s bioactivity up to 30-50%. But some people state bread is explicitly a problem so we should look at the manufacturing process specifically.

Chorleywood bread making process – the case for fructans?

All the above are commonly found in all wheat-based food, but bread is processed, what effects does this have? The Chorleywood process was developed in 1961 and improves production time reducing costs of bread production. This production method can also use a lower protein content flour, which was the type of flour available in the UK, to reduce costs of having to import flour with higher protein. The protein content in UK wheat has increased since this development, but this process is still used and widely disparaged as a cause of digestive distress.

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One fascinating study looked at the differences in symptoms between the general population and those with IBS and whether a longer fermentation would lead to lower gut fermentation and gas (1). Now, this study was tiny and was completed in vitro (it was not a controlled trial in human subjects, although human stool from volunteers was used) so, the conclusions would need further study. The Chorleywood process produced more gas more quickly, after simulated digestion. The more prolonged fermentation process also led to a higher level of bifidobacteria in the stool, the levels of these microbes are reduced in IBS. Bifidobacteria also produce less fermentation in the gut, suggesting increasing numbers compared with others may help reduce symptoms.

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So, the combination of less gas delivered more slowly and increasing commensal bacteria that produce less gas anyway, was suggested to equal better tolerance, which is perhaps a leap of faith to suggest that this reduction will reduce symptoms without it being tested in humans. Voila, testing in humans has been done (2)! A more extensive study in humans also looked at Chorleywood process compared with sourdough and showed that a more extended fermentation leads to the breakdown of ATI components and reduced fodmap levels BUT NO DIFFERENCE IN SYMPTOMS OF IBS. Both studies used constipated volunteers, so no difference there, the symptom production in the second study was reported to possibly be a nocebo effect – expecting symptoms due to previous experience. Which is possible, six slices per day is a considerable amount to consume for people who have an intolerance to wheat. Diet was excluded as a confounding factor but what is not clear is how the bread was eaten and whether this was different in the two groups – toasted, fresh, or frozen, perhaps taking us back to resistant starches? Also, about a third of people with constipation based IBS will have pelvic floor dyssynergia, which in theory could elicit symptoms that might not necessarily be helped by changes in the diet, if symptoms are severe. Both these studies were pilot studies and need further investigation on a broader population of people with IBS.

Yeast

For many people with IBS yeast is anecdotally reported to result in symptoms. We do not have any evidence that this is a problem and this has been dismissed by the medical establishment as a cause. No evidence means precisely that, we don’t know, so would it be an issue? Saccharomyces cerevisiae, a yeast, has been studied in improving IBS symptoms, so we have another situation of modulating the gut microbiota to improve symptoms. While we have absolutely no evidence that a low yeast diet is useful, in IBS treatment, it might lead to altering the microbiome and should not be advised, but this is an area indeed worthy of further study.

I think in conclusion, symptom inducement in IBS with bread is complicated and needs further study – with this detail of research required for one food item – is it any wonder that we have not got a cure for this medical condition?

  1. Adele Costabile, Sara Santarelli, Sandrine P. Claus, Jeremy Sanderson, Barry N. Hudspith, Jonathan Brostoff Alison Lovegrove, P R. Shewry, Hannah E. Jones, Andrew M. Whitley, Glenn R. Gibson (2014) Effect of Breadmaking Process on In Vitro Gut Microbiota Parameters in Irritable Bowel Syndrome PLOS one Volume 9 Issue 10 e111225
  2. Laatikainen R, Koskenpato J, Hongisto SM, Loponen J, Poussa T, Huang X, Sontag-Strohm T, Salmenkari H, Korpela R (2017) Pilot Study: Comparison of Sourdough Wheat Bread and Yeast-Fermented Wheat Bread in Individuals with Wheat Sensitivity and Irritable Bowel Syndrome. Nutrients. 2017 Nov 4;9(11). pii: E1215. doi: 10.3390/nu9111215.

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.

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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.

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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