Tag: Lactose intolerance

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

IMG_1610

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

saffron-rex1/4 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.

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Kedgeree, breakfast like a king! Low FODMAP, low lactose, wheat free, gluten free

Imagine that you are in Edwardian England and a rather wealthy person! As part of the many breakfast choices would be this dish, originating in India and traditionally composed

Downton Abbey cooks Kedgeree

of hard-boiled egg, fish and rice. You can just taste the opulence, great to breakfast like a king – but this meal is great for a light brunch, served on wheat free bread also – really yummy! I often like to imagine if I was alive in Edwardian times as I love the dresses and the lifestyle – but the reality would be more likely to involve wearing plain clothes, clogs and working in the mills in Lancashire, as my relatives did!

© IWM (D 25995)

This dish is very mild, no spicy hot flavours, just like a fishy korma – some of the Lancashire men I spent my early working career with, used to call chicken korma ‘chicken soft lad’ and were merciless in their deriding of any man choosing this option when going out for a curry after the pub! However its good and mild for dodgy guts, so enjoy your fish ‘soft lad!’ If you have coeliac disease then check your spices have not been contaminated with gluten! My version of this wonderful dish is as follows:

Ingredients

175g of smoked Haddock

175g of Basmati Rice

4-5 dry green cardamom pods

5cm strip of cassia bark

Salt

Freshly ground pepper

1 tablespoon of garlic infused olive oil

1 teaspoon of turmeric

1/4 teaspoon of asafoetida

1/4 teaspoon of ground cloves

1/2 teaspoon of cardamom powder

1/2 teaspoon of ground coriander

300 mls of lactose free milk

4 teaspoons of cornflour

2 hard boiled eggs.

Method

Poach the haddock in lactose free milk until cooked, drain off the milk and retain for the sauce. Flake the fish and remove any bones and retain till later.

Add the rice to a pan, cover with water about 2 cm above the rice and add crushed green cardamom, cassia bark, salt and pepper. Bring to the boil, when boiling turn down the heat to low and simmer for 20 minutes until the rice is cooked. Remove cardamon pods and cassia bark. Cool.

Hard boil eggs for 10 minutes and cool under running water, remove shell and cut into slices – retain till later.

Add oil to a pan with the rest of the spices and cook till the spice aroma is released. Add cornflower to the pan and cook for about a minute. Slowly add milk to the pan – this will form a thick paste initially and needs to be mixed well to avoid lumps. After 1/3 – 1/2 of the milk has been added you can add the rest quickly and bring to the boil and stir till thickened.

Add the sauce to the rice, add fish and mix well, taste and add more seasoning if needed. Warm in the microwave prior to serving, serve with sliced eggs on the top.

If you are interested in Edwardian food check out the following website http://downtonabbeycooks.com/

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“Read your labels” – retrospectively is no good! A reflection, a survey and slight feeling of dietetic hypocrisy.

It’s Saturday, I wake and stumble down the stairs bleary eyed, hairdo that wouldn’t look amiss on Edward Scissorhands. Cat’s breakfast is made first and then I make my morning cup of tea. First mistake of the day, I use cows milk – damn, now my inner consciousness devil voice starts to say “it’s only a splash of milk can this make a difference?, go on drink it” I think for a couple of seconds and decide that I will make another cup of tea with lactose free milk, then I make my porridge, again with lactose free milk. First critical lapse incident managed, cool!

Now for the confession. On Saturday I like to go for a coffee at a cafe and have my weekly treat a small biscuit or cake with my coffee. Now I asked for lactose free milk coffee  – ok so far, and then chose a coconut macaroon, wheat free – I did enquire if this was the only wheat free choice and I was told it was. Now, I’m not that fond of macaroons but it was the only choice, so I bought it and sat down to drink my coffee and read the paper. The more savvy of you here will be shouting at the screen “DID YOU READ THE LABEL?”, did I? Well, err, (feeling REALLY sheepish) not before I had bought it and certainly not before I had eaten a good portion of the biscuit :-(. I then decided unconsciously to take a peek at the ingredients list. This is where I was totally disappointed with myself because guess what? Yes!! Someone had added a FODMAP to my biscuit. SORBITOL of all

I don’t go this far! No finger wagging in my clinic.

things, in my biscuit, I felt so disappointed and really guilty of hypocrisy. You may be wondering why I feel hypocritical, well, in my clinic when I see people who have to use special diets reading labels is very important. When it gets to this part I furrow my brow and look quite serious and say “reading your labels is very important to following your diet and here is a list of what to look for”. People often say when I see them again that they have made mistakes and a good proportion of those are through not looking at the label. I suggest to them that this is part of the learning experience and then the advice is then reiterated, read the labels FIRST, before you buy and certainly before you eat.

So, I have joined the ranks of people who make retrospective label reading mistakes, perhaps this is a normal part of changing your diet and maybe everyone does this? At least I suppose you read it to see and are then aware of your mistake, but the damage is already done. It really makes you consider human behaviour in this, why would I do this now, when I was successful earlier on in the day? Was it because earlier I had another choice available, do you think? How many of you make this mistake – perhaps we could do a survey?

Survey is anonymous and will close in 1 month – if you wish to know more check this out  http://polldaddy.com/privacy/ or contact Polldaddy directly http://polldaddy.com/about/

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Autumn thick warming roasted carrot and pumpkin soup, lactose free, milk free, egg free – vegeliscious!

Roasted carrot and pumpkin soup

600g peeled carrots, cut into 4 lengthwise

500g pumpkin

1 tablespoon of garlic infused olive oil

1 teaspoon of turmeric

1 teaspoon of cumin

1 teaspoon of coriander

1 teaspoon of ground ginger

1.2 litres of water

small bunch of coriander leaves (depends how much you like the taste.)

Salt & pepper

coriander leaves and nigella seeds to serve

Method

Peel and slice carrots and pumpkin and place in a roasting tin, pour in the olive oil and coat the vegetables well. Sprinkle on spices and mix well.

Roast till the vegetables are soft in texture.

Place in a food processor or blender, add the other ingredients and blend well.

Warm the soup again then serve with a sprinkling of nigella seeds and coriander leaves.

Serves 6

(approximately per serving)

Kcal 67

Protein 1.2

Fat 2.9

Carbohydrate 9.0

Fibre 2.8

There is some debate as to whether pumpkin is safe for the FODMAP diet – it contains mannitol – amount varies on where it is grown, the one I used was grown within 10 miles of home. If you have problems with pumpkin, or are on a FODMAP exclusion you could replace the pumpkin with more carrot and this should work just as well.

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Book Review The Complete Idiots Guide to Eating Well with IBS Kate Scarlata RD

This book is a comprehensive guide to eating with irritable bowel syndrome. It is very user-friendly, you can dip in for a quick read or take your time. I liked the summaries at the end of every chapter and the hints and tips are very useful. The book contains lots of recipes all with nutritional breakdown and a gut fact attached to each one! Covering the fact that healthy eating – with foods that are tolerated – is very important.  The foods that can be problematic are covered and Kate does explain, in user-friendly terms, the reasons why these foods can result in symptoms, but also adds that everyone’s symptoms are individual, so it’s advisable to use the advice accordingly. She also explains how to use a food and symptom diary to identify problematic foods, which is extremely useful for those people who are managing their IBS symptoms themselves.

The book is published for the American market, red flag symptoms are discussed, however one area that does differ in the UK is the identification of people with coeliac disease. Please note that everyone (children and adults,) who have IBS should be, or have been, screened by serological testing (blood tests – endomysial antibody (EMA) IgA and/or tissue transglutaminase antibody tTGA) for coeliac disease, in the UK. At the time of the writing of the book, the emphasis on testing IBS patients for coeliac disease was geared more toward those with IBS-D in the US, the author (in her private practice) however, recommends that all of her IBS clients be tested for coeliac prior to altering their diet. These are guidelines from the National Institute of Clinical Health & Excellence (NICE) available here:-

http://guidance.nice.org.uk/CG86

I have seen patients’ whose main symptom of coeliac disease is constipation, so everyone is at risk and should be tested. Ask your GP and eat wheat, barley and rye (bread, pasta, chappatis, some breakfast cereals) before your test, see above guidelines. Read what Coeliac UK have to say here:-

http://www.coeliac.org.uk/coeliac-disease/how-to-get-diagnosed

Other differences I noticed was histamine intolerance was mentioned in the book – this is not well recognised in the UK, but it can be identified by your dietitian by using elimination diets and is likely to be covered somewhat in an additives free diet (benzoate additives for example, but substances that promote a histamine response are also found naturally in some fermented foods.) It is also advised for people on certain antidepressants – the MAOI (Monoamine Oxidase Inhibitor) diet, to help people avoid dangerous rises in blood pressure, this diet is rarely seen now in general dietetic practice.

http://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitor

Other food intolerances are also mentioned, it is important to see a state registered dietitian if you suspect you have histamine intolerance as identifying these rare intolerances can be challenging.

This book is certainly worth considering if you want to buy a book to help you manage your IBS symptoms, I particularly liked the chapter on travelling and eating out, often areas where it is difficult to acquire advice. The book also discussed lifestyle factors and other areas outside the area of Low FODMAP foods, which is also included, and as such it should contain advice that can help most people with IBS who feel that their diet, or eating in general is problematic.

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This book was provided free of charge by the author.

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Low FODMAP Chicken casserole plus low fat processed food and food intolerances, incongruous ideals?

At my usual supermarket shop this morning I was very pleased to find a low dairy, low lactose own brand cream cheese. Wow – I thought – will have to give this a try, but as I always do out of habit I had a look at the nutritional information on the side of the carton. The amount of fat and saturated fat in the product was staggering 26.6g/100g of fat, 23.0g/100g of saturated fats, from coconut oil. Why is it that food that is meant for individuals who have to modify their diet as a result of allergies, intolerances or as a result of autoimmune conditions are higher in fat and calorie dense? You could argue that cream cheese is usually high in fat and you would be correct at 24g/100g of fat and 16g/100g of saturated fat but the free from brand is higher. It’s often the additional specially manufactured foods in a ‘free from’ diet that can be higher in calories than the standard alternative version, that means if you need to follow a specific diet you may be exposed to more calories as a result. Yes I do see people who are underweight and would really benefit from the extra, but I also see those who have problems in maintaining a healthy weight. For example some gluten-free bread is quite high in fat. Adding fat improves the taste and texture of free from food and you don’t often find a low-fat variety, it’s technically challenging I suppose. Yes, foods higher in fats and sugar are a treat – see recipe for chocolate covered coconut ice cream for an example, but when staples such as wheat free bread can be higher in fat this becomes more difficult to manage, if you need to control your calorie intake. Try and include plenty of alternatives such as rice, potatoes, lean meats, fish, vegetables and fruit in your diet (when tolerated) – those foods that are not processed are lower in calories, and often cheaper. This doesn’t mean you can’t have manufactured alternatives, as they are important to incorporate, to feel you are not being excluded too much, increase variety and help you to follow your diet, but try to keep these foods to a minimum of you are able. For the staples, such as bread, which is important if you need to take packed lunches, check the food labels of free from items and choose the ones that are lower in fats, sugar and calories when you can.

Check the label for nutritional information as well as the allergen labelling. Look at the following links:

http://www.nhs.uk/Livewell/Goodfood/Pages/food-labelling.aspx

http://www.nhs.uk/Livewell/Goodfood/Pages/food-labelling-terms.aspx

The following recipe is a low FODMAP chicken casserole.

700g Chicken Thighs (skins removed, trim off any visible fat – use thigh meat as it imparts a stronger flavour to the dish.)

3 celery sticks including leaves.

200 mls dry white wine

5 g Fresh thyme

1 dessert spoon of garlic infused olive oil

1/2 teaspoon of asafoetida

Juice of 1/2 a lemon

freshly ground pepper and dash of salt

Measure out wine in a measuring jug and add chopped thyme, olive oil, lemon, asafoetida, pepper and salt mix well.

Cut celery sticks and place in a casserole dish with the chicken thighs.

Pour over the mix and leave to marinade for 2 hours.

Cook for 1 hour gas mark 6/200 C remove from oven and allow to relax for five minutes.

This dish was served with low-fat roast potatoes made by par boiling for five minutes, drain off water and replace pan lid. Shake the pan to roughen the edges of the potatoes and use spray olive oil to reduce the amount of fat used. Roast till golden.

If wished you can pour off the liquid when the chicken is cooked to make a sauce, drain off the fat and discard and using a small pan pour in liquid and add cornflour mixed with a little water, to thicken.

Serves 4-6 people (but not my husband, who ate considerably more! This dish prompted a five-minute face wash from my cat after having a taste – a rare occurrence.)

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