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.

The Perfect Watercress Soup – low FODMAP

Watercress soup is sublime and tradition in our household means that we have it as a starter every Christmas. I have considered the fact that we can’t use onion – the complete taste profile onion gives to the dish – including the slight amount of sweetness it provides and I have replaced the onion with alternatives in hope of retaining it’s benefits without its nasty gut side effects.

Watercress is a member of the brassica family of vegetables, therefore it is related to broccoli, cabbage, radish and rocket. Watercress has lot’s of peppery goodness, but although it is rich in some nutrients you would only gain benefit if you include it in your diet regularly – luckily it has lots of uses. It tastes excellent with salmon and watercress is great to use as the leaves for a salad, if you enjoy it’s slightly hot taste! It contains some vitamin A, vitamin K and folate, plus iron (plus is a reasonable source of vitamin C to help absorption of the iron – it is probably better eaten as a salad leaf to achieve this benefit.) As it is a source of iron it is therefore useful for vegans to include in their diet alongside other sources – but this recipe would have to be made with almond milk and dairy free margarine instead of butter to make in suitable. Perhaps I could try that next!

The soup does contain butter and uses full cream milk – but this is a soup for special occasions – so it is OK to have this amount of fat occasionally and you could change to semi skimmed milk and 20g fat, if needed, if you do find that rich foods result in symptoms. The garnish I have used is watercress leaves, radish sprouts and dried seaweed – radish sprouts and seaweed are not integral to the dish, however – and the conkers in the picture are not edible. I hope you enjoy it!

Ingredients

  • 1 bag of fresh watercress
  • 500ml of full fat lactose free milk
  • 1 sprinkle of asafoetida
  • 1/4 teaspoon of sugar
  • Salt to taste
  • 40g butter
  • 1 tablespoon of corn flour

Method

  • Melt the butter in a pan and add the cornflour whilst mixing and the sprinkle of asafoetida and the sugar. This will not form a traditional roux, but not to worry.
  • Slowly drizzle in the milk – note that it will start to thicken at this stage and a whisk might be a better tool to use to ensure that no lumps are formed.
  • When all the milk is added then bring to a slight boil to thicken.
  • Add the watercress and cook until wilted then blend the soup
  • Season to taste.
  • Serves 1-2

Autumn jacket potatoes

It’s Autumn, I love this time of year but as the dark nights role in thoughts of wholesome, warm filling meals arrive. What could be more sustaining than a jacket potato for people following the low fodmap diet? This is also married with carrot and celeriac, oregano and thyme and of course mixed with cheese – not so much – but enough to provide ample calcium.

However food means more than sustenance – it is family, experience, love – in fact food ripples throughout life and our lived experiences. Many of us have stories to tell about food – both negative and positive. There are two considerations for people who wish to follow a low fodmap diet, what benefits might there be? Much longed for reduction in symptoms? The benefits are often the driving consideration. But what about negatives – how is changing the way that I eat going to affect my quality of life? You might be somewhat surprised at this suggestion – negatives in quality of life? But this diet is supposed to improve my situation, surely?

Consider cooking for the family, going out for a meal with a treasured friend, traveling on holiday and having a suitable option for lunch at work. How much additional planning and work is it going to take to follow this diet – can I afford to have additional work when I already have a very busy schedule to follow? These are all considerations that should be taken into account when deciding to follow an elimination diet – these are considerations that the dietitian can help you with and are what your dietitian will be contemplating as part of the assessment process. This is also another reason that the reduction phase of the diet should be as short as possible. The re-introduction phase will provide some freedom and release from some of the restrictions the low fodmap diet instills.

There are options for people who may not wish to follow a complete exclusion and would find that following the low fodmap diet too much to plan – because planning is what you will need to do, to be successful. There is a shorter low FODMAP version that the dietitian may consider if the full diet is too challenging and a wheat free or lactose free diet if these food types are considered to be the main issue from a diet history.

It hasn’t gone unnoticed by me how people with IBS try hard with regards to treatments – sometimes unfortunately too hard and continue far too long when diet treatments are not working. People then should explore other treatments and often need help or a nudge to move onto other options. To some extent this hard effort is why I work in the area of digestive illness, because I know my patients will often try their upmost to make changes, more than in other areas of dietetics and when this works, it is satisfying – although, truly, it is their hard work that has produced dividends. Symptoms of IBS really are the great motivator, I would suggest that their may be no greater drive towards change than these symptoms provide – imagine what could be achieved with such an instigator, if it was a positive driver rather than a negative one?

But, enough of the musings and lets get back to the recipe…

Ingredients

  • 3 jacket potatoes
  • 3 carrots
  • 2cm of celeriac (tip here: keep some blanched celeriac ready cut in your freezer for any recipes that ask for celery)
  • 150g grated cheese
  • 1 teaspoon oil
  • 1/2 tablespoon of chopped fresh oregano or 1 teaspoon of dried
  • 3 sprigs if thyme or 1 teaspoon of dried
  • Seasoning

Method

  • Warm the oven to 200 degrees C and then wash and prick the three jacket potatoes, place them on a baking tray and add to the oven. Depending on the size cook for 1 hour to 1 hour 20 minutes.
  • Whilst the potatoes are cooking add the oil to a pan and add the herbs and cook for 2-3 minutes.
  • Slice the carrots and celeriac and boil in a pan of hot water till soft. Mash and add the herbs and seasoning.
  • Grate the cheese.
  • When the potatoes are cooked scrape out the potato leaving the skins intact. Mash the filling with the carrot mix and add 100g of the grated cheese and mix. Add back to the potato skin shells and top with the remaining cheese.
  • Grill till the cheese has melted and then serve (serves 3)

A nice cup of tea

There is nothing more quintessentially English than a nice cup of tea. We debate the nuances of how to make it properly – milk before the tea or after, warm the pot before adding the hot water and tea or not, or how much tea to add to the pot. Tea also has lots of reported health benefits but does it help people with IBS? If you are interested, please read on…

Tea is culture, it’s refreshing, herbal tea is reported to be calming, relaxing – we all could do with a little of that, surely? Well perhaps all is not as it first appears.

Standard tea (black, white, green, yellow and oolong) are the true teas

Tea contains caffeine, a stimulant, not as much as coffee but certainly enough to have a systemic effect if sufficient is consumed. It is worth changing to decaffeinated if you have IBS, caffeine can not only stimulate the gut causing diarrhoea type symptoms it also disrupts sleeping patterns and poor sleep can be a symptom of IBS for some people. Some individuals with IBS also have overactive bladders, symptoms which can be influenced negatively by caffeine intake. Tea has lower levels of caffeine than coffee and certainly less than energy drinks, but do consider reducing or slowly swapping to decaffeinated if you drink caffeinated versions.

Oolong tea is high fodmap so will need to be avoided for the low FODMAP diet and tested as part of a re-introduction protocol, if you wish to drink it.

One study reported hard stools for tea in people with IBS (Simren et al 2001) but this was a prospective self reported study and has not been tested directly by a true randomized controlled study. This probably should be investigated but there are fewer studies in people with IBS with constipation for all treatments, unfortunately.

Rooibos

Rooibos is not a true tea and as such does not contain any caffeine and lower levels of tannin’s than true teas. It does however contain some of the poly-phenol compounds found in true tea. For the Monash version of the low fodmap diet it is categorized as low in FODMAP.

Herbal teas

Peppermint

Peppermint has been widely investigated for IBS symptoms. It acts as a smooth muscle relaxant so it can reduce those lower digestive tract spasms. Many people use the tea for the same effect. A number of people with IBS will also experience reflux, or upper gastrointestinal symptoms. Peppermint may also relax the sphincter (a ring of muscle) that prevents stomach acid from traveling up the food pipe (oesophagus). If someone has reflux it is probably not a good idea to drink peppermint tea. However it is good to help with lower abdominal pain so feel free to try it for that. If you want to read more about peppermint and IBS see my other blog post here:

https://clinicalalimentary.blog/2018/01/21/peppermint-and-ibs/

Camomile

Camomile is often stated as a treatment for IBS and ‘helps’ abdominal pain and induces sleep. Camomile acts as a neuroendocrine modulator so it has been suggested as a possible treatment to help with anxiety, insomnia and stress. This does suggest that it could be helpful for IBS type symptoms however Camomile contains FODMAP sugars therefore for those people with fodmap intolerance it is probably best avoided. Camomile also interacts with some drugs – please discuss this with you doctor or pharmacist before trying camomile tea. Common interactions are suggested with sedatives, blood thinners, anti-platelet drugs, aspirin, NSAID painkillers like ibuprofen and naproxen, but also others too (source: WebMD)

Fennel

Fennel is another herbal tea that is suggested to be a good option for those people with IBS. It again, also contains FODMAPs so if you are following the diet, perhaps this is one to avoid.

Dandelion tea

This tea has lot’s of anecdotal suggestions that it helps digestive symptoms, from increasing appetite, soothing minor digestive ailments and relieving constipation. There is no evidence that any of these symptoms are improved. Dandelion tea is another tea that it high in FODMAP so this might be the reason for the anecdotal reports of improving constipation, as lots of FODMAP containing foods are prebiotic (food for gut bacteria) and can help increase bowel function. Dandelion tea has also implications for drug interactions so it is best avoided for people taking diuretic medications, lithium and ciprofloxacin (an antibiotic.) Discuss this with your doctor or pharmacist before considering dandelion tea.

Fruit teas

Many people love fruit teas – they are naturally low in caffeine, however for me, they always promise more than they give. The odour of them is very tempting and I always feel disappointed that they are not more highly flavoured when drunk. If you like them though fruit teas should be fine to use. Use flavours suitable for the low FODMAP diet, if you are following it.

Testing tolerance to teas

For people following the low fodmap diet if you want to test the tea’s above which are high in FODMAP, to see if you can tolerate them, you can. Everyone has an individual tolerance to teas high in fodmap. Once your symptoms are reduced to a good level you could re-introduce the teas above and see how you get on. Use a standard cup as a portion and increase to three over three days, monitoring your symptoms as you go.

Following a Low FODMAP diet and adding milk to tea?

If you are following the low FODMAP diet then lactose is a problem for some people and if you need to exclude lactose then you can use lactose free cows milk – this is suitable for the low fodmap diet and the calcium it contains is slightly better absorbed than from milk alternatives. If you have been tested for lactose intolerance and you are not intolerant, you can use standard milk. Lactose free cows milk also marries with tea very well and you will not notice a difference in taste. This also means that Chai tea (milky tea with spices also added) is not suitable for people following the Low FODMAP diet, as it will contain lactose. You could make your own Chai tea with lactose free milk, if you wish.

Needing a milk free diet and have milk in tea? Which is the best option?

Well, for tea without sugar the best option is cashew milk, and for those who have sugar in their tea then coconut or almond milk are the better choices, according to people who have to follow milk free diets. I can attest to the cashew milk being suitable for tea without sugar, I tried it and really couldn’t taste a difference. Please ensure that your milk alternative is fortified with calcium, as cow’s milk forms a very good source of calcium in the diet and changing to milk alternatives may reduce your calcium intake. You could choose ones that are also fortified with B12 if you are following a vegan diet.

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