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.

Chestnut and herb stuffing

Is it too soon to be thinking of Christmas? It’s hardly past Halloween and Bonfire night but if you are like me and make your food for Christmas then perhaps we do need to start. I love chestnuts, and they are suitable for the Low FODMAP diet. Although I have used bacon and butter – with a small change to these ingredients the recipe and removing the bacon, the recipe can also be made suitable for vegans, plus it is rich enough to form the centre dish for a vegan Christmas.
As I was writing this recipe it reminded me of the song ‘Are you going to Scarborough fair – parsley, sage, rosemary and thyme’ I had inadvertently used this reverent combination in the recipe. I love this song; it’s a traditional ballad, a melancholy tale of loss and the impossible demands of love steeped in the legend of herbs anthropomorphic emotional properties. Being a scientist at heart, I don’t generally ascribe to flowers or herbs changing someone’s emotions however I am, I think, also a romantic too to some extent – so I can recognise and appreciate the sentimentality of the song. Can you be both? I think so.
This stuffing is not necessarily a healthy recipe, but Christmas is a time where a treat is allowed, it is a time to cook for friends and relatives and flavour is essential.

Ingredients

  • 1/2 tin (200g) of chestnut puree
  • 10 Walnuts
  • 3 Sprigs thyme
  • 130g Grated celeriac
  • 100g Gluten-free bread
  • 1 Sprig of rosemary
  • 2 Tablespoons of parsley
  • 20g Sage
  • Grated rind of 1 lemon
  • 90g Streaky dry cure bacon
  • 100g cooked whole chestnuts
  • 40g butter
  • Seasoning

Method

  • Grate the celeriac
  • Chop the walnuts, whole chestnuts and herbs
  • Grate the lemon rind
  • Using a loaf tin lined with butter and the bacon rind – allow the rashers to drape over the edge – long enough so the slices can be folded back over the loaf when the tin is full.
  • Warm the oven to 180 degrees C.
  • Melt the butter in a frying pan and add the celeriac, fry for five minutes then add the chestnut puree. Add the chopped nuts, herbs lemon rind and seasoning and mix well till combined.
  • When combined spoon the mix into the loaf tin till full, then fold over the rest of the bacon rashers to cover the top of the loaf.
  • Place the loaf tin in a tray of water to prevent the sides from burning and cook on the central shelf for 10 minutes.
  • Serves 6-8.

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

Vegan ‘chicken’ and pumpkin couscous – low fodmap

An autumn favourite is pumpkin and numerous varieties can be found. When I was young pumpkin in the UK was unheard of – in fact we used to make Halloween lanterns with a swede! That certainly was a recipe for injury – although the pumpkin isn’t always easy to carve.

I have also decided to venture into a vegan recipe using vegan ‘chicken’ low FODMAP suitable products are based on soya protein or alternatively you could use Quorn ‘chicken’ pieces.

This was a fairly easy recipe to make and was lightly spiced – if you want a heavier spice then you can add more Ras El Hanout. Do check your spice mix has no high fodmap ingredients such as onion or garlic. Enjoy!

Ingredients

  • 200g Pumpkin
  • 30g Pumpkin seeds
  • 30g Pine nuts
  • 20g Sunflower seeds
  • 30g Course peanut butter
  • 200ml Water
  • 1 teaspoon of Ras El Hanout Spice
  • 200g Soya protein based chicken pieces
  • 250g Corn couscous
  • Spray oil
  • 30g mint leaves
  • Seasoning (salt and pepper) to taste

Method

  • Chop the pumpkin and boil in water till soft.
  • Spray oil into a frying pan and add the Ras El Hanout and fry gently with minimal oil to release the flavours, add the chopped mint leaves.
  • Add the peanut butter, seeds and water to the frying pan and cook till thickened
  • Add the ‘chicken’ pieces and cooked pumpkin
  • Weight the couscous and pour over the same amount of boiling water (250 ml) and leave to cook – run a fork through the mix to give texture to the couscous
  • You can either serve the ‘chicken’ sauce and couscous separately or mix the ‘chicken’ sauce through the couscous, as I have done.
  • Serves 5-6 enjoy!

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)

Do you have a problem with lactose?

The-chemistry-of-milk

The following script is based on an article I wrote for the Allergy & Free From show magazine last year. With some updates!

What is lactose?

Lactose is a sugar, for this sugar to be used by us, the walls of our lower digestive system produce a digestive enzyme called lactase. This enzyme helps to break down the sugar so it can be made small enough to be taken into the body and used as energy. See the above infographic.

What causes lactose intolerance?

Congenital lactose intolerance occurs because of the gut not being able to produce any lactase enzyme from birth – this is very rare. Primary lactose intolerance is where the gut loses the ability to create the lactase enzyme over time. Secondary lactose intolerance can occur with a digestive disease, gastrointestinal infections and food poisoning, which may or may not be short term.

Some people’s ethnic background puts them more at risk of lactose intolerance because in South America, Africa and Asia, over half of the indigenous population have primary lactose intolerance and in some Asian countries almost everyone can have primary lactose intolerance.

What symptoms might I have?

The symptoms from lactose intolerance can be unpleasant and embarrassing and range from loose, watery poo, wind, bloating and a distended tummy. Some people get stomach cramps, loud digestive gurgling noises, feeling sick and occasionally are sick. These symptoms occur because undigested lactose in the bowel pulls fluid from the body as it moves through the lower digestive tract, causing diarrhoea. Then lactose is then used for energy by the bacteria usually found in the bowel – this causes bloating and wind.

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When do I need to see my doctor?

Usually, digestive symptoms because of food poisoning are often quick to resolve (lactose intolerance after a digestive system infection usually resolves after six weeks), if you still struggle with symptoms, see your doctor, don’t be tempted to self-diagnose. Don’t be shy in talking about your symptoms – doctors have heard them all before. You can always write down your symptoms before you go if you just find them too difficult to talk about.

The following symptoms are not expected with lactose intolerance if you have swelling of your lips, mouth or face; rashes or wheezing within minutes to a few hours of drinking milk. This might suggest an allergy – see your doctor. Or, alternatively, blood mixed in your poo with a temperature and feeling unwell. These are not symptoms generally associated with lactose intolerance and may be due to another medical problem.  Contact your GP and don’t make drastic changes to your diet.

All children should be seen by their doctor and lactose intolerance because of cow’s milk protein allergy should be considered. Because babies and young children are more vulnerable, any symptoms of blood or mucus in poo, green vomiting, a temperature and severe tummy pain in young children call NHS 111 for advice or discuss with your doctor urgently.

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What tests are available for lactose intolerance?

No blood tests can identify lactose intolerance. Sometimes your doctor might advise a test called a hydrogen breath test – but often they will recommend following a full lactose-free diet for one month and then introduce lactose to test that symptoms return, which is usually very useful in identifying this intolerance. Testing food is also essential to find your own level of lactose tolerance. Most people can have a small amount without having any symptoms at all, and this knowledge can make following a lactose-free diet a little bit easier. A registered dietitian can help you do this effectively and check you are getting the correct nutrition from your modified diet.

Might symptoms be caused by something else?

Occasionally, it’s possible to have lactose intolerance along with other digestive complaints, such as:

Coeliac disease (autoimmune gluten enteropathy) this is because gluten, a protein in wheat, barley and rye, damages the bowel surface so it cannot make the lactase enzyme very well. See your doctor, and your doctor will complete tests for coeliac disease if it is suspected. It is vital to continue to eat food containing gluten to make quite sure that the tests used can identify coeliac disease well. Lactose intolerance usually resolves with treatment for coeliac disease.

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A few people with inflammatory bowel disease (IBD – Crohn’s disease and ulcerative colitis), which causes the bowel wall to become swollen and ulcerated, can also occasionally have problems digesting lactose. Due to inflammation of the bowel wall sometimes it cannot make the lactase enzyme very well. This lactose intolerance can resolve with treatment for IBD.

People with irritable bowel syndrome (IBS) can have problems digesting lactose, this might occur because of the gut microbe fermentation of some foods (called FODMAPs.) Lactose is a FODMAP. FODMAPs are sugars found widely in the diet that are poorly digested and result in symptoms for people with IBS. If you wish to try a low fodmap diet ask your doctor for a referral to a registered dietitian to help you. Don’t be tempted to exclude all carbohydrates from your diet. Wholegrain starchy carbohydrates are essential for long-term gut health.

Where is lactose found?

In animal milk, some cheeses, some yoghurts, processed foods made from animal milk and some medications. Most medications contain tolerable amounts so don’t stop taking them. Discuss alternatives with your doctor or pharmacist if you are taking a few medicines containing lactose, as this might be enough to cause symptoms.

Lactose-containing ingredients can be recognised on the food package ingredients list by the following words – milk, lactoglobulin, milk solids, buttermilk, lactose, artificial cream, whey powder, cheese, condensed milk, curd, skimmed milk powder, cream cheese, modified milk, evaporated milk, margarine and butter. As milk is an allergen, it will be listed as bold, in italics or in a different font or colour on the ingredients list. But lactose is not an allergen as such, so it doesn’t need to be listed separately to milk. Lactose-free animal milk products will be explicitly stated on the packaging by the manufacturer.

Where can I find lactose free products?

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Much lactose-free milk and alternative milk products can be found at larger supermarkets and can also be sourced online. Some manufacturers are Lactofree (Arla), Candia, supermarket home brands, free from milk (Alpro, Oately, Rice Dream, Good Hemp, Koko and Provamil.) Please note rice milk should not be given to children under 4 ½ years of age.

Other products, due to the processing methods used, might be lower in lactose naturally and some people can eat them with no problem such as standard hard cheeses and some yoghurts. Many other foods are typically free of lactose.

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The new ‘alternative’ on the block:

Tiger nut milk is a new marketed product trend, and I really don’t see the point of having this milk, unless you are from Spain and have Horchata as a cultural drink. Tiger nuts are tubers, and you can buy tiger nut milk ready made – but often making your own is advocated by bloggers and companies alike. Marketed as paleo – with little other nutritional content in the milk except for carbohydrate this marketing ploy seems a bit odd. Neither has it been tested for fodmap content.

So, people who have food intolerances and IBS, or those with inflammatory bowel disease, who may have associated conditions that result in extreme lethargy are required to make their own milk? You have to be kidding, right? There is no advantage to having this product nutritionally over and above other milk, and it does not naturally contain reasonable levels of calcium. This is exploitative of vulnerable patients in my opinion and risks long-term low calcium intake.

Is animal milk bad for me?

poison milk

No, quite the opposite in fact – lactose-free animal milk contain good levels of calcium iodine and vitamin B12. Unless you have any religious, cultural or ethical reasons to avoid it, you could just swap to lactose-free animal milk products. These products contain the same level of nutrition found in regular animal milk and have the added advantage of tasting the same. We also know that the calcium found in animal milk is slightly more readily absorbed into the body than the calcium used to fortify plant-based milk.

The internet is full of alternative articles scaremongering around the consumption of cows milk. While I have no issues at all with people who decide to avoid animal products for ethical, cultural or religious reasons, scaremongering others to avoid cows milk due to spurious health risks and unevidenced harms is unacceptable.

You might have heard that animal milk leaches calcium from the bones, this is just untrue, and stories of milk being ‘too acidic’ for the body has no basis in science. Neither does milk cause excessive mucus production in the body or inflammatory bowel disease.

However, if you have changed to plant-based milk for religious, ethical, cultural or personal choice, do ensure these are fortified with calcium and ideally vitamin D (plus vitamin B12 if you are vegan.)

Another nutritional consideration for those avoiding animal milk is that milk and dairy products are the primary sources of iodine for most people. So, avoiding cows milk and/or fish can also risk low levels of iodine in the body. Adults need 150 micrograms per day, pregnant and nursing mothers slightly higher at 200 micrograms, most milk alternatives are rarely fortified, too much-added iodine can also be problematic so ask your dietitian if you feel you are not getting adequate amounts.

What about raw milk?

Raw milk contains lactose and is therefore unsuitable for people with lactose intolerance and can risk gastroenteritis (food poisoning) if it is not properly treated. I would not take the risk of drinking raw milk, particularly if you have any other digestive complaints.

Can I buy a supplement to help me digest lactose?

Yes, they are available online or from health food shops. However, the effectiveness of them varies. But they might be useful to have to hand when eating out and travelling when it might be a little more challenging to avoid lactose.

Does having lactose intolerance affect my future health?

Not generally, but not getting adequate calcium in your diet because you have stopped having all milk products long term can lead to weakened bones. Adults should ensure they have at least three portions of lactose-free dairy or calcium-fortified alternatives a day (a portion size is a glass of lactose-free milk, a small matchbox size of hard cheese, or a yoghurt.) People with bowel diseases and teenage boys need more than this, and other children less. Discuss with your doctor or dietitian. A useful calcium information sheet can be downloaded free from the British Dietetic Association website under ‘food facts’.

I do not have any affiliations with the dairy industry and have never been funded or paid by them.