A diet low in FODMAP’s may be of benefit to some IBS (Irritable Bowel Syndrome) sufferers as it removes or alleviates symptoms of bloating, wind, abdominal pain with alternating bowel habits between constipation and diarrhoea with or without nausea and vomiting, but not all! Neither will it remove other physiological symptoms such as skin conditions, joint pain and discomfort, headaches or migraines.
A diet high, FODMAP’s (fruits, dairy, vegetables and grain cereals) are a category of carbohydrates, which rapidly fermented in the gut/ intestine.
It is important when speaking with your GP that you ask to be referred to a registered dietician with FODMAP approach training.
The low FODMAP diet is complex and so it is advisable to speak with a dietician, and one who is registered and experienced with this specialist diet. This is important as it is all to easy to begin a diet but omit certain foods which subsequently will also mean that either we do not benefit fully or we miss out on essential vitamins and minerals, this can have a detrimental affect on our body through lack of nutrition. Without the appropriate knowledge of foods, ingredients, processed foods, labels and eating out we can easily read information wrongly as some ingredients are ‘hidden’ being called different names like E numbers. There is a lot of confusing advice, some research has become outdated, then there is new research, and it is all too easy to read information on the internet to follow it to our detriment or even peril. It can also become ineffective.
The FODMAP diet is relatively new, so it is possible that a GP or gastroenterologist does not know if this diet, ask for them to refer you to a registered dietician to receive the correct up-to-date information. There are FODMAP trained dieticians working in the NHS and privately both may require referrals from your GP or consultant private dieticians may also require a referral. A vast amount of research and training is being undertaken a growing number of registered dieticians who are skilled in the delivery of the low FODMAP diet with formal training at a variety of global institutions.
Vegetables and Legumes
- Garlic – avoid entirely if possible
- Onions – avoid entirely if possible
- Baked beans
- Black eyed peas
- Broad beans
- Butter beans
- Celery – greater than 5cm of stalk
- Kidney beans
- Mange Tout
- Savoy Cabbage
- Soy beans
- Split peas
- Scallions / spring onions (bulb / white part)
Fruit – fruits can contain high fructose
- Tinned fruit in apple / pear juice
Meats, Poultry and Meat Substitutes
- Processed meat – check ingredients
Cereals, Grains, Breads, Biscuits, Pasta, Nuts and Cakes
- Wheat containing products such (be sure to check labels):
- Egg noodles
- Regular noodles
- Pasta made from wheat
- Udon noodles
- Wheat bread
- Wheat cereals
- Wheat flour
- Wheat rolls
- Bran cereals
Condiments, Sweets, Sweeteners and Spreads
- Gravy, if it contains onion
- High fructose corn syrup (HFCS)
- Milk chocolate
- Stock cubes
- Sugar free sweets containing polyols – usually ending in -ol or isomalt
- The follow items can be added to yoghurts, snack bars etc:
- FOS – fructooligosaccharides
- Beer – if drinking more than one bottle
- Dandelion tea
- Fruit and herbal teas with apple added
- Fruit juices in large quantities
- Fruit juices made of apple, pear, mango
- Orange juice in quantities over 100ml
- Sodas containing High Fructose Corn Syrup (HFCS)
- Soy milk made with soy beans – commonly found in USA
- Sports drinks
- Tea, fennel
- Tea, chamomile
- Tea, oolong
- Wine – if drinking more than one glass
- Cream cheese
- Ice cream
- Milk – cow, goat and sheep
- Sour cream
- Yoghurt – including greek yogurt
egetables and Legumes
- Bamboo shoots
- Bean sprouts
- Bok choy / pak choi
- Broccoli – avoid large servings
- Brussel sprouts – 1 serving of 2 sprouts
- Butternut squash – 1/4 cup
- Cabbage – 1 serving of 1 cup
- Celery – less than 5cm of stalk
- Collard greens
- Corn / sweet corn- if tolerable and only in small amounts – 1/2 cob
- Chick peas – 1/4 cup
- Chilli – if tolerable
- Eggplant / aubergine
- Green beans
- Green pepper (green bell pepper)
- Leek leaves
- Lentils – in small amounts
- Red peppers (red bell pepper)
- Pumpkin, canned – 1/4 cup, 2.2 oz
- Scallions / spring onions (green part)
- Silverbeet / chard
- Spaghetti squash
- Spinach, baby
- Sweet potato – 1/2 cup
- Tomato – avoid cherry tomato
- Honeydew and Galia melons
- Lemon including lemon juice
- Passion fruit
- Paw paw
Meats, Poultry and Meat Substitutes
- Quorn, mince
- Cold cuts / deli meat / cold meats such as ham and turkey breast
Fish and Seafood
- Canned tuna
- Fresh fish e.g.
- Seafood (ensuring nothing else is added) e.g.
Cereals, Grains, Breads, Biscuits, Pasta, Nuts and Cakes
- Wheat free or gluten free breads
- Bread made from oats, rice, corn, and potato flours
- Wheat free or gluten free pasta
- Buckwheat noodles
- Rice noodles
- Porridge and oat based cereals
- Cornflakes – 1/2 cup
- Rice bran
- Rice Krispies
- Almonds – max of 15
- Brazil nuts
- Bulgur / bourghal – 1/4 cup cooked, 44g serving
- Buckwheat flour
- Brown rice / whole grain rice
- Cornflour / maize
- Coconut – milk, cream, flesh
- Corn tortillas, 3 tortillas
- Hazelnuts – max of 15
- Macadamia – max of 10
- Pecans – max of 15
- Pine nuts – max of 15
- Potato chips, plain
- Potato flour
- Pumpkin seeds – max of 1 – 2 tbsp
- Rice cakes
- Rice crackers
- Rice flour
- Sesame seeds – max of 1 – 2 tbsp
- Sunflower seeds – max of 1 – 2 tbsp
- Tortilla chips
- Walnuts – max of 10
- White rice
Condiments, Sweets, Sweeteners and Spreads
- Acesulfame K
- Barbecue sauce
- Chocolate, dark
- Chutney, 1 tablespoon
- Fish sauce
- Garlic infused oil
- Golden syrup
- Jam / jelly, strawberry
- Ketchup (USA) – 1 sachet
- Maple syrup
- Mayonnaise – ensuring no garlic or onion in ingredients
- Olive oil
- Oyster sauce
- Pesto sauce – less than 1 tbsp
- Peanut butter
- Soy sauce
- Sweet and sour sauce
- Sugar – also called sucrose
- Tomato sauce (outside USA) – 2 sachets, 13g
- Vinegar, balsamic – less than 2 tbsp
- Vinegar, rice wine
- Worcestershire sauce
- Alcohol – is an irritant to the gut, limited intake advised:
- Beer – limited to one drink
- Clear spirits such as Vodka
- Wine – limited to one drink
- Coffee, espresso, regular or decaffeinated, black
- Coffee, espresso, regular or decaffeinated, with up to 250ml lactose free milk
- Coffee, instant, regular or decaffeinated, black
- Coffee, instant, regular or decaffeinated, with up to 250ml lactose free milk
- Espresso, regular, black
- Fruit juice, 125ml and safe fruits only
- Lemonade – in low quantities
- Soya milk made with soy protein
- Sugar free fizzy drinks / soft drinks / soda – such as diet coke, in low quantities as aspartame and acesulfame k can be irritants
- ‘Sugar’ fizzy drinks / soft drinks / soda that do no contain HFCS such as lemonade, cola. Limit intake due to these drinks being generally unhealthy and can cause gut irritation
- Tea, black, weak e.g. PG Tips
- Tea, chai, weak
- Tea, fruit and herbal, weak – ensure no apple added
- Tea, green
- Tea, peppermint
- Tea, white
Dairy Foods and Eggs
- Cheese, brie
- Cheese, camembert
- Cheese, cheddar
- Cheese, cottage
- Cheese, feta
- Cheese, goat / chevre
- Cheese, mozzarella
- Cheese, ricotta – 2 tablespoons
- Cheese, swiss
- Dairy free chocolate pudding
- Lactose free milk
- Lactose free yoghurt
- Oat milk
- Parmesan cheese
- Rice milk
- Soy protein (avoid soya beans)
- Swiss cheese
- Whipped cream
Cooking ingredients, Herbs and Spices
- Herbs: Basil, Cilantro, Coriander, Mint, Oregano, Parsley, Rosemary, Tarragon, Thyme
- Spices: All spice, Cinnamon, Cumin, Five spice, Paprika, Turmeric
- Baking powder
- Baking soda
- Cocoa powder
- Cream, 1/2 cup
- Icing sugar
- Vegetable oil
January: Beetroot, Leek, Squash, Cabbage, Parsnip, Shallot, Celeriac, Carrot, Onion, Kale, Celery, Turnip, Potato, Brocolli, Brussel sprouts, Pear, Apple, Clementine
Goose, Lobster, Scallops, Brill, Clam, Cockles, Haddock, Halibut, Hake, Lemon sole, Monkfish, Mussels, Oyster, Plaice, Turbot
February: Cabbage, Chicory, Potato, Leek, Brocolli, Squash, Kale, Onion, Parsnip, Shallot, Celeriac
Guinea fowl, Goose, Halibut, Mussels, Lobster, Brill, Clam, Cockles, Cod, Haddock, Halibut, Hake, Lemon sole, Mussels, Oyster, Salmon, Turbot
March: Parsley, Radish, Carrot, Leek, Sprouting broccoli, Sorrel, Potato, Mint
Sardine, Lobster, Cockles, Cod, Halibut, Hake, Lemon sole, Mussels, Oyster, Salmon, Sea trout
April: Rosemary, Spinach, Morel mushroom, Wild garlic, Radish, Carrot, Celery, Kale, Watercress, Strawberry, Rhubard
New season lamb, Cockles, Cod, Crab, Halibut, Salmon, Sea trout
May: Samphire, Asparagus, Cauliflower, New potato, Parsley, Mint, Broad bean, Carrot, Spinach, Lettuce, Celery, Cherry, Raspberry, Rhubard
Duck, Sea trout, Sea bass, Lemon sole, Cod, Sardine, Lamb, Crab, Dover sole, Halibut, Herring, John Dory, Plaice, Salmon
June: Artichoke,Courgette, Broad bean, Lettuce, French bean, Pepper, Spinach, Asparagus, Celery, Aubergine, Pea, Mangetout, Tomato, Gooseberry, Elderflower, Strawberry, Redcurrant, Cherry
Hare, Crayfish, John Dory, Lamb, Cod, Crab, Dover sole, Haddock, Halibut, Herring, Lemon sole, Mackeral, Plaice, Salmon, Sardine, Sea bass, Sea trout
July: Artichoke, Beetroot, Courgette, Aubergine, Fennel, Pea, Runner bean, Tomato, Watercress, French bean, Sage, Lettuce, Mangetout, Cauliflower, Broad bean, Blueberry, Strawberry, Loganberry, Raspberry
Clam, Pike, Trout, Pilchard, Lamb, Cod, Crab, Dover sole, Haddock, Halibut, Herring, John Dory, Lemon sole, Mackeral, Plaice, Salmon, Sardine, Scallop, Sea bass, Sea trout
August: Artichoke, Basil, Beetroot, Pea, Tomato, Broad bean, Brocolli, Cucumber, French bean, Lettuce, Fennel, Mangetout, Aubergine, Spinach, Courgette, Sweetcorn, Apricot, Damson, Melon, Strawberry
Lamb, Cod, Crab, Dover sole, Grey mullet, Haddock, Halibut, Herring, John Dory, Lemon sole, Mackeral, Monkfish, Plaice, Salmon, Sardine, Scallop, Sea bass, Squid
September: Artichoke, Aubergine, Beetroot, Brocolli, Sweetcorn, Cucumber, Courgette, Kale, Spinach, Onion, Tomato, Lettuce, Mangetout, Runner bean, Pumpkin, Leek, Plum, Blackberry, Apple, Fig, Damson, Grape, Melon
Autumn lamb, Partridge, Wood pigeon, Duck, Venison, Grouse, Brown trout, Oyster, Mussel, Sea Bass, Clam, Cod, Crab, Dover sole, Grey mullet, Haddock, Halibut, Herring, John Dory, Lemon sole, Mackeral, Monkfish, Plaice, Salmon, Sardine, Scallop, Squid, Turbot
Watercress, Squash, Celery, Brocolli, Beetroot, Leek, Mushroom, Runner bean, Courgette, Marrow, Kale, Pumpkin, Elderberry, Fig, Apple, Grape
Autumn lamb, Duck, Grouse, Guinea fowl, Partridge, Oyster, Mussel, Brill, Clam, Cod, Crab, Dover sole, Grey mullet, Haddock, Halibut, Hake, John Dory, Lemon sole, Mackeral, Monkfish, Plaice, Sea bass, Squid, Turbot
Parsnip, Chestnut, Beetroot, Swede, Cabbage, Runner, bean, Turnip, Potato, Kale, Celery, Celeriac, Squash, Pumpkin, Leek, Cranberry, Pear, Quince, Apple, Clementine
Duck, Grouse, Teal, Partridge, Brill, Clam, Haddock, Halibut, Hake, Lemon sole, Monkfish, Mussels, Oyster, Plaice, Sea bass, Squid, Turbot
Celery, Red cabbage, Swede, Celeriac, Turnip, Kale, Brussel sprout, Pumpkin, Beetroot, Parsnip, Brocolli, Leek, Onion, Pear, Apple, Clementine, Cranberry
Turkey, Partridge, Duck, Goose, Haddock, Sea bass, Brill, Clam, Halibut, Hake, Lemon sole, Monkfish, Mussels, Oyster, Plaice, Turbot
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Coeliac disease symptoms vary among people as a result the symptoms can range from very mild to severe. The reactions are different from an allergic reaction as symptoms do not cause anaphylactic shock. Coeliac disease is a ‘multi-system’ disorder for the reason that symptoms may affect any area of the body.
Symptoms of eating gluten differ among individuals which can last from a few hours to a few days whilst eating gluten so less gluten makes your symptoms vary in severity:
• Stomach pains, cramps, bloatedness,
• Severe or occasional diarrhoea, excessive wind and/or constipation,
• Persistent or unexplained gastrointestinal symptoms, such as nausea and vomiting,
• Recurrent stomach pain, cramping or bloating,
• Deficiency of one or a combination of iron, vitamin B12 or folic acid,
• Tiredness and/or headaches,
• Unexpected or rapid weight loss,
• Mouth ulcers,
• Alopecia (hair loss),
• Dermatitis herpetiformis (skin rash)
• Tooth enamel problems,
• Liver abnormalities,
• Repeated miscarriages,
• Joint pain and/or bone pain,
• Neurological; nerve; ataxia which is poor muscle coordination; neuropathy numbness and tingling in the hands and feet,
• Amenorrhea which is a lack of periods in women,
• Symptoms in young children and babies may differ and require close monitoring to refer to a GP.
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Hippocrates dating back to 400 BC discussed food reactions in the development of various health complaints, it seems ridiculous that formal research studies on adverse food reactions only began in the 20th Century have only recently appeared in scientific journals.
These are a variety of food complaints which more and more people are being affected by, especially in the Western diet. It could be the increased amount of processed food which we eat and lack of natural fruit and vegetables. However, the adverse food reactions, food allergies and food intolerances now affect millions of people; some of whom have been seen by medical professionals, others through their own knowledge of their body and reactions to foods.
These adverse food reactions are believed to be the cause of a variety of common health complaints and diseases are not solely cereals, dairy, carbohydrates but also meats, fruits and vegetables as well as spices, additives, flavourings, sugar, fats, anti-biotics given to livestock etc.
Which are increasingly believed to be responsible for many undiagnosed health complaints which impact treatment and health problems which are mediated by the immune system.
The immune system protects us from illness and disease, by continuously lowering the danger represented by Antigens; parts of proteins which our bodies recognise as dangerous so neutralize it (in a nutshell our immune system is our internal army), in foods and microorganisms like bacteria.
The immune cells identifies a dangerous antigen, they act to neutralize it and prevent it from causing harm in the body. Antigens from bacteria or viruses interact with our cells, which is how we become sick, catch the flu, cold but in food antigens we may risk the attack of a wide range of immune-related symptoms ranging from a runny nose to hives or (worse still), anaphylactic shock.
Consequently, more and more healthcare practitioners are referring patients to dieticians and Allergy Avoidance Diets to identify food allergies and food intolerances in their patients to increase better health and future problems.
The difficulty is that your General Practitioner (G.P) Doctor may not have the knowledge or understanding to deal with your problem and refer you to a Consultant at your local hospital or to a dietician to discuss how to manage your body’s reactions to foods.
There are more and more nutritionists, dieticians and physicians who now consider that the only definitive way to identify and manage adverse food reactions is through an Allergy Avoidance Diet to eliminate and find the cause of the problem through one of the following diets:
~ Elimination Diet followed by food challenges Diet; any food that is suspected of causing an allergy or intolerance is eliminated for a period of four days to three weeks, until symptoms are gone. Therefore, depending on the severity and type of symptoms, the Elimination Diet could range from moderately to severely restrictive in the amount of foods allowed. Elimination Diets typically include a variety of hypoallergenic foods including lamb, pears, apples, rice, most vegetables, most beans and legumes (except peanuts) and the “non-gluten” grains (for example, millet, quinoa, and amaranth). Once the body has adjusted to the absence of suspected foods, these foods are systematically added back into the diet, and any resulting symptoms are recorded every two to four days depending on whether there is a reaction or not.
~ Rotation Diet, in this diet problematic foods are eaten only once every four days.
An Allergy Avoidance Diet may be especially beneficial for those suffering from adverse food reactions.
Food hypersensitivities or food reactions, are classified in two types; immediate or delayed. Immediate hypersensitivity reactions occur within hours or even a few minutes after a food is eaten, typically causing very obvious physical symptoms such as a rash, the hives, a running nose, or a headache or rarely anaphylactic shock, a life-threatening condition in which the throat swells and blocks the passage of air. The foods which are most often the cause of immediate allergic responses include milk, eggs, peanuts, walnuts, soy, strawberries, wheat, fish and shellfish. Many people with immediate food hypersensitivities must completely eliminate the offending food from their diet to avoid the serious symptoms. It may also be similar citrus fruits or apples which cause these symptoms it varies among different individuals.
N.B. Immediate hypersensitivities affect only a small percentage of the population.
Foods known to cause immediate hypersensitivities in a small number of people, have now been implicated as a cause of delayed/masked food allergies in much larger numbers of individuals. Delayed food hypersensitivity reactions are believed to affect millions of people; some physicians have suggested that as many as 50% oa a western population suffer from masked food allergies.
Reactions may be a variety of symptoms; dark circles or puffiness under the eyes, fluid retention, dermatitis, sinus congestion, fatigue, abdominal pain or discomfort, joint inflammation, mood swings, indigestion, migraines, headaches, chronic ear infections, asthma, poor memory, anxiety and depression.
Delayed hypersensitivities do not appear immediately which adds to the problem after consuming a particular food as you may be unsure what you have eaten which caused the reaction possibly blaming the wrong food so suffering again until the correct food is eliminated. The immune response is often considerably delayed making it is difficult to determine which food is causing the symptoms, as a result many people continue unawares of their sensitivity to certain foods. This is why through dietary manipulation as in the Elimination Diet or Rotation Diet, so hidden food allergies are identified. The foods most commonly associated with delayed hypersensitivities include dairy products, eggs, wheat, soy products, peanuts, shellfish, and refined sugar.
Immune-mediated food allergies represent one type of adverse food reaction. Another type of adverse food reaction is called food intolerance which refers to any abnormal physiological response to a food that is not caused by an antibody/antigen reaction whether caused by enzyme deficiencies, or caused by poor function of the digestive tract or a sensitivity whether a natural or synthetic chemical.
The most common food intolerance is lactose intolerance, which affects as many as 30% of American adults, and is particularly common in people of African and Asian heritage.
People with lactose intolerance do not produce enough of the digestive enzyme called lactase, this breaks down the milk sugar (lactose) found in dairy products. The problem is when too much undigested lactose makes its way into the large intestine, people suffer from gas and/or diarrhoea.
Wheat reactions may be known as wheat intolerance, wheat allergy, and wheat sensitivity. Wheat is quite unique in adverse food reactions, for the reason that it has long been classified as the primary “gluten grain” as well as its research history which has been both complicated and controversial. It is necessary in understanding allergy-related issues associated with gluten is important for understanding problems connected to wheat.
“Gluten” is unscientific in its use; if that word is being used to describe any single substance or even category of substances. The term “gluten” used is from the world of industry not science. In industrial baked goods, gluten is the gummy, yellow-gray material that is left over after dough (made from flour and water) has been washed or carbohydrates cooked. This is as the dough is washed, many of the water-soluble substances and starches are washed off and what’s left is a complicated mixture that has traditionally been referred to gluten. The dough used to produce gluten is from many cereal grains including wheat such as rye, barley, which can also be used to produce gluten. In industrial practices, wheat is the common food source for producing gluten.
If a gluten dough-ball is dried out and analyzed, it is found to be 80% protein by weight, the remaining 20% is made up of fats, carbohydrates, and minerals. From a chemical point of view, gluten is a diverse mixture of substances.
There are 4 primary types of gluten proteins:
Glutelins have a more specific name when they are found in wheat where they are called glutenins. The prolamin proteins in gluten have been implicated in the process of protein-based wheat allergy. The role of prolamin protein in food allergy is also complicated because prolamins are found in all cereal grains, not just wheat. The prolamin proteins found in wheat are the gliadin proteins; in oats, they are avenins; in corn they are zeins; in rye they are secalins; and in barley they are hordeins.
Protein-Based Wheat Allergy
With respect to wheat, and within the prolamin family of proteins found in gluten, it is the alpha-gliadin polypeptides that have been most closely linked to food allergy. These alpha-gliadin polypeptides include peptide A, peptide B, and peptide C. These small proteins appear particular to wheat. If gluten is produced from sources other than wheat, the prolamin proteins in the gluten change from gliadins to other types of prolamin proteins, like avenins in oats or secalins in rye. In these non-wheat cases, the allergy-triggered events associated with the prolamin proteins become less predictable, and sometimes fail to occur altogether.
The differences in prolamin protein composition between wheat and other cereal grains have prompted controversy in the area of allergy and in use of the term “gluten grains.” Traditionally, wheat, oats, barley, and rye have been referred to as the “gluten grains” and placed on a par with wheat in terms of allergy. When a person has traditionally been advised to avoid wheat products for allergy reasons, that person has also traditionally been advised to avoid oats, barley, and rye as well. The recommendation in this traditional context has been to avoid all “gluten grains.” The differences in protein chemistry between wheat and all other cereal grains, however, has caused some organizations to start thinking about wheat as a grain that falls into its own unique category and to place restrictions only on wheat and wheat gluten when allergy is the issue. These organizations have largely abandoned use the term “gluten grains,” and have begun to think exclusively about wheat and wheat gluten. These steps have had interesting and controversial consequences with respect to health problems involving wheat allergy. For example, several organizations formed to support individuals with celiac disease have altered their public health recommendations to include acceptability of oats for persons diagnosed with celiac disease. Previously, oats had been categorically avoided as gluten grains for all persons following dietary restrictions related to the diagnosis of celiac disease.
Non-Gluten Sources of Wheat Allergy
There are other components of wheat that have been associated with allergy to the wheat allergy problems associated with wheat’s prolamin proteins. These components include wheat germ agglutinin (WGA), a glycoprotein, and two very short amino acid strings called tetrapeptides (PSSG and GGGP). These substances are present in significant amounts in wheat but do not appear to be present in the same way in other grains.
Whole Grains versus Processed Grains
Wheat allergy-related problems are believed to be triggered in part by the highly processed nature of wheat products in the marketplace. Commercially produced breads are typically formulated to contain a specific amount of highly processed wheat flour (stripped of the germ, the bran, and majority of fibers, vitamins, and minerals) and a specific amount of equally processed wheat gluten. Manipulation of this flour-to-gluten ratio can dramatically improve textures of highly processed breads and baked goods as a result the natural balance of nutrients found in whole wheat is dramatically altered by these processing events, which points to these processing impacts as the major underlying reason for prevalence of wheat allergy. 100% whole grains are the only grains recommended among the World’s Healthiest Foods, these allergy-related considerations involving wheat processing are completely avoided with the World’s Healthiest Foods approach.
The Specifics of Coeliac Disease
Coeliac disease is a health condition that some people associate with simple gluten intolerance. However, coeliac disease is in fact a multi-system autoimmune disease in which changes in liver function, digestive tract function, and the function of other organ systems comes into play. The role of a specific enzyme, called tissue transglutaminase, or tTG, appears to be especially important in celiac disease. Short strands of protein (polypeptides) found in gliadin (one family of wheat proteins) are acted on by this enzyme, and many resulting problems associated with Coeliac disease may result. For some, but not all individuals, a blood test measuring antibodies to tTG can be an effective screening test for Coeliac disease.
Adverse Reaction to Food Additives
Many people are also unable to “tolerate” natural and synthetic chemicals, such as sulfites, that appear in abundance in our food supply. These sulfur-containing preservatives are used in dried fruits, wines, and many other processed foods. Between 1980 and 1999, the United States Food and Drug Administration received more than 1,000 reports of adverse reactions, some fatal, to sulfites. It has been estimated that at least 1% of all people with asthma are sensitive to sulfites.
Synthetic food colourings, including Food Dye and Color Yellow No. 5 (tartrazine), are problematic for many people. Monosodium glutamate (MSG) is one further example of an additive used to increase flavor, particularly in Asian foods. After eating at restaurants that use MSG, many people become bloated or experience severe headaches.
Adverse Reaction to Salicylates
Salicylates and amines are examples of naturally-occurring food substances found in many vegetables, herbs, spices, fruits, and chocolate. These naturally-occurring components of food have been associated with a variety of symptoms including mental confusion, depression, and migraine headaches.
The Role of an Elimination Diet
Food allergies and food intolerances are a major source of undesirable symptoms that negatively impact the quality of life of many people. Therefore, the only definitive way to identify and manage adverse food reactions is through the use of an Elimination Diet followed by carefully organized food challenges.
This process is quite arduous and must be done carefully if adverse food reactions are to be identified, as a result, it is best to perform an Elimination Diet with the support of a knowledgeable health practitioner, however it can be done on your own if like me you are determined.
In an Elimination Diet, any food that is suspected to cause an allergy or intolerance is eliminated. Depending on the severity and type of symptoms, the Elimination Diet may range from moderately restrictive to severely restrictive in the amount of foods allowed.
Food Excluded on an Elimination Diet
Standard elimination diets eliminate the most common allergens, such as wheat, soy, corn, dairy, eggs, gluten, nuts, citrus, fish, chocolate, and shellfish, caffeine, alcohol, and artificial food additives. More restrictive Elimination Diets remove all of the foods previously listed plus those foods that contain salicylates and amines.
The Challenge Phase of an Elimination Diet
The purpose of the Elimination Diet is to avoid all problematic foods for a minimum of four days, or until you experience some relief from your symptoms. It is worth noting that for some people, it takes up to three weeks before improvement is seen. However, once the body is cleansed, the foods that were eliminated are systematically added back into the diet, one food at a time; being noted in a diary.
This re-addition of foods is called the “challenge” phase of the diet. On the first day of food challenges, a food is eaten one to three times during the day. Over the next few days, the dieter returns to the Elimination Diet, and watches for the return of any symptoms.
If any symptoms develop, it is possible that the dieter is “allergic” to the recently reintroduced food. If no symptoms develop, it is likely that the reintroduced food is not a problem for the dieter, and he/she can move on to the next food challenge. To more accurately determine food allergies and food intolerances, it is extremely helpful during the challenge phase to keep a diary of foods eaten and any emotional, mental or physical reactions.
It can take several months to complete an Elimination and Challenge Diet. If a person does not have the time or desire to undertake such a process, a Rotation Diet may be a more appropriate option for managing the symptoms associated with food allergies.
In a Rotation Diet, foods are rotated so that a person eats a food (or food family) only once every four days. For example, if you suspect a sensitivity to wheat, you would rotate wheat-containing foods into your diet every fourth day. It is believed that by decreasing the consumption of problematic foods by rotating them, the symptoms associated with these foods can be reduced.
Thankfully there is an increasing body of scientific literature points to hidden food allergies and food intolerances as a cause of many medical conditions including migraine headache, arthritis, irritable bowel syndrome, asthma, attention-deficit hyperactivity disorder, and recurrent otitis media. Common health complaints such as fatigue and eczema are also attributed to adverse food reactions.
I am glad as being a sufferer who hasn’t been taken seriously by health professionals then the more research then maybe sufferers may be taken seriously rather than hypochondriacs or psychosomatic.
Clinicians and researchers believe that the number of people suffering from adverse food reactions is constantly increasing. They cite several reasons for this:
• Repeated consumption of a limited number of foods: Eating a relatively small number of foods several times during the day; such as wheat, a common food allergen, which is found in breakfast cereals, the bread used to make a sandwich at lunch time, and the spaghetti eaten at dinner time. Also, wheat is a thickening agent used in food processing, so it is a common “hidden” ingredient in many processed foods. Or consider the number of times you can eat corn in one day: in your corn flakes at breakfast, in your corn tortilla at lunchtime, and your corn-on-the-cob at dinnertime. Other commonly eaten foods such as milk and eggs are also a frequent cause of allergic symptoms. The repeated exposure to these foods taxes the immune system.
• Improper digestion and poor integrity of the intestinal barrier: The digestive tract plays a vital role in preventing illness and disease by providing an impenetrable barrier. When the integrity of the intestinal barrier is compromised, a condition coined “leaky gut syndrome” develops. With leaky gut syndrome, partially digested dietary protein can cross the intestinal barrier and be absorbed into the bloodstream. These large molecules can cause an allergic response, producing symptoms directly in the intestines or throughout the body.
One of the causes of leaky gut is an absence of “friendly” bacteria in the intestines. The “friendly” bacteria help maintain the health of the intestines by producing fuel (as short-chain fatty acids) for intestinal cells and by competing with disease-causing bacteria for nutrients. Parasitic infections, treatment with antibiotics, stress, and candida overgrowth can disrupt the proper balance of “friendly” bacteria. It is also believed that not being breastfed or only for a short period of time as an infant or an early introduction of solid foods to infants contributes to leaky gut syndrome and subsequent food allergies.
• Over-worked immune systems: Constant stress, exposure to air and water pollution, and pesticides and chemicals in our food puts a strain on our immune system, making it less able to respond appropriately to the antigens in food.
• Genetics: Food allergies and intolerances seem to be hereditary. Research indicates that if both parents have allergies, their children have a sixty-seven percent chance of developing food allergies. When only one parent is allergic, the child has a 33% chance of developing food allergies.
An Allergy Avoidance Diet emphasizes the consumption of a wide-range of so-called hypoallergenic foods.
These foods include lamb, pears, apples, rice, most vegetables, most beans and legumes (except peanuts) and the non-gluten grains (for example, millet, quinoa, and amaranth).
The only sweeteners allowed are maple syrup or brown rice syrup.
Drinks include rice milk, pear nectar, chamomile tea, and sparkling water -without any added sweeteners.
Foods that are included in an Allergy Avoidance Diet must be carefully selected for each individual, so that all problematic foods are eliminated.
Any food that is known, or suspected, to cause an adverse reaction is either completely eliminated from the diet, or eaten on a rotation basis. Wheat, corn, cow’s milk, eggs, dairy products, peanuts, and soy foods are among the most common food allergens. Many people also react to artificial food additives, such as monosodium glutamate, sulfites, and food colorings; foods containing these ingredients must be eliminated.
If you are simply trying to avoid wheat, dairy, or corn, you can include a wide variety of fruits and vegetables in your Allergy Avoidance Diet. However, if you suspect that you are sensitive to amines and/or salicylates, you must avoid all foods containing these naturally occurring chemicals. Unfortunately these chemicals are widespred in many commonly eaten fruits and vegetables, as well as many other foods. Examples of foods that contain salicylates and/are amines are tomatoes, broccoli, olives, spinach, mushrooms, avocado, all dried fruit, smoked meats, canned fish, hard cheeses, soy sauce, miso, chocolate, cocoa, beer, cola drinks, vinegars, and yeast extract.
N.B. With the Elimination or Rotation diet, be aware that many processed foods contain at least one of the most common food allergens. Milk, soy, wheat, peanuts, and eggs are staples in the food industry, and often appear in foods as “natural flavors,” which means that the food label may not list the ingredient.
Additional Information about Allergy-Related Meal Planning
If you decide to experiment with some of the allergy avoidance methods listed above, you will discover that some allergy-related meal planning is really quite simple. If you decide, for example, that wheat is a food you want to avoid, you automatically know that wheat bread is off your grocery list.
Highly processed foods, or sauces and condiments, you will find that allergy avoidance becomes more difficult, because wheat is not always so easy to spot. Soy sauce, for example, often contains wheat as a key ingredient. So do teriyaki sauce and food starch.
Prepare homemade meals to avoid the risk of hidden ingredients.
Allergy-related meal planning in any of the following five areas, when selecting foods for yourself or your family.
1. Dairy-free meal planning
2. Wheat-free meal planning
3. Egg-free meal planning
4. Soy-free meal planning
5. Yeast-free meal planning
Dairy-free meal planning
In addition to cow’s milk itself, products made from cow’s milk including yogurt, ice cream, sour cream, half and half, cottage cheese, hard and soft cheeses, butter, and puddings can be made from cow’s milk.
One of the most common allergenic proteins in cow’s milk is called casein, and all variations of this word appearing on an ingredient list signify the presence of cow’s milk as a food source: casein, caseinate, calcium caseinate, ammonia caseinate, magnesium caseinate, potassium caseinate, and sodium caseinate.
Casein can be used in food processing as an extender, tenderizer, and protein fortifier, and can be found in unexpected places, including chewing gum, luncheon meats, and imitation sausage. The words “non-dairy” do not necessarily mean that a product does not contain casein, and many non-dairy products on the market, including soy cheeses, almond cheeses, and rice cheeses use casein as a primary protein-boosting ingredient.
Wheat-free meal planning
All of wheat’s components, including wheat bran, wheat germ, wheat starch, wheat nuts, and wheat berries would be excluded from a wheat-free meal plan. Similarly, any type of wheat, including bulgar, durum, and graham would be excluded. Semolina, seitan, triticale, couscous, and tabouleh would also be avoided, along with any product containing the word “gluten” (or a variation of this word) in its ingredient list. These include high-gluten flour, vital gluten, and wheat gluten.
Much more hidden are the food additives that may or may not be made from wheat. These additives include:
• Dextrin, an incompletely hydrolyzed starch that may be derived from the dry heating of corn, potato, rice, tapioca, arrowroot, or wheat
• Caramel color, which can be made from heat treatment of many food-grade carbohydrates, including molasses, corn sugar, invert sugar, milk sugar, barley malt syrup, or wheat starch hydrolysates
• Extracts, including vanillin extract, which often use grain alcohol in preparation of the extract and contain wheat protein residues
Egg-free meal planning
The desert sections of the grocery store contain the most egg-based products, including puddings, custards, ice creams, cakes, cookies, meringues, cream-filled or fondant-filled chocolates, fudge, icings and frostings, doughnuts, and muffins.
Baked goods and baking mixes also frequently contain egg. The list here includes waffles and waffle mixes, pancakes and pancake mixes, and french toast. Egg noodles, breaded meats, breaded fish, breaded poultry, souffles, hollandaise sauce, most mayonnaise, meat loaf, some sausages, many fried rice dishes, egg drop soups, egg noodle-containing soups, and egg substitutes can also contain egg.
On an ingredient list, any of the following words would also indicate the presence of egg: albumin, egg white, egg yolk, dried egg, egg powder, egg solids, ovalbumin, ovomucin, ovomucoid, ovovitellin, and livetin. The fat substitute Simplesse (TM) also contains microparticulated egg protein.
Soy-free meal planning
An ever-increasing number of ingredient-listed items can include some soybean-derived component. Items that indicate or may indicate the presence of soy include: hydrolyzed soy protein, hydrolyzed plant protein, hydrolyzed vegetable protein, texturized vegetable protein (TVP), isolated soy protein (ISP), soy flour, soy grits, soy nuts, soy milk, soy sprouts, isolated vegetable protein, vegetable gum, vegetable broth, or natural flavoring. Soy sauce, shoyu, tamari, miso, tofu, tempeh, natto, edamame, soy oil, soy curd and soy granules would all be avoided on a soy-free meal plan.
Yeast-free meal planning
A yeast-free meal plan is one of the most confusing to implement because of the controversies surrounding residual amounts of yeast in many commercially-prepared, processed foods. For example, small amounts of yeast many become present during the drying of tea, coffee, and spices.
The culturing of yeast is also used a starting point for commercial production of fermented products, including vinegars and ciders. Citric acid, a food additive, is also derived from yeast-culturing and yeast-fermenting processes.
Many cow’s milk-containing products also contain yeast, since yeasts thrive on milk sugar (lactose). This list of products typically includes sour cream, buttermilk, cream cheese, ricotta cheese, and powdered milk. Because yeasts also thrive on concentrated sugars, many canned and frozen fruit juices, and particular fruit juice concentrates, can contain yeast. Since the mid 1970s, several dozen research studies on this topic have appeared in food science journals.
An Allergy Avoidance Diet, when carefully planned, provides sufficient amounts of all essential nutrients. Care must be taken with children and pregnant women to ensure adequate caloric and protein intake.
As adverse food reactions are implicated as a contributing factor in the development of several medical conditions, identifying and eliminating the foods that cause reactions can be helpful for many people. Specifically, an allergy avoidance diet is beneficial for those suffering from irritable bowel syndrome, migraine, recurrent otitis media, rheumatoid arthritis, and asthma.
Individuals following an Allergy Avoidance Diet may experience uncomfortable symptoms caused by detoxification, including headache, muscle pains, or fatigue. These symptoms typically appear 2-3 days into the diet, and disappear within seven days.
When offending foods are reintroduced into the diet, individuals experience mild to severe reactions to food. It is advisable, to follow an Allergy Avoidance Diet, especially a strict Elimination/Challenge Diet, only under the advice and supervision of a health care practitioner.
Quinoa seed crackers
3 tablespoons flaxseeds,
3 tablespoons sunflower seeds
2 tablespoons sesame seeds
3 ounces (1/2 cup packed) cooked quinoa
2 ounces (1/2 cup, minus 1 tablespoons) quinoa flour (or, substitute 2 ounces superfine brown rice flour)
2 ounces (1/2 cup, plus 1 tablespoon) quinoa flakes
3 ounces (1/2 cup) potato starch
1 teaspoon baking powder
1 teaspoon xanthan gum
1/2 teaspoon guar gum
1 teaspoon fine sea salt
2 ounces butter, softened
2 ounces olive oil
2 to 5 tablespoons ice-cold water
Preparing to make the crackers Preheat the oven to 400°. Pull out a sheet tray and line it with a sheet of parchment paper.
Preparing the seeds. Put the flaxseed, sesame seeds and sunflower seeds, into the food processor. Pulse it until they have broken down but not butter.
Mixing in the dry ingredients. Add the cooked quinoa, quinoa flour, quinoa flakes, potato starch, baking powder, xanthan gum, guar gum, and salt to the food processor. Let it run for a couple of minutes, so everything has a chance to mix and dance, and the flours to become blended well.
Finishing the dough. Add the softened butter to the mix. Spin the food processor around. Slowly, drizzle in the oil, with the food processor running. At this point, the dough should be clumping together quite well, but not yet one big ball. If the dough feels at all too dry, add the water, 1 tablespoon at a time. Turn off the food processor.
Rolling out the dough. Put the clumps of dough onto the baking sheet. Squidge the dough together into a vague lump and carefully, gently, roll it out the approximate length and width of the baking sheet. If you desire, top the crackers with additional sesame seeds.
Baking the crackers. Bake the crackers until they are browned and firm to the touch, but not too brown or firm to the touch, about 20 minutes in our oven. Take them out of the oven and let them cool on the baking sheet.
Transfer the cracker (which should be one big sheet, or at least several) to a cutting board. When the cracker has completely cooled, cut it into the size of cracker you want. And so the cracker becomes crackers.
Makes about 20 crackers
200g/7oz quinoa, cooked according to the packet instructions
handful fresh parsley, chopped
1 tbsp chopped fresh mint
1 red pepper, finely diced
1 cucumber, finely diced
1 red onion, finely diced
100ml/3½fl oz extra virgin olive oil
1 lemon, juice only
salt and freshly ground black pepper
Mix together the quinoa, herbs, vegetables in a bowl; dress with olive oil and lemon juice, season, to taste, with salt and freshly ground black pepper.
Vegetarian Spicy Quinoa pepper and bean stew
Prep Time: 10 min
Cooking Time: 20 min
Total Time: 30 minutes
2 1/2 tablespoon olive oil
1 onion, chopped
Pinch salt to taste
Freshly ground peppercorns
2 clove(s) garlic, chopped
1 red bell pepper, diced
1 tsp chilli flakes, or to taste
10 fresh diced tomatoes, without skin or a 450g tinned tomatoes
450g tin black beans
1 red pepper, chopped
1 yellow pepper, chopped
1 orange or green pepper, chopped
Sprigs of fresh herbs chopped marjoram, oregano and tthyme or 1/2 tsp of dried herbs
1 Litre of vegetable stock
1 cup of cooked quinoa
1 small tin of sweet corn
6 mushrooms sliced
1 small courgette chopped
In a large deep flat pan heat the olive oil over medium heat. Add the chopped onion, stir until soft. Add, red bell pepper, cook until tender. Add the chili flakes tomatoes, herbs, black beans, and vegetable stock. Simmer, partially covered and stirring, 15 minutes. Add garlic, sweet corn, courgette, mushroom, peppers, or any other ingredients you choose, cook and cover for 3 minutes. Stir in quinoa and season with salt and fresh pepper to taste.
Serve, top with:
• fresh herbs to taste
• fresh grated Cheddar or cheese of choice
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Personally, I believe gluten causes my digestive symptoms, reactions and fatigue in People Without Coeliac Disease as gluten and symptoms in people without coeliac disease as gluten is a trigger of digestive symptoms and fatigue “non-coeliac gluten intolerance”. As a sufferer of what the doctors have resigned to say is IBS in whom coeliac disease had been excluded whose symptoms were controlled on a gluten-free diet.
I eat a daily gluten-free diet, rarely eating gluten free bread or baked goods as I do not find them comfortable in the digestive transit, although small amounts are the key eaten proportionally with fruit, vegetables and proteins, as excess gluten-free could also cause discomfort. My symptoms are worse within thirty minutes of gluten ingestion and had significantly worse bloating, abdominal pain, altered bowel pattern and fatigue, sleeplessness due to the food going through the system causing pain en route.
Gluten is a trigger of inflammation and/or gut dysfunction in IBS and gluten sensitivity the next is to determine whether it is the/or one of the causes of functional symptoms in patients with a positive anti-gliadin antibodies, and gluten restriction.
Mast cells have been implicated showing increased activated mast cells present in the duodenum, ileum and/or colon of individuals with IBS symptoms,these are:
• found resident in tissues throughout the body, particularly in association with structures such as blood vessels and nerves, and in proximity to surfaces that interface the external environment
• are bone marrow-derived and particularly depend upon stem cell factor for their survival
• express a variety of phenotypic features within tissues as determined by the local environment
• withdrawal of required growth factors results in mast cell apoptosis
• appear to be highly engineered cells with multiple critical biological functions
• may be activated by a number of stimuli that are both Fc epsilon RI dependent and Fc epsilon RI independent.
• through various receptors leads to distinct signaling pathways
• may immediately extrude granule-associated mediators and generate lipid-derived substances that induce immediate allergic inflammation
• may also be by the synthesis of chemokines and cytokines as secretion, occurs hours later, may contribute to chronic inflammation.
Biological functions appear to include:
• a role in natural immunity,
• involvement in host defence mechanisms against parasitic infestations,
• immunomodulation of the immune system,
• tissue repair and angiogenesis.
The trigger in these individuals is believed to be a type of immune stimulating event such as:
• an intestinal infection , as in the post-infectious form of IBS
• proteins in the gut such as foods and/or microbes that are sensed by the body as being foreign attackers.
The role of microbes is getting a lot of scientific and research attention whereas food proteins as a cause of IBS, has generally been doubted by research scientists and previously ignored
The presence of genetic markers as for Coeliac disease predicted responsiveness to a gluten-free diet in people with IBS, supporting with my personal experiences. In following a gluten free diet individuals with at risk genetics but who are without proven Coeliac disease, though many had positive testsm with a higher occurrence of these genetics in individuals with augmented mast cells in their intestinal lining, known as Mastocytic Enterocolitis (MCE) or also Mastocytic Inflammatory Bowel Disease (MIBD).
Therefore, it is of the utmost importance that MCE or MIBD are recognised as an inflammatory process in some IBS sufferers as it narrows down the affected area rather than only dietary causes and implications.
• a gluten-free
• low fruit, vegetables, dried legumes,
• no dairy.
The diet results are in a very positive response when I have been similarily diagnosed and treated.
The role of mast cells and gluten in IBS requires research but that costs money, I wish I was Bill Gates and could fund this area of research on the link and affect between mast cells in gastrointestinal disease.
A really useful guide by NICE on how diet can help assist and cause IBS – which I found concisely provides the information to patients to manage the diet effectively.
However ALWAYS check with your GP for other possible causes to check initially for bowel cancer or ovarian cancer which affect the same area of the body and can confuse patients, then a doctor can refer you to a dietician (if food intolerance or allergy is suspected) and to ensure a healthy diet is maintained if not eating certain foods such as wheat and dairy.
How and what does it mean to be managing one’s own health care?
Doctors happily write prescriptions for any and every complaint except the common cold!
All these medications are not beneficial for our health as they are unnatural man-made products which can cause addictions and other problems…
100grams/4oz Red lentils
450 grams/1lb Carrots peeled and grated
450 grams/1lb Potatoes peeled and grated
2L/4 pints of fresh or prepared Chicken stock
2L/4 pints of fresh or prepared Vegetable stock
1 teaspoon of Chilli flakes (or more if preferred)
A large bunch of fresh Coriander chopped or 2 teaspoons of dried coriander
Freshly ground Salt and pepper to taste
In a large 6 Litre stock pot bring the stock to the boil, adding the chilli flakes.
Add the Red lentils stirring to prevent sticking bring to the boil for ten minutes.
Peel and grate the potatoes and carrots adding to the pan, stirring well cook for ten minutes.
Add the chopped coriander, salt and pepper to taste, cooking for a further ten minutes.
Serve with crusty fresh bread and butter – gluten and dairy free if you’re like me!