It’s becoming more common nowadays for people to be intolerant or allergic to certain foods, and while some may disregard this concept as a fad, a cry for attention or perhaps an attempt at being trendy – food intolerances really do exist. Improperly managed they can cause a wide variety of symptoms that can be extremely uncomfortable and can significantly affect your quality of life.

It is estimated that one-fifth of the population believe that they have a food intolerance. (1) Many people with food intolerances know that there is a food that is disagreeing with them, but they can’t quite put their finger on what it is. Sometimes there’s a reaction and sometimes there isn’t, it all seems so vague and confusing that it’s easier just to throw your hands up, give in and eat whatever (or practically nothing, as some people chose to do).

If you suspect that you’ve got a food enemy, this article will hopefully show you some of the avenues that you can investigate to find what it is that you’re reacting to, and what you can do about it.

Food allergies are a reaction by the immune system to a specific part of a food, usually one of the protein components.  Symptoms of food allergies can include hives, swelling around the mouth, rashes and/or vomiting.  The worst case scenario is an anaphylactic reaction, which can be life threatening.  Food allergies do not disappear and are usually present from birth. Most commonly these reactions are to foods such as peanuts, cow’s milk, egg, tree nuts, soy, fish and shellfish, however it’s possible to be allergic to anything (1).

At this point of time there isn’t much we can do about it except for avoid the foods and be ready to administer first aid should exposure occur.

There is however, some hope for future treatment for allergy sufferers. A recent trial by the Murdoch Children’s Research Institute found that use of a certain strain of probiotics was able to reduce peanut allergy in 23 out of the 28 children studied. This is only a small study so far, so it’s unlikely that this will be a widely accepted treatment for a while to come, and it’s not recommended to try this at home due to the life-threatening nature of these allergies, however it does highlight the importance of keeping your gut healthy and also provides some hope. (2)

Recognising the difference between an allergy and an intolerance is important, as the incorrect use of these terms is often what leads to the general confusion about the whole area.

Food intolerances are reactions to foods that are not classed as an allergy. In some instances it can be due to a lack of enzyme such as in lactose intolerance, and in others it can be due to a reaction from the IgG or IgA immune cells. Unlike fructose malabsorption and coeliac disease, this is not a widely accepted phenomena and research into this area is still in its infancy.

Food intolerances are usually developed as a result of gut flora imbalances and/or damage to the lining of the digestive system (often referred to as intestinal permeability, or leaky gut) however they can occur when a food is regularly consumed in large quantities (3) (4).

Food intolerances are not life threatening like an allergy, and the symptoms that can occur from eating something you are intolerant to are usually digestive (bloating, heartburn, diarrhoea, constipation, cramping and gas) however if you’re eating food intolerances too frequently then it can create symptoms elsewhere in the body that are less likely to be related to food (1). These include brain fog, headaches, mood swings or weight gain.  Food intolerance symptoms are often delayed in their onset (they can come on 48 hours after eating) which means they are much harder to identify as the culprit for your symptoms.

Fructose malabsorption can be a common issue for many people with digestive complaints, especially bloating, pain and diarrhoea.  It is estimated that up to 70% of people with IBS (irritable bowel syndrome) have fructose malabsorption (5).  The diet to manage this is known as the FODMAP diet.

The FODMAP diet was originally developed by Dr Sue Shepherd, an Australian dietician. She has proven, through her pioneering PhD research, that limiting dietary FODMAPs is an effective treatment for people with symptoms of IBS. Several research papers have confirmed her work and so this diet has become better known in the last few years, even being accepted overseas.

Fructose is a naturally occurring sugar found in certain fruits and vegetables, and in some people this sugar cannot be effectively processed in the small intestine.  As a result it is left to ferment, which can cause bloating, diarrhoea and/or constipation, flatulence, stomach pain, and even mood imbalances (6).

As wheat contains FODMAPs, some people attribute non-coeliac reactions to gluten to fructose malabsorption.

It is important to remember that high FODMAPs foods are not always the only culprit for IBS symptoms.  Consider being aware of your reaction to fatty foods, caffeine, alcohol, fibre (excess or lack of), medications and stress, which may also influence your symptoms. Hormonal problems and bacterial imbalances can also be responsible.

Contributing factors towards the development of fructose malabsorption include:

• Diabetes (especially type 2)
• Diets that are high GI (glycaemic index)
• Stress
• Certain medications including Corticosteroids and Metformin
• Digestive damage from excessive alcohol, smoking and other factors

As you can see from the above list, fructose malabsorption is likely to occur from poor blood sugar regulation and digestive damage – commonly seen in inflammatory bowel disorders such as Crohn’s disease and ulcerative colitis (6).

Diagnosis

Fructose malabsorption can be diagnosed using a hydrogen breath test, which recognises unabsorbed fructose.

The FODMAP elimination and challenge diet is also a way of determining whether you react to FODMAPS, and narrowing down what types and how much. The FODMAP diet is very strict, so it’s not a long term solution but rather a means to identify which foods in this group you are reactive to.

The FODMAP diet

FODMAPs are found in the following foods:

• Fermentable Oligosaccharides (e.g. Fructans and Galactans)
• Disaccharides (e.g. Lactose)
• Monosaccharides (e.g. excess Fructose)
• And
• Polyols (e.g. Sorbitol, Mannitol, Maltitol, Xylitol and Isomalt)

The list of foods that are to be avoided in a full FODMAP diet is rather large, but it includes a lot of fruits, honey and some other sweeteners, wheat products, most dairy sources, soy milk, legumes, and certain vegetables including garlic, onion, mushrooms and asparagus (8).

Chemical sensitivies.

There are a number of substances that are naturally contained in foods which can cause reactions in some people, including rashes, headaches, fatigue, digestive symptoms, hyperactivity and irritability. The main food chemicals which can cause symptoms are salicylates, amines and MSG.

Salicylates can be found in a wide range of fruit (especially in unripened fruit) and vegetables (more concentrated in the outer leaves), as well as nuts, herbs and spices, jams, honey, yeast extracts, tea, coffee, bear and wines. Aspirin also contains salicylates.

Amines are high in foods such as deli meats (salami, bacon, ham, frankfurts), tinned fish and tinned meats, tomato paste and pasta sauces. They are also present in cheese, chocolate, wines, beer and yeast extracts.

MSG (monosodium glutamate) is well known for the reactions it can cause, particular when used as a flavour enhancer in some Asian cooking, soups, sauces and packaged snack foods. It is also found in high amounts naturally in some foods such as tomatoes, blue and parmesan cheese, mushrooms, broccoli and some meat and yeast extracts.

Sulphites can cause a worsening of asthma symptoms, headaches and fatigue. The food additives to watch out for in this category are the numbers E220 – E224, E226 and E227. They are found in a lot of dried fruits, packaged salads and fruit salads, some dried foods such as garlic, ginger, potatoes, soft drinks and fruit drinks, pickles, sauerkraut and corn syrup. People who are very sensitive to sulphites may benefit from increasing their intake of the mineral molybdenum.

Histamine intolerance often mimics the symptoms of a food allergy, however it is an inflammatory reaction caused by an impaired ability to breakdown the chemical histamine, which is naturally present in many foods. Symptoms of histamine excess include hives and itching, racing pulse, anxiety, swelling of the face and throat, runny nose, conjunctivitis, headaches, digestive upset, fatigue, confusion and irritability. This problem is often developed after some form of disruption to the digestive system, usually an infection or course of antibiotics, but can also be triggered by stress and other digestive problems. Some medications such as painkillers, asthma medications and sleeping medications can also interfere with the enzymes that process histamine. Methylation problems can also affect histamine levels, and people who are in this category are more likely to experience mood disorders such as depression and OCD. Some of the main food triggers include red wine, fish (unless very fresh), smoked, processed or fermented meats, left-over foods, most cheeses, citrus fruits, pineapple, raspberries, prunes, tomatoes and tomato products, spinach, red beans, eggplant, olives, pumpkin, pickles and relishes, chocolate, soy sauce, most alcohol drinks and tea. (9) (10)

Coeliac disease

is one of the most well known forms of food intolerances, first discovered in the 1950s it was originally thought to only be a childhood disorder. The prevalence of this condition is increasing, however it is thought that there are many people with this condition who are still undiagnosed.

It is not an allergy or sensitivity, but rather an autoimmune reaction to gluten, which is often genetically inherited.  In people with coeliac disease the immune system causes severe damage to the cells of the small intestine, which causes digestive symptoms and significantly impacts on the absorption of nutrients, resulting in nutritional deficiencies. At a microscopic level, your digestive lining should be coated in hair like protrusions called vili – essentially it looks like a shag pile rug – and this creates lots of surface area to absorb nutrients. When damage has occurred in people with coeliac disease, these vili become flattened and fried, resulting in malabsorption problems.

Diarrhoea, cramping, bloating and constipation can be caused by celiac disease. However not everyone with coeliac disease experiences digestive problems, and so it can go undiagnosed for a long period of time, wreaking havoc in secret. Fertility issues, anaemia, osteomalacia, osteoporosis, autoimmune problems and mood disorders can all be related to undiagnosed coeliac disease (11) (12) (13).

Having the gene for coeliac disease does not automatically mean that you have the condition, but you cannot have coeliac disease without having the gene for it.

If you suspect that you have coeliac disease but have been avoiding gluten, then you can get yourself tested for the coeliac genes first.  If you do have the genes, you will need to eat gluten containing foods for 6-8 weeks before doing the antibody tests (as these would not be accurate without having eating gluten previously).  This will confirm whether you have coeliac disease or not. In some cases your doctor may refer you to get a biopsy performed, which is considered to be the most conclusive diagnosis.

Many people who are avoiding gluten have not been adequately screened for coeliac disease before commencing a gluten free diet and so coeliac disease often goes undetected (14).

In people with gluten intolerance/sensitivity or fructose malabsorption they can often handful small amounts of gluten with experiencing problems, however with coeliac disease you might get away without experiencing symptoms, but the damage to the vili will always happen. This means that having the diagnosis of coeliac disease gives you the knowledge of whether you need to be 100% strict with gluten avoidance or not.

Some ways to make life easier for yourself:

It can be very overwhelming and stressful to get a diagnosis of a food intolerance or allergy, particularly if it is a common food such as wheat or dairy. Thankfully due to the magic of the internet there is more help than ever for people trying to manage their diet around food intolerances.

Join a support group. There are plenty of Facebook groups and online forums dedicated to specific food intolerances, and often the people in these groups have done plenty of research so will be able to share resources and recipes with you.

Research food substitutions. Instead of giving your favourite recipes the flick, try substituting ingredients you can’t have for foods which will create a similar effect. For example, eggs, which are commonly used to bind dishes can be replaced with a little corn meal or extra kneading; cheese can be replaced with ‘vegan cheese’ which is often made with cashews and nutritional yeast; cow’s milk can be replaced with oat, nut or seed milks and wheat flour can be replaced with several gluten free flour options. Keep your pantry stocked with these and that way you won’t be disappointed if you get a whim for cooking a particular dish.

Plan your meals in advance. Meal planning and prepping can make life easier for everyone, but especially so for those dealing with food intolerances. Create a list of meals that you can have and rotate through these. Try a new recipe each week and eventually you will have a big repertoire of recipes that you are familiar with.

Call ahead. If you’re going out to eat, call ahead and advise of any food intolerances so that the kitchen can have options prepared.  It can be a good idea to ask if they’re okay for you to bring your own gluten free bread or milk alternative.

Educate your friends and family. Share this article and other information with friends and family who might be struggling to understand, and discuss with them what foods you can and can’t handle and how much you can tolerate, if any. Most people will be happy to accommodate your requirements as long as they understand.

You may be interested in:

Ultra low histamine 4-week meal plan and recipe eBook

Low Salicylate Meal Plan (one week)

Bread or Dead by Allison Jones

Coeliac Disease; How to take control of your health and healing your gut with herbs.

Works Cited

The post The Many Faces of Food Intolerance appeared first on Alison Mitchell Naturopath.

I love a good risotto in Winter. Heck, I love risotto any time of the year. So when fellow Naturopath and gut health afficiando Allison Jones (nice name hey?) shared with me this delicious recipe for a gut friendly (dairy free, gluten free, vegan and potentially low fodmap) risotto made from nutritious buckwheat and beetroot, I just had to nab it to share with you. Tip: Wear gloves when handling the beetroot so you don’t end up with red stained hands!

Want more recipes from Allison? You can visit her page here.

A while back now, I decided to improve my plant-based cooking repertoire. Even though I like to keep my kitchen non-denominational, I like to dabble in different dietary scenes. But, as a lifelong omnivore I was guilty of being very lazy when it comes to making meals from plant foods. All that changed a few years back when I decided to improve my diet and also found a love for recipe development. In the last year I set myself a challenge to improve my plant-based cooking repertoire.

This recipe for Buckwheat Risotto put to good use all of the principles of recipe development that I’d learnt – the need to balance different flavours with a range of complementary textures to keep the palate surprised and content. I’ve now been making this recipe for almost two years, so I’ve had plenty of time to get it just right.

Buckwheat has become a featured ingredient in many of my recipes. I love using it since it’s gluten free (don’t be fooled by its name), with a unique flavour and texture, depending on how it’s cooked. It feels very nourishing and satisfying to eat. It’s also highly nutritious, with a good balance of carbohydrate, protein, minerals and antioxidant plant compounds such as rutin and quercetin.

In this recipe, I’ve paired buckwheat with other earthy ingredients: roasted beetroot, porcini mushrooms, thyme and hazelnut. If you’re not familiar with porcini mushrooms, they’re a veritable umami powerhouse – delivering plenty of that unique savoury flavour provided by the natural glutamate content.

And, because I always look after you, dear reader, I’ve provided both a pressure cooker/Instant Pot option and a stove top option. Everyone wins!

This risotto is perfect in the depths of winter, but also in the transitional seasons. You will certainly not regret making this.

Buckwheat risotto with porcini, thyme, hazelnut and roast beetroot

Gluten Free, Dairy Free, Vegan, options for Low FODMAP

Serves 4-6

Pressure cooker/Instant Pot and stove top options (stockpot required)

Equipment: pressure cooker or stockpot, large glass heatproof bowl, baking trays, frypan (if browning the mushrooms), large measuring cup, kitchen knife, chopping board, tongs

Ingredients

• 1 1/2 cups buckwheat groats
• 15g dried porcini mushrooms
• 3 cups water, divided (pressure cooker option) OR 6 cups of water, divided (stovetop option)
• 1 bunch of thyme
• 1 1/2 tablespoons gluten free miso paste
• 1 1/4 tablespoons white wine vinegar
• 1 teaspoon fine sea salt
• 1 tablespoon olive oil, plus extra for the beetroot and mushrooms
• 250g white button mushrooms, sliced in half or in thick slices (if browning on the stove) (use oyster mushrooms or canned champignon mushrooms for a low fodmap option)

To serve

• 2 large beetroot
• 100g hazelnuts

Method

The Prep

1. Pre heat the oven to 180C/350F fan forced
2. Boil 2 cups of the water and pour over the porcini mushrooms in a large glass heat proof bowl. Let sit for 20 minutes.
3. Peel and chop the beetroot in to large bite sized pieces, then spray/coat with oil and place into separate oven trays.
4. Place the beetroot and hazelnuts in the oven. Remove the hazelnuts after 5-7 minutes (keep an eye on them to avoid burning). Roast the beetroot for 30 minutes total until a knife goes through each piece.
5. Once the porcini has soaked for 20 minutes, remove them from the liquid and set aside. Transfer the porcini liquid in to a large measuring cup and add any extra water needed to make 3 cups.

Pressure cooker/Instant Pot option

6. Reserve smaller stalks of the thyme and place the rest in the pressure cooker, with the leaves still attached to the stems.
7. Add all ingredients to the pressure cooker (including the porcini liquid and soaked porcini mushrooms) except the beetroot and hazelnut. Place the sliced button mushrooms last, to sit on top of everything else. Alternatively, these can be browned on the stove in olive oil.
8. Cook at high pressure for 6 minutes and then let the pressure release naturally for 5 minutes. At the 5 minute point, release remaining pressure.
9. Reduce the liquid in the risotto by selecting “saute” or “brown” on the pressure cooker. This will take between 5-8 minutes and requires occasional stirring.
10. Once the risotto is at the desired texture, remove the thyme stems with tongs, being careful to get all of them out – you’ll need to stir a few times and look carefully to remove them all.
11. Once ready to serve, plate up the dish and then place roasted beetroot, hazelnuts and mushrooms (if browned on the stove) on top of the risotto along with the leaves from the reserved thyme.

Stovetop option

6. Add all ingredients to the stockpot (including the porcini liquid and soaked porcini mushrooms) except the beetroot and hazelnut. Add the remaining 3 cups water.
7. If mushrooms are being browned on the stove, do not add them to the stockpot.
8. Reserve smaller stalks of the thyme and place the rest in the stockpot, with the leaves still attached to the stems.
9. Bring to a boil, then remove the lid and cook on high heat, stirring every few minutes. The risotto will be done in approximately 30 minutes or until soft, but slightly chewy.
10. The sliced mushrooms can be browned in some olive oil in a separate fry pan while the risotto is cooking.
11. Remove the thyme stems with tongs, being careful to get all of them out – you’ll need to stir a few times and look carefully to remove them all.
12. Once ready to serve, plate up the dish and then place roasted beetroot, hazelnuts and mushrooms (if browned on the stove) on top of the risotto along with the leaves from the reserved thyme stems.

About Allison:

Allison Jones is a Clinical Nutritionist and Naturopath in southern Sydney. She specialises in digestive health, with an interest in the gut microbiome. Allison is also a a passionate (and obsessive!) recipe developer, creating original recipes that are both nutrient dense and delicious. Find her at bodyelectricvitality.com.au

The post Buckwheat risotto with porcini, thyme, hazelnut and roast beetroot appeared first on Alison Mitchell Naturopath.

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It is estimated that one-fifth of the population believe that they have a food intolerance. If you’re reading this article, you’re probably one of them. If you can’t quite put you finger on what food isn’t agreeing with you, then it’s time to get clued up.

In this article you can read about the difference between food intolerances and food allergies, plus 5 common causes that you can investigate, and practical tips to help manage your allergy or intolerance.

Want to learn more? You can read the full article here: http://casadekarma.com.au/the-ultimate-guide-to-food-allergies-intolerances/

The post The Ultimate Guide to Food Allergies and Intolerances appeared first on Alison Mitchell Naturopath.

Health & Wellbeing Podcast #3

If you have been following me for a while you probably know that I love to talk about digestive health and the importance of gut health for overall wellbeing. I was very excited to have the opportunity to talk about all things digestion (and of course poo) with my fellow naturopath, the beautiful Hayley Stockbridge.

Hayley practices at Manly on Sydney’s Northern Beaches and in Stanmore in Sydney’s Inner West. Her major focus is always educating her patients to live healthier and happier lives. She treats women, men and children of all ages and a wide variety of health issues such as weight loss, digestive problems, anxiety/stress, fertility, hormone imbalances, food intolerances and headaches.

You can also connect with Hayley on Facebook and Instagram.

We answered a few digestion questions in this podcast which was lots of fun, I would love for people to keep submitting questions for future podcasts. You can submit them in the comments section below, on my facebook page or via the contact form.

Want to subscribe to get podcasts automatically? You can do that here: https://itunes.apple.com/au/podcast/health-wellbeing-podcast/id1006574743

Podcast Breakdown

3:57 What is a normal bowel movement?

6:50 Question 1: I’ve had GORD ever since I can remember, I’m on Nexium and I take metamucil. I still get the occasional bit of reflux but mostly it’s controlled with the medication. I don’t want to stay on it because I don’t want to rely of a medication. I also get diarrhoea every week or so that’s watery, explosive and smelly and really urgent and uncomfortable, and I’m frequently bloated. Is any of this connected and what do you suggest I do about it?

9:05 Diet for reflux, food intolerances.

9:40 The importance of easing of PPI medications slowly.

11:00 Reflux often due to a structural/mechanical issue, but this doesn’t mean you’re doomed.

12:50 Testing and avenues to look at for assessing causes of reflux, most common food triggers of reflux.

14:15 Question 2: I feel bloated and grumpy whenever I eat bread, but my GP said I’m not celiac so I can eat as much wheat as I want. I don’t get it though, why am I getting these feelings if I’m ok with bread?

15:00 Non celiac gluten intolerance including fructose mal-absorption

18:34 The general overconsumption of wheat and gluten containing foods and the issues with processing of wheat

22:40 It’s advisable to rule out celiac disease, as knowing this will determine how much gluten you can tolerate.

24:00 Sourdough may be an option for people sensitive to wheat as the fermentation breaks down some of the gluten and gliadin

25:45 Gluten free products are not always better for you

26:45 Experiment to find out what foods work best for you

27:55 Question 3: Help for constipation please! I have been taking movicol for about 5 yrs now. I go to the toilet once a day, but if i don’t take movicol I go once a week. I don’t like relying on it, but I don’t know what else I can do. Hayley and I discuss some common approaches to supporting constipation and diet for good bowel movements.

30:29 Papaya vs Pawpaw

33:00 Probiotics

34:40 Apple cider vinegar benefits

36:00 Dandelion coffee/tea

37:00 Manual work for constipation

37:25 The importance of exercise for healthy bowel movements

38:57 Toilet time – make time each morning to train your bowels to go at that time, and don’t suppress the urge to go when you need to.

39:50 Our yoga efforts.

41:00 Question 4: My 4 year old daughter frequently complains of stomach pains, I’m always at the doctors with her trying to find out what it is but they can’t find anything. It can be really upsetting for her, and sometimes she’s doubled up and crying with the pain. We eat well, but she always has a runny nose and this stomach pain is very concerning. She started preschool last year and seems to get sick all the time, I’m worried about how she’ll go at school with this stomach pain. She used to go to the toilet every 3-4 days, and even though this is considered normal the doctors gave her parachoc to try and help in case this is causing the pain, now she does go to the toilet easily (although it’s very lose) . Is there anything else I can do for her?

46:00 Infant massage for stomach pain

47:15 Our favourite digestion herbs

The post Digestion Podcast appeared first on Alison Mitchell Naturopath.