South African cookbook for allergies and food intolerance. Hilda Lategan

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СКАЧАТЬ the principles of the low FODMAP diet are commonly recommended by medical practitioners in some countries, in Australia especially, the low FODMAP diet is still a relatively new concept in South Africa. Read the following information together with the information above regarding irritable bowel syndrome. Keep an accurate record of your food intake and determine if it is necessary to eliminate all the food items below. Remember that unnecessary exclusion may lead to an unbalanced diet with a poor intake of nutrients. It is also valuable to note your state of mind every day as food is often blamed for symptoms, when in fact stress is to blame. Consult a dietitian to assist you in creating a balanced meal plan.

      Food items and ingredients which are eliminated in the low FODMAP diet:

      •Oligofructose, inulin and FOS (fructo-oligosaccharides). These serve as prebiotics (food) for the “good” bacteria (lactobacillus and bifidobacterium) in the gastrointestinal tract and are often added as functional ingredients (fructans) in products such as meal-replacement formulas. However, inulin and FOS may worsen the symptoms of IBS in some people. Although IBS symptoms can be relieved by avoiding inulin and FOS, keep in mind that in the long term this elimination may hamper the growth and survival of good bacteria.

      •Processed and convenience foods such as breads, pizzas, pastas, instant breakfast cereals, cakes, biscuits and crackers to which fructans have been added to improve the quality and shelf life of the products. On the food label fructans will be indicated as “flour enhancer” or “stabiliser”.

      •Polyols such as lactose (milk sugar), fructose (when more than 12% of the total carbohydrates are present as added fructose in cool drinks, fruit juices, flavoured waters and energy drinks) and sugar alcohols such as sorbitol, mannitol, maltitol, xylitol, polydextrose and isomalt in sugar-free products such as chewing gum and sweets.

      •Vegetables such as artichokes, beetroot, Brussels sprouts, cabbage, fresh chicory, fennel, garlic, leeks, onions, peas and green beans, and fruits such as peaches, prunes and watermelon. This is a limited list. When you investigate this topic more deeply, only a few vegetables and fruits will remain “safe”.

      •Grains such as wheat, rye and barley.

      •Legumes such as cooked dried beans, chickpeas, lentils and soya products, as well as nuts such as pistachio nuts.

      •Dried chicory in drinks such as coffee.

      The determining of a food allergy or intolerance

      Allergic reactions can be determined by skin-prick tests, electrodermic skin tests, blood tests and intestinal biopsies, or record-keeping of all food intake and the resulting reactions. Refer to the three examples of record-keeping.

      With an elimination diet, all suspected foods are excluded from the diet with the intention of reducing or eliminating the cause of the symptoms.

      The so-called food-challenge test can be done to confirm a food allergy or intolerance and usually takes place when a person is evaluated and is symptom-free after doing an elimination diet. The suspected food items are reintroduced to the diet one by one in a certain ratio and in a certain order. It is important to do this food challenge in collaboration with your doctor and dietitian, especially if you have a history of anaphylactic reactions. (Read the last remark under “Symptoms”.) All reactions should be monitored and carefully noted.

      A proper medical evaluation and diagnosis regarding a food allergy or intolerance is of the utmost importance. Eliminating foods unnecessarily could result in nutrient deficiencies in the body, which may hamper the immune system of the body even more. Consult a registered dietitian who will help you to plan a balanced diet and formulate a meal plan to meet your personal nutritional requirements, taking your specific health problems into account.

      Example 1: Food and symptom record

Date	Time	Food/drink consumed	Symptoms	Severity of symptoms*

      * Symptoms according to scale: 1 = mild 2 = mild to moderate 3 = moderate 4 = severe

      Example 2: Food and symptom record

Food, liquids and medicine takenDay and date	Negative symptomsTime of the day
Breakfast
In between
Lunch
In between
Supper
Late evening
Environmental factors such as wind, dust, pollen and so on, which aggravate symptoms

      Example 3: Weekly food and symptom record

Day/date
Symptoms after a night’s sleep
Breakfast
Symptoms
In between
Symptoms
Lunch
Symptoms
In between
Symptoms
Supper
Symptoms
Late evening
Symptoms
Medication taken
Environmental factors (dust, smoke, and so on)

      Healthy nutrition

      A healthy, balanced diet consists of a variety of food items to provide for the body’s energy needs, to regulate ongoing processes in the body and to provide building material to repair and maintain a healthy body. It is also important to maintain a healthy body weight.

      When avoiding certain food items due to a food allergy or intolerance, the elimination diet should still comply with the guidelines for optimal nutrition regarding gender, age and stage of life.

      The South African Food-Based Dietary Guidelines are easy to follow and include the following:

      •Eat a variety of foods every day and distribute the food evenly in your meals over the entire day.

      When foods must be excluded due to a food allergy or intolerance, the diet and meal plan should be adjusted with the remaining permissible foods to comply with the needs of the body for sufficient nutrients to repair and maintain the body, as well as the need for energy production.

      •Make starchy food part of most of your meals. Eat more low-glycaemic-index (low GI) starchy foods.

      When, for example, excluding gluten-containing grains, the choice of starchy food is more complicated and in some instances good planning is needed to balance the glycaemic index of a meal. Other sources of fibre should be considered when grains are excluded from the diet. Grains are also an important source of B vitamins. Unrefined grains include whole-wheat products, rye, barley, oats, sorghum, unpolished or brown rice, and buckwheat.

      •Eat at least five portions of fruit and vegetables every day.

      Vegetables and fruit contain a variety of vitamins and minerals which can strengthen the immune system. They also provide good fibre and energy. Unpeeled vegetables and fruit, fruit juice with pulp, and purée made from whole fruit provide good fibre.

      •Eat cooked dry beans, split peas, lentils and soya regularly.

      Provided you are not allergic or intolerant to one or more of these foods, they can be a good source of fibre in СКАЧАТЬ