Friday, April 18, 2014

Eating out when your gut is touchy

Adhering to a new way of eating is difficult enough when you're cooking for yourself, let alone when you find yourself away from home.

Let's face it - dining out while on a special diet is tough. And I don't mean a diet to lose weight. I mean a diet that is sometimes imposed on you, like when you're allergic to some kind of food or trying to heal an inflamed gut. 



But sometimes there's no way around it. Maybe you're travelling for business or are on vacation. Or you've been invited to a birthday party or a holiday event. What are you going to do - stay home because of the foods that might be there?

Eventually when you're on a special diet long enough, you become familiar with and more confident making it work for you. Eating out should be an enjoyable social experience. The trick is to look for friendly places to dine. Places that demonstrate an awareness of gluten-free or dairy-free eating, or are willing to make substitutions. I can't stand it when I see this written on a restaurant's menu: "NO substitutions". Run, don't walk!!

A good idea is really to telephone ahead to a restaurant or cafe and explain your special dietary needs to the chef. Chefs are becoming increasingly aware of food intolerances. Tell them what you can and can't eat. Ask about the ingredients in specific dishes. They are intimitely familiar with what's on their menu and what would be suitable, or how they can modify a dish to work for you. If they want your business, they'll make it happen.

If you're following a low-FODMAP diet such as myself, there are several cuisines where you can assuredly find something that will work:

Middle Eastern and Indian

Kebabs (skewered meats), tikka dishes, tandoori dishes, plain cooked rice

Southeast Asian
Fried rice (without scallion), steamed or sticky rice, rice paper rolls, sushi (check the fillings), omelets (check fillings), steamed fish, chili, ginger or peppered shrimp, meat, fish or poultry; roasted meats, steamed and stir-fried vegetables, rice noodle soup (pho), sorbets

Italian
In my opinion this is one of the toughest, although not impossible. You're just going to have to ask a LOT of questions.


Risotto (no onion, no garlic), gluten free pasta with pesto (check for garlic), carbonara or many marinara sauces without onion and garlic (good luck); steamed mussels, grilled chicken or veal, shrimp cocktail, mozzarella salad (if not dairy intolerant), antipasto, polenta, steamed vegetables, gelato, granita, and zabaglione (if not dairy intolerant)

Mexican
Another tough one because of the beans and salsa. But, you can try.

Plain corn chips, tacos (no salsa), tamales (without onions or garlic), tostadas, fajitas (without the onion and ask for corn tortillas), arroz (rice), and some of the desserts like flan or arroz con leche (rice pudding) depending on your level of dairy tolerance

Pub Food
plain grilled or roasted meat with vegetables (check gravies for onions, garlic), grilled fish, risotto, salads, flourless cakes, sorbets, meringues.

Another option is to "take your own"

Take your own salad dressing, to make sure it doesn't contain garlic or onion or any other high-FODMAP ingredient
Take your own wheat-free bread or roll to a sandwich bar and ask them to fill it
Take your own wheat-free bread or roll to a hamburger place where they provide the patty and fillings
Take your own gluten-free pasta to have it topped with low-FODMAP sauces, etc.
Take your own pizza base to a restaurant and ask them to top it with onion-free sauces and low-FODMAP ingredients.

Eating at a friend's or family's house

Ask politely what they intend to serve and then decide if you'd like to ask them to make alterations or if you'd rather bring some of your own food. This way you won't starve while everyone else is eating. If necessary, eat something before you go. Then just nibble on appropriate snacks during the event. Don't let the food (or lack of it) spoil your good time or anyone else's.

Travelling

The key to successful vacationing is planning, planning, planning!

Bring your own food on board the airline. That stuff they serve is crappy anyway, even if you didn't have a special diet to follow! 
Take snacks and easy-to-transport foods with you so that in a pinch, you won't be stuck with nothing and starve. Nonperishable foods such as breakfast cereal, crackers, appropriate trail mixes and nuts are always easy to take with you.

Overseas Travel

You may have to check with US Customs anad Border Protection and inquire about food restrictions in the country to which you are travelling. But once you're there, especially in many countries, such as the UK, Ireland, Italy, Germany and Australia, gluten-free products are relativey easy to purchase. While in other countries, especially in Eastern Europe and across the Middle East, it can be more difficult. In many Asian countries, much of the local food is rice, tapioca or potato based so it's a lot less challenging to find foods that will work for us.

Travel within North America is undoubtedly easier without the language barrier to deal with when trying to make oneself understood abroad. But I say, never pass up an opportunity to get out of your own country and see another part of the world.  Even if you slip up a little and end up not feeling well the next day, you make note of what didn't work and move on.

The easiest solution to eating while travelling is camping...I can pre-cook food at home, put it in plastic storage containers and bring it along with me to reheat. Easy, peasy and no gut-wrenching stomachaches to deal with.

Friday, April 11, 2014

Where to begin with IBS

Week 1 is behind me and I feel loads better being on this new eating plan!

If you have IBS or think you do, there are several things you can do right now to start feeling better right away.


Probably one of the first places to begin improving digestion is to minimize, or remove entirely, common stomach irritants such as coffee, alcohol, pepper, spicy foods and anything you already know you're sensitive to. At least for a little while. After some time you may be able to bring these foods back.

The FODMAP diet removes the other common gastric system upsetters that many people have trouble with: cabbage, broccoli, cauliflower, onions, leeks, shallots, and garlic, unfortunately, as well as other less commonly known irritants: carbohydrates / sugars from fruit, lactose, and gluten, to name a few. 

Another way to minimize discomfort is to eat more frequent but smaller meals. Eating too much at one sitting causes stress on the digestive system, having a lot to suddenly handle.

Avoid carbonated beverages, especially if you have excess gas.

Engage in non-strenuous exercise - walking, easy cycling, tai chi or yoga - until you feel better and can do more strenuous exercise. A hard workout just isn't good when you're feeling weak and don't want to rattle your stomach. But not exercising at all just isn't wise, especially when you have had IBS for months or years. I find that gentle forms of exercise can usually be well-tolerated. When I'm not feeling up to par, I go for a long walk and do some stretching. Something is better than nothing.

Getting proper sleep and learning to relax are also key to calming the digestive tract. I will go to bed a little earlier than usual and just read to relax.

So in addition to the above, here's what I've done: I have adhered strictly to the FODMAP eating plan except for one thing. I ate some non-dairy cherry "ice cream" forgetting that cherries are currently out. Can't say I can report any specific symptoms from that. 

What did me in though is the cream I put in my coffee the last 2 mornings. (Yes, I'm occasionally still drinking coffee. It's a hard one to give up). Anyway, I digress. FODMAP says that cream is a better additive than the milk in half and half (the milk contains a ton of lactose). On Wednesday I did ok with it but not yesterday. Two days in a row is apparently too much for me. Back to tea for a few days. Then I don't know what I'm going to do about my morning coffee. All those non-dairy creamers taste horrible, especially soy creamer, and they have such terrible ingredients. This is such a total bummer. 

But I can report that overall, this FODMAP thing is working. Part of this process is learning what I can tolerate and what I can't. It's looking a lot like lactose is a problem.

For the elimination portion of this eating plan, I have 5 weeks to go. Then comes the "food challenge" part. But more on that in future posts.

On to the recipe.

If you've followed me for some time, you know that on the weekends I sometimes like to whip up a batch of muffins for breakfast. They are quick to make - you can usually pop one into your mouth inside an hour. I don't usually eat a lot of pineapple but I just happened to have a can in my pantry and since pineapple is on the FODMAP list of acceptable fruits and contains digestive enzymes which I figured couldn't hurt, I decided to make these. They are also gluten-free. Best eaten the day they are made.

Pineapple Muffins


1 cup fine rice flour
1/2 cup cornstarch
1/2 cup potato flour (I didn't have any so I used tapioca flour)
1 tsp. baking soda
2 tsp. baking powder
1 tsp. xanthan gum
1/2 cup superfine sugar
2 eggs
6 Tbsp. unsalted butter, melted
One can crushed pineapple, drained (reserve liquid)
3/4 cup suitable yogurt
1 cup confectioner's sugar, sifted

Preheat oven to 350F. Line a 12-cup muffin pan with paper baking liners. Sift the rice flour, cornstarch, potato flour, baking soda, baking powder, and xanthan gum three times in a medium bowl (or mix with a whisk to ensure they are well combined). Add the sugar and mix until well combined.

Break the eggs into a second bowl and whisk. Using a large spoon, stir in the melted butter, pineapple and yogurt. Fold into the flour mixture.

Spoon the batter into the muffin liners. Bake for 15-20 min until a toothpick inserted into the center of the muffins comes out clean. Remove from oven and let cool in the pan for 5 min before transferring to a wire rack to cool completely.

Combine the confectioners' sugar with enough of the reserved pineapple liquid to form a smooth spreadable icing. Drizzle over the cooled muffins and serve.

Makes 12. Each has about 270 calories, and 49g carbs. To cut the carbs and calories, I didn't glaze mine.

Friday, April 4, 2014

What is IBS, and what am I gonna do about it?

Last week I shared with you that this blog would be headed in a slightly different direction and that I would be focusing on improving my digestion. This week I want to share a little more about IBS and my plan for tackling it. 

Years ago my gastroenterologist had indicated that I had a "functional" problem, because none of the tests (endoscopy and colonoscopy) showed any physical signs of damage or inflammation. I strongly suspect that, after all these years of dealing with a variety of symptoms, I have Irritable Bowel Syndrome.

So what is IBS exactly? According to the NIH (National Institute of Health):

"Irritable bowel syndrome is a functional gastrointestinal (GI) disorder, meaning symptoms are caused by changes in how the GI tract works. People with a functional GI disorder have frequent symptoms; however, the GI tract does not become damaged. IBS is a group of symptoms that occur together, not a disease. In the past, IBS was called colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel. The name was changed to reflect the understanding that the disorder has both physical and mental causes and is not a product of a person's imagination."

Rather than quote the entire website, which by the way does an excellent job of describing the condition, I would simply direct you there, if you're interested in knowing more. Click here for more information.

Estimates show that anywhere from 10-15 million Americans suffer from unexplained digestive problems that could be considered Irritable Bowel Syndrome.

So what can one do about it? The NIH recommends the following:
  • making changes to one's eating, diet, and nutrition
  • taking medications (if needed)
  • taking probiotics
  • exploring therapies for mental health
Hippocrates said, "let food be thy medicine and medicine be thy food", and I have always believed this. I also realized that just "eating healthy" wasn't going to be enough, because I was doing that and things weren't improving. I knew that I'd have to make some changes to my diet, so following the first NIH recommendation was a given. 

My internet research on diets for IBS led me to a variety of sites that kept talking about FODMAPs. WebMD covered it, as did the Irritable Bowel Syndrome Group Forum, the IBS Information Page on About.com, and of course, there's even "an app for that".  But what in the world are FODMAP's? 

FODMAP stands for:

"Short-chain carbohydrates (oligosaccharides), disaccharides, monosaccharides and related alcohols that are poorly absorbed in the small intestine. These include short-chain (oligo-) saccharide polymers of fructose (fructans) and galactose (galactans), disaccharides (lactose), monosaccharides (fructose), and sugar alcohols (polyols) such as sorbitol, mannitol, xylitol and maltitol.

The term FODMAP is an acronym, deriving from "fermentable, oligo-, di-, mono-, saccharides and polyols". The restriction of these FODMAPs from the diet has been found to have a beneficial effect for sufferers of irritable bowel syndrome and other functional gastrointestinal disorders (FGID). The low FODMAP diet was developed at Monash University in Melbourne, Australia by Dr. Peter Gibson and Susan Shepherd, PhD."

I promptly went on Amazon and bought this book by the creators of the diet. Though there are many books on IBS out there, I wanted to hear this news directly from the people who developed it. I read their well-written and detailed explanation of the diet, how it works and why, and it convinced me to give it a try. 

In short, this pdf provides a quick and dirty list of what to eat and not to eat. But I would advise you to read the book, or any book on the subject, to better understand how and why this might work for you.

So I started the other day. The hardest thing for me, believe it or not, is giving up onions and garlic. I cook everything in onions and garlic. You know - I love FLAVOR! The second hardest is giving up the high-lactose dairy products I count on for protein (like cottage cheese and yogurt) and half and half in my coffee. Gluten is no big sacrifice, since I'd already more or less given that up anyway. But, I want to feel better, so I'm ready to do whatever it takes.

The book also has recipes. The very first recipe sounded really good to me and it was. (I violated another rule of IBS sufferers: don't eat too much at one meal as this puts strain on the digestive system. I couldn't help myself - they were just too good)! This recipe serves 3-4. 

Pumpkin, Chive and Feta Fritters

10 oz. fresh pumpkin or other winter squash, cut into 3/4 inch cubes
(or use a can of pumpkin. See note below)*
1/3 cup fine rice flour
2 Tbsp. cornstarch
1/2 tsp. xanthan gum 
1/4 cup chopped chives
1/2 cup crumbled feta
2 eggs, lightly beaten
1/2 to 1 tsp. ground cumin
salt and freshly ground black pepper
2 Tbsp. oil
3 Tbsp. light sour cream if you're not lactose-intolerant
Garden Salad 

Cook the pumpkin in a medium saucepan of boiling water for 8-10 minutes until soft, then drain and mash*. Allow to cool.

Sift the rice flour, cornstarch, and xanthan gum into a large bowl, whisking to ensure they are well combined. Add 2 Tbsp. chives, the feta, mashed pumpkin, eggs and cumin and mix well. Season with salt and pepper.

Heat 1 Tbsp. of the oil in a medium skillet over medium heat until good and hot. Add a heaping tablespoon of batter per fritter and cook 3-5 minutes. Flip over and flatten with the back of a spatula cooking for another 3-4 minutes until golden brown and cooked through.

Transfer the fritters to a plate and and keep warm while cooking the rest with the remaining oil. Mix together the sour cream and remaining tablespoon of chives. Serve the fritters with a nice big garden salad and a dollop of the sour cream. I skipped the sour cream because I am avoiding nearly all dairy at the moment.

* If you're short on time, you can always open a can of pumpkin, which is what I did. If you do this, you may need to add a little more starch. Make sure your batter isn't too wet after mixing everything together. I added a little sorghum flour that I had on hand.