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clinical alimentary

Know your guts, love yourself.

Pickled vegetables – Low Fodmap

I am a real fan of Ottolenghi’s work, his recipes are delicious, but unfortunately they do contain lots of ingredients high in Fodmaps, so not that great for people with IBS. This weekend however was a bit different – a recipe suitable for the Low Fodmap diet was published in the Guardian magazine. I have tweaked it a little, because I feel that if you are posting a recipe it needs to be referenced to the original source and modified – this is the only time I have, so far. The recipe was for pickled baby turnips – I have added baby turnips and radishes (for colour) and a little Worcestershire sauce into the pickle mix. This mix will last a few days in the fridge but no longer, as thorough sterilizing techniques have not been employed.

Ingredients

Pack of baby turnips (you can use standard turnip around 200g chopped)

5-6 Radishes

1/4 of a carrot spiraled and cut into short lengths

1 stick of fresh turmeric (you can use powdered but this will likely cloud the pickle liquor)

1 teaspoon Worcestershire sauce

2 teaspoons of granulated sugar

120ml White wine or rice vinegar

175ml Water

1 teaspoon of salt

Method

Chop the turnips and radish into quarters, wash thoroughly.

Pour the water, Worcestershire sauce and vinegar into the pan and add the sugar.

Warm and dissolve the sugar and heat to a rolling boil.

Take off the heat and cool. Add the vegetables, turmeric and salt.

Add to a jar and refrigerate.

These vegetables taste great with cold cuts of meat – don’t be too concerned that they contain a little sugar to counteract the sharpness of the vinegar. You will not be eating the pickling liquor, so it is really not a great amount of sugar that you will be adding into your diet.

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Chocolate, Courgette and Pecan Cake – Low Fodmap, gluten free

It’s Bank holiday weekend and as usual the weather is dismal, at least it’s not snowing like last week – time for some baking to lift the mood. How about a cake with some vegetables? Not something you fancy? It is worth trying this cake, the courgette adds some moisture to the gluten free cake and you really can’t taste it – so why not give it a try? Now as usual this cake is for a treat only, despite it containing a vegetable😉 – I am not suggesting you have cake every day – neither am I suggesting you be a total nutrition evangelist and avoid it for the rest of your life. It is not too sweet and very rich in flavour, so a small piece is all you will need to get a chocolate hit. It does contain a large amount of fat too, it would still be classed as high fat, if you have IBS, again a small piece is advisable. This gluten free option is certainly not going to lead to weight loss! It is a great option for a celebration, so you can share it with others and not be tempted to have more than one piece!

Ingredients

  • 250g of plain gluten free flour
  • 200g icing sugar
  • 65g of good quality cocoa powder
  • 2 teaspoons of bicarbonate of soda
  • 1 tablespoon of baking powder
  • 1/2 teaspoon of salt
  • 4 eggs
  • 350 ml of vegetable oil
  • 100g pecan nuts
  • 2 grated courgettes

Method

  • Warm the oven to gas mark 4, line a cake tin with parchment.
  • Grate the courgette.
  • Chop 50g of the pecan nuts and add to a bowl.
  • The other 50g of pecans, save for decorating, choose the best looking ones.
  • Weigh out the dry ingredients into the bowl containing the pecan nuts.
  • Crack the eggs into a bowl and add the oil, mix well.
  • Add the wet ingredients to the dry ingredients and mix using a hand blender.
  • Add the courgettes.
  • Mix well.
  • Add to a 7inch cake tin lined with parchment.
  • Cook in the oven for 90 minutes or until a skewer inserted in the cake comes out clean.
  • Trim the top of the cake flat and turn it over for decorating.
  • Add some sugar to a pan and cook till it caramelizes, dip in the pecans and cool.
  • Add the rest of the caramel to the top of the cake and cool.
  • Serves 10-12

If you are a coeliac check your cocoa powder, baking powder and and bicarbonate of soda is gluten free. The cake is low fodmap but occasionally people with IBS can have a problem with chocolate despite this fact. It is very difficult to provide an ‘IBS’ friendly recipe that will suit absolutely everyone. If anyone tells you different be suspicious, IBS can result in numerous food intolerances, remember only 70-80% are successful with the low fodmap diet, suggesting that other food might be problematic for some – or food isn’t actually the problem.

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Cod with caper and olive sauce

Flavourings such as capers can be included on the Low Fodmap diet and are especially important when onion and garlic are not available in the range of flavours that can be used to develop dishes. Capers are a delicate taste and one that I certainly did not appreciate when I was younger. I remember very well taking a jar of capers to a party when I was a teenager and not one person who attended the party liked them. But perhaps this was because I had stated to absolutely everyone in my eagerness – taste these, aren’t they really disgusting? Perhaps this preconditioned everyone else that of course capers are MEANT to taste dreadful, perhaps not too surprising that everyone else thought so. However when we are younger we have more taste buds therefore we taste more acutely and this is thought to be as a result of the higher energy needs of children enabling them to prefer and seek out energy dense foods. Bitter and sour notes in food are avoided – we only start to appreciate bitter notes in food when we are in our early twenties. As my taste has developed as I have aged I now really relish capers – they go rather well with fish and are better eaten warm and add a depth of flavour. I noted a very similar effect of olives, and do now love their saltiness and rich flavour. We also can develop aversions to foods and food aversion might be psychologically conditioned – a learned behaviour. If we experience sickness during a time when we are eating we can develop a strong aversion to that food, it is common that people undergoing chemotherapy can develop aversions to food. This can happen if strong negative emotions are developed during eating also, the food a ‘reminder’ of the episode therefore avoided.

Development of taste matures as we age, capers are an acquired taste, but one that will expand the range of dishes available to people following the Low Fodmap diet. Taste is a very complex sense – why not challenge yours and make this recipe?

Ingredients

2 pieces of white fish

1 egg

Gluten free flour for dusting

2 tablespoons of capers

1 Lemon (juice only)

1 tablespoon of oil

1 tablespoon of green olives

Salt and pepper to taste

(serve with steamed kale and new potatoes.)

Method

Mix the egg with a fork and add to a flat plate, add the flour to another flat plate with a small amount of salt and pepper.

Dip the fish fillets into the egg first, then the flour.

Fry in a small amount of oil till the flour is golden and then remove the fish fillets and cook for ten minutes in an oven till cooked through (timings will depend on how thick the fillets are.)

Add capers, olives and the juice of the lemon to the pan and warm through. You should not need to add salt to this sauce as the olives and capers add plenty of saltiness to the dish

Serve the fish and pour over the capers and olives, serve with green vegetables (I used kale) and boiled new potatoes in their skins for added fibre.

Enjoy!

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Rhubarb cordial

Rhubarb is one of my favourite vegetables – yes you heard right – it is a vegetable, a stalk, but with a glorious colour and taste. It marries very well with ginger. Rhubarb has an anecdotal use as a laxative in herbal and Chinese traditional medicine but paradoxically it is also suitable for a low fodmap diet. The leaves contain high levels of oxalic acid and are toxic so not to be consumed but the stalks are very popular around the Calder valley – perhaps because we are not too far from the rhubarb triangle.

What about the chemistry of rhubarb – well Andy Brunning of Compound Interest has produced the following excellent graphic.

The-Chemistry-of-Rhubarb

I can find no RCTs for the use of rhubarb as a laxative or its use to assist in ameliorating any symptoms in IBS so I can only assume that the anecdotes are just that but the information in the graphic is very interesting, non the less. But what about recipes – to make a rhubarb cordial and puree see the recipe below which makes around a pint of cordial.

400g of rhubarb

1 inch stick of ginger

Adequate water to cover the rhubarb in a pan

Sugar or sweeteners (not polyol based) to individual taste.

Wash and slice the rhubarb stalks, peel and chop the ginger and add to a small pan. Cover with water and cook till very soft. Add sugar (I used just enough to remove the tart taste.) Pass through a sieve or blend. then cool and add to a bottle – I used the one in the image it once contained rhubarb liqueur. The pureed rhubarb that remains in the sieve can be used to add to lactose free yoghurt as a breakfast fruit puree. Store the cordial in the fridge – you can either drink it cold or warm. Sweeteners will work just as well in the cordial and for those ‘nutrition evangelists’ that decry sweeteners as toxic- we have NO evidence that they are harmful and if they are used to reduce energy consumption for weight management or for diabetes management, then that surely has to be a benefit?

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Ginger, pumpkin and rice noodles Low Fodmap

This tasty recipe can be served with fish or chicken but it can be used as a lunch meal – hot or cold by itself, if you don’t eat meat. The noodles were ginger and pumpkin rice noodles – gluten and wheat free and suitable for a low fodmap diet, they are made by King Soba.

Ingredients

150g of noodles

1 teaspoon of cumin seeds

1 tablespoon of pumpkin seeds

1 tablespoon of pine nuts

2 carrots

Spray oil or 1/2 teaspoon of garlic infused oil

A few drops of soy sauce.

Method

Cook the noodles till soft in boiling water with a small amount of salt.

Peel then trim the carrot till the sides are straight and peel down the length of the carrot to produce strips, then cut them in half lengthwise. This makes thin strips that can cook quickly in a wok.

Add the oil to a wok and fry the cumin seeds for a few seconds to release the flavour.

Add the pine nuts and pumpkin seeds and a few drops of soy sauce (ensure gluten free if you have both IBS and coeliac disease.)

Then add the carrot and cook till softened.

Add the cooked noodles and mix well, then serve.

Serves 2.

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I use these noodles regularly and the dish was made from stock from my store cupboard.

Minted Boston runner beans

What on earth are Boston beans? I am, as many of you know, a down to earth Lancashire gal and labelling food with a new name to boost sales really doesn’t go down too well with me. Not impressed, however I am wrong, it seems – after a Google search – that Boston is a variety of bean which is a smaller variety and a plant which grows a good crop of French beans. A good crop – therefore these beans should not be expensive then, but they are a smaller bean, therefore exclusive? I also suspect that someone will label them a ‘super’ runner bean and a vegetable that you can’t possible live without. Anyhow, enough of me getting into a tizzy and being slightly cynical about the vagaries of available supermarket runner bean varieties. Some people might be very interested in the differences in crop variety, but it’s not for this blog, plus ordinary beans are just as super and will work just as well for this recipe. It’s mothering Sunday tomorrow and I will be cooking a chicken so this really simple runner bean recipe should go really well with it.

Ingredients

1 sprig of fresh mint

1 packet of runner beans

Juice of 1/2 lemon

1/2 lemon sliced

Salt

Spray oil

1 teaspoon of sesame seeds

Method

Spray the beans with oil and pour over lemon juice. Chop the mint and mix into the beans, then add a small amount of salt, roast for 15 minutes till soft. Spray lemon slices with oil and roast them at the same time as the beans. Garnish the beans with roasted lemon slices and sesame seeds. Serve – simple!

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How does the free from toad get in the hole?

It’s March and it is snowing today! I have been out and I did get soaked to the skin – urgh! It is not nice snow – more the sloppy sort that doesn’t stick around long enough to freeze properly. If you are thinking of cooking a really warming comforting meal you need go no further than the recipe for toad in the hole. But there is a catch if you are lactose and gluten or wheat free. How does the toad get in the free from hole? Make the following recipe and find out!

Ingredients

400 mls of lactose free milk

6 gluten free sausages

200g of gluten free self-raising flour

1 teaspoon of gluten free mustard powder

salt & pepper

3 eggs

1 tablespoon of olive oil

Method

weigh the flour into a bowl and add the mustard powder and mix well

break the three eggs into the bowl and add the lactose free milk

add salt & pepper and mix well

add the oil to a dish and heat in the oven

prick the sausages and add to the pan

pour around the batter and place in the top of an oven at gas mark 7 or 220 degrees C till the surface is nice and brown.

Serves four for a meal – if you have a problem with higher fat foods and your IBS then you might need to be cautious with your portion size. Also don’t forget this is a high fat meal so it is for occasional consumption only – when you really need a lift midwinter after going for a long walk in the snow perhaps!😉

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Spaghetti Bolognese – Low Fodmap

This is a family favourite, a classic dish that is the stalwart of many family meals so we should look at modifying it to make it suitable for ALL the family – even those with IBS. Whilst I would not advocate everyone following a low fodmap diet if they don’t need too, the occasional meal where everyone can participate without faffing around cooking some items separately is a bonus. This will make the meal slightly more expensive using gluten free pasta but is maybe worth it occasionally. It is not likely to be harmful for others to eat gluten free pasta occasionally as long as people do not go fully gluten free or low fodmap without good reason (a diagnosis of coeliac disease or a diagnosis of IBS when coeliac disease has been tested negative on a gluten containing diet.)

Passata

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1 jar of roasted peppers (or roast 3-4 of your own, then skin them)

4 tomatoes

a handful of basil

1-2 teaspoons of dried thyme and basil

Salt and black pepper to taste

Method

Blend this with a hand blender till smooth – add some water if this is too thick.

Bolognese Sauce

1 dessert spoon of garlic infused oil

600g of lean minced beef*

Passata (above)

2 teaspoons of gluten free flour + water

method

Add the oil to the pan and fry the meat with 3 dessert spoons of the passata.

Add the remaining passata to a pan

Add two teaspoons of gluten free or corn flour and water mixed till smooth

Cook this till thickened and add to the meat.

Cook till tender.

Spaghetti

You do need to watch gluten free spaghetti and keep it moving when cooking to prevent it from sticking. Use the method advised on the packet and add to a large pan of boiling water. Keep testing it – it should be ready at the point it is still relatively firm but soft enough to eat, take care not to overcook it.

Add the spaghetti and bolognese to the dish to serve and top with a little grated Parmesan cheese.

Serves 6

*If you find that red meat causes symptoms of IBS choose lean and a small portion – or you could also use 1/2 beef and 1/2 turkey to reduce the amount of red meat contained in the dish.

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Lasagna – low Fodmap

This is a recipe for lasagna – many people with IBS find that lasagna is a dish that results in symptoms but this version is low fodmap and not too high in fat levels so should be suitable for most people. It is fairly easy to make but has a number of steps to complete.

Ingredients

1-2 roasted red peppers (or you can buy a jar of roasted red peppers if you don’t have the time or inclination to roast and peel your own.)

4 tomatoes

a packet of fresh basil

100 ml water

250g of lean red meat

1 tablespoon of garlic infused oil

1 teaspoon of asafotida

750 ml of lactose free milk (semi skimmed is suitable)

2 teaspoons of corn flour.

2 teaspoons of light spread

40g parmesan (and extra to grate on the top of the lasagne just prior to cooking.)

2 courgettes

1 egg

1 packet of gluten/wheat free pasta sheets

Small amount of salt to taste

Method

Blend together the red peppers, tomato and 4-5 sprigs of basil to form a sauce for the meat and courgette.

Using the tablespoon of oil fry the asafoetida to release the flavour and then add the meat and fry for 5 minutes. Add 1/5th of the red sauce to the pan and continue to cook the meat for 10 minutes. Prepare the white sauce add the spread to a pan and melt, then add the cornflour, it will form a ball. Slowly incorporate the milk into the spread and flour mix till it is all mixed in, then add the grated Parmesan cheese. Cook till the sauce thickens, then cool. When the sauce is cooled whisk in 1 egg.

Start to build the layers add any remaining basil leaves as you build up the layers – I started with a layer of pasta but you can decide how you want to make up the dish. Then add a layer of sliced courgettes and add some pasta pepper sauce. Then add pasta, and then the layer of meat sauce. Another layer of pasta and then courgettes and red sauce. Finally top with the white sauce and sprinkle with grated Parmesan cheese. Cook for 30 minutes and serve with a green salad.

Serves 4-5

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