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Allergies and food intolerances

Are you missing essential nutrients? Allergies and food intolerances are on the rise. And more of us are choosing vegetarian and vegan diets. But while dietary restrictions can result in missing out on vital nutrients, they don’t have to – just follow Kate Marsh’s easy plan. Maintaining health Luckily, you can ensure you meet your nutritional requirements by eating a range of other plant foods including wholegrains, fruits, vegetables and vegetable oils. If you’re not allergic to seeds, you can also use these in place of nuts – both tahini (sesame seed spread) and sunflower seed spread make tasty alternatives to good old peanut butter. If nuts are off your list but you can still eat seeds, a slice of wholegrain toast with tahini paste and sliced banana makes a deliciously satisfying snack rich in the fibre and healthy fats usually found in nuts. Bananas are also high in potassium, an important mineral found in nuts. Diets and Allergies

1. Nut allergy

If you had a peanut allergy, you’d know about it – it’s the most common cause of severe food allergy reactions. Symptoms can be triggered after exposure to even trace amounts – simply touching a surface where peanuts have been can be enough for some people. And the results can be fatal. Whether you have a peanut or tree nut allergy, it’s essential to maintain a strict, nut-free diet – which means you’re potentially at risk of missing out on all of nuts’ heart-healthy ingredients: essential fats, dietary fibre, a range of important vitamins and minerals, plant sterols and antioxidants. Note: Allergies to invertebrate seafood (including prawns, lobster, crab, oysters, and squid) affect 1 per cent of Aussies – making them more common than the 0.5 per cent of us with allergies to fish.

2. Seafood allergy

If you’re one of the 1.5 per cent of the population with an allergy to seafood, you’re missing out on more than prawns on the Barbie or a paella. Seafood is our major source of omega-3 fatty acids, which have been linked with a reduced risk of heart disease, stroke, dementia, macular degeneration, depression and some types of cancer. But that doesn’t mean you have to go without – there are other foods that contain these important fats, including linseeds, canola oil, walnuts, soy and flaxseed oil. Some foods now also have added omega-3 from non-seafood sources, for example, omega-3 eggs – these come from chickens fed on an omega-3 rich diet. Boost your nutrients: Get your omega-3s without seafood: a delish roast vegetable, walnut and chickpea salad drizzled with flaxseed oil dressing. Walnuts and flaxseed are rich in omega-3 and chickpeas are a rich source of protein, iron and zinc; essential nutrients found in seafood. Maintaining health An allergic infant needs an appropriate dairy-free formula, such as one based on soy or a special, hydrolysed formula (where the proteins that cause the allergy are broken down). Calcium-fortified soy milk, soy yoghurt, soy custard and tofu are suitable supplements for older kids, but oat and rice milk aren’t – their protein contents are too low for a growing child’s needs. Try a yummy fruit smoothie made with calcium-fortified soy milk, soy yoghurt and banana or berries. Soy products are also a great source of the good quality protein usually supplied by dairy products. Diets and Allergies

3. Cow’s milk allergy

Cow’s milk is a common cause of food allergy in babies, estimated to affect one in 50 infants in Australia and New Zealand. Most grow out of this by the age of 3 but until then, infants need to avoid cow’s milk, cow’s milk products (such as cheese, yoghurt, cream, butter) and products that contain cow’s milk. Unfortunately, this means they’re at risk of missing out on the calcium and protein normally received through dairy consumption.

4. Wheat intolerance

Wheat is the staple grain in Australia, but for many it can cause many uncomfortable symptoms, such as wind, bloating and constipation and/or diarrhoea. If you’ve been diagnosed with wheat intolerance, you’re probably not eating breads, cereals and pastas which can mean missing out on important dietary fibre and healthy wholegrains – unless you know what alternatives to eat. Maintaining health Fortunately, plenty of other grains can provide you with similar health benefits. Try breads and crackers made with rye, porridge made from oats, soups, casseroles and risotto made with barley or pancakes made with buckwheat flour. You can also replace couscous with quinoa, add buckwheat kernels to bread or mix oats Start your day with a flavourful, wheat-free muesli by combining rolled oats, rye and barley, quinoa flakes and amaranth with a mixture of dried fruit, nuts and seeds. It’s allergy-free, but you’ll still get all the benefits of having a variety of fibre-rich wholegrains in your breakfast bowl. Diets and Allergies

5. Lactose Intolerance

Lactose intolerance occurs when your body produces low levels (or none at all) of the enzyme lactase, leaving you with symptoms like bloating, stomach pain and diarrhoea when you eat lactose-containing foods. The cause may be genetic (it is very common in Asian populations, for example), a temporary result of a stomach bug or age-related – our production of lactase can decrease as we age. If you require a lactose-free diet, you’ll need to avoid milk, custard, ice-cream, yoghurt. Depending on your level of lactase deficiency, you may also need to avoid soft cheeses, cream and products with small amounts of dairy too. Maintaining health Dairy is an important source of calcium, zinc, protein and vitamin B12, so make sure you include replacement foods in your diet, such as lactose-free milks and yoghurt plus calcium-fortified soy milks, yoghurt and custard. Rice and oat milks with added calcium are also suitable, but only for adults – they’re too low in protein for kids. Other nondairy sources of calcium include canned fish with bones, almonds, unhulled tahini, calciumset tofu, dried figs and green leafy vegies.

6. Coeliac disease

Those with coeliac disease have an immune system response to food containing gluten – so when gluten-containing grains are eaten, damage is suffered to the lining of the intestinal wall, preventing nutrients from being properly absorbed. To manage coeliac disease, all products made from wheat, rye, barley and oats (which includes most breads, cereals, biscuits, crackers, pasta and noodles as well as a range of processed foods that may contain small amounts of gluten) need to be strictly avoided. Similar to wheat intolerance (see p33 for more on intolerance), this can make it difficult to get enough fibre and wholegrains, but coeliac disease allows for fewer alternatives. Luckily, brown rice. Boost your nutrients: To make sure you get all the benefits of wholegrains, try starting the day with a bowl of porridge made from brown rice, buckwheat and quinoa. Mix in some stewed apple and cinnamon for sweetness and finally, add a handful of chopped nuts and seeds – this will give you extra fibre and nutrition. Boost your nutrients: Looking for a lactose-free calcium boost? Try a calcium-rich salmon mornay for dinner, using lactosefree milk, canned salmon, brownrice, peas and corn, topped with light tasty cheese. The milk, salmon and cheese also provide protein, zinc and vitamin B12 – other important nutrients found in regular milk – while the salmon is rich in vitamin D, helping you to better absorb the calcium. Diets and Allergies

Did you know?

According to The Coeliac Society, this condition affects about one in 100 people in Australia – but three out of four sufferers don’t even know they have it! Maintaining health To ensure you’re not missing out on important vitamins and minerals from fruit, include moderate amounts of low-fructose fruit such as berries, citrus fruits, pineapple, kiwi fruit and ripe bananas. Eat plenty of vegetables and salads, but avoid or limit asparagus, leeks, onion and artichoke, as these contain fructans.

7. Fructose malabsorption

Fructose malabsorption occurs when the digestive system is unable to break down fructose (the sugar found in fruit and honey) and fructans (the chains of fructose molecules found in some vegetables and wheat products). Fortunately, most people with fructose malabsorption don’t need to cut all fructose out of their diet, but instead need to reduce the amount they eat by avoiding foods high in fructose. Boost your nutrients: When you need to limit your fruit intake, snack on a platter of raw vegetables including cherry tomatoes, carrot sticks, snow peas and red capsicum – these vegetables are rich in vitamin C, potassium and beta-carotene, important vitamins and minerals found in fruit.

8. Vegetarian and Vegan Diets

Diets and Allergies There are many reasons to go vego, but you need to be wellplanned beforehand – it’s not as easy as simply cutting out meat! Avoiding all meat, chicken and fish can potentially mean missing out on iron, zinc and omega-3 fats; avoiding all animal products by following a vegan diet can potentially mean missing out on calcium and vitamin B12 as well. B12. If you’re a vegan, ensure you choose a brand of soy milk fortified with calcium and vitamin B12 so you don’t miss out on these important nutrients. As vitamin B12 is only found in animal products, it’s especially important for vegans to choose foods fortified with this vitamin such as some soy milks, meat substitutes and Vegemite, or to take a supplement, as deficiency can lead to irreversible nerve damage. Lastly, don’t forget your omega-3 fats – supplements (DHA only) made from an algae source are now available as an alternative to fish oil, or see “Seafood allergy??? on p29 for other useful ideas. Maintaining health To ensure you’re getting essential nutrients, include foods such as legumes, tofu, nuts, seeds, wholegrain breads and cereals in your daily diet. Green leafy vegetables provide iron too. However, as our bodies don’t absorb iron in plant foods as well as iron from red meat, you’ll need to include vitamin C-rich fruits and veggies such as berries, citrus fruits, kiwi fruit, tomatoes, capsicum and broccoli to increase your iron absorption. If you eat eggs, these can provide iron, zinc and vitamin B12, while dairy products are a great source of calcium, zinc and vitamin A tofu and vegie stir-fry with capsicum, broccoli and plenty of leafy greens, served with brown rice and a sprinkle of cashews makes the perfect vego or vegan meal. Tofu, brown rice and nuts all provide iron and zinc, while the vegies are rich in vitamin C to boost iron absorption.

Allergy vs food intolerance

Many people have difficulty distinguishing between food allergies and food intolerances, but they’re quite different. Food allergies result from the proteins found in foods such as nuts, cow’s milk, seafood and eggs – the body’s immune system overreacts, triggering an immediate flood of chemicals that cause a range of symptoms (some of which are life-threatening). It’s like sending in a SWAT team to respond to a knock at the door! Food intolerances however, are triggered by chemicals found in foods and, because they’re dose-dependent, cause reactions of varying degrees. Moreover, an allergy is related to a specific food, while intolerance is a reaction to chemicals, which may occur naturally, or are added to a wide variety of foods. How many Australians are affected? The Australasian Society of Clinical Immunology and Allergy (ASCIA) estimates that around one in 20 children and one in 100 adults suffer from food allergies. Luckily many allergies are not severe and most kids will grow out of them. However, allergies to nuts, seeds and seafood are likely to be life-long and allergies developed as an adult generally persist. Food intolerances are more common although how many of us are affected is unknown. Intolerances may include reactions to lactose, fructose, wheat, gluten, additives and naturally occurring chemicals such as salicylates, amines and glutamate. Could I have an allergy or intolerance? Symptoms to a food allergy include swelling, hives, eczema, diarrhoea, vomiting and, in some cases, breathing difficulties and anaphylaxis. Reactions are usually immediate and can be severe and even lifethreatening. Food intolerance and sensitivity are much more common. Symptoms include hives, skin rashes, headaches, digestive problems, asthma and eczema. Unlike a food allergy, reactions are delayed and dose-dependent, making them more difficult to detect and diagnose. Kate Marsh is an Advanced Accredited Practising Dietitian, who has celiac disease and type 1 diabetes and follows a vegan diet.