Food allergies and intolerances
A food allergy occurs when the body‟s immune system reacts to certain substances in food – called „allergens‟ – as if they were harmful, by producing antibodies. These can cause immediate, often severe, symptoms such as: sneezing, congestion, swollen lips or eyes, vomiting, skin hives, hypotension (dangerously low blood pressure), or even difficulty breathing accompanied by a severe fall in blood pressure (anaphylactic shock, which can be fatal).
However, a food intolerance is a digestive system response to food, and is usually not as immediate or severe as an allergic reaction. Symptoms tend to take longer to appear than in the case of allergy and can include: headache, nausea, stomach cramps, vomiting, fatigue and digestive problems (such as diarrhoea). Food
intolerance is harder to diagnose than a food allergy, and the most reliable method of diagnosis is to cut out the suspected food from the diet to see if the symptoms
improve.
Diagnosing food allergies
If you suspect you have a food allergy or intolerance, it is important for you to be diagnosed by a doctor. Allergies are checked using either a skin test or a blood test. The skin test injects a tiny amount of the suspect food protein, sterilised, between the skin layers. Swelling within an hour indicates an allergy. A blood test checks
antibody responses to allergens. Intolerances are identified, as indicated above, by an elimination diet. After you have been diagnosed, you should be referred to a registered dietitian for expert advice on how to manage your diet to meet your nutritional needs within the limits imposed by the allergy or intolerance.
Ways to help prevent food allergy
It is highly recommended that mothers, if possible, exclusively breast-feed infants until six months of age and then start introducing solids. Pregnant or breast-feeding women do not need to exclude any specific allergens from their diets, unless they or their babies have been proven to be sensitive to them. Normal infant feeding
guidelines advise that cow‟s milk, peanuts and egg white should not be introduced before one year of age.
Gluten sensitivity / Celiac Disease
Protein is the part of wheat that most commonly causes sensitivity, but wheat contains over 100 different proteins and there could be sensitivity to just one or to several. One of those proteins is gluten. Avoiding gluten also involves excluding other grains containing gluten, such as rye and barley, whereas oats is only problematic in about 5% of people with Celiac Disease. In other words, sensitivity must be
established on an individual basis. Planning a wheat and gluten-free diet can be challenging, as wheat is used extensively to make products such as breads, pasta, cereals, porridge, biscuits, cakes and some thickening agents.
Some starchy foods that do not contain gluten include:
Maize (sweetcorn, popcorn, Maizena, Corn Thins, Corn Flakes and Creemy Meal) Sorghum (Maltabella porridge)
Rice (Rice Crispies, Coco Pops, Strawberry Pops, rice cakes)
Soya (Pronutro - original / banana / chocolate / strawberry flavours) Potato
Sweet potato Tapioca Sago
Practical tips for gluten-free cooking and baking:
Breadcrumbs can be substituted with crushed corn-flakes or puffed rice. Cooked rice can be used to stuff meat instead of breadcrumbs.
Sauces and desserts can be thickened using corn flour. For each tablespoon (15ml) of wheat flour substitute with 6ml of maize flour .
Muffins and biscuits will have a better texture if they are baked in small sizes. There is a product that makes life a little easier – Entice self-raising flour that is a cup-for-cup substitute for wheat flour.
Sweet or Savoury Waffle Mix For a sweet waffle:
250ml (1 Cup) Entice self-raising self-binding rice flour* 250ml (1 Cup) Jungle Oats (if you are not sensitive to oats) 45ml (3 Tbs) sugar
5ml (1 tsp) salt 30ml (2 Tbs) oil 500ml (2 Cups) water
5ml (1 tsp) ground cinnamon For a savoury waffle:
Reduce the sugar to 1 Tbs. Do not add the cinnamon.
Add seeds such as sunflower, linseed and or sesame seeds.
Eat topped with avocado pear, cottage cheese and chilli or any other topping of your choice.
Preheat the waffle iron.
Pour a ladleful of batter into the waffle iron and cook. Serve with honey or as desired.
The batter keeps in the fridge for up to 5 days, or wrap in plastic and freeze the cooked waffles.
Light and Tasty Bread
330ml (1 1/3 Cup) Entice self-raising self-binding rice flour* 15ml (1 Tbs) sugar
5 ml(1 tsp) salt 2 eggs
330ml (1 1/3 Cup) milk or rice milk
80g (5 Tbs) butter, melted and cooled slightly Optional extras
2 tsp seeds mixed into the batter and sprinkled on top - suggestions are caraway, or a combination of linseed, sunflower and or sesame seeds OR 80ml (1/2 C) pecan nuts
Preheat the oven to 220°C
In a bowl, mix rice flour, sugar and salt. Whisk together the melted butter, eggs and milk.
Add the milk mixture to the rice flour mixture and stir to combine. The batter is quite liquid.
Fold in the optional extras, if desired. Pour into a greased loaf pan.
Bake at 220°C for 20-25 minutes, or until ready. Wheat sensitivity
Avoiding wheat in a diet provides similar challenges to the development of a gluten-free diet, with a notable exception: other grains such as rye, barley and oats can be included.
Food labels can be confusing because wheat is often not clearly detailed in the ingredients lists or products. Look out for ingredients that can indicate if a product contains wheat: flour, bran, couscous, malt, thickener, modified starch, semolina or spelt. It is important to note that if a product is labelled as "free of gluten", it means that it will be free of wheat as well; however, if it is "free of wheat" it does not
necessarily mean that it is free of gluten.
Some starchy foods that do not contain wheat include: Wheat-free rye bread and crackers
Rye flour Pearl barley
Maize (sweetcorn, popcorn, Maizena, Corn Thins, Corn Flakes and Creemy Meal) Sorghum (Maltabella porridge)
Rice (Rice Crispies, Coco Pops, Strawberry Pops, rice cakes)
Soya (Pronutro - original / banana / chocolate / strawberry flavours) Potato
Tapioca Sago
Practical tips for gluten-free cooking and baking:
Breadcrumbs can be substituted with crushed corn-flakes or puffed rice. Cooked rice can be used to stuff meat instead of breadcrumbs.
Sauces and desserts can be thickened using corn flour. For each tablespoon (15ml) of wheat flour substitute with 6ml of maize flour .
Muffins and biscuits will have a better texture if they are baked in small sizes. There is a product that makes life a little easier – Entice self-raising flour* that is a cup-for-cup substitute for wheat flour.
Sweet or Savoury Waffle Mix For a sweet waffle:
250ml (1 Cup) Entice self-raising self-binding rice flour* 250ml (1 Cup) Jungle Oats (if you are not sensitive to oats) 45ml (3 Tbs) sugar
5ml (1 tsp) salt 30ml (2 Tbs) oil 500ml (2 Cups) water
5ml (1 tsp) ground cinnamon For a savoury waffle:
Reduce the sugar to 1 Tbs. Do not add the cinnamon.
Add seeds such as sunflower, linseed and or sesame seeds.
Eat topped with avocado pear, cottage cheese and chilli or any other topping of your choice.
Preheat the waffle iron.
In a bowl, blend all ingredients together into a smooth batter. Pour a ladleful of batter into the waffle iron and cook.
Serve with honey or as desired.
The batter keeps in the fridge for up to 5 days, or wrap in plastic and freeze the cooked waffles.
Light and Tasty Bread
330ml (1 1/3 Cup) Entice self-raising self-binding rice flour* 15ml (1 Tbs) sugar
5 ml(1 tsp) salt 2 eggs
330ml (1 1/3 Cup) milk or rice milk
80g (5 Tbs) butter, melted and cooled slightly Optional extras
2 tsp seeds mixed into the batter and sprinkled on top - suggestions are caraway, or a combination of linseed, sunflower and or sesame seeds OR 80ml (1/2 C) pecan nuts
Preheat the oven to 220°C
In a bowl, mix rice flour, sugar and salt. Whisk together the melted butter, eggs and milk.
Add the milk mixture to the rice flour mixture and stir to combine. The batter is quite liquid.
Fold in the optional extras, if desired. Pour into a greased loaf pan.
Bake at 220°C for 20-25 minutes, or until ready.
Dairy allergy
Cows‟ milk protein causes one of the most common allergies in children. This is
different to lactose intolerance, which is due to the lack of an enzyme essential for the digestion of milk sugar (which is what lactose is). Milk forms such an essential part of any child‟s diet that a dairy-free diet should be carefully planned by a registered dietitian to avoid any long-term nutrient deficiencies.
For infants, milk substitutes in the form of soya or hydrolysed formulas may be given on the advice of a doctor. A high percentage of milk-allergic infants can also become allergic to soya protein, however, so other alternatives may need to be considered. Milk forms an essential part of a child‟s diet and it provides many nutrients for growth such as calcium and protein. If your child is not having dairy you should plan the diet with a registered dietitian for guidance on adequately balancing the diet and for
information on calcium supplementation. Some dairy-free products:
Cardin, Ole and Blossom Lite margarines Orley Whip
Soya milk and tofu
Alpro soya desserts and flavoured milks
Practical tips for cooking and baking without dairy
When cooking or baking with milk, it is usually the quantity of fluid that is needed and not the fact that the liquid is milk. Rather use water as a substitute for milk in these recipes.
Orley Whip is the only coffee creamer free of milk solids. It can be diluted for use with cereal and in baking.
Custard can be prepared by using custard powder and soya milk or Orley Whip. Add a little vanilla essence to mask the flavour of the soya.
White sauce can be made with milk-free margarine, cake flour and soya milk / diluted Orley Whip. Flavour it with parsley, mustard and / or herbs.
Tofu (soya curds) can be substituted for cheese in the dairy-free diet, and it is available in selected stores.
Crushed potato crisps can be used as a topping for dishes or pizza. Dot the chips with milk-free margarine and sprinkle with paprika.
Soya allergy
Soya allergy is an adverse reaction to one or more of the proteins found in soya. Soya is increasingly being adopted by the food industry as a protein extender or a milk substitute because it is a good source of protein and it has texturising and emulsifying properties. It is so widely distributed in processed foods that avoiding soya in the diet can prove to be very difficult.
Check the ingredients lists on the labels of the following foods, as they may contain soya:
margarines meat substitutes sausages
processed cold meats snack bars
pies
canned meat
breads (especially high protein breads) burger patties and hotdogs
infant formulas
liquid meal replacements Peanut allergy
Peanut allergy can be life-threatening and can affect both children and adults. Some people can show severe facial swelling and restricted breathing after even the
slightest exposure to peanuts. The most common symptom of peanut allergy, however, is urticaria (skin rash).
Check the ingredients lists on the labels of the following foods, as they may contain peanuts:
baked goods health breads biscuits
snack bars
some cereals and mueslis mixed nuts
Chinese, Thai and Indonesian dishes What about allergy to other nuts?
Peanuts actually belong to the legume family. Therefore, the majority of peanut sensitive individuals are not necessarily allergic to tree nuts such as pecans, walnuts or almonds. However, some people have multiple allergies and they may also prove to be sensitive to tree nuts, such as brazil nuts, cashews, hazelnuts, macadamia nuts, pine nuts and pistachio. However, there is a likelihood of peanut allergy sufferers also being allergic to soya, as peanuts and soya are in the same legume family and share similar allergenic proteins.
Tree nut allergy
Tree nuts include almonds, hazelnuts, Brazil nuts, pine nuts, cashew nuts, sweet chestnuts, pecan nuts, pistachios and walnuts. They are from a wide variety of plants, which are usually botanically unrelated.
Tree nuts often present a hidden danger because their versatility has led to them being widespread in food production. Meat dishes, desserts, drinks, breakfast cereals, breads and cakes, candy and confections, chocolate products, vegetable dishes and sandwich spreads may be triggers of anaphylaxis.
The most common allergens in this group of foods are peanuts, hazelnuts and brazil nuts. However, with a tree nut allergy it is wise to avoid all nuts, unless certain nuts have been accurately identified as the only potential allergens.
Egg allergy
This allergy is more common in young children than in adults, and tends to subside with age. It is the protein components in the egg white and egg yolk that are allergenic, although egg white is responsible for the majority of allergic reactions. Egg is often a “hidden” ingredient in batters as it is a binding agent that sticks breadcrumbs and flours to coated foods such as fish, fish cakes and schnitzels. In cooking, eggs have many functions such as binding, adding lightness, raising and emulsifying. Beaten egg is also brushed onto pastries, rolls and buns to promote browning during baking.
Practical tips for cooking and baking without egg
Look for recipes that use only 1-2 eggs as well as baking powder or bicarbonate of soda or where egg is not an important ingredient in the recipe
Use the following substitutions for each egg:
Biscuits / cakes using only 1 egg = ½ teaspoon baking powder + 1 tablespoon water
Commercial cake mixes = 1 tablespoon vinegar + 1 tablespoon water + ½ teaspoon baking powder
To give lightness to the finished product, sift the flour a few times and beat well to trap air into the mixture after adding each ingredient. Do not leave the
mixture to stand as air will escape – bake immediately. Bread recipes that need only 1 egg can be made without.
The binding effect of egg can be substituted by adding mashed banana or grated apple. Unflavoured gelatine can also be used: dissolve 3 tablespoons in warm water and add with the liquid ingredients (remember to reduce the liquid in the recipe by 3 tablespoons or else the mixture will be too wet).
Crumbs and flour usually coat food without egg - if not, then dip the food with milk and then coat.
Fish and shellfish allergy
Both types of shellfish - crustaceans (crayfish, langoustine, shrimps, prawns, crabs) and molluscs (oysters and mussels) - as well as other species of fish are known to be common allergens. These allergies can also be of life-threatening severity.
