Blog Posts

Cow’s Milk Protein Allergy, the next steps…

Welcome to the final part of the four part overview of how to not just survive but thrive with Cow’s Milk Protein Allergy. I really hope this series has helped and has answered most of your questions.

  1. Cow’s Milk Protein Allergy, the basics
  2. Management of Cow’s Milk Protein Allergy
  3. Cow’s Milk Protein Allergy and Complementary Feeding
  4. Cow’s Milk Protein Allergy, the next steps…

As your infant with a cow’s milk allergy is getting older you may be starting to think about what happens next. You may also be wondering when you are able to reintroduce cow’s milk (unless you are vegan or avoid dairy for other reasons). The avergae age for children to grow out of their milk allergy is 18 months, however this is an average so it could mean your child will grow out of it sooner or later.

It is recommended that children with a milk allergy continue being breast fed or given a hypoallergenic formula until the age of 2.

Plant based alternative milks which are fortified with calcium can be used in your child’s diet in cooking and cereal from 6 months.  It may be possible to switch to calcium-enriched alternative milks as a main drink from the age of 1 if your child is monitored by an appropriate health professional such as a paediatric dietitian or paediatrician. This is because plant based alternative milks do not have the same amount of fat and protein as full cream milk. It is important that we ensure that children are growing well and have these nutrients replaced by other means.

Remember also that rice milk is not suitable for a main drink up to the age of 5 due to the high arsenic content.

Calcium

Calcium is an important factor in all children and toddler diets whether they have a milk allergy or not. I have outlined the daily requirements below and as you can see requirements drop significantly over the age of 1.

Age Calcium requirements per day
Under 1 525mg
1-3 350mg
4-6 450mg
7-10 550mg
11-18 800mg (girls) 1000mg (boys)
Adults 700mg
Breastfeeding mums 1250mg

Here are a few foods below with their calcium values next to them. I’ve put regular cow’s milk at the top for reference.

Food Portion Calcium
Cow’s milk 100ml 120mg
Calcium enriched alternative milk (soya/coconut/hemp/almond/oat etc…) 100ml 120mg
Cheese 30g (matchbox size) 220mg
Yoghurt 120g 200mg
Calcium fortified soya yoghurt/dessert/custard 125g 150mg
Calcium fortified breakfast cereal 30g 137mg
Calcium-fortified bread 1 slice (40g) 191mg
Sardines (with bones) ½ tin (60g) 258mg

For more sources of calcium and more information in general look at the BDA Calcium Food Fact Sheet

Remember that children need to be taking a Vitamin D supplement of 10ug per day in order for them to absorb the calcium they are consuming.

Iron

The other nutrient that I feel gets neglected is iron, please see the table of requirements below.

Age Iron Requirements
7-12 months 7.8mg
1-3 years 6.9mg
4-6 years 6.1mg
7-10 years 8.7mg

Red meat is the best source of iron followed by other meat. Good sources also include: fortified breakfast cereal, beans, nuts, dried fruit and wholegrains. Further information on meat free sources of iron can be found here on a fellow Paediatric Dietitian’s blog: Five Perfect Iron-rich Plant Foods.

If you are concerned that your child is not getting enough of any nutrients contact me or your GP.

Reintroduction of cow’s milk proteins

It is common to attempt reintroduction of the cow’s milk proteins from the age of 1. Or at least 6 months after diagnosis if the child was diagnosed very early on. Often children are accidentally exposed to cow’s milk by older siblings or in public. This can often be a blessing as parents and carers rarely like to do it on purpose. These reactions can be monitored, it’s useful to report back to the health professional who is overseeing your child’s treatment if an accident occurs, no matter what the outcome.

Starting reintroduction can be a really scary prospect, nobody wants to intentionally make their child unwell. Remember that any accidents or a failed reintroduction will not harm your child, they may have unpleasant symptoms for a short time but it does not affect them in the long term.

If your child has a severe non-IgE allergy or an IgE mediated allergy speak to your Dietitian or Paediatrician about reintroduction. If you’re not sure what kind of allergy they have check with your GP or Health Visitor or feel free to contact me.

The MAP Milk Ladder

The Milk Allergy in Primary Care (MAP) milk ladder is a fantastic resource that enables families to introduce cow’s milk protein back into a child’s diet systematically and gradually. It is only suitable for infants and toddlers with a mild-to moderate non-IgE allergy.

The MAP milk ladder is based on the idea that the more you process milk proteins, the more they are denatured (broken down). It also makes a difference what they are processed with, for example wheat creates a matrix around the milk proteins.

Click here for the MAP Milk Ladder. It is good to talk to your GP, dietitian or Paediatrician before starting the milk ladder and there are instructions on the back.

*I have heard that there will be an updated milk ladder coming soon called the iMAP ladder, when this comes out I will update this post.

Conclusion

I really hope that you have found this series on cow’s milk allergy useful, it is a real passion of mine after I have lived through it myself. It feels like the worst thing in the world especially if your baby is tiny when diagnosed but I hope I have given you lots of information and practical tips to make the journey a bit easier. Please contact me if you have any questions or comments. I love to hear from you!

If you are at all concerned with your child’s intake have a look below at my new service:

Nutritional analysis-4
Click here to check your child is getting everything they need for growth and development.

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Cow’s Milk Allergy and Complementary Feeding

Welcome to part three of a four part overview of how to not just survive but thrive with Cow’s Milk Protein Allergy. Here’s what’s coming up:

  1. Cow’s Milk Protein Allergy, the basics
  2. Management of Cow’s Milk Protein Allergy
  3. Cow’s Milk Protein Allergy and Complementary Feeding
  4. Cow’s Milk Protein Allergy, the next steps…

Complementary Feeding

Complementary feeding is the period when infants no longer get all the nutrients they need via breast milk or infant formula and therefore other foods and liquids need to be introduced1. It is often referred to as weaning or introducing solids but both of these terms can be confusing.

The advice from the World Health Organisation is to exclusively breastfeed until 6 months and then start complementary feeding. However recent evidence has shown that no harm comes to babies with early introduction of solid foods and it can even reduce the incidence of food allergies. The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition2 updated their advice to say that complementary feeding should not begin before 17 weeks (4 months) but also should not be delayed beyond 26 weeks (6 months), so therefore the introduction of pureed food needs to occur between 4-6 months when the infant is showing signs of interest. They should be able to hold their head up without slumping, be bringing their hands to their mouths and showing an interest in food. If you have any concerns about this, talk to a dietitian.

Generally there is no difference to starting complementary feeding with a child who hasn’t got a milk allergy. You can start with baby rice (just check the label for milk as some products do contain other ingredients) made up with breast milk or their hypoallergenic formula. Or start with pureed cooked vegetables and fruit. Banana and avocado don’t even need to be cooked first, you can just puree them as is. You can add pure baby rice to fruit or vegetables that are a bit watery.

We’re avoiding all dairy products but all other allergens are ok. The other things you need to avoid right now are whole nuts (until 5), honey (until 1) and soya (until 6 months).

Infants who have a strong risk of peanut allergy (severe eczema or egg allergy) should be seen by an allergist or a paediatrician with an interest in allergy before having nuts. Introduction of peanut based foods such as peanut butter should be encouraged between 4-11 months for all other infants. Remember children should not have whole nuts until 5 years old due to the risk of choking.

Label Reading

Due to EU legislation, anything that has cow’s milk or soya in will say milk or soya in bold, italics or underlined on the ingredients list. This is law, so if it’s not there it’s safe for your baby. A lot of products have “may contain” or “made in a factory” in an alert under the ingredients. We really have to use our common sense here – if it’s cereal for example it’s unlikely to have much cross-contamination. However something like a chocolate bar may have gone through the same machine. It also depends on the severity of your child’s allergy, if it is a non-IgE allergy or the worst case scenario is diarrhoea you may be happy to risk it.

When you have introduced the basics you can then increase the variety of food your baby eats. Again, nothing is off the menu apart from milk and soya until 6 months. So there’s no reason why you can’t blend food that you are eating or give them combinations such as banana and smooth peanut butter.

Ideas for dairy free first foods:

  • blended fruit and baby rice
  • wheat biscuits or instant oats with breastmilk or hypoallergenic formula
  • soup
  • blended vegetables
  • hummus
  • adult foods without any salt, blended
  • you can add peanut butter to soups/blended vegetables

6 months onwards

From 6 months infants should have the ability to deal with larger pieces of food and they can start enjoying finger foods. To begin remember: the bigger the better, aim for the food to be shaped like your finger. Avoid small items such as whole grapes or coin shaped food which is easy to choke on. It is also best to avoid chunks of apple until later too as apple can disintigrate and chunks come away easily.

Ideal finger foods include:

  • chunks of banana
  • soft vegetables in chunks
  • fingers of toast (you can load these with hummus, dairy free spread, peanut butter or dairy free cream cheese)
  • strips of chicken
  • bread sticks/rice cakes

Baking

You can bake most things as you would do normally. Just use a dairy free spread (Vitalite, PURE, Flora Dairy Free or supermarket own-brands) and if the recipe calls for milk use a plant-based alternative. Oat milk works well as it doesn’t have a strong taste.

A lot of foods are already milk and soya free such as cocoa powder and mayonnaise.

Recipes

Most recipes can be altered to be suitable. Use plant based alternative milks and your dairy free margarine or oil.

White sauces are very easy if you just mix cornflour into any plant-based alternative milk. (Mix a tiny bit in first to form a paste and then add the milk gradually to avoid lumps)

Free printable-4
For my family friendly dairy free recipes click here.

Puddings

Don’t despair that yoghurt is not an option, there are plenty of other puddings. Here are some ideas:

  • fruit (obviously!)
  • You can make custard with your favourite alternative milk and normal old fashioned custard powder.
  • Rice pudding and tapioca also work well with alternative milks.
  • There are lots of manufactured dairy free pudding and yoghurts in big supermarkets, a lot are soya based but there are coconut based puddings too now that it’s trendy! You can also find nut and pea based puddings if you’re lucky. This includes ice-creams. Sorbets tend to be milk free too.

So, dairy free complementary feeding is not as hard as you think, once you get used to label reading it’s a doddle! If you’d like more support from a friendly bunch of people who are going through the same as you join my Facebook Support Community.

And don’t forget to download your free recipes!

Free printable-4
Click here for your free recipes

References

  1. WHO(World Health Organization). 2002. Complementary Feedng. Report of the Global Consultation. Geneva. 10-13 December 2001. Summary of Guiding Proncipes. http://apps.who.int/iris/bitstream/10665/42739/1/924154614X.pdf?ua=1 Accessed March 10, 2017

  2. Fewtrell, M. et al. Complementary Feeding: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. JPGN, vol 64, number 1, January 2017 (http://journals.lww.com/jpgn/Fulltext/2017/01000/Complementary_Feeding___A_Position_Paper_by_the.21.aspx)

 

Management of Cow’s Milk Protein Allergy

This is part two of a four part overview of how to not just survive but thrive with Cow’s Milk Protein Allergy. Here’s what’s coming up:

  1. Cow’s Milk Protein Allergy, the basics
  2. Management of Cow’s Milk Protein Allergy
  3. Cow’s Milk Protein Allergy and Complementary Feeding
  4. Cow’s Milk Protein Allergy, the next steps…

When you have an infant with cow’s milk protein allergy the main treatment is to avoid the proteins casein and whey. This post covers what to do whilst babies are still solely breast or formula fed. I will cover weaning onto solids in the next post.

Free printable-4
Scratching your head at what to cook on a dairy free diet? Click here!

Breastfeeding

Breastfeeding is the ideal way to feed infants and there is a raft of evidence showing benefits for both mother and child, for a fab summary see this blog post by Charlotte Stirling Reed. This blog post by Dietitian Priya Tew is also excellent and describes the ups and downs of breastfeeding which I can really relate to!

As a breastfeeding mum you could be lucky and not have to alter your diet. Often breastfeeding mums only find out that their baby has a cow’s milk protein allergy when they start complementary feeding (introducing solid food).

However, for the unlucky ones (and that included me) your baby will have symptoms of cow’s milk protein allergy with proteins that are transferred through your breast milk. In this situation the only solution is for the mother to cut out cow’s milk. Remember that your baby can continue to have symptoms for two weeks following the elimination of dairy from your diet. This is a combination of it working through your system and their digestive systems recovering.

The first 2 weeks can be really tough, especially if you’re still dealing with a very unhappy baby, but try to persevere, it does get easier! I have a food allergy and intolerance support community on Facebook, if you want a place to get encouragement and empathy come over and join us (click here).

My top tips for a dairy free diet whilst breastfeeding:

  • Find a plant-based, calcium enriched alternative milk that you like. There are lots to choose from including: soya, oat, hemp, almond, hazelnut, coconut and rice. Just make sure it’s enriched with calcium, any organic milks will not so check the label.
  • Find a dairy free spread that you like. There are plenty to choose from:Vitalite, PURE, Flora Dairy Free or supermarket own-brands
  • Once you have dairy free milk and spreads then you can make most things dairy free – you can bake or convert recipes quite easily.
  • Take a calcium and vitamin D supplement, you need 1250mg of calcium per day and 10ug of vitamin D. You can request a supplement from your GP as it will be difficult to get this from diet alone. Or you can buy supplements in chemists for breastfeeding mums, just check the label.
  • Cocoa and eggs are dairy free so you can make chocolate cake – yay!
  • Look for vegan products and recipes. You can eat anything in vegan cafes and restaurants. Pret a Manger and Boots as well as others have vegan options.

If you need further information or are pulling your hair out drop me a line, we can have a quick, no-strings preliminary chat which wouldn’t cost you anything. I have lived through this so can help! Click here for my contact details. 

Formula Feeding

Not everyone can breastfeed and not everyone wants to. Obviously regular infant formula contains milk and therefore is not appropriate. Babies with cow’s milk protein allergy need a hypoallergenic formula. There are different brands but these are the two main types:

Extensively hydrolysed formulas contain milk protein which is broken down into very tiny bits. Most infants tolerate these and they taste a bit better.

If an infant has blood in their stools or anaphylaxis they will probably go straight onto an Amino Acid Formula. The proteins in these are completely broken down.

Your GP, dietitian or Paediatrician will advise you on the best formula for your child.

If your baby is refusing to drink the formula due to the taste you can try weaning them onto it gradually. If you are giving them 5 ounces you can try 1 ounce of the new formula to 4 ounces of the one they are used to. On day 2 increase to 2:3 and so on until they’re completely on the new formula. As a last resort you can flavour hypoallergenic formulas but in this case it is best to talk to a dietitian for further advice.

Soya formulas are available but are not suitable for infants below the age of 6 months. Again, talk to your paediatrician or dietitian for further information about soya formulas.

Gastro-oesophageal reflux

A lot (not all) of children with cow’s milk protein allergy also suffer with gastro-oesophageal reflux. This can result in vomiting or persistent crying. Some babies do not have symptoms and this can be described as silent reflux. If you are concerned about your child regarding gastro-oesophageal reflux speak to your GP or health visitor and see this link to the Great Ormond Street Hospital website.

Free printable-4
Click here for a printable of 10 really easy and tasty recipes that you’ll be surprised are totally cow’s milk free!

In my next blog post I’ll be looking at weaning infants with cow’s milk allergy onto solid food, also known as complementary feeding. I’ll talk about label reading as well as what to give and when.

If you have any questions or comments, contact me or post them in the comments below.

Cow’s Milk Protein Allergy, the basics

This is part one of a four part overview of how to not just survive but thrive with Cow’s Milk Protein Allergy. Here’s what’s coming up:

  1. Cow’s Milk Protein Allergy, the basics
  2. Management of Cow’s Milk Protein Allergy
  3. Cow’s Milk Protein Allergy and Complementary Feeding
  4. Cow’s Milk Protein Allergy, the next steps…

Background

Cow’s milk protein allergy is pretty common in the UK. The proteins which cause the allergic response are casein and whey. The estimated prevalence is between 2-3% of the population. It is common in infants and young children and effects 2-7.5% of infants below the age of 1 year. It is unusual to develop a cow’s milk protein allergy later in life.

Symptoms often include:

  • Diarrhoea
  • Constipation
  • Nappy rash (secondary to diarrhoea)
  • Mucus in stools
  • Blood in the stool
  • Reflux or vomiting
  • Wind, bloating or abdominal pain
  • Swelling of face, lips or eyes
  • Skin rashes (redness or hives)
  • Eczema
  • Runny nose

In rare cases cow’s milk allergy can cause breathing difficulties and anaphylaxis. If at any point your child is unable to breathe, call the emergency services immediately.

Allergies are split into 2 types: IgE mediated and Non IgE mediated (often called intolerances)

IgE mediated allergies can be diagnosed by a blood test or a skin prick test. When the milk protein’s whey or casein are ingested, IgE antibodies are released to fight off the offending proteins which the body sees as a threat. The symptoms often come on very quickly with an IgE reaction and in severe cases can include anaphylaxis.

Non IgE mediated allergies are still true allergies, they tend to have the same symptoms but they are more delayed and would not include anaphylaxis. They are also caused by the immune system but not a specific antibody reaction. There are no diagnostic tests for non-IgE mediated allergies, to diagnose there needs to be a period of elimination and then reintroduction to prove that the symptoms come back. To be honest, not many parents that I have come across reintroduce allergens on purpose once the symptoms are gone.

Cow’s milk allergy can occur both in breast and formula fed infants and there is often a family history of some kind of allergy such as hay fever, asthma or eczema if not cow’s milk-allergy itself. Children do tend to grow out of this allergy with the majority doing so before the age of 5.

Lactose Intolerance

A lot of people confuse cow’s milk protein allergy with lactose intolerance. Which is not surprising considering the similarity of the symptoms and that they both are a reaction to cow’s milk. In lactose intolerance it is the milk sugars that cause the problem, not the protein. With lactose intolerance the sufferer is lacking in the enzyme lactase and is therefore unable to break down the sugar lactose. This means that lactose carries on through the digestive tract causing trouble. Undigested sugars cause symptoms such as: bloating, wind, diarrhoea, constipation and abdominal pain.

Lactose intolerance is often temporary following a gastrointestinal infection. However, there are people who are born unable to digest lactose and they will need a low lactose diet for life. A low lactose diet is not too difficult and is catered well by supermarkets.

Lactose free dairy products are not suitable cow’s milk protein allergy sufferers as they still contain milk proteins.

This printable infographic summarises the differences between cow’s milk protein allergy and lactose intolerance: Cow’s Milk Protein Vs Lactose Intolerance

What do you do if you think your child has a cow’s milk protein allergy or Lactose Intolerance?

The first port of call should be your GP or Health Visitor or you can speak to a Registered Dietitian. Uncomplicated cow’s milk protein allergy can be managed by your GP and it is best practice to be referred to a Dietitian. They will refer you to a Paediatrician or allergy centre if needed. This tends to be if a child has multiple allergies, eczema or asthma.

How to treat Cow’s Milk Protein Allergy

Following a cow’s milk protein or dairy free diet is the only way to treat cow’s milk protein allergy.

Breastfeeding mums may need to eliminate cow’s milk protein from their diets if the infant has symptoms with her milk alone.

Formula fed babies will need to be switched to a specialised hypoallergenic formula. This would need to be discussed wth your GP, Dietitian or Paediatrician. There are soya formulas on the market but these are not recommended in babies under 6 months of age. It is better to speak to your GP, Dietitian or Paediatrician initially.

My next blog post in this series will look in depth at the cow’s milk free diet and management.

Free printable-4Click here for a printable of 10 really easy and tasty recipes that you’ll be surprised are totally cow’s milk free!

References

http://www.bsaci.org/guidelines/milk-allergy

https://www.allergyuk.org/food-intolerance/allergy-or-intolerance

http://www.nhs.uk/chq/Pages/Could-my-child-be-intolerant-to-cows-milk.aspx?CategoryID=62&SubCategoryID=63

Bread and Butter Pudding

This blog is all about comfort food. I love a bit of stodge, obviously as part of a healthy diet!  I needed to use up half a loaf of bread quickly which was an awesome excuse to make bread and butter pudding. It’s so easy to do, just butter the bread (you can use whatever spread that is in the fridge), cut into triangles and arrange in an oven proof dish. Scatter over raisins if you like, mixed fruit also works well. I did three layers of bread and butter.

To make the custard just beat an egg with 500ml of milk and approximately 100g of sugar. Pour over the layered bread and butter. Squidge the bread into the custard (technical term!) and cover wth cling film. Put into the fridge for a couple of hours or over night.  The bread needs to be really soggy. Sprinkle brown sugar over the top if you’re feeling naughty. Bake in an oven preheated at 180 degrees celsius for 20-30 minutes or until the pudding is risen and golden. Serve on it’s own or with custard, cream or yoghurt.

If you enjoy my blog and recipes, come over to Facebook and give my page a like 👍🏻, just click here.

Green Lentil and Chorizo Soup

If you like warming soups then this will be right up your street, it’s like spicy pea and ham soup. It is not pretty, especially if you use green lentils but it is delicious!

Allergen info: free from cow’s milk, soya, gluten, egg or nuts depending on the stock used.

fullsizeoutput_916
It is genuinely the most unattractive soup I’ve ever seen but it was tasty!

 

Prep:  10 minutes      Cook:   60 minutes       Serves: 4

Ingredients

  • approx 200g of chorizo, chopped into rings
  • 1 onion, chopped roughly
  • 2-3 peppers of ant colour, chopped roughly
  • 1 chilli, chopped or chilli powder to your taste, I used ½ teaspoon
  • 2 cups green or red lentils
  • 1.5 litres of low sodium stock (I just happened to make my own this time, but that is rare!
  • 1 teaspoon paprika
  • ½ teaspoon ground black pepper
  • coriander to serve

Method

  1. put the chopped chorizo into a big pan (no oil needed) and brown, then add the onions and peppers. You can either keep the heat high and keep stirring or turn it down and let the vegetables soften down slowly.
  2. once the chorizo has browned nicely and the veg is getting softer take out the chorizo and set aside in a bowl.
  3. add the stock, lentils, chilli and spices to the pan and bring to the boil. Simmer for 30-60 minutes or until the lentils are lovely and soft
  4. Blitz with a hand blender until smooth
  5. add the chorizo and warm it through, garnish with coriander.
img_1183
Before it was blended

Fairtrade Mango Chicken Curry

Fairtrade Fortnight this year is Monday 27 February to Sunday 12 March. The Fairtrade Foundation define Fairtrade as being about “better prices, decent working conditions and fair terms of trade for farmers and workers”.

I was inspired to make a dish to highlight mango which I wouldn’t necessarily consider as savoury or Fairtrade. I looked up a couple of recipes and then made this up. I’m so proud of it, it was delicious! Sweet, spicy and hot, just what I like! The sprig of coriander at the end really brings the dish to life.

This curry is free from dairy, soy, wheat, gluten and eggs.

Ingredients

  • 1 tbsp vegetable oil
  • 1 onion chopped
  • 2 cloves garlic, crushed
  • A thumb of ginger chopped
  • 1 red pepper
  • 1.5 tsp turmeric
  • 1 tsp cumin
  • 1/2 tsp chilli powder
  • 2 tsps Fairtrade curry powder
  • 1/2 tsp black pepper
  • a glug of Fairtrade white wine (approx 2 tbsp)
  • 1/2-1kg  chicken – I used thighs
  • 1 can Fairtrade coconut milk – I used full fat
  • 2 Fairtrade mangoes, chopped into chunks
  • 1 stock cube
img_0731
An easy way to chop up mango, just peel the cubes off the skin.

Method

  1. warm the vegetable oil to a high heat in a large heavy bottomed pan then brown the chicken for a couple of minutes each side, it’s easier to do this in batches. Set aside on a plate when done.
  2. Turn down the hob temperature then add the chopped onion to the pan, fry until translucent then add the ginger and garlic, fry for another couple of minutes.
  3. Add the spices and mix until combined and warm through. Before they start to catch on the bottom add a good glug of white wine and stir. Let this cook for 5 minutes until it stops smelling vinegary.
  4. Add the tin of coconut milk and allow to melt in. Then add the mango, chicken and stock cube.
  5. Bring to the boil and simmer for 30 minutes.
  6. Serve with basmati rice and garnish with coriander.

Keep your eyes peeled for my next Fairtrade blog post which is going to be on something very dear to my heart – coffee!!!

If you’re interested in having lots of new healthy recipes, check out my meal plan pages, there may be a plan to suit you.

Fairtrade goods are available from most good supermarkets as well as www.ethicalsuperstore.com and www.steenbergs.co.uk as well as others.

Vegetable, Barley and Bean Stew with Dumplings

This is a very nutritious, tasty and filling recipe that only costs about £4.30, that’s 72p per serving. It is full of fibre and is low Glycemic Index and will therefore not cause any spikes in your blood glucose. There are at least 4 portions of vegetables in here so you’re well on your way to meeting your target.

Prep: 20 minutes    Cook: 1 hour 5 minutes     Serves: 6 adults or 2 adults and 2 children twice

Ingredients

  • 1 tbsp vegetable oil
  • 2 small onions (chopped)
  • 3 flat mushrooms (chopped roughly)½
  • 6 small carrots (chopped into chunks)
  • 4 sticks of celery (chopped)
  • 2 x 400g tins chopped tomatoes
  • 1 cup pearl barley
  • 1 x 400g tin of butter beans
  • stock cube
  • 1 tsp cumin
  • 1/2 tsp ground black pepper
  • 1 tsp turmeric
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I really like using flat mushrooms, they’re much easier and quicker to wash and chop and are full of flavour

Dumplings

  • 100g vegetable suet
  • 200g self raising flour
  • pinch salt
  • approx 10 tbsp cold water
  • 1 tsp dried thyme

Method – Stew

  1. warm oil and fry onions until translucent, add mushrooms and fry for a further 5 minutes
  2. add the rest of the ingredients plus 1 ½ cans of water and stir
  3. bring to the boil and simmer for approx 45 minutes or until the vegetables and pearl barley are tender.

Method – Dumplings

  1. mix together the dry ingredients then add ½ the water and mix together (I used my hands), keep adding spoonfuls of cold water until the dough is soft and pliable.
  2. separate into 16 (ish) small balls and place on top of the simmering stew.
  3. shut the lid and they will be ready in approximately 20 minutes

Enjoy!

If you’re interested in stabilising your blood glucose, click here to read about my 7 day plan.

Should you be reducing your added sugar intake?

There are only 8 days left of Sugar Free February, I’m not going to lie, it’s been tough! It got me thinking – should we all be cutting out added sugar?

What is added sugar?

There are different sources of sugar in your diet. Sugar can either be intrinsic (ie within a food or drink) or extrinsic ie added to food or drink.

This infographic from The Rooted Project (original source) nicely summarises what is meant by added, free or extrinsic sugars.

free-sugars-rooted-project

How much sugar are we advised to eat per day?

The advice from the Government’s Scientific Advisory Committee on Nutrition (SACN) is to have no more than 5% of daily energy intake in free sugars per day. This equals:

  • 19g or 5 sugar cubes for children aged 4 to 6.
  • 24g or 6 sugar cubes for children aged 7 to 10.
  • 30g or 7 sugar cubes for 11 years and over, based on average population diets.

This seems like quite a lot until you start looking at labels and realise how much is added to savoury food as well as sweet.

Some people try to avoid it all together and the media now use terms such as addictive and describe sugar as the root of all our problems. But lets look at the whole picture.

How does added sugar effect the body?

When we consume free sugar it is broken down in the small intestine into glucose, fructose and galactose and is absorbed into the blood. This causes a rise in blood glucose which stimulates the production of insulin.

Why is this a problem?

Sugar is an excellent source of calories, there are 4 kcals in 1 g and although there are more in fat, sugar is much easier and quicker to absorb. It is pure energy and has no other nutritional value i.e. no vitamins or minerals. This can be described as “empty calories”

Having large amounts of sugar, especially fructose can lead to insulin resistance (source). But don’t worry, eating fructose in fruit is much less of a problem.

Eating too much sugar can be linked to cancer which is thought to be due to the constant need for the body to produce insulin (source).

Basically eating too much sugar causes people to gain weight.

Glycaemic Index

However – you don’t often eat sugar on it’s own. Usually it is combined with other ingredients which reduces the speed that it is absorbed into the blood.

It depends on what you eat as to the speed that glucose is absorbed into your blood. Free sugars on their own are high glycaemic index (GI). That is, if you consumed a sugary drink or a boiled sweet the sugar does not need to be broken down very much and can be absorbed really fast. However, if you add fat, protein or fibre it slows down the absorption rate. The slower it is absorbed, the lower GI it is. This graph shows how fast different carbohydrates are absorbed (source).

Potatoes.ai

Following a low GI diet can make you feel fuller for longer due to no sugar spikes and subsequent dips and often have the beneficial effects of other nutrients such as fibre.

What about fat?

As people have reduced their fat intake over the past 40-50 years the intake of sugar has increased. The food industry has had to increase sugar to improve the flavour. Unfortunately the original evidence that encouraged people to reduce fat in their diets was flawed. It is becoming more apparent from recent research that increasing fats, even saturated fat does not have an adverse affect (source). Increasing certain dairy products can even be beneficial (source).

Bottom line

Sugar is added to food to improve it’s flavour but it can lead to weight gain if consumed in large amounts.

Here’s my practical advice:

  • try to have sugar-free, low GI breakfast as it makes a huge difference with feeling hungry mid-morning and sets you up as you mean to go on.
  • eat low GI meals and snacks for the rest of the day
  • try to stick to the SACN guidelines above
  • occasional treats are fine but if you want to keep your blood glucose stable eat sweeter things after a meal

Personally, the major benefit I have found so far from removing added sugar from my diet is less hunger between meals. However, I will not continue completely in March, life is fairly drab without it, it’s quite inconvenient and I really like chocolate!

If you don’t know where to begin, I have a 7 day plan designed to get you going with stabilising your blood glucose, this features daily e-mails from me, a meal plan, recipes and a shopping list, you can find more information here.

Slow Cooker Vegan Butternut Squash Stew

Here’s the recipe for the stew that I posted a video of recently:

Click here for the video.

Ingredients

  • 1 cup chopped onions (I used frozen)
  • 1 cup chopped celery
  • a pack of butternut squash (frozen)
  • cup of lentils
  • tin of chick peas
  • 2 x 400g tins of chopped tomatoes
  • 1 tin of water
  • 1 tsp cumin
  • 1 tsp turmeric
  • 1 tsp bouillon or a stock cube
  • optional extras: sliced peppers/mushrooms/any other veg you fancy!

Method

  1. put all ingredients into your slow cooker and mix (or bash!), cook for 6 hours on high or 8-10 on low

It’s definitely worth a try as it’s so easy!

If you would like more healthy recipes like this then come over and like my facebook page: www.facebook.com/katerobertsnutrition.