Specialist dietitian recommendation please?
October 28, 2022 6:00 AM Subscribe
My husband has a rare progressive condition (adult FPIES) that causes him to be allergic to a very large number of foods. These include most nuts, corn, peas, asparagus, kale, lentils, beans, whole wheat flour and oats. This is a real diagnosis given to him at the specialist allergy clinic at our local hospital as referred by his GP (i.e. this is not some BS pseudoscience). In addition, he is vegetarian and I am unable to persuade him to start eating meat or chicken (so far) and he hates fish and seafood so will never persuade him to eat those. I'm looking for ideas for meals for him and also am looking for a professional to suggest things he can eat in order to keep him as healthy and happy as possible.
Can anyone recommend a reputable online dietician he could work with please? He has a few meals he can eat, such as mac and cheese, eggs with soya based bacon, a paneer curry I make from scratch, halloumi with salad, etc. But I wonder if a good dietician could help come up with some more ideas we haven't thought of. I'm also keen to here and meal ideas you might have I'm really worried as he is adding trigger foods to his list quite frequently. Thank you.
Can anyone recommend a reputable online dietician he could work with please? He has a few meals he can eat, such as mac and cheese, eggs with soya based bacon, a paneer curry I make from scratch, halloumi with salad, etc. But I wonder if a good dietician could help come up with some more ideas we haven't thought of. I'm also keen to here and meal ideas you might have I'm really worried as he is adding trigger foods to his list quite frequently. Thank you.
Asian food? Tofu is good protein, and can be roasted, fried, etc. Rice, fried rice, ramen, udon, etc. Check on buckwheat. Are peanuts on the list? If you can generate a list of what he can eat, you can search recipes with those foods and get ideas. I hope a new diet helps his feel well.
posted by theora55 at 6:40 AM on October 28, 2022
posted by theora55 at 6:40 AM on October 28, 2022
Best answer: This is so, so hard. I was a vegetarian for 15 years and developed anaphylaxis to soy, milk and eggs in addition to already being allergic to nuts. I held on to vegetarianism WAY longer than I should have because it was a complex and heartbreaking issue (why on earth would I compromise my morals just because there's nothing for me to eat?) and I really did need to get very sick before I started eating chicken. I'm not suggesting that that is the answer here, I am really only emphasizing how hard it was and how the most obvious solution may be truly off the table forever.
When I was in a trigger phase where I was developing new allergies frequently, I pared down what I ate CONSIDERABLY. I was stringent about only eating my own food that I had prepared to avoid cross-contamination, and I really did eat the same meal for breakfast, the same meal for lunch and the same meal for dinner for MONTHS. It was worth it to not trigger another reaction and add a new food to my list. As far as WHAT those repetitious meals might be, I would suggest:
Quiche with a gluten-free crust, since eggs and milk are okay
Brown rice, soy chorizo, whatever other Mexican-ish toppings work for him
Rice noodles with curry or a Pad Thai-style sauce, tofu for protein
Pasta Carbonara (no bacon, gluten-free noodles)
Snack plate with cottage cheese, fresh fruit, crackers
I also think it might be helpful to just focus on eating enough over the course of the day rather than eating distinct meals.
Good luck -- I will be thinking of you both. This is a tough thing to navigate.
posted by kate blank at 6:49 AM on October 28, 2022 [1 favorite]
When I was in a trigger phase where I was developing new allergies frequently, I pared down what I ate CONSIDERABLY. I was stringent about only eating my own food that I had prepared to avoid cross-contamination, and I really did eat the same meal for breakfast, the same meal for lunch and the same meal for dinner for MONTHS. It was worth it to not trigger another reaction and add a new food to my list. As far as WHAT those repetitious meals might be, I would suggest:
Quiche with a gluten-free crust, since eggs and milk are okay
Brown rice, soy chorizo, whatever other Mexican-ish toppings work for him
Rice noodles with curry or a Pad Thai-style sauce, tofu for protein
Pasta Carbonara (no bacon, gluten-free noodles)
Snack plate with cottage cheese, fresh fruit, crackers
I also think it might be helpful to just focus on eating enough over the course of the day rather than eating distinct meals.
Good luck -- I will be thinking of you both. This is a tough thing to navigate.
posted by kate blank at 6:49 AM on October 28, 2022 [1 favorite]
One idea might be a plant-based doctor for additional advice? Plant-based doctors are generally much more fluent in nutrition than non plant-based ones. Here is one search option, includes regular and telehealth options.
posted by Glinn at 7:14 AM on October 28, 2022
posted by Glinn at 7:14 AM on October 28, 2022
Best answer: Oh my gosh, I'm so sorry he (and you!) are dealing with this. My husband also has a crazy long list of food allergies so I've got a bunch of ideas for you. PM if you want specific recipes for anything below.
Quinoa, barley, and amaranth are good alternatives to oatmeal, and can be used as the base of savory salads as well. Jook or congee, a thin rice porridge, is a popular breakfast dish in many Asian countries, and is usually served with egg and scallions. Plain full fat yogurt with fresh fruit, chia seeds and hemp hearts, topped with honey is also a good protein rich breakfast.
I'm a big fan of vegetarian tacos. They make wheat/corn free tortillas these days! For fillings try crispy roasted cauliflower, 'barbecued' jackfruit, or pan fried mushrooms. Use lots of cumin and chili powder, and serve with shredded cabbage, cheese, and avocado.
I've also been getting into salads with roasted root vegetables like beets, sweet potatoes, parsnips, and radish, on a base of romaine or spinach with green onion, shredded carrots, and sometimes hearts of palm with toasted pumpkin seeds, flax, and hemp hearts for protein and fiber. I usually make a tahini dressing to add some healthy fats.
You could also try tempeh, which is similar to tofu, but the protein is more digestible due to the fermentation process. Since it used the whole bean, it has more protein and fiber than tofu as well. I like marinating mine in a sweet soy and ginger sauce with smoked pepper and pan frying (so kind of a bacon-y flavor), but there are tons of ways to prepare it.
Tom kha soup is quick and easy. You can swap soy sauce for fish sauce and extra lime juice for lemongrass if that's hard to find. Use veggie stock and tofu instead of chicken. I also add a bit of extra sugar because that's how my favorite Thai restaurant makes it.
It sounds like he could do gluten free pizza, which opens up a lot of options.
You should also take a look at Madhur Jaffrey's Vegetarian Cooking of the East. It's hands down the best cookbook for branching out into new dishes I've found. I went through a phaee of making pakoris out of every vegetable I could find. Cauliflower and celeriac were my favorites, with the tamarind mint chutney. So good!
BTW I eventually convinced him to start eating meat, by making bone broth using locally sourced venison and chicken bones. He started to feel so much better, as his issues have caused leaky gut syndrome and bone broth and liver really helps with that. We eat almost exclusively wild game we hunt ourselves now, although I realize that's not realistic for most people.
Best of luck finding some good new dishes!
posted by ananci at 8:03 AM on October 28, 2022 [2 favorites]
Quinoa, barley, and amaranth are good alternatives to oatmeal, and can be used as the base of savory salads as well. Jook or congee, a thin rice porridge, is a popular breakfast dish in many Asian countries, and is usually served with egg and scallions. Plain full fat yogurt with fresh fruit, chia seeds and hemp hearts, topped with honey is also a good protein rich breakfast.
I'm a big fan of vegetarian tacos. They make wheat/corn free tortillas these days! For fillings try crispy roasted cauliflower, 'barbecued' jackfruit, or pan fried mushrooms. Use lots of cumin and chili powder, and serve with shredded cabbage, cheese, and avocado.
I've also been getting into salads with roasted root vegetables like beets, sweet potatoes, parsnips, and radish, on a base of romaine or spinach with green onion, shredded carrots, and sometimes hearts of palm with toasted pumpkin seeds, flax, and hemp hearts for protein and fiber. I usually make a tahini dressing to add some healthy fats.
You could also try tempeh, which is similar to tofu, but the protein is more digestible due to the fermentation process. Since it used the whole bean, it has more protein and fiber than tofu as well. I like marinating mine in a sweet soy and ginger sauce with smoked pepper and pan frying (so kind of a bacon-y flavor), but there are tons of ways to prepare it.
Tom kha soup is quick and easy. You can swap soy sauce for fish sauce and extra lime juice for lemongrass if that's hard to find. Use veggie stock and tofu instead of chicken. I also add a bit of extra sugar because that's how my favorite Thai restaurant makes it.
It sounds like he could do gluten free pizza, which opens up a lot of options.
You should also take a look at Madhur Jaffrey's Vegetarian Cooking of the East. It's hands down the best cookbook for branching out into new dishes I've found. I went through a phaee of making pakoris out of every vegetable I could find. Cauliflower and celeriac were my favorites, with the tamarind mint chutney. So good!
BTW I eventually convinced him to start eating meat, by making bone broth using locally sourced venison and chicken bones. He started to feel so much better, as his issues have caused leaky gut syndrome and bone broth and liver really helps with that. We eat almost exclusively wild game we hunt ourselves now, although I realize that's not realistic for most people.
Best of luck finding some good new dishes!
posted by ananci at 8:03 AM on October 28, 2022 [2 favorites]
Best answer: I've dealt with esoteric food issues so one tip to share is that I always start from what they can eat.
So, I see eggs on your list - I'd investigate...
Baked avocado eggs
Shakshouka
Fritattas
Tofu is a huge area but some of our favourites are -
Brothy Thai Curry
Multiple recipes for crispy baked tofu
We use it in place of beans for things like maple baked beans - freeze and crumble or else cube small, bake, and then use in the recipe like cooked beans.
There are the tofu and sweet potato and rice noodles on the market as well, which we find work best in Asian-type dishes but have used with more Italian-type meals too. Also a spiralizer for zucchini noodles, sweet potato noodles, butternut squash noodles. You can also use spaghetti squash as a base.
Rice-based meals - check out (eliminating the peas and nuts, although if he can have pine nuts they are great in it - but it's really the spices that make it special) something like ouzi rice; I make ours with tvp rather than the lamb, but add in some ghee on top of the olive oil. Other search terms would be pilafs, one-pot rice dishes.
One thing I don't see on your list is soups - butternut squash, cream of broccoli, carrot and ginger - those can be very satisfying flavour-wise when people are getting tired of a limited range of main dishes, and paired with a salad or a kind of "appetizer tray" of things it's a nice meal.
posted by warriorqueen at 8:08 AM on October 28, 2022 [2 favorites]
So, I see eggs on your list - I'd investigate...
Baked avocado eggs
Shakshouka
Fritattas
Tofu is a huge area but some of our favourites are -
Brothy Thai Curry
Multiple recipes for crispy baked tofu
We use it in place of beans for things like maple baked beans - freeze and crumble or else cube small, bake, and then use in the recipe like cooked beans.
There are the tofu and sweet potato and rice noodles on the market as well, which we find work best in Asian-type dishes but have used with more Italian-type meals too. Also a spiralizer for zucchini noodles, sweet potato noodles, butternut squash noodles. You can also use spaghetti squash as a base.
Rice-based meals - check out (eliminating the peas and nuts, although if he can have pine nuts they are great in it - but it's really the spices that make it special) something like ouzi rice; I make ours with tvp rather than the lamb, but add in some ghee on top of the olive oil. Other search terms would be pilafs, one-pot rice dishes.
One thing I don't see on your list is soups - butternut squash, cream of broccoli, carrot and ginger - those can be very satisfying flavour-wise when people are getting tired of a limited range of main dishes, and paired with a salad or a kind of "appetizer tray" of things it's a nice meal.
posted by warriorqueen at 8:08 AM on October 28, 2022 [2 favorites]
Best answer: There's a whole world of omelet-type dishes that can be eaten along with a salad or with fruits for dessert: look for omelette (aux fines herbes, with mushrooms, with spinach), frittata and tortilla espanola. They are easy to make and I never get bored because there are so many choices.
Instead of the normal mac n cheese, try making pasta with gorgonzola, my personal favorite food. In theory the fermentation of the cheese is good for you, but I think the good bacteria die in the cooking proces. The fermentation does kill off lactose, though, if that is an issue. Again, with a salad or with fruits for desserts, so it doesn't all get too beige.
You mention a paneer curry -- is that saag paneer? Otherwise that might be nice to try. Maybe together with Madhur’s sesame seed potatoes (til ke aloo)?
Is buckwheat an option? Because that would open a whole world of foods that are satisfying and nutrition-rich. Look for buckwheat crêpes, for instance, or buckwheat noodles. I was about to try to make buckwheat crespelle the other day, but someone stole my crêpes ;-) It would have worked just fine. I haven't tried making bechamel with gluten-free flour, I have used potato starch instead, someone probably knows what is the best solution.
I'm about to try the soup recipe in this article right now, and the book it's from looks very inspiring.
posted by mumimor at 8:36 AM on October 28, 2022
Instead of the normal mac n cheese, try making pasta with gorgonzola, my personal favorite food. In theory the fermentation of the cheese is good for you, but I think the good bacteria die in the cooking proces. The fermentation does kill off lactose, though, if that is an issue. Again, with a salad or with fruits for desserts, so it doesn't all get too beige.
You mention a paneer curry -- is that saag paneer? Otherwise that might be nice to try. Maybe together with Madhur’s sesame seed potatoes (til ke aloo)?
Is buckwheat an option? Because that would open a whole world of foods that are satisfying and nutrition-rich. Look for buckwheat crêpes, for instance, or buckwheat noodles. I was about to try to make buckwheat crespelle the other day, but someone stole my crêpes ;-) It would have worked just fine. I haven't tried making bechamel with gluten-free flour, I have used potato starch instead, someone probably knows what is the best solution.
I'm about to try the soup recipe in this article right now, and the book it's from looks very inspiring.
posted by mumimor at 8:36 AM on October 28, 2022
Soy is a bean - could you confirm that it's an exception to the bean allergies? If so, maybe there are other legumes that would be tolerated as well?
I've experienced trying to make/buy vegetarian meals that are soy-free, lentil-free and pea-protein free, and it's really difficult since most vegetarian food (especially commercial) relies on legumes of some kind. Tolerating soy (and eggs) will go a long way though, both nutritionally and for difficulty level.
posted by randomnity at 5:40 AM on October 29, 2022 [1 favorite]
I've experienced trying to make/buy vegetarian meals that are soy-free, lentil-free and pea-protein free, and it's really difficult since most vegetarian food (especially commercial) relies on legumes of some kind. Tolerating soy (and eggs) will go a long way though, both nutritionally and for difficulty level.
posted by randomnity at 5:40 AM on October 29, 2022 [1 favorite]
Response by poster: Thank you so much - lots of new ideas of recipes to try. He's not a very adventurous eater for understandable reasons but he's already agreed to having quiche, fried rice, and quinoa so that's a great start. He is able to have soya at the moment although as he's allergic to peas and most other beans I'm not sure how long that will last...but he has agreed that if he develops an allergy to soya he thinks he will start eating chicken. He is definitely allergic to peanuts - they are his original and worst trigger and it went on from there.
posted by hazyjane at 6:15 AM on October 29, 2022 [2 favorites]
posted by hazyjane at 6:15 AM on October 29, 2022 [2 favorites]
I have a long list of allergies and intolerances, and am currently working through an elimination diet, so I am eating an extremely limited diet. I’m working with a dietitian, who offers with her fee a service called “living plate”. This is a meal planning site, where you can filter out foods you avoid, and it will give you a meal plan- I’d check it out. I do eat meat (and more than I want right now), as I can’t eat dairy, beans or nuts, which leaves eggs, tofu and peanut butter (which I can actually eat). If you are in BC I can refer my dietitian if you message me.
posted by Valancy Rachel at 8:45 AM on October 29, 2022
posted by Valancy Rachel at 8:45 AM on October 29, 2022
Is he allergic just to kale, or to all brassicas/cruciferous vegetables?
posted by aniola at 11:33 AM on October 30, 2022
posted by aniola at 11:33 AM on October 30, 2022
Response by poster: Just kale so far. He is fine with brocoli, cauliflower etc.
posted by hazyjane at 1:52 PM on October 30, 2022
posted by hazyjane at 1:52 PM on October 30, 2022
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or adding a dairy based protein powder to yoghurt?
posted by chariot pulled by cassowaries at 6:05 AM on October 28, 2022