Diet Dilemmas – Safe and Nutritious Food Substitutes

By Cassandra Sova, MS, RD, CD, CNSC

Finding safe food substitutes for some food allergens may be a difficult task, and many commonly used substitutes are not nutritionally equivalent to their allergenic counterparts. This article will guide you through food substitutes for some of the most common food allergens, helping you find safe food substitutes that are nutritious and delicious.

When first using food substitutes in cooking or in baking, start by finding recipes that are already allergen-free. Try recipes from the FARE newsletter, allergen-free cookbooks or reputable allergy friendly websites.

Always remember to read labels of all ingredients used in a recipe to make sure it is allergen-free.

Once you become more comfortable cooking allergen-free, you can try adapting your family recipes. To begin easing into the process, try finding recipes that only require one substitution. This will allow you to see how each substitute changes the final product.

Substitutes for Common Allergens:

Milk
There are many milk substitutes available such as soy, rice and almond milk. Always choose “enriched” or “fortified” versions. This indicates that calcium and vitamin D have been added. These milks are not created equal. Soy milk is the most nutritious option as it provides almost as much protein, vitamin D and calcium as regular milk. Rice and almond milk are low in protein and fat, but provide comparable amounts of calcium and vitamin D.

These milk substitutes often work well for cooking and baking. Choose the safe milk substitute with the highest content of protein and fat to help make a finished product that is closer to the original. Avoid using infant formulas for cooking and baking because heating them to high temperature can destroy the nutritional quality and may have a negative effect on flavor. Replace butter with milk-free margarine.

There are several yogurt substitutes that are comparable to the milk-based versions. Read the label to ensure that the yogurt has calcium added. These yogurt substitutes vary in protein content. Soy yogurt provides a good source of protein and overall is most similar to milk-based yogurt.

More cheese substitutes are now available in the marketplace. Be cautious, as they are typically not nutritionally equivalent to milk-based cheeses. For example, most soy cheese is lower in fat than milk-based cheese. Veggie cheeses are usually low in calories, protein, fat and calcium. Although the nutrition is not comparable, the taste and texture help make delicious meals. With both milk-free yogurt and cheese, read the ingredient label very carefully to ensure there is no milk cross-contact.

Wheat
For everyday cooking, create a meal with wheat-free sides and entrées. Try loaded baked potatoes, stir-fry over rice, or quinoa stuffed peppers. There are many wheat-free grains available, such as rice, corn, millet, potato, tapioca and quinoa. Many of these grains are also made into wheat-free flours.

Wheat-free flour blends typically produce a better texture in baked products than replacing wheat with a single grain flour. Wheat-free flour blends are available in your grocery store or health food store, or you may make your own flour mixture using the following recipe:

  • ½ cup millet
  • ¼ cup potato starch
  • ¼ cup oat flour

Many wheat-free recipes rely on refined flours like white rice flour instead of whole grains. These flours are usually less nutritious than regular versions. They may be lower in iron, folic acid, other B vitamins, and fiber. Try using more nutritious flours like brown rice flour, quinoa flour or chick pea flour. Eat more fruits and vegetables for a boost of vitamins and fiber. Take a complete multivitamin/multimineral supplement if you are avoiding wheat to meet all your vitamin and mineral needs.

Eggs
Try a commercial egg replacement, or use one of the following substitutes for one egg for baked goods:

  • 1½ tablespoon water, 1½ tablespoon oil, and 1 teaspoon baking powder
  • 1 teaspoon baking powder, 1 tablespoon water, and 1 tablespoon vinegar
  • 1 teaspoon yeast dissolved in ¼ cup warm water.

Try using tofu to replace the egg in meatloaf. Use soy milk as a binder to help
the crumbs stick to chicken tenders.

Peanuts and Tree Nuts
Mix seeds with raisins or other dried fruits. Add dry cereal or allergen-free chocolate chips to create your own trail mix. You can also use sunflower or soy nut butter as peanut butter substitutes. These products are versatile and great for making allergen free sandwiches or incorporating in all kinds of recipes from snacks to cookies to allergen-free shakes. Check out the manufacturers’ websites for recipes using their products.

Focus on Taste and Nutrition:
When choosing safe food substitutes, focus on both taste and nutrition. Read
the food label to find food products that are nutritionally similar to the foods they
are replacing. It is also important to eat a variety of foods from all food groups. Talk to your doctor or dietitian if an entire food group is eliminated because of your food allergies.

Cassandra Sova, MS, RD, CD, CNSC, is a clinical dietitian specialist in the Allergy and GI Department at Children’s Hospital of Wisconsin.

This article was originally published in the Winter 2014 issue of FARE’s Food Allergy News. Read more of the newsletter here.

Maintaining a Healthy Diet with Food Allergies: Cheryl Harris, MPH, RD

cherylpic littleWhen you have food allergies, it’s often a challenge to find foods that are safe, tasty, and nutritious all at the same time. Worrying about hidden allergens, reading labels multiple times, and the caution you have to take with every meal can make it difficult to find a balanced diet. As a dietician, Cheryl Harris, MPH, RD aims to help people, especially those with food allergies or celiac disease, find ways to live and eat well. She will be speaking on the topic at FARE’s Food Allergy Conference in Arlington, VA on May 18.

We asked Cheryl to tell us a bit about her session and her experience at our conferences in the past.

You’ve been to a conference before – what was your favorite part?

FARE always does a great job. I think we’re so very lucky to have Dr. Wood in our backyard, and it’s so gracious of him to present every year. I mean, how great is it to have a Q&A with one of the go-to allergy experts in the country? It’s quite a privilege to get the latest and greatest in the allergy world directly from the source. I’m also really looking forward to the session on managing emotional issues with food allergies because that is so critical, and it’s an area that often gets too little attention.

What will you be covering in your session?

We’ll be covering a range of topics, from nutritional potholes and how to avoid them to tips and tricks that help make life more wonderful. Obviously the first step is strictly avoiding the allergen, but the second step is supporting yourself or your child to ensure a balanced, nutritious, and varied diet.

What challenges do people with food allergies typically face from a nutritional standpoint?

Oh, that’s the hardest one to sum up briefly, because it totally depends on what the problematic food and the child’s age. Every allergy has its own nutritional impact, and of course, the more severe the allergy, the harder it is, especially for people who can only use foods from a dedicated allergen-free facility. Not surprisingly, research studies have shown that children with multiple allergies and/or milk protein allergies are much more likely to be underweight or malnourished.

Food allergies inevitably change the whole family’s relationship with food. Many toddlers are picky in the best of times. Not surprisingly, young children who have learned that food can lead to a trip to the ER are often much more reluctant to try new foods, and who can blame them? It adds an extra layer of hurdles for parents.

There’s still time to register for one of our upcoming conferences, being held in Arlington, VA (May 18); and Anaheim, CA (June 1). Register today on our website: www.foodallergy.org/conferences

Read more about Cheryl on her website www.harriswholehealth.com