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Eating Well with Dietary Restrictions

Planning, preparing, and serving healthy meals consistently can be difficult for everyone.  It can be especially difficult when you or someone you’re serving has a dietary restriction. From a school birthday treat, to a sample at the grocery store, consumption of seemingly benign foods can be risky for those with dietary restrictions. Through food education, careful planning, and effective communication, healthy and satisfying meals can be enjoyed by all regardless of restrictions.     

Education & Communication
When planning a meal for someone with dietary restrictions, it’s important to listen intently and to ask clarifying questions. When requesting accommodations for your own dietary restrictions, it’s important to be very clear about your eating guidelines and to offer suggestions for substitutions for your restrictions. The term “dietary restriction” is used to broadly describe various guidelines for food exposure and consumption. Intolerant, allergic, preferred, and forbidden are just a few of the key terms used to discuss what foods people do, don’t, can, and cannot be exposed to or consume. Food allergies can be fatal; therefore, a medical doctor is the most reliable source of information on this topic and should be consulted before restricting anything for an extended period of time. Now we’ll take an in-depth look at some common dietary restrictions and how we can serve and eat healthy food with these guidelines in mind.

Allergies
Food allergies cause the most severe physical responses of all of the dietary restrictions that we’ll discuss. The severity of an individual’s allergic reaction varies widely based on tolerance level and current physical health. However, for some people with a food allergy even minimal exposure can trigger anaphylaxis (a dangerous histamine response). If not treated immediately, the results can be fatal as the throat swells, breathing is labored, and blood pressure drops drastically. Those aware of having allergies this severe may opt to carry an emergency treatment epinephrine auto-injector, which immediately reverses the symptoms.
Due to their potential fatality, the Food Allergen Labeling and Consumer Protection Act (FALCPA) of 2004 requires that the presence of certain food allergens be highlighted in clear language on product ingredients lists. Even so, the risk of cross-contamination and cross-contact is still a possibility. Cross-contact is accidental exposure through products that don’t contain the allergen as an ingredient but have come in contact with said allergen during processing, shipping, or handling. Guaranteeing that a product wasn’t exposed to specific allergens throughout the entire manufacturing, shipping, and storage process requires highly involved monitoring and even then isn’t infallible. Therefore, all intended ingredients, even those that are seemingly innocuous, must be thoroughly reviewed in order to prevent an allergic reaction.

Wheat & Gluten
Wheat is a common food allergen and affects those with dietary restrictions differently depending on the type of restriction. While the terms are often used interchangeably, wheat allergy, celiac disease, and gluten sensitivity are all distinct dietary guidelines. Since there are numerous protein types found in wheat, any number of them may cause an allergic reaction in someone with a general wheat allergy. This particular allergy is typically managed through a wheat-free diet as it isn’t necessarily gluten or gluten alone to which one is allergic. An allergy specifically to the gluten protein is known as celiac disease. This chronic autoimmune digestive disorder requires a strict gluten-free diet, which also implies a wheat-free diet. Non-celiac gluten sensitivity is related to intolerance to gluten or other components of wheat and therefore may also restrict gluten in the diet. Gluten is typically found in grains like barley, wheat, andrye but is also common in products one might not expect, like ketchup and beer. Therefore, looking for products that carry a gluten-free label may be a safer option than those without, even if they seem like they shouldn’t have gluten in them. These distinctions are key to properly understanding what to expect when referencing gluten and gluten-related disorders.

Medical Condition Restrictions
Dietary restrictions are also commonly used as a way to manage specific non-allergy medical conditions. Conditions like diabetes, high blood pressure, and inflammatory bowel disease may call for certain dietary restrictions. Diabetic dietary restrictions are based on the two most prevalent types of diabetes, individual nutritional goals, and individual doctor’s recommendations. A delicate balance of carbohydrates, protein, fats, vitamins, minerals, and fiber intake is required to regulate blood-glucose levels in diabetics. Therefore, a doctor may recommend restricting carbohydrate intake in order to help manage diabetes. Similarly, a diet based on high blood pressure is personalized by a medical professional, as a high sodium intake may increase blood pressure. When serving food to someone with dietary restrictions from high blood pressure, erring on the side of caution by restricting salt or seasoning is a harmless option, but discussion is ultimately the most effective way to ensure inclusive meals. In the case of inflammatory bowel disease, or IBD, the intestinal tract may become irritated when certain trigger foods are ingested. A medical doctor may recommend a high-protein and/or high-calorie diet for someone with IBD. Since IBD trigger foods are specific to each individual, guidelines should always be requested by or given to meal hosts. Ultimately, a medical doctor is the most qualified person to determine whether any foods should be restricted on a long-term basis.

Peanuts, Tree Nuts, & Soy
Other commonly confused, but distinctly different, food allergies are to peanuts, soy, and tree nuts. These types of allergens are commonly processed and handled similarly, making cross-contamination and cross-contact a plausible risk. When products made without allergens are processed in the same facility as an allergen, consumption of these products may still trigger an allergic reaction. All three of these types of allergies can cause very serious allergic reactions, even when exposed in small amounts and symptoms typically manifest immediately after exposure. This is especially important to remember around holidays when children are offered candy and treats without labels that may not contain allergens but may have been cross-contaminated. With that in mind, allergic reactions to peanuts are the leading cause of food-allergy induced anaphylaxis. Avoiding products that contain these types of allergens requires especially careful attention to detail, as they are abundant even in unexpected food. For example, many children are exposed to soy very early on in life as it is a main ingredient in soy-based baby formula. This requires being adept at label reading and being able to spot other ingredient terms commonly used in place of the more easily recognized terms. In this case, conscious communication and diligent label reading is key to preventing allergic reactions.

Intolerance
Another form of dietary restriction is due to food intolerance, an inability to breakdown or properly digest specific components of certain food. While an allergic reaction triggers an immune system response via antibody production, intolerance triggers a digestive system response, often through digestive discomfort. Food intolerance symptoms typically manifest gradually, sometimes only after prolonged exposure, or only when exposed to large quantities. Like food allergies, food intolerance should be diagnosed by a qualified medical professional who can advise on necessary restrictions.

The most common food intolerance, lactose intolerance, is an inability to properly digest milk or certain dairy products. Intolerance to lactose comes from a lactase deficiency. Lactase is the enzyme produced by the small intestines used to break lactose into even simpler sugars in order to absorb them into the bloodstream. Lactase deficiency occurs when lower levels of lactase are produced than necessary. This causes lactose malabsorption, which is when undigested lactose is broken down by bacteria in the colon instead of by lactase in the small intestines and creates gas. Reaction severity varies based on how much lactose an individual can tolerate but may ultimately lead to digestive discomfort.

Dietary Preferences
Dietary preferences also vary widely and are uniquely individual as they can be related to ideological lifestyle, religious, or personal preference. Variations of vegetarianism are common lifestyle dietary preferences. Judaism, Islam, Hinduism, and Buddhism are common religions with dietary restriction preferences. While exposure to avoided food groups doesn’t typically result in immune system or digestive system responses, it can still result in emotional distress and physical discomfort.

Lifestyle Preference
Restricting meat, animal products, and animal by-products is common for ideological and environmental reasons. Vegetarianism is a broad term used to describemultiple specific dietary restrictions and specifically a diet free of meat products and/or animal products. A lacto-vegetarian can consume dairy products but does not eat meat, eggs, poultry, or fish. An ovo-vegetarian can consume eggs but does not eat dairy products, meat, poultry, or fish. A lacto-ovo vegetarian can consume dairy and eggs but does not eat meat, poultry, or fish. In these cases the common restrictions are meat, poultry, and fish, while a preference for eating eggs and dairy products makes the three distinctly different. The most restrictive subgroup of vegetarianism, vegans, restrict all animal products/by-products, including seafood, eggs, and dairy products. All of these forms of vegetarianism require careful label reading, as many of the restricted foods are used as ingredients in seemingly animal-free products. For instance, Jell-O and marshmallows often contain gelatin, which is derived from animal by-products and is restricted for someone who avoids all animal products and by-products. These dietary restrictions may result in lifestyle restrictions as well, including avoiding leather, bee products, and bodycare products made with animal by-products. These distinctions are important to understand and further clarify for each individual in order to avoid accidental ingestion of a restricted food.

Religious Preference
Religious dietary restrictions also vary widely based on individual preference and ideological views. Common religious dietary preferences include Jewish Kosher foods, Muslim Halaal, Hindu vegetarianism, and Buddhist vegetarianism.

Both strict Hinduism and strict Buddhism call for a vegetarian diet, but each has its own distinctions and allowed exceptions. In strict Hinduism vegetarianism is common but the consumption of beef is even more widely restricted, as cows are sacred in the religion. Strict Buddhism also calls for vegetarianism but diets vary based on geographic location and culture.

In the Jewish religion, dietary laws, or Kashrut, can be complex and are extensively detailed based on food preparation, storage, and consumption. Kosher refers to all foods that are acceptable for consumption when following Kashrut. Kosher food must be prepared in a Kosher kitchen, where dairy, meat, and pareve foods, or neutral foods that contain neither meat nor dairy ingredients, are all kept separate. This separation extends to using different cooking tools for each of the sections. If the kitchen in question doesn’t typically serve strictly Kosher meals, this may require locating a local Kosher catering company for a certified Kosher meal. The serving materials must also be Kosher, meaning plates, cups, bowls, and utensils must not have ever been used for a non-Kosher meal. Specifically, Kashrut may mean not eating meat and dairy products in the same meal or waiting six hours between consuming the two in the same day, no non-Kosher wine, no pork, no shellfish, no split-hooved/cud-chewing animal products, and no fish unless it has fins and scales. While these restrictions are highly specific, adherence varies widely and inquiring about individual preferences is the best means to ensure a suitable meal.

Islamic dietary laws, or Halaal, are also variable depending on individual preferences and practices. Generally, Halaal restricts the consumption of alcohol in any form, lard, gelatin, whey, animal rennet, carnivorous animals, seafood without fins or scales; pork/pork products are strictly forbidden. Aside from pork, some meat is permitted for consumption, but must be strictly prepared according to Halaal guidelines. During preparation, utensils used to prepare Halaal foods must be separated from non-Halaal utensils. Pregnant women, the ill, and young children are often not required to observe these restrictions. However, each individual may observe distinct restrictions at their discretion, so personally inquiring about dietary preferences is most effective.

Eating Well
Now thatwe have a better understanding of some common dietary restrictions, let’s take a look at some of the ways we can eat well and serve good food to others with those restrictions in mind. Here are some helpful tips for eating well with dietary restrictions, from planning to preparing and serving.

1) Learn About Food
Understanding food groups, how specific foods are processed, and their nutritional value is important for everyone, but especially for those with dietary restrictions. Being able to predict how your body might respond to specific foods can prevent discomfort and stress in the long run. Willy Street Co-op offers a plethora of classes on food, from growing it to cooking it. These classes can be an invaluable resource for anyone interested in further food education.

2) Learn to Read Labels & Ingredients Lists
We’ve discussed the importance of reading labels, but I can’t stress enough how important this skill is and how handy it can be when having a meal prepared by someone else. Becoming familiar with ingredients list terms that are used in place of standard wording is also a useful skill. Also, remember to look out for a future class on understanding labels at the Willy Street Co-op in the coming months.

3) Plan Meals
Planning meals not only opens the door to discussion about dietary preferences, it also aids in discussion about individual food narratives. Meal planning can become a part of a routine that makes eating the food you’ve carefully planned and prepared a uniquely personal experience. It’s also an opportunity to involve those with whom you share meals in the planning and decision-making process.

4) Track Consumption
There are numerous smartphone apps, online programs, and other newfangled technologies that are useful for tracking food consumption. Ultimately, good old pen and paper also do the trick. You can keep track of any number of things, from everything you eat to macronutrients. This detailed log would be especially handy if you suspect you have an allergy or intolerance. Visiting your doctor with your suspicions is sufficient, but visiting your doctor with a food diary provides extremely helpful information for your doctor to determine by what and how much you are adversely being affected.

5) Shop the Bulk Aisle
The Willy Street Co-op’s Bulk department is a great resource, especially when shopping for diners with dietary restrictions. You can find hard to find ingredient substitutions and alternatives thatmake preparing food with restrictions just as much of a treat as preparing food without restrictions. Being able to get the exact amount you need allows you to try various ingredients and cuts down on waste. Everything from coconut flour to no-salt added spices can be found in the Bulk department. With considerations like separating gluten-free oats from gluten-containing oats, the Co-op’s conscious inclusivity makes it a dietary-safe haven for those with restrictions. (Due to the possibility of cross-contamination in our bulk aisle, we don't recommend that anyone with a severe allergic reaction to a food purchase a product from this area; packaged food with labeling declaring it to be free of the relevant allergen is safest.)

6) Look for Alternatives and Substitutions for Restricted Foods
If you have a dietary restriction, trying out new ingredients for dishes you might have loved pre-restriction is a good way to begin adapting to your new diet. It’s often the case that others with the same restriction have discovered substitutions and alternatives for restricted foods. Doing some research on the topic may yield a surprising amount of results and possible options.  For instance, brown rice pasta is a great substitute for wheat pasta and coconut flour is a great alternative to wheat flour. Small alterations to recipes can make all the difference for someone with dietary restrictions. You can also try some of the dishes made with substitutions or alternative ingredients at the Willy Street Co-op Hot Bar for some great meal ideas.

7) Set Food Goals
Food goals can be anything from enrolling in one of the Willy Street Co-op’s many cooking classes to eating at consistent times throughout the day. Food goals help us keep nutrition in the forefront of our minds and keep us involved in our personal nutritional development. Ultimately, the goal is to learn how to consistently make positive nutritional choices. Also, the Willy Street Co-op hosts Katy Wallace, an exclusive nutrition consultant who offers free lectures and individual in-store consultations for Owners looking to reach nutritional goals.

Now that we’ve reviewed dietary restrictions and strategies for eating well with them in mind, you should feel confident in your ability to communicate with others about restrictions. You are now equipped with the necessary tools for planning, serving, and preparing healthy food for anyone, regardless of restriction. It’s important to keep in mind that any long term restriction of food should be directed by a medical professional. If you suspect you have a reason for a dietary restriction, your doctor should be your first source of information. Remember, the Willy Street Co-op has been around long enough to see and adapt to all kinds of dietary restrictions, so when you’re ready to learn more about dietary restrictions, talk about them with people who are just as passionate about them, or try some restriction-free dishes, you know where to find us. Go forth and eat well!

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