Introduction Since the first edition of Recipes for Dairy-Free Living there has been a growing awareness and diagnosis of food intolerances, sensitivities, and allergies.Increasingly, people have been looking for alternative ways to eat the foods they love without experiencing the ill side effects. Many individuals who experience health issues related to dairy food consumption have found that wheat and gluten are also contributing factors, myself not withstanding. Although I had discovered my dairy allergy, it wasn't until several years later that I learned I was also intolerant to wheat and gluten. To better understand what it means to be gluten intolerant and eliminate it from your diet, I've added a section on gluten to the introduction that addresses this growing concern and its impact on diet-related health issues. In this edition, each recipe is not only dairy-free but also 100 percent wheat- and gluten-free! But I didn't stop there. Recognizing that many people who experience food intolerances may also face multiple food allergies, I've included at the top of each recipe, a coding system that indicates other common allergens the recipe is free of. If you see an asterisk next to an ingredient, it's simply alerting you that the ingredient may be replaced with other options. For example, if you see an asterisk next to soy yogurt* in an ingredients list, and you have a sensitivity to soy products, this indicates that soy yogurt can be replaced with rice or almond yogurt to make the recipe soy-free. Furthermore, each recipe has been reformulated to reduce unnecessary oils and refined sweeteners without compromising flavor. The expanded Basics section is the backbone for many of the recipes in this book and is where you will find the master gluten-free flour mix (page 172), instructions for making your own nondairy nut milk (page 173), and nut cheese (page 175). You will also find new recipes in every chapter, photos for inspiration, and an updated listing of manufacturers, distributors, and other resources. The Dairy-Free & Gluten-Free Kitchen provides the basic information you need to manage your dairy- and gluten-free decisions and offers a collection of delicious recipes--prepared with accessible ingredients--that will make implementing a dairy- and gluten-free diet effortless. I'd like to extend my sincere appreciation to all of my readers and clients for sharing your food intolerance discoveries over the years--each of you has given me the inspiration for updating and revising Recipes for Dairy-Free Living and bringing you this second edition. Thank you and enjoy! Understanding Dairy Issues Dairy products and their isolated constituents come in many forms and are in more foods than you might realize. The extracted protein, fat, and sugar from dairy have many different uses in food manufacturing and are used to lend texture, structure, and flavor to so many everyday foods. Beyond the obvious items in the dairy case, many other products contain dairy in the form of lactose or milk proteins. One example is a dairy protein called casein that is often added to milk-alternative cheeses to enable the cheese to melt. In addition to various processed food items, dairy components are also used in pharmaceutical drugs sold both over the counter and by prescription. So the first step in implementing a dairy-free lifestyle is to have a basic understanding of what dairy is and how it can affect us. Lactose Intolerance Although the terms lactose intolerance and dairy allergy are often used interchangeably, they engage very different body processes. Lactose is milk sugar, a carbohydrate, which occurs naturally in the milk of animals. Many people are intolerant to milk products because they lack the enzyme called lactase. This enzyme, found in the gastrointestinal tract, is critical in the digestion of lactose. If the lactase enzyme is missing or depleted, the gastrointestinal tract cannot adequately break down the milk sugar, leading to a wide variety of symptoms. Individuals experiencing this are described as being lactose intolerant . The symptoms of lactose intolerance can vary greatly from one individual to the next as well as varying within the individual. They include, but are not limited to, stomach cramps, bloating, flatulence, and diarrhea. It's difficult to estimate how many people are lactose intolerant. However, it is estimated that up to fifty million Americans suffer from some form of dairy intolerance. The condition encompasses many ethnic groups; age also plays a major role in the ability to tolerate dairy products. As we mature, our body's ability to produce the lactase enzyme in our gastrointestinal tract begins to diminish. That is why lactose intolerance can intensify with age. Tolerance is dependent upon the amount of lactase in each individual's system and the amount of dairy products ingested at any given time. Think of it this way: If you have a limited amount of lactase enzyme in your gastrointestinal tract and you ingest limited amounts of dairy, your body may be able to break the lactose down on its own. However, if you have a limited amount of lactase enzyme available and you ingest moderate to high amounts of dairy, you will have exceeded your body's capacity to digest the lactose and thus will experience symptoms. Unfortunately, there is no way to establish what constitutes limited, moderate, and high dairy intake, because it is completely individualized. To some people, limited amounts of dairy can translate to milk on their cereal in the morning, yogurt in the afternoon, and pasta with Parmesan cheese for dinner. For others this amount of dairy would be considered high or excessive. And some people could tolerate this amount of dairy only if they avoided dairy products entirely for the next several days. Many people who are strictly lactose intolerant can avoid problems simply by taking a dairy digestive aid. These digestive aids are widely available and can be purchased over the counter at supermarkets, drugstores, and specialty stores. The amount of lactase enzyme you will require will depend on how much dairy you ingest and how much lactase is already present in your gastrointestinal tract. Select a product that has the right amount of FCC lactase units to complement your digestive tract. For example, when comparing various products I found that the suggested dosage could vary drastically from one product to the next, with one brand containing 9,000 FCC lactase units per caplet and another containing only 1,000. Milk Proteins and Allergy Milk proteins come in many different forms, several with names that are difficult to pronounce. The important thing is to be able to recognize them when they appear on a label. The main ones to look for are casein and whey, but proteins can also be identified as hydrolysates, caseinates, lactalbumin, and lactoglobulin. All of these are milk proteins. As with the symptoms of lactose intolerance, reactions to milk proteins can vary greatly from one individual to the next. Reaction to milk proteins is regarded as a food or dairy allergy. It is important to understand that a food allergy triggers an immune system response to compounds, in this case proteins, in an offending food. It is caused by an allergic antibody called IgE (Immunoglobulin E). However, it is significant to note that it is possible to be both lactose intolerant and develop a food allergy to dairy proteins. Symptoms of dairy allergy tend to range in severity from digestive issues including: stomach cramps, bloating, flatulence, diarrhea, constipation, bleeding from the bowel, rectal fissures, and itching, to respiratory problems, such as asthma, sinus and lung congestion, ear aches, itchy and watery eyes, skin rash, hives, and eczema. And possible behavioral problems, including migraine headaches, fatigue, brain fog, irritability, and anxiety. If you suspect that you may have a dairy allergy, seek out a medical professional specializing in food allergies, a nutritionist, or naturopath, who can help you understand and manage your condition. Listed in the bibliography (see page 190) are resources for finding a professional in your area and obtaining additional information. The Need for Calcium It's true that dairy products are a source of calcium. So, when dairy is no longer an option in our diet, we need to find alternative ways to fulfill our daily calcium requirement. Calcium rich foods are plentiful in the plant kingdom, particularly in vegetables, legumes, grains, nuts, seeds, and, yes, even fruit. I was quite surprised to find how many calcium-rich foods I was already eating as part of my normal diet. But the question remained, was I getting enough calcium? To be sure that I would get the calcium my body needed, my doctor recommended that I take a calcium with magnesium supplement, along with vitamin D. She emphasized that I increase the amount of plant-based foods in my diet and that the supplements were simply an insurance policy. As to which type of calcium supplement works best, Calcium Carbonate or Calcium Citrate both are good. Calcium carbonate is inexpensive but should be taken with an acidic beverage for best utilization. Calcium Citrate is a bit more expensive but is more easily absorbed, particularly for individuals taking any type of acid blockers. Daily calcium requirements vary; check with your doctor to be sure you're at the correct level. When you understand the role calcium plays in your overall health and you know which foods are high in calcium, making an informed decision on how you will meet your daily calcium requirement becomes a lot easier. To find out more, I turned to Kazuko Aoyagi, an expert on the subject of diet, nutrition, and exercise. Calcium 101 by Kazuko Aoyagi Most people know that calcium is a mineral necessary for forming and maintaining healthy bones and teeth. However, few people realize that calcium also plays an important role in regulating other body functions, including: blood clotting blood pressure enzyme activation contraction and relaxation of muscles (including normal heartbeats) nerve transmission cell membrane permeability (allowing fluids and other materials to pass in and out of cells) About 98 percent of the calcium in our body is stored in our bones. When there is not enough calcium present in the diet, calcium is "borrowed" from the bones and released into the bloodstream to maintain these essential body functions. Symptoms of calcium deficiency include osteoporosis, rickets, and impaired muscle contraction (muscle cramps). Over time, dietary calcium deficiency can lead to a loss of bone density, resulting in osteoporosis. However, there is still much debate over whether a lack of dietary calcium is the main cause of loss of bone density. Although dairy foods are often touted as a way to build strong bones, there has never been a study that conclusively links the consumption of dairy products to bone health. Factors Contributing to Healthy Bones Osteoporosis, or the thinning of the bones, is often associated with older people, but the process can start earlier than you might expect. Peak bone mass is achieved by age twenty-five, so it is important to build strong bones as a youth. After age twenty-five, bone mass replenishment slows, and maintaining bone mass becomes increasingly important. Once bones begin to thin, it is hard to reverse the trend with calcium alone. Many factors, such as diet, exercise, medications, hormones, heredity, and lifestyle choices, can influence both the development of bone density and the ability to maintain bone density during the aging process. Diet. Bones require a wide variety of nutrients to develop normally and to maintain density after maturity. Simply getting the recommended dietary allowance (RDA) of calcium is not enough to keep your bones healthy. Vitamins and minerals, along with proper nutrition, all play a major role. The key nutrients include protein, calcium, phosphorus, magnesium, zinc, boron, manganese, copper, vitamin D, vitamin C, and vitamin K. Magnesium is especially important, as it is necessary for transporting calcium to the bones. Consuming gallons of milk or taking hundreds of calcium pills will do no good without the presence of magnesium and other elements and minerals. Ironically, drinking too much milk or taking a large dose of calcium supplements can actually cause a calcium imbalance because milk does not contain enough magnesium. Calcium Absorption. Calcium balance in adults is complex because your body does not absorb all of the calcium you ingest. Once you have met the RDA for calcium of 1,000 milligrams, your body will absorb only what it needs and excrete the rest. Phytates, found in grains, and oxalates, found in green leafy vegetables, reduce the body's ability to absorb calcium somewhat by binding to the calcium so that it cannot be absorbed efficiently. However, recent studies have shown that the amount of fiber, phytates, and oxalates found in the average American diet do not appear to pose a problem for calcium absorption. Research also revealed that vegetarian diets provide adequate amounts of calcium, as measured by body stores. Exercise. Weight-bearing exercise stimulates bone formation and helps build and maintain strong bones. Thin bones become a major problem when muscles weaken significantly and when bones aren't challenged with weight. A study conducted by NASA showed that weightlessness in space decreased skeletal density in humans and primates by as much as 10 percent. Unfortunately, as we age, most of us become less physically active and the amount of weight-bearing exercise in our daily routine diminishes. Medications and Hormones. Some medications can actually inhibit the amount of calcium absorbed from food by increasing the calcium lost through the kidneys. One example is a commonly used asthma medication containing corticosteroids. Corticosteroids may also interfere with the production of sex hormones in both men and women, which can contribute to a decrease in bone density. The level of gonadal hormones (estrogen for women and testosterone for men) also appears to regulate bone mass by influencing the absorption of calcium in the intestines. If you are taking medications, you should discuss your nutritional concerns with your doctor. Heredity and Lifestyle. Lactase deficiency is particularly common among North American African Americans, Asians, Mexicans, Native Americans, and people of Mediterranean or Hispanic origin. In most people, it appears to be an acquired rather than inherited disorder, sometimes beginning after a viral or bacterial infection or other disorder of the gut. Lifestyle choices, such as cigarettes, alcohol, and a high sodium intake and animal proteins can also contribute to calcuim loss. If you're interested in learning more about calcium and nutrition, see the additional resources listed in the bibliography (page 190). Kazuko Aoyagi, PhD, is an associate director of technology at a pharmaceutical company and an Advanced Study Program Fellow at MIT, where she continues her study in medicine. Dr. Aoyagi writes articles for various publications, including Prevention magazine, Impala Racing Team newsletters, and health and fitness websites. Dairy Alternatives in the Supermarkets When I started cooking dairy-free, one of my biggest tests of success was cooking for my family and friends. Would they notice a change? Would they find my desserts rich and satisfying? I began in the health food store by going on a shopping spree, loading up with all kinds of alternative products for milk, butter, cheese, and yogurt. If I was going to make dairy-free meals enjoyable, it was important to find alternatives I liked. I tried cooking and baking with some of these products and soon found out that not all dairy alternatives are created equal. I also realized that I couldn't run to the natural food store every time I needed something. So I changed my approach: I began looking very closely at the new products making their way into supermarkets and was pleasantly surprised to find almost all of the alternatives I was seeking. Recognizing how busy our lives are these days, I've made sure that all of the recipes in this cookbook use ingredients that can be purchased from your neighborhood supermarket. The Dairy-Free & Gluten-Free Kitchen uses common, easily obtained ingredients. If you have difficulty finding a product used here, turn to the manufacturers and distributors section in the resources (page 192) for a comprehensive guide with contact information that will allow you to communicate with the manufacturer directly. Excerpted from The Dairy-Free and Gluten-Free Kitchen by Denise Jardine All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
