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Sunday, May 22, 2011

“I’m going to starve to death!”


About 5 years ago I was a new nutritionist and I had a patient that I knew I had to take off all nightshades and gluten. He’s Italian. When I told him about his plan, I wasn't prepared for his reaction. He sat in front of me, mouth gaping, eyes wide, completely gobsmacked, stammering  “I’ll starve to death… I can’t eat anything!”. I hadn't the heart to tell him cheese was next off the list.

In his mind, I’m sure he thought I was punishing him for his obesity. Nothing could have been further from the truth. Yes he was class 1 morbidly obese, but an increase in activity and a decrease in calories would have brought down his excess weight without any issues.
This alone wasn’t going to solve all of his health problems. In all of his complaints I saw inflammation from head to toe with signs of gluten sensitivity and diabetes or heart disease looming nearer on his horizon.
I gave him his plan and off he went and a month later, at his first follow-up, he returned. He felt a lot better but was struggling trying
to adapt to his new lifestyle. Life, love and family were always shared around a table and for him it was going against nature and his family
not to eat the way he had grown up. The calorie-reduction was fine
but to avoid tomatoes, peppers and wheat was too much for him.
It didn’t matter that his heartburn and headaches were dramatically reduced; he was overwhelmed with all of the changes.
After that first follow-up, I never heard from him again.
Over the years, I have learned that some patients aren’t ready for serious change in their life to prevent disease and need to have a diagnosis of a disease before they’ll take action on their health.
Sad but true and I see it all the time. What people don’t realize is that they are not their diagnosis and in fact they can avoid diagnosis if they change their lifestyle, including the foods they eat. Is it a serious commitment, yes, absolutely. It’s also fun to use new foods in different ways, if you’re willing to learn.
With my first hard lesson under my belt, I now take time to evaluate my patient needs, see how willing they are to make serious changes and in some cases, ease them into a new lifestyle. I try to support them with meal plans and recipes to help them get started.
With my new quest outlined, I began researching, adapting and developing recipes without nightshades and gluten. It’s been a fun gastronomic journey, with a more than a few recipe duds along the way but here’s a substitution guide I learned, to help get you started.
For those naysayers – YES, you can still eat well!
What are nightshades anyway?
Nightshades are inflammatory foods: potatoes, peppers of all kinds, eggplant, paprika, tomatoes and tobacco. Although these are packed with valuable vitamins and minerals they contain a chemical alkaloid called solanine that can trigger pain in people who are susceptible. So, how do you know if you need to remove these from your diet?
Why should I avoid nightshades?
Nightshades should be avoided if you have an inflammatory disease like: arthritis (RA/OA), IBD, IBS, GERD (heartburn), heart disease, eczema or psoriasis, asthma, COPD, PMR, PMS, diabetes, depression, fibromyalgia, cancer, chronic headaches or migraines. For people who are trying to or have quit smoking the avoidance of these foods apply to you as well, especially tomatoes as they contain nicotine, yes nicotine.
How would I know if I’m having a problem with nightshades?
Stop and listen to your body after you eat these foods and see what it’s telling you. It can be as simple as; cramping or bloating in the gut (bowels not stomach), increased breathing problems, heartburn, a mild headache or even body aches and pains can increase subtly after eating these foods. It doesn’t mean you have to double over in pain to be affected; you may feel more pain and stiffness in your susceptibility areas (headache, gut, breathing, mood and joints) that no amount of massage, stretching or yoga can relieve.  
Ok one step at a time. Take out the nightshades.
What do you eat instead of nightshades?
This seems like a daunting task to remove all of these foods since they’re in most of our favourite recipes but be patient, experiment and see what works best for your palate. All the substitutions here offer the same or more nutrients and vitamins than the nightshade foods, which is great, more nutrient bang for your buck! 
In a macrobiotic diet it avoids nightshades completely, so head to your local library for a good macrobiotic cookbook that offers you recipe solutions to get you started on your gastronomic journey to wellness.
Potatoes
• Sweet potatoes or yams are a great substitute and offer valuable beta-carotene to your diet.
• White kidney beans or garbanzo beans offers protein, texture and thickening to soups, stews or pasta dishes without a strong taste or colour.
• Cauliflower gives you great added flavour, thickens soups and stews or can be used on their own instead of mashed potatoes.
Sweet Peppers (green, orange, yellow)
• Kohlrabi, a member of the turnip family, gives you lots of vitamin C and are great raw, in salads and can be cooked in a soup or stew. Make sure you cut off the tough exterior to get at the crunchy, turnip/radish like texture inside.
• Radishes for salads offer colour and texture with a little heat.
Hot peppers (cubanele, pimiento, pepperonini, paprika, poblano, ancho, jalapeno and chipotle chilies). This is the hardest sacrifice for the spicy food lovers, but rest assured these are good solutions for your heat fix.
• Horseradish, raw, grated into recipes will add heat without masking the flavour of your favourite recipe.
• Wasabi powder (without the green food colouring) adds lots of heat when needed and you can make it as concentrated (as hot), as you want.
• Garlic, adds great depth of flavour to any meal.
• Turmeric is a great to add colour to your recipes.
• Hot mustard is great to add in soups, savory baking and stews.
• Ginger, fresh grated or minced is a great option for a bit of a bite to snacks like hummus or in chicken soup.
Eggplant
• Summer squash – green or yellow zucchini offer a similar texture and great colour to any traditional eggplant recipe like moussaka.
• Sweet potato or squash are great, have a similar texture and offer amazing colour and taste to any recipe.
Tomatoes (red, yellow or orange)
This fruit is so popular and used in so many international dishes that is a hard to give you a one off substitute for every recipe. It’s more of a “substitute as you go” fruit given all its uses, but here’s a guide.
Salsas:
• Papaya or mango green or ripe, offer great sweetness, texture and colour to a traditional salsa recipe.
• Beets, offer amazing colour and sweetness raw or roasted.

Tomato Sauce:
• Pesto. Why stick with the traditional basil, pine nuts and parmesan cheese pesto - get inventive with different pesto’s: walnut and parsley, pepita and cilantro, almond and basil and instead of cows milk use Spanish goat Manchego in your pesto or use firm tofu for lactose free recipes.
• Cauliflower, mashed with garlic, caramelized onions and anchovy’s are a creamy solution to a creamy pasta or tomato sauce that doesn’t make you feel deprived.
• Roasted garlic with olive oil and a bit of unsalted butter offer a great spread as a pizza base or tossed with a gluten free pasta.
Ketchup:
This is the most popular condiment in the world and is added to most rubs and BBQ sauces, so how can you avoid it? Make your own, it’s not that hard to do.
• A puree of carrots, pears and apple add a beet or ground pomegranate (used in East Indian cooking) for colour with spices (including tamarind) and it’s a yummy substitute for any dish, adapt and make your own BBQ rub and sauce.
Indian foods
Oh the spices of India, the curries, dahl and chutneys that we know here in North America contain a lot of nightshades. Look for recipes from Africa and the south part of India, they don’t use a lot of tomatoes in their recipes.
• Tamarind is a popular African and South East Asian cooking paste, tamarind is sour when young but left to mature it’s sweet and can be used in, chutneys, jams and sauces (we have it in Worcestershire and HP sauce)
• Most curry spice blends may have cayenne, paprika or hot pepper based spices as part of the blend, which means it’s a no-no. It’s easy to make your own blend if you have a mortal and pestle or a coffee/spice blender. For whole seeds like cardamom or coriander you need to toast them in a dry pan before you blend them into a powder, to remove their bitter taste.
When in doubt on what to eat or how to cook your favourite dishes, look to your local library as your resource for all types of international recipes. The net also can have some great recipes but be aware that some may still contain some nightshades like potatoes or peppers even though they may not include tomatoes.

Chickpea Soup  Serves 4

1 tbsp Olive oil
4 Garlic cloves, minced
3 Shallots, chopped
2tsp Cumin
2tsp Coriander (dried or 1 tbsp fresh chopped)
5C Vegetable Stock
3 Sweet potatoes or Yams, diced
540mL Chick Peas, drained and rinsed
1tbsp Cornstarch
2tbsp Tahini (sesame butter)
1-2tsp Horseradish, fresh grated
Salt and pepper to taste

In a large saucepan cook the onions and garlic in the olive oil until softened, add salt and pepper, stir for another minute. Pour in the vegetable stock, sweet potatoes or yams and horseradish and cook until they almost tender but not mushy. Add the can of rinsed chickpeas to the soup let them heat through- only takes 5 minutes. Add the tahini and cornstarch and using an immersion blender, blend until smooth.
Vegetarian Nightshade Free Chili      Serves 4-6
This chili recipe is free from all of the common allergens AND it is free of nightshades (tomato, potato, peppers, paprika, eggplant).

2 tbsp olive oil
1 small onion, chopped
6 cloves of garlic, diced
2 large carrots, chopped
1 celery stalk, chopped
1 can black beans
1 can kidney beans
1/2L Low sodium vegetable stock (Imagine or Kitchen Basics)
1 tbsp turmeric
1 tbsp cumin
1/2 tsp ground clove
1/2 tsp coriander
1tbsp grated horseradish or ginger root
salt & pepper to taste
1 lb chicken ground (optional)


Saute veggies in oil until onions until they're slightly browned. Add all ingredients into a crockpot and cook on low 6-8 hours. Or into a stockpot and let simmer for 1hr and serve with gluten-free corn bread. 
You can use extra-lean ground meat or ground chicken in this recipe, just make sure you brown the meat with the onions and the garlic.

Now to tackle gluten-free… stay tuned for a gluten-free substitutions and recipes in the near future!

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