Working with Dietary Restrictions

If you have dietary restrictions, it can be extremely frustrating to try to follow a nutrition plan, especially one that hands you a meal plan filled with foods that you personally can't eat. It is easy to get overwhelmed trying to build a meal plan to get yourself healthier when you have a list of foods that are no longer considered safe for you to eat (but they're considered the "healthy" option for the majority of people). Let's talk about some of the more common dietary restrictions and focus on the "yes foods" for each that can be the foundation of a healthy-for-you diet.

IMPORTANT! If you do not have a diagnosis from a medical professional and you suspect you may have one of the below conditions, call your doctor now and schedule an appointment to start this conversation. Limiting foods that you are not actually allergic to or intolerant of can result in an unbalanced diet that is at higher risk of nutrient deficiencies.

That said, let's look at a few types of dietary restrictions that require eating differently for better health if you have them.

Food Allergies/Intolerances:

Allergies are an immune response to something you've taken into your body - the body attacks the allergen as if it's a disease and the symptoms you experience are often uncomfortable and sometimes life-threatening. Anaphylactic (IgE mediated) reactions are what most people think of with allergies - these reactions result in symptoms like hives, breathing problems, swollen eyes and so forth. Intolerances - with symptoms like GI upset, gas, diarrhea, are usually a different sort of allergy (non-IgE mediated), and avoiding your specific allergens entirely for either type of reaction would be best for your health. Suspected food allergies should be confirmed by an appropriate medical professional (like an allergist).

The top 9 allergens that must be clearly indicated on US packaged food labels are wheat, dairy, eggs, soy, fish, shellfish, tree nuts, peanuts and sesame. (Sesame was just added to the top allergen list in 2021 and labeling requirements took effect in 2023). If you are feeding someone with food allergies, the first thing you should be sure to do is to read those labels. Turn the package over, read the back, and look for anything written in bold type in the ingredients list, and for the allergen statement that is usually right below the ingredient list that states "Contains: ". If the food contains an ingredient that you (or a person you're cooking for) can't have, then don't buy it. If the label declares that a food was "Manufactured in a facility that also..." or "Processed on equipment that also..." handles an allergen that needs to be avoided, the food may or may not contain it, but could have gotten cross-contaminated. There is a known risk, usually small but real, and it's up to the allergic person to make a judgment call on these food items.

When dealing with food allergies and other types of dietary restrictions, I find that it's easier to move past the mental/emotional block by focusing on a "yes" list. It's so easy to get stuck thinking about all the things we can't eat that it's hard to think of what we can.

If you're allergic to wheat (often specifically to the gluten protein, which is also found in rye and barley), you can still eat: meat, seafood, fruit, vegetables, beans/lentils, most dairy, eggs, nuts and nut butters, and starchy foods that are made from corn, buckwheat, or oats.

If you're allergic to dairy, you can still eat: meat, seafood, fruit, vegetables, beans/lentils, eggs, nuts and nut butters, pasta (skip the cream-based sauces), most bread, and plant-based 'milks' for your cereal.

If you're allergic to eggs, you can still eat: meat, seafood, fruit, vegetables, dairy, most starchy carbs, but you'll want to check the ingredients list on most packaged baked goods. Milled flax (1 tbsp flax + 3 tbsp water, let it sit for a minute before using) is a great allergy-friendly plant-based egg replacement for home-baked goods.

If you're allergic to soy, you can still eat: meat, seafood, fruit, vegetables (except edamame/mukimame), dairy, eggs, nuts and nut butters, most starchy carbs (check the ingredients labels - soy lecithin is used in a lot of commercial baked goods). Watch out for salad dressings and deep fried foods (find out what kind of oil they use- most vegetable shortening is soy-based)

If you're allergic to fish, you can still eat: meat, shellfish, fruit, vegetables, dairy, eggs, nuts and nut butters, starchy carbs, beans/lentils, and baked goods. Skip the Caesar dressing - traditionally, there is anchovy paste in that one.

If you're allergic to shellfish, you can still eat: meat, true fish, fruit, vegetables, dairy, eggs, nuts and nut butters, starchy carbs, beans/lentils, and baked goods. Watch out for the natural red food coloring cochineal - it's made from cochineal insects which are related closely enough to shellfish that they trigger some people's shellfish allergies.

If you're allergic to tree nuts, you can still eat: meat, seafood, fruit, vegetables, dairy, eggs, peanuts and peanut butter, starchy carbs, beans/lentils, and you'll want to read food labels on baked goods in particular when you're shopping.

If you're allergic to peanuts, you can still eat: meat, seafood, fruit, vegetables, dairy, eggs, tree nuts and tree nut butters, starchy carbs, beans/lentils. Watch out when you go out to eat - ask what type of oil they use for deep-fried foods, as there are some places that use peanut oil as a 'healthier alternative'.

If you're allergic to sesame, you can still eat: meat, seafood, fruit, vegetables, dairy, eggs, nuts and nut butters, most starchy carbs (choose buns/bread without sesame seed or "everything" toppings), and beans/lentils. Exercise caution and ask the server which dishes don't have sesame if you enjoy Chinese, Japanese, Thai, Korean, and similar cuisine. Sesame oil or seeds are often included in dishes cooked in these styles.

If you have more than one allergy at play, of course it will limit you further, but in spite of how it may feel, there are plenty of options out there for you. It may mean you cook at home more often to be sure your food is safe for you, and you may need to set some boundaries around eating out or eating at the homes of friends/family in order to fuel your body with what is right for you.

Alpha-Gal allergy:

Worth mentioning, there is an increasing incidence rate of alpha-gal syndrome, which temporarily causes an allergy to a sugar found in mammal meat. This allergy is a relatively new thing, and is linked to tick bites, specifically Lone Star ticks. Your "yes" list if you are unlucky enough to contract this allergy will include poultry and fish, but exclude meat and animal-based gelatin. You'll be able to eat eggs, fruit, vegetables, beans/lentils, grain-based products, but may be asked by your medical provider to limit dairy (there is mixed data on dairy). Some people are back to eating meat within 5-10 years, and if you are bitten again, it can restart or extend the time frame in which you have allergic symptoms to beef, pork, lamb, veal, goat, bison, etc. This is a preventable food allergy - if your work or recreation takes you outdoors, use insect repellent and do thorough tick checks when you come in.

Celiac:

Celiac disease is different from allergies and must be diagnosed by a medical professional (like a gastroenterologist). It is also an immune response, but the mechanism isn't the same. People with celiac cannot process gluten (which is found in wheat, rye, and barley), and the body attacks it. Over time, it can cause damage to the intestinal lining and symptoms can be pretty severe. This is more than just a general "I don't feel that great after I eat a lot of bread", and people with this diagnosis should take care to avoid all gluten-containing foods. Their "yes" list is the same as for someone with a wheat allergy - meat, seafood, dairy, eggs, fruits, vegetables, nuts and nut butters, and starchy foods that are not made with (or cross contaminated with) wheat, rye, or barley.

Religious dietary considerations:

If you observe religious fasting days/seasons, or abstain from certain foods or beverages based on your beliefs, again focus on your "yes" foods rather than your "no" foods, and eat a balanced diet that provides adequate caloric intake during your non-fasting times. There are a wide variety of beliefs that might influence food choices, and your meal planning should work within that context to provide proper nutrition without having to choose between your spiritual and physical priorities. Reach out via the 'contact us' page if you would like help meal adapting your meal plan to your spiritual priorities.

Vegan/Vegetarian (Plant-based) dietary considerations:

A vegan or vegetarian lifestyle should include a wide variety of ingredients, just as an omnivorous lifestyle, in order to provide proper nutrition. Vegans, in particular, should be mindful of iron and B-vitamins, which tend to be more difficult to get adequate amounts of from plant-based foods. Never supplement iron before talking to your doctor, as it's easy to overdo that particular supplement and iron toxicity is a real thing - instead, try pairing iron-rich foods like beans with vitamin-C rich foods like greens or orange juice to improve absorption of the iron you have access to through foods.

Other specialized diets:

Your medical provider may ask you to limit your diet to prioritize including or excluding any number of nutrients, whether it's something that will help prevent a recurring condition, extend your quality of life while you live with a chronic condition, or prevent an adverse interaction with prescribed medications. It's important to follow those instructions, and if you are under medical care and want to talk to a nutrition coach about what that might look like for you, be sure to disclose the details of what your doctor is asking you to limit or increase intake of (in quantifiable per day or per week amounts, if possible) so that you can get the best help putting your food choices together to hit the goals set by your medical provider. It's outside of the scope of a Certified Nutrition Coach to write plans designed to treat a medical condition, but in cooperation with your medical team, we can help you figure out your own particular "yes" list, help you increase the variety of palatable food choices that meet your goals, and help hold you accountable to eating in the way that will help you live your best life.