I Am Intolerant…


…Mainly to fodmaps, but increasingly to people making snippy little comments and writing comment pieces in national newspapers about ‘faux’ food intolerances because they aren’t allergies.

These kind of articles are clickbait pure and simple, based round the idea that endless amounts of people are saying they don’t like stuff by calling it an allergy instead, all written by someone who doesn’t know what an allergy is versus an intolerance. Even the good ones like this are designed to make readers sneer.

Here’s the Oxford English Dictionary definition of an allergy: A damaging immune response by the body to a substance, especially a particular food, pollen, fur, or dust, to which it has become hypersensitive.

1.1 informal A strong dislike: their allergy to free enterprise.

And here’s the one for intolerance: Unwillingness to accept views, beliefs, or behaviour that differ from one’s own: a struggle against religious intolerance an intolerance of dissent

1.1 An inability to eat a food or take a drug without adverse effects: young children with lactose intolerance [count noun]: he may have a food intolerance to dairy products

You’ll note that while they have some overlap, they aren’t the same thing. In very general layman’s terms allergies tend to cause immediate reactions such as hives, swelling of the throat and lips and anaphalyxis. Intolerances tend to have delayed reactions such as diarrhoea, nausea, vomiting, bloating, fatigue and joint pain.

People can be born with allergies or develop them as they age. They can also grow out of them as they age as is not uncommon with cow’s milk protein rather than lactose. Intolerances can be inherent like the billions of people who are lactose intolerant or be brought on by other things such as a virus or food poisoning or pregnancy. Both involve the human immune system which is a fiendishly complicated beast that even doctors and scientists barely understand in its complexity.

Medicine is a constantly evolving thing and for example only a decade ago fodmaps had never been heard of even though people were having issues with them. Nut allergies killed children for generations but people thought they had choked on the nuts rather than had anaphylaxis. Babies and children were labelled as ‘failing to thrive’ when they had what we now know as coeliac disease or allergies.

One big problem is that a little bit of information can be incredibly dangerous and leads to the cult of the Deliciously Ella style wellness bloggers attributing everything to gluten and woo. These people are actively detrimental when they suggest cashew nuts and avocados can cure cancer and I have no time for them at all.

But other people suffer from the too little information, too many opinions issue too and that’s the ones who read or write these clickbait articles and don’t actually read about about the subject beyond fleshing out an anecdote akin to the episode of Sex and the City where Carrie said she was allergic to parsley when she just didn’t like it. They never seem to speak to people with intolerances or learn about the complexities of living with them.

I first approached my GP about food making me sick and fatigued in 1992. That was the year that I developed chronic nausea. I haven’t had a day when I don’t feel sick at least some of the time since. That was also the year when I developed another period of mysterious fatigue attributed to glandular fever and missed an entire term of school.

I was told for the next four years despite missing more school than I attended, losing almost three stone in weight, vomiting and passing blood, regularly experiencing pain bad enough to black out and having my hair fall out, that it was all in my head.

A lot of it was explained by gallstones and the removal of my gallbladder. I stopped vomiting blood at least but eating was still like culinary Russian Roulette. I could find no rhyme or reason to why I constantly felt so ill and had diarrhoea so badly I had to be rehydrated on a drip on more than one occasion.

I saw doctors and and gastroenterologists and dieticians. It was complicated further by having a diagnosis of ME/Chronic Fatigue Syndrome. This is an illness with a tortured identity. Many doctors (and journalists) don’t believe it exists. It was known once as ‘yuppie flu’ and the NHS regards it as ‘psychosomatic’ at best and ‘malingering due to psychological issues’ at worst.

In the UK, 250,000 people have it (four times the number of MS sufferers) and is now believed to be an neuro-immune illness equal in severity to HIV and Parkinson’s. The only drug treatment to have had success so far is a drug also used for cancer patients . It affects more women than men and is heavily stigmatised with sufferers literally being told it is all in their head. In the UK, the only ‘treatment‘ is Graded Exercise Therapy and Cognitive Behavioural Therapy to challenge negative beliefs about your health.

I was 10 when I got it and went from running around everywhere to being bedbound. Quite the trick to keep up as a kid and then for another 27 years. It took me 25 years to get pain relief for the muscle pain that characterises the illness (the myalgia of the name and not unlike it’s close cousin fibromyalgia) because the disease is treated by psychiatrists in the UK, not neurologists.

Imagine then how difficult it was to get a roomful of shrinks and GPs who’ve only heard of ME as a made up attention seeking thing shrill women have to take my food issues seriously. (Food issues that also mutated into an eating disorder because I was so frightened of eating.) And that’s before you encounter the NHS issue of seeing each symptom separately in chronic conditions so joint pain isn’t connected to nausea.

It was quite literally the 15th gastroenterologist and 16 years after my gallbladder removal I saw who mentioned fodmaps and yes, I thought he was crazy when he said it might down to garlic and onions. It seemed like bullshit and wishful thinking. And then I did the exclusion diet with an NHS dietician and my life was transformed.

Not simplified though. On top of the fodmaps, I’m fructose malabsorbing (a fancy term for fructose intolerance) and my gut flora is destroyed by complications of the gallbladder surgery. I probably have ‘leaky gut syndrome‘ but the NHS doesn’t believe in it. I’m also having liver, pancreas and small bowel issues investigated.

It’s complicated and distressing and incredibly boring. It feels like 90% of my conversation revolves around my bowels and my diet. It feels like 110% of my inner thoughts revolves round my guts and my dinner. I have spent the last 6 weeks being so strict on avoiding my trigger foods that I thought I could cheat and eat some crab in garlic butter the other night and was thrilled to see that I didn’t even feel bloated. A refreshing change after the surprise dried onion in a burger one night that made me literally shit myself.

Except that the morning after the (amazing) garlic crab my joints were so swollen and tender I couldn’t get out of bed without crying and needing painkillers strong enough to be classed as a controlled narcotic. I still felt fatigued and shaky the next day. No more garlic butter for me clearly. You live and learn the hard way.

I know not everyone who has intolerances to fodmaps (one of which is wheat by the way) or lactose reacts that badly. I’m unlucky in that respect. But we also live in a society that sees illness as weakness and always viewed as something to be ‘cured’ not chronic. Auto-immune diseases such as ME/fibro/lupus and things like Ehlers-Danlos Syndrome are more prevalent now because modern medicine ironically makes us well enough to have chronic illness.

Nearly all these illnesses include gut issues such as food intolerances but are essentially invisible so they confuse healthy people because there might not be a crutch or wheelchair to indicate disability and they aren’t as easy to explain as say, a stroke. They fluctuate and they take a long time to be diagnosed and even then little is known about them and there’s little biomedical research happening. My practice nurse at the GP who gave me a flu jab this week had never heard of ME/CFS for example so I don’t expect the general public to be experts.

Sadly this ignorance doesn’t stop people who can’t even spell ME offering (often well meaning) advice when you mention it. Rest assured I have thought of trying yoga in the last quarter of a century, but unfortunately it doesn’t have magical abilities. If I had more energy I’d find it grimly amusing that people who insist that those food intolerances don’t exist, believe yoga and pilates and green juice can cure a disease that can be seen as altered spinal fluid in lumbar punctures.

But it’s exhausting dealing with all that repeatedly when I just want to order an appetiser. I appreciate genuine questions and thoughtfulness about my health more than I can tell you. But I want to talk about nice things over lunch. I don’t want to be forced tell a waiter or a friend of a friend about private, intimate, embarrassing, distressing things (that’s why I have a blog after all) just to choose soup or a salad.

Sometimes when people start to argue with you over what you can eat, you just want the whole subject to go away and you say you’re allergic to garlic because you cannot face this battle again. Allergy is a magic word that people don’t argue with and if like me you sobbed this morning while eating an egg because you are grieving all the foods you will never eat again, you need to avoid drama to survive with your sanity intact.

I do feel guilty about abusing the word allergy but when the option is argument, embarrassment, opiates or incontinence, then I can’t beat myself up too hard. The thing is that you can’t tell why someone is using the word without interrogating them.

They may call an intolerance an allergy to feel listened to after years of being ignored. They might tell you they are avoiding gluten or wheat because the Kardashians are doing it because that’s less shameful for most women than talking about their bowel movements. They may not know exactly what is causing their health issues and be in the reintroduction stage of an exclusion diet which is why they ate cake, not garlic bread. Or they are worried people will think they are a Kardashian loving airhead if they mention a dietary issue that’s actually causing great distress so they head the criticism off first self knowingly. Or maybe it’s a first date and not great timing to mention gassiness…

They might be feeling the peer pressure to order dessert because women are socialised to eat together to assuage guilt. They might be feeling left out because food is sociable. They might because of a lack of education or a brainfart, not realise the dish contains the thing they are avoiding. They may be having difficulty coming to terms with not being able to eat freely and sabotaging their diet. They may not really know the difference between an allergy and an intolerance themselves. They might just be tempted to see if they can cheat. They might not know what lengths a kitchen has to go to over allergies. Or they might just be human and thus illogical and imperfect and inexplicable. It’s very easy to expect perfection in someone else’s diet rather than our own.

We have a responsibility as decent human beings not make anyone else’s life harder. So if I lie and say I’m allergic to peppers when I just hate them, I’m harming other people. But if you insist on a full medical history and a quasi legal case as to why they ate X and not Y and sharing those clickbait articles then you are probably making a sick person’s life harder. If the person chooses to share their details with you that’s different but wait to be invited first.

I’m sure everyone is now going to rush to tell me about all the food related pisstakers they know, but in my experience it’s like claiming benefits. Bring up the subject and everyone knows someone their aunt’s friend’s co worker lives next door who is a benefit cheat. Yet the official figures don’t back it up and when pushed they’ve never actually met one for sure themselves because laypeople aren’t privy to medical details and have to go on a certain amount of trust instead…





Fodmap Tips and Tricks*


I know I sound completely obsessed by Fodmaps at the moment and I think I probably am. You can’t make a major dietary change and stick to it for life without going a bit tunnel vision in the process. Not only does it help focus your mind, it distracts you from the sense of tedium you get as you eat the same meal again. And again. And again.

I’ve been attempting to be free of my particular Fodmap triggers since just after Christmas so have managed the guts (pun intended) of six months of it and learned plenty along the way so thought I’d share a few nuggets of information I’ve picked up. I’m pretty much fine with wheat and lactose unless I combine them with other Fodmap triggers, so my experiences might not be as helpful for the wheat-free brigade, but you never know.

The main thing I’ve learned is that people will put onions and garlic in every single bloody thing possible. I won’t even be surprised if someone serves me an onion based dessert or sticks a clove of garlic in my cocktail (and yes, I do know there’s a bar called Garlic and Shots in London before you ask. I had a terrible night there once.)

Being an allium dodger in this town is hard. No cuisine completely eschews them and between onions, garlic, shallots, spring onions, leeks and their powdered versions, there’s a lot of ways to add them to things. I find lunchtime easier because not only am I lucky enough to be able to eat a sandwich, eggs are still on the menu before 5pm. Variations of breakfast  and brunch food work well here if you avoid black pudding with its dried onion evilness.

My other lunchtime option is always sushi or sashimi. Not only is it less expensive at lunchtime, it’s now relatively easy to come by on the go (just avoid Marks and Spencer here. Theirs is vile.) Scotch eggs are another potential if you don’t mind a blast of sulphurousness as an accompaniment to lunch. Cocktail sausages are surprisingly filling with a bag of crisps on the side and make any bus journey seem like an actual picnic.

Yet crisps are a Fodmap minefield. Gone forever are my beloved Tayto cheese and onion or a pickled onion Monster Munch, but so are just about any ‘fancy’ versions that sound like a meal in a bag. From prawn cocktail to roast pork with mustard or the suchlike, they will have dried onion in. I have become the person who always chooses ready salted now.

And don’t even think of trying vegetable crisps instead. The beetroot are little deep fried Fodmap bombs covered in salt. Kale chips smell like death itself and come doused in onion powder or garlic salt. Prawn crackers and mini poppadoms should be surrounded at parties and guarded fiercely because they are the only snack foods in town you can still eat. Cashews and pistachios inexplicably have Fodmaps and let’s not even remind ourselves of the existence of dip because it is gone to you forever. Lactose, pulses, vegetables and alliums combine to do their worst here.

Ironically the fact you have to basically give up savoury snacking (and sweet ones if you like Haribo. Those fizzy ones will kill you off trust me) means you will be even hungrier by the time of the main meal which can make it harder to concentrate and spot potential menu pitfalls. Instead of adding joy to life, chorizo adds problems to every dish it finds its porky charms into, which in 2015 is most of them. Soup is a complete no go as all stock will have onions in it. Pasta is problematic as a base and a vehicle for Fodmappy sauces. Pulses have to be avoided and the foodie fascination with avocado and cauliflower with their tricksy little polyols cannot end soon enough for my innards.

In fact this whole ‘healthy’ eating kick at the moment that constantly replaces certain foodstuffs with fruit and veg products is a nightmare for me. Date syrup or agave instead of sugar, root veg instead of flour, cauliflower instead of rice, green juicing and smoothies, all agonising for me. Especially accompanied with the constant refrain that they are ‘healthier’ so I end up with envy of other people’s cast iron digestive systems as I politely shuffle their wonder food round my plate without being able to eat it.

My failsafe on most menus these days is steak and chips or salmon and potatoes which means that ‘ethnic’ food tends to be a no no. I may think I’m all cosmopolitan living in Brixton but my small bowel is acting like UKIP and classing everything as ‘foreign muck’ to be viewed with culinary suspicion. About all I can eat from outside Northern Europe is dim sum and some Vietnamese dishes. On a recent trip to The Real Greek, the only thing on the entire menu I could safely eat were the boiled potatoes. Thank god for white wine.

Because the Fodmap fun doesn’t stop with drinks. Oh no, fruit juice is a complete no go for me now along with anything dandelion, fennel, chicory or chamomile based. Cocktails have to be checked carefully for certain juices and purees and rogue agave syrup. Red wine bloats me and gives me terrible hangovers in any amount. Beer, except oddly Guinness, is an occasional treat. Luckily prosecco and cava work fine as do espresso martinis, so I’m sure I’ll survive Happy Hour if not the main meal itself.

After years of mocking those people, I now understand why they bring their own portion of fish to be steamed alongside some rice. Only now that I’m in eating disorder recovery do I actually look strange around food. Alanis Morrissette would have a field day.

I’ve tried the Monash University Fodmap app and it’s mainly only been useful in acquainting me with the names of fruit and vegetable varieties. I cannot become the person who asks if the tomatoes in the sauce are baby plums or cherry or vine ripened after some of the responses from wait staff to queries about garlic and onions. I see why people with food intolerances stick to chains where they serve the same thing repeatedly and can consult their big binder of facts. Wahaca were helpful and can adapt five or six dishes for me. Nandos suggested the chips and shrugged on everything else but since I live in South London I can always go to the chicken shop on the way home or simply eat before I go out.

So if anyone has any tips on Fodmap free dips or tips on what the hell to serve wheat and dairy free Fodmappers who of course can’t eat fruit for dessert, do tell me in the comments. I’ll buy you a drink in thanks. We should both be ok with soda water…

*the trick is that you can’t live without potatoes on this diet.

foodbank list

Live Below the Line

foodbank list

It’s that time of year again when Twitter does Live Below the Line (and spends the three weeks before emailing me to ask if I have any tips for them.) I’m actually pretty short on tips, but I’m very very full of opinions on the subject and I’m pretty sure none of them are what you expect from someone who writes on food poverty.

I really don’t like the campaign and thus won’t be taking part, this year or anything other year. I’ve spent the last 15 years working toward not having to count every penny I spend on food and I find it upsetting to be asked to go back to it even for a day or two. I think at best, the campaign is feelgood charity and at worst, it’s poverty tourism. I think you’d be better to be more engaged with the issues for another 360 days of the year and donate the cost of a coffee or muffin every day or every other day than do the 5 day challenge. That’s not say that individuals don’t do fantastic things with it, but that I dislike the tone of the campaign itself.

I find the Live Below the Line website a bit of a masterclass in excitably vague promises, telling us about the extreme poverty 1.2 billion people across the world live in. There’s no mention of why this is from war, migration, capitalism, corruption, lack of women’s rights or over population. There’s mention of the charities they partner with to direct the fundraising, but very little explanation of how this will be done unless you go to every single charity’s website and dig for it. I’d prefer a few more facts myself.

I’m aware that anything that raises awareness for issues is valuable for orgs and the £5 for 5 days strapline does that but I find it actually dodges most of the issues associated with food poverty by picking 5 days over 7 days. This allows people to do it Monday to Friday in the office with lots of support and make an event of it. I can imagine it could even be quite fun doing it this way which is nice.

Which is exactly what food poverty isn’t. It’s not nice. It’s frightening and shitty and isolating. It excludes you from society and it shames and stigmatises you and your family. It has no end in sight and it’s not something you can easily discuss with people. I’m not suggesting Live Below the Line mimics the neverending vibe of poverty and like the Hotel California once you join, you can never leave, but I do think a lot more could be achieved by making it 7 days instead.

It’s not fun to have strictly budget all your meals, hoping that nothing will go off before you were expecting it or that the offers you were relying on have sold out, but it’s the moments when you have to forgo socialising because of your food budget that really hurts. You can’t go out for birthday drinks, make your kid a cake, meet friends for coffee, go to their house for dinner because you need to bring wine and you can’t invite people to yours because they probably expect more than toast and custard creams for their tea. A 7 day challenge would show a little bit more of that social aspect of poverty.

You’re probably thinking this is nitpicking and fairly irrelevant in the UK, not like those people who live on £1 per day in far flung foreign lands, but sadly it’s not. Food poverty in the UK is on the rise and with the massive increase in benefit sanctions, cuts and delays, zero hour contracts and wage freezes, more and more people here routinely only have just over £1 per day for food.

A 24 year old on Job Seeker’s Allowance gets £57.35 per week. From that if they live in rented accomodation, they will have pay any Housing Benefit top ups since the Broad Rental Market Rates (or the amount per week per area) were reduced, leading to an average shortfall of £10 per week. They then pay gas, electric, water, phone, broadband (essential for jobseeking now) and council tax since Council Tax Benefit was scrapped for working age adults in 2013 (as an aside my bill went up by £44 a month overnight). Then they need to pay for transport as job seeking rules now mean that many people have to attend the Job Centre everyday to fulfil their 30 hour per week Job Seekers Agreement. There’s also the costs of toiletries and personal items such as loo roll or sanitary products, hair cuts, clothes (gotta look smart for job seeking) and any outstanding debts. Then you get to food.

The BBC suggested that on this budget the maximum amount someone could spend is £12 per week on food which is £1.71 per day. That could be manageable with a minimum of discomfort if you live near a large supermarket or market where you can shop around and access a good variety of options without having to pay additional costs to do so. At this amount, every penny matters, both with buying and preparing the food and even buying a can of Coke once a week becomes a luxury.

Living on a small food budget constantly affects your physical and mental health. Hot meals become something you only have occasionally. Fruit and vegetables are luxuries. You get tired and cold easily yet you can’t sleep well. Your brain doesn’t function at full capacity. If you already have health problems, they get worse. You can’t accomodate food intolerances. Depression seeps in. You feel you have to defend and justify yourself constantly as someone tells you yet another way to budget better, ignoring the fact you can’t budget bugger all.

As I’ve mentioned before there is a reason you live in food poverty and I find it uncomfortable that the Live Below the Line campaign doesn’t acknowledge the fact the issue exists in the UK. I feel that by focusing attention outside our own country, it actually makes it harder to draw attention to the needless increase in poverty here.

You’ve all seen the figures in the last week or two about the Trussell Trust’s food banks feeding 1 million people in the last year and the riposte that it might not have as many as that because it could have been that the same person or family was referred the maximum 3 times. No matter what way we phrase it, that means that some households are getting poorer and poorer and all that happens is we squabble over semantics.

Welfare advisors, charity workers and benefit claimants warned that these thing would happen when the Welfare Reform Act 2012 went through. Policies such as the welfare cap, bedroom tax, removal of the Social Fund and delays in the introduction of Personal Independence Payment didn’t happen by accident. They were deliberately created by the coalition government and they have pushed the most vulnerable into greater poverty and insecurity in a way that smacks of ideology over even austerity.

And as one of those people, the worst thing is that no one is really talking about it. People who describe themselves as poverty campaigners never mention the disabled who are being hit disproportionately hard by the current cuts and changes. The media focuses on the few families in 100k housing or with enough kids for each day of the month. Programmes like Question Time barely ask about welfare even when the Secretary for State is on it. And when the subject does get mentioned, it’s entirely about in terms of fraud. Not about working poverty increasing hugely or the attempts to dismantle social security as a safety net.

One of my best friends had two brain haemorrhages last March. He’s currently homeless and still waiting for any benefits to come through. He applied for PIP last May and so far Atos has cancelled his assessment for it 5 times. Another friend has been sanctioned on JSA because of a glitch with the Universal Jobmatch site. She’s disabled but claiming JSA instead of Employment Support Allowance because the delay on ESA payments after application is running at 13 weeks. That’s more than 3 months to get any money at all. It took 14 months for me to get put in the correct group on ESA and awarded the money I was owed.

I know it’s unfair to take out my frustrations and fears as a disabled person in the UK in 2015 on the Live Below the Line campaign and I’m not saying that people in poverty elsewhere should be ignored, but I do find it galling that many people who will do this campaign and enjoy the kudos that comes with going without for a few days will ignore the fact that people who live in their community face it daily. Live Below the Line has become the acceptable way to care about food poverty and allow many people to do very little long term.

How many people asking for sponsorship on this will know if the cleaners in their office get the Living Wage? How many bothered to look and see what main political parties’ policies are on social security two weeks away from the election? How many contribute to a food bank or wrote to their MP about fuel poverty? How many watch those programmes that demonise benefit claimants and then laughs about ‘scroungers’ afterwards on social media? How many read papers like the Daily Mail that propagate the myth that most sickness benefits are claimed fraudulently but say it’s ok because they just read the showbiz sections?

By all means, do Live Below the Line (and I know some very fine people doing it) but please don’t assume that five days of mild discomfort teaches you very much about the reality of many people’s lives. As I said, you’d be better off donating regularly from your daily budget, but really everyone would be better off if we put pressure on our elected representatives to create a fairer society and stop expecting poor people to solve their own problems. Never did the phrase ‘charity begins at home’ have quite as much resonance.

(The image at the top is a Trussell Trust food bank list for 3 days food.)

Inside the A&C Deli, Brixton

Save Our Shops

Inside the A&C Deli, BrixtonThey say a workman is only as good as his tools and while I think natural talent and practise play a part too, there’s a lot of truth in that statement. And for people who cook, their tools are the ingredients they use. Great food doesn’t always need specialist equipment but it does need something to create it with, preferably better quality ingredients.

We’ve all tried to cook a meal and been thwarted by our ingredients: the bacon that spewed out white water and refused to crisp at all, the tomatoes that were woolly and flavourless, the pulses that simply wouldn’t soften. Often it’s less about the price of the products and more about where they come from. Those tomatoes might have been Finest or Taste the Difference and still been nothing more than red water while the bag of cheap chickpeas from the corner shop might have been been more velvety than the branded ones.

Learning how and where to shop for your food is as important a part of learning to cook as how to prepare the ingredients once you get them home, but is an element that rarely gets talked about beyond a certain amount of showing off these days. I had a Ladybird book as a child that probably seems incredibly quaint now with a mummy and housewife popping to her greengrocer, butcher, baker and probably candlestick maker. But it acknowledged the link between where the food is farmed and where it is cooked. Good shops matter. Read more

garlic oil

Slow Cooker Fodmap Friendly Garlic Oil

garlic oil

Today is a great day for me. It’s the day I get to combine my two food obsessions and talk about slow cookers and FODMAPs. Basically this is a birthday present to myself. North/South Food is five years old this week and I haven’t had time to make a cake to celebrate, so writing a piece about my two favourite subjects will do instead!

I’ve given a little bit of background on Fodmaps before on this post, but if you don’t have time to read back, I’ll give you a crash course here too (bearing in mind my level of scientific knowledge wouldn’t even make it onto a L’Oreal advert voiceover.) They are a relatively recent discovery and research and knowledge into them is ever evolving so don’t take my word as gospel rather than an overview.

FODMAPs as an acronym stands for Fermentable Oligo-saccharides Di-saccharides Mono-saccharides And Polyols which are basically a selection of short chain carbohydrates encompassing certain sugars and types of fibre found in foods. They include:

  • lactose in dairy products
  • fructose in fruits, juices, honey and agave syrup
  • polyols such sorbitol which is found in dried fruit and wine and used as an articial sweetener
  • fructans found in onions, garlic, prebiotics and Jerusalem artichokes
  • galacto-oligosaccharides found in legumes and beans
  • galactans found in wheat, rye and barley

Read more