Laura Manning is a Clinical Dietitian at The Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center at Mount Sinai. Today, she is discussing the basics of lactose intolerance.   

THE BASICS

According to the 2020 Dietary Guidelines for Americans, it is recommended that adults consume 3 servings of low fat or fat free dairy products daily as part of a healthy diet.[i] Dairy products consist of milk, yogurt, cheese and kefir and supply the primary source of calcium for Americans. Calcium is associated with improved bone health and is especially important to consume during childhood and adolescence, as bone mass is being built at this time.[ii] In adults, dairy intake is associated with lower blood pressure[iii] and a reduced risk of cardiovascular disease[iv] and type 2 diabetes. [v],[vi]

One 8-ounce glass of milk from cows, sheep and goats consists of carbohydrates (12g of lactose) for energy, protein (6-8g of casein) for growth, fat for brain health, and the all-important calcium for bone development. The fat content can vary widely as there are a variety of milk choices on the market; from milk that contains zero fat (skim) to milk with a full fat content (whole). Additionally, dairy milk is comprised of phosphorous, potassium, magnesium, vitamins A, D, B12, niacin and riboflavin. It is a widely consumed beverage and supplies us with important nutrients across the lifespan.

Fact: Most people are born with the innate ability to digest dairy, as lactose is found in breast milk. However, the ability to digest dairy milk may become more and more difficult as we get older. It is estimated that about 30 million Americans are lactose intolerant by the age of 20.[vii]

WHAT CAUSES LACTOSE INTOLERANCE?

We typically digest milk with an enzyme (lactase) found in our small intestine. Lactase cleaves the sugar from milk into glucose and galactose to make it more digestible. This product is then absorbed into the bloodstream to be used for energy. However, some people may not produce adequate amounts of the lactase enzyme and, as a result, may experience symptoms such as gas, bloating and diarrhea soon after consuming milk products. Low enzyme levels cause the lactose to remain intact as it travels to the colon, where it attracts bacteria and begins to ferment. The uncomfortable symptoms associated with an intolerance are a result of this fermentation process.

TYPES OF LACTOSE INTOLERANCE

Primary lactose intolerance is the most common food intolerance in the world and is more prevalent among certain cultures. It is the most common form of the disorder and is often founds in people of African, Asian, Hispanic, Mediterranean and southern European descent. Secondary lactose intolerance may arise due to an injury, surgery or illness where inflammation or changes in the small intestinal structures occur. Crohn’s and Celiac disease are the two most common intestinal diseases associated with having lower levels of lactase production. This is a very frequent topic that I discuss with patients at the IBD Center at Mount Sinai. Lactose intolerance can also present during a Crohn’s or Ulcerative Colitis flare.

There is a small subset of people who may have intolerance to casein, the protein component in milk. Of the 6-8 grams of casein in milk, 2-3 grams are known as beta casein and come in two forms, known as A1 and A2. Most cows contain an even distribution of A1 and A2, but before milk became industrialized, most cows were producing A2. A2 milk may be an easier to tolerate form of milk and you will see it beginning to pop up in the dairy aisle.

YES, THERE ARE LACTOSE-FREE CHEESES!

If you have lactose intolerance, it does not mean that you should avoid all dairy products. This is a common misconception and can lead people to miss out on the important nutrients that dairy products provide. There are varying levels of lactose in dairy products, ranging from 12 grams in a glass of cow’s milk to 1 gram in a serving of aged cheddar cheese. Most people with lactose intolerance can tolerate up to 12g of lactose in one sitting, and approximately 18g of lactose if spread throughout the day.[i] However, some individuals may need the help of an added enzyme to assist with their digestion. Over-the-counter enzyme pills and chewables consumed at the time of meal will help break down the lactose, making it more enjoyable to eat without all of the gas and bloating that typically accompanies digestion. It may even be possible to train the body to tolerate lactose if given small amounts over a period of time.[ii] Additionally, having lactose-containing dairy as part of a meal, rather than on an empty stomach, will further help aid in the digestion process.[iii]

On a Low FODMAP diet, lactose is one of the fermentable sugars that should be lessened in the elimination phase of the diet. You are able to consume dairy products on the Low FODMAP diet, but the lactose content should be small. Take a look at the Nutrition Facts label. The lactose will be considered ‘low’ if there are 4 grams of carbohydrate or less per serving. Just be sure, keep it to the serving size indicated and have one single serving per meal. Low lactose cheeses permitted with this diet include aged cheeses such as cheddar, Swiss and Parmesan. Greek yogurt is low lactose as well, but try stick to the unflavored/original yogurts and add fruits for natural sweetness. You’ll be happy to know that butter is almost completely lactose free! You can also select dairy products that contain the lactase enzyme in them. Dairy can be challenging to tolerate for many people, but following a few guidelines on food choice and quantity allows you to keep it in your diet and reap all the nutritional benefits dairy has to offer.

Resources that can help you:

Mount Sinai Make an appointment at the Feinstein IBD Clinical Center here or contact the office at 212.241.8100.

Epicured For exceptional low FODMAP, IBD-friendly prepared meals delivered right to your door, visit our menu.

DOWNLOAD the Low FODMAP Cheeseboard infographic!

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DISCLAIMER: Mount Sinai is an investor in Epicured. This material is for informational purposes only, and Mount Sinai makes no representation or guarantee as to any results or experience with Epicured. You should consult with your physician before using a dietary program such as Epicured. Mount Sinai employees do not receive material benefit from endorsing or recommending Epicured. 

Laura Manning is not employed by Epicured. Laura is a full-time employee of the Mount Sinai Health System and receives no compensation, monetary or otherwise, from Epicured. 

REFERENCES: 

[1] Dietary Guidelines for Americans 2015-2020. Recommended amount of dairy to be consumed daily for Americans 9 years and older. www.choosemyplate.gov. accessed June 8, 2018.

[1] Weaver CM, et al. The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporosis Int. Published online Feb 8, 2016.

[1] Machin DR, Park W, Alkatan M, Mouton M, Tanaka H. Effects of non-fat dairy products added to the routine diet on vascular function: a randomized controlled crossover trial. Nutr Metab Cardiovacs Dis. 2015;25(4):364-369.

[1] Dalmeijier, GW, et al. Dairy intake and coronary heart disease or stroke: A population-based cohort study. Int J Cardiol 2013;167:925-929.

[1] Margolis, KL, et al. A Diet High in Low Fat Dairy Products lowers diabetes risk in in post menopausal women. J Nutr 2011;141:1969-1974.

[1] Sluijs I, et al. The amount and type of dairy product intake and incident of type 2 diabetes: results from the EPIC-InterAct Study. Am J Clin Nutr 2012;96:382-390.

[1] Lactose intolerance. Statistics accessed from the web June 6th, 2018. U.S. National Library of Medicine. https://grh.nlm.nih.gov/condition/lactose-intolerance#statistics.

[1] Corgneau M, Scher J, et al. Recent advances on lactose intolerance: Tolerance thresholds and currently available answers. Crit Rev Food Sci Nutr. 2017;57(15):3344-3356.

[1] Pribila BA, Hertzler SR, Martin BR, Weaver CM, Savaiano DA. Improved lactose digestion and intolerance among African-American adolescent girls fed a dairy rich diet. J Am Diet Assoc. 2000; 100(5):524-8.

[1] Shaukat A, Levitt MD, et al. Systemic Review: Effective management strategies for lactose intolerance. Annals Int Med. 2010; 152(12):797-803.

 

 

 

 

 

 

 

 

Renee Cherkezian, RN is a nurse-turned-chef and co-founder of Epicured.

Chef Renee preps the Za’atar Chicken. Credit: Ben Fink Productions

In my house growing up, we would put za’atar on just about everything. Za’atar is a traditional Middle Eastern & Mediterranean spice blend and one of my very favorite flavors. Food carts and lunch joints across the Middle East use it for labneh, a thick and tangy sheep’s milk yogurt. In Lebanon, the traditional salad of tomatoes and ripped pita called fattoush is topped with a dusting of za’atar.

The za’atar you buy in the spice shop is usually a blend of different herbs. According to Lior Lev Sercarz, the master spice blender from the spice shop La Boîte, the most traditional elements of a za’atar blend are its namesake za’atar leaves along with sumac, sesame seeds and thyme.

When creating our new Za’atar Chicken, we looked all over the perfect blend. Which za’atar tasted best dry? Which za’atar tasted the best with extra virgin olive oil? Most importantly, which za’atar best complimented the chicken’s marinade of lemon zest, lemon juice, garlic infused olive oil, sumac, parsley black pepper?

I tested 7 different za’atars before finding one that met this standard. La Boîte’s blend was simply the best, hands down. The Za’atar Chicken is one of my favorite new creations. It’s healthy, fresh, and it takes me back to my childhood when I was first inspired to cook. I hope you enjoy.

The Za’atar Chicken with Quinoa Tabbouleh. Credit: Ben Fink Productions

Laura Manning is a Clinical Dietitian at The Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center at Mount Sinai.

Inflammatory Bowel Diseases (IBD) such as Crohn’s disease and ulcerative colitis are believed to be caused by a combination of genetic predisposition and alterations in the gut microbiota. These disorders are on the rise in industrialized areas like North America and Western Europe [1], forcing scientists to reconsider the role of modern diets in the development and management of these diseases. Indeed, our gut bacteria look quite a bit different from our ancestors’ as we eat more and more processed foods to help us keep up with our busy lives and to allow us to prepare foods quicker and easier.

Can Food Choices Descrease Your IBD Risk?

Studies show that certain dietary patterns may put people at greater risk for IBD [2]. For example, having a low-fiber, high-fat diet may increase inflammation and cause disease relapses. This is typical of a diet with a lot of processed foods. In contrast, a diet high in soluble fibers, fruits and vegetables and low in saturated fat may be beneficial to our microbiome and have anti-inflammatory properties. [3,4]

Our Low FODMAP Lemon Rosemary Chicken meets many of Laura’s “IBD-friendly” requirements. Photo credit: Ben Fink Productions for Epicured.

FOOD AS IBD TREATMENT

In addition to conventional medication focused on modifying the immune-inflammatory pathways in the gastrointestinal (GI) tract, diet can also play an essential role in the management of IBD, especially for patients with a lot of unpleasant GI symptoms such as diarrhea, urgency and abdominal cramps. Unfortunately, there is not enough scientific evidence to suggest that there is a “silver bullet” diet for IBD, or, for that matter a single diet approach that can take someone with IBD from a very severe flare-up all the way down to remission (i.e. no signs of inflammation at all).

The good news is that in academic medical centers across the world (including at Mount Sinai where I practice), there are studies underway to look at the link between IBD and a variety of diets, including, of course, low FODMAP.

Low FODMAP & IBD: What We Know Today

There is very strong evidence showing the benefits of the Low FODMAP diet for managing symptoms in patients with Irritable Bowel Syndrome (IBS), a much more common disorder of gut-brain dysregulation with many of the same symptoms as IBD [5].  We are now seeing that the diet can help manage symptoms in patients with IBD as well, especially when they’re in remission. Here’s why:

Often times, a person with IBD can be technically in remission (a healed intestinal tract) but continue to experience symptoms that mimic an IBD flare-up. This is known as IBD with IBS overlay and it is extremely common, affecting 40-60% of IBD patients. High FODMAP foods can trigger IBS symptoms in people with IBD and make them feel like they are experiencing a flare-up [6]. In fact, in a recent study, the Low FODMAP diet was shown to lower symptoms like gas, bloating, diarrhea, nausea and fatigue [7,8] in patients with IBD.

FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are hard to digest sugars which pass through the small intestine without being properly broken down by enzymes. Once these sugars reach the colon, they cause an osmotic shift bringing more water into the lumen which causes all the potential unpleasant side effects of pain, bloating and diarrhea. Additionally, the bacteria ferment (think of brewing beer), and the residual FODMAPs give off gas, as if there wasn’t enough to manage!

“OK… SO WHAT CAN I EAT?”

The most common question patients with IBD ask me is “what can I eat?” My goal is to help patients find ways to eat that will allow them to manage symptoms and feel like they are in control. That’s where the low FODMAP diet becomes so useful. A FODMAP elimination and reintroduction process can be a life-changing tool for IBD patients to identify the triggers that add to their daily stress. We know food alone does not cause IBD but many patients will begin to notice “trigger foods” that increase their symptoms of gas, bloating, and diarrhea. The best way to identify your trigger foods is to simply keep a journal of what you eat. Note if there are changes that occur in our bowel function when certain foods are eaten more than others.

IT’S NOT: ‘ONE SIZE FITS ALL’

Don’t get frustrated. What works for one person with IBD may not work for another. This is one of the many challenges that I have as a dietitian working with patients at the Feinstein IBD Center at Mount Sinai. Having worked with patients with IBD for over 15 years, I have seen many different diet therapies work and not work, and I must tailor suggestions to each individual person.

Food is a very important topic because it evokes a lot of emotion in people. People with IBD must carefully think about what to eat and the timing of their meals and if I can offer suggestions that help ease this stress, then I can successfully increase their nutrition, allow people to eat comfortably at work and at gatherings and lessen anxiety that commonly accompanies mealtime. Food is a large part of our culture as well as a basic human need and patients with IBD welcome guidance to help manage their disease and lead the healthiest life they can.

Resources that can help you:

Mount Sinai Make an appointment at the Feinstein IBD Clinical Center here or contact the office at 212.241.8100.

Epicured For exceptional low FODMAP, IBD-friendly prepared meals delivered right to your door, visit our menu.

IBD 101 Here are the basics: IBD (including Crohn’s Disease and Ulcerative Colitis) is an autoimmune condition where the digestive tract becomes inflamed and forms ulcerations that can cause a wide range of symptoms including frequent bowel movements, weight loss, and vitamin deficiencies. The gastrointestinal (GI) tract contains harmless bacteria that aids in digestion and the metabolism of vitamins. In people with IBD, the body mistakes the bacteria as foreign invaders and cells travel from the blood system to the GI tract, creating an inflammatory response and causing a variety of GI symptoms [9]. IBD can also affect your eyes, skin and joints and can have a profound impact on daily life.

________________

DISCLAIMER: Mount Sinai is an investor in Epicured. This material is for informational purposes only, and Mount Sinai makes no representation or guarantee as to any results or experience with Epicured. You should consult with your physician before using a dietary program such as Epicured. Mount Sinai employees do not receive material benefit from endorsing or recommending Epicured. 

Laura Manning is not employed by Epicured. Laura is a full-time employee of the Mount Sinai Health System and receives no compensation, monetary or otherwise, from Epicured. 

REFERENCES: 

[1] Molodecky, N.A.; Soon, I.S.; Rabi, D.M.; Ghali, W.A.; Ferris, M.; Chernoff, G.; Benchimol, E.I.; Panaccione, R.; Ghosh, S.; Barkema, H.W.; et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 2012, 142, 46–54.

[2] Hou JK, Abraham B, El-Serag H. Dietary intake and risk of developing inflammatory Bowel disease: a systematic review of the literature. Am J Gastroenterol 2011;106:563–73.

[3] Brown, K.; DeCoffe, D.; Molcan, E.; Gibson, D.L. Diet-induced dysbiosis of the intestinal microbiota and the effects on immunity and disease. Nutrients 2012, 4, 1095–1119.

[4] Ananthakrishnan AN, Khalili H, Konijeti GG, et al. A prospective study of long-term intake of dietary fiber and risk of Crohn’s disease and ulcerative colitis. Gastroenterology 2013; 145:970–977.

[5] Schumann D, Klose P, Lauche R, Dobos G, Langhorst J, Cramer H. Low fermentable, oligo-, di-, mono-saccharides and polyol diet in the treatment of irritable bowel syndrome: A systematic review and meta-analysis. Nutrition, Jan 2018;45:24-31.

[6] Selina R Cox Alexis C Prince Clio E Myers Peter M Irving James O Lindsay Miranda C Lomer Kevin Whelan Fermentable Carbohydrates [FODMAPs] Exacerbate Functional Gastrointestinal Symptoms in Patients With Inflammatory Bowel Disease: A Randomised, Double-blind, Placebo-controlled, Cross-over, Re-challenge Trial Journal of Crohn’s and Colitis. Dec 2017; 11

[7] Zhan, Y.L.; Zhan, Y.A.; Dai, S.X. Is a low FODMAP diet beneficial for patients with inflammatory bowel disease? A meta-analysis and systematic review. Clin. Nutr. 2017.

[8] Prince AC, Myers CE, Joyce T, et al. Fermentable carbohydrate restriction (low FODMAP diet) in clinical practice improves functional gastrointestinal symptoms in patients with inflammatory bowel disease. Inflamm Bowel Dis 2016;22:1129–1136.

[9] What are Crohn’s and Colitis. http://www.crohnscolitisfoundation.org/what-are-crohns-and-colitis/what-is-crohns-disease/. Accessed from the web May 12, 2018.

MOROCCAN TAJINE IS BACK AT EPICURED AND BETTER THAN EVER!

Whatever your taste – chicken, lamb or veggies – our Tajine is for you!

This dish is inspired by recipes from Morocco and Northern Africa and served with a side of gluten-free quinoa.

Renee discovered this extraordinary dish on a visit to Marrakech. After feasting on chicken tajine with apricots and almonds, she savored the memory and created the ultimate low FODMAP version.

MAKE WAY FOR CHICKEN TAJINE!

This special low FODMAP dish replaces the sweet flavors of onion, honey, apricots & dates with garlic oil and sweeter veggies and low-FODMAP sugars. Our Tajine chicken is simmered with cumin, turmeric, cinnamon, cloves, ginger, and paprika… all great inflammatory, pro-digestion spices to help cleanse the liver.

It’s a tasty treat!


 ANTIBIOTICS & YOUR GUT

A recommended read from the New York Times! Learn about some of the latest thinking on the use of antibiotics in animals and its impact on our gut microbiome. Worth noting: all our meats are 100% antibiotic-free!


 

SOME POPULAR DISHES

SESEME CRUSTED WILD SALMON  order now>

TIKKA MASALA  order now>

THREE-SPICE TURKEY CHILI  order now>

 

DRAGON FRUIT ANTIOXIDANT SMOOTHIE  order now>

 


 FODMAP FAQs WITH OUR CONCIERGE DIETITIAN

By Carena Lowenthal

A FEW QUESTIONS WE GET ALL THE TIME!

  1.  What is a FODMAP?

FODMAP’s are a group of small chain carbohydrates than can be difficult to digest for many people.  They pass from the small intestine into the large intestine undigested where they can be fermented and pull water into the intestine.  They could cause bloating, cramps, diarrhea or constipation.  FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.

Our Low FODMAP Cheat Sheet is a great thing to keep around! Here’s a printable one and one for your phone.

  1.  I see you have garlic oil in your recipes, I thought garlic wasn’t allowed on the low-FODMAP diet?

Correct, garlic is not allowed in the solid form.  However, garlic infused oil, is allowed.  It has a lot of the flavor without the FODMAP component.

  1.  How long do I have to follow a low-FODMAP diet?

Usually people are placed on this diet for 2-6 weeks for an elimination phase.  Then they would be testing the groups, in a methodically, proven way, to help determine where the intolerances lie.  Once you find out what you need to avoid, you can go back to an appropriate diet.  Epicured is 100% low-FODMAP so you can use our service during the Elimination Phase as well as to fill in after you’ve gone back to your new plan.

FODMAP ELIMINATION, FODMAP RE-INTRODUCTION, AND HOW EPICURED FITS IN

Have more questions for Carena? Email concierge@getepicured.com! We’re here to help.

 


 

 

MARK JUNE 14TH… EPICURED IS CATERING THE JUNTO HEALTH CONFERENCE(LINK: https://juntohealth.org/) 

INTRODUCING OUR NEW BUCKWHEAT BOWL!

It’s a delicious mix of buckwheat and yes, it’s gluten free and low FODMAP, harvested from a plant valued for its grain-like seeds. We add roasted cumin carrots & parsnips with lemon-tahini dressing.

Our low FODMAP Roasted Spiced Carrot & Parsnip Buckwheat Bowl

Our low FODMAP Roasted Spiced Carrot & Parsnip Buckwheat Bowl

ORIGIN: The dish comes to us from the Mediterranean/Middle-Eastern region and is packed with low FODMAP depth of flavor and nutrients, deliciously gluten-free. Ingredients include naturally sweet carrots and parsnips, as the cumin mixture gives a rounder flavor.  This cumin flavor is also gently reflected in the gluten-free buckwheat base. The Lemon-tahini dressing is like the cherry on top.

Our Buckwheat Bowl is high in protein and rich in Omega 3 & 6.


TRY A LOW FODMAP PESTO SAUCE FOR SUMMER & YOUR MEMORIAL DAY PLANS!

This is the same sauce we use in our low FODMAP Basil Pesto Spaghetti Squash.

A great pesto is simply one of the best tastes of summertime. For those of you staying away from garlic, you can still indulge! We use a garlic-infused oil for it’s flavor. Enjoy!
Takes about 10 minutes.

Yields
1.5 Cups
5 cups basil leaves
1 chives, bunch (~1 cup)
4 tablespoons garlic-infused olive oil
(make your own or buy some at the supermarket)
4 tablespoons olive oil
1/3 cup parmesan
1/3 cup pine nuts
Salt

Directions:
1) Bring a large quart of salted water to boil. Place basil and chives in water for 10-15 seconds then remove them and place in a bowl of ice water.
2) Once the basil and chives are chilled, remove them from the water and squeeze out any excess water.
3) Place basil, chives, and remaining ingredients in blender. Mix on med-high speed until sauce is smooth and thick. Season with salt, as desired.


“AN EPICURED EXTRA”

Epicured's low FODMAP Strawberry-Rose Chia Seed Pudding

“EAT LIKE THE PROS…”

…with Stefani Pappas, RD.

“I never liked chia seed pudding until I tried Epicured’s version – it is delicious!”

“My practice is called Stef Health Tips and is located in Great Neck, NY. As a Registered Dietitian Nutritionist, I am dedicated to leading a healthy and active lifestyle, and inspiring others to do the same. My approach encourages whole, natural, and real foods, but works with clients to incorporate their favorite foods into a balanced diet. I enjoy seeing my clients fall in love with a healthy lifestyle and become their very own nutrition expert!” Read more!


“WHAT ARE EPICURIANS EATING…”

Our Turkey Meatballs are now our top selling item. Take a look:

Low FODMAP Turkey Meatballs with Gluten-Free Basil Pomodoro Sauce & Grated Parmesan  Turkey Meatballs with Basil Pomodoro Sauce and Grated Parmesan

Low FODMAP Tikka Masala with Basmati Rice  Chicken Tikka Masala

Low FODMAP Three-Spice Turkey Chili  Three-Spice Turkey Chili

Low FODMAP Sesame Crusted Wild Salmon  Sesame Crusted Wild Salmon

Low FODMAP Baked Lasagna Bolognese   Baked Lasagna Bolognese


AND DON’T FORGET…

We have a lot coming in the next 8 weeks. Here’s a preview:

Za’atar Chicken with Tabboule
Summer Vegetable Lasagna
Morroccan Tajine
Updated Fruit Bowl
Iced Coffee

 

 

 

Our favorite Za’atar, thanks to Lior Lev Sercarz of La Boite. Credit: Thomas Schauer

NEW ARRIVALS AT EPICURED
Make room for Za’atar Chicken with Quinoa Tabbouleh

Enjoy a traditional Eastern Mediterranean savory low FODMAP dish that marries an herbal Za’atar blend of toasted sesame seeds, dried thyme and sumac, over chicken, with a fresh tabbouleh salad. The chicken is richly marinated in lemon zest, lemon juice, sumac, parsley, garlic-infused olive oil, and black pepper, then grilled, and finely brushed with a layer of Za’atar, sourced from master spice blender Lior Lev Sercarz. The zesty herbed chicken rests over a bed of gluten-free Quinoa Tabbouleh, a delicious combination of parsley, tomatoes, scallions, mint, quinoa, lemon, and olive oil. This perfect low FODMAP summer dish can be ordered for delivery today!


WANT TO KNOW WHAT OTHER “EPICUREANS” ARE BUYING?

Top 5 Most Popular Items!

 THREE SPICE TURKEY CHILI

 PULLED BBQ CHICKEN

 PEANUT BUTTER & CHOCOLATE ENERGY BITES

 CHICKEN HAWKER LETTUCE WRAPS

 CHICKEN TIKKA MASALA

 


SAVE ROOM FOR COCONUT SHRIMP STEW!

This fresh and vibrant stew which combines French cuisine with a bit of Asian-inspired low FODMAP magic!

No thickening agents are used in this stew; it is thickened naturally with the fiber from the vegetables and coconut milk.


Our Nordic Ice Packs.

SUMMER PREP:
With the dog days of summer almost here…

We’re already adding extra ice packs to Epicured’s delivery boxes to protect against heat and keep your orders fresh & delicious!


SHARING CUSTOMER COMMENTS:

“The very best part (OF EPICURED) for me, as an accomplished cook, is that there are so many choices for more exotic fare, things I wouldn’t cook for myself. Epicured is a game changer for me: deliciously gluten-free, convenient and low FODMAP!

I love the Thai Green Curry, the Seared Lamb Medallions, the Pad Thai, The Chicken Lettuce Wraps and I always, always, order extra Turkey Chili as it freezes so well and is easy to thaw out if I know I’m going to have a busy day. And the two different kinds of Energy Bites are so delicious! They not only satiate my sweet tooth but they keep me full and are perfect to throw in my bag when I need to pack a snack.”

READ MORE

 


Top-5 Reasons People Snack at Night

And how to avoid a night-time snack attack…

FROM CARENA LOWENTHAL, MS, RD, CHWC, a registered dietitian here at EPICURED. Carena is also a certified health & wellness coach, and herself an IBS-sufferer. She works as our Concierge Dietitian to make sure customers have an excellent experience using Epicured to manage digestive illnesses.

Let’s first explore the top reasons people snack at night:

  1. They didn’t eat enough all day because of lack of time, they “forgot,” they didn’t have access to food, etc. and by night they are starving!
  2. Their minds are in the habit of nighttime snacking and it’s a hard habit to break. People can be conditioned to sitting in front of the TV/computer/with a book/etc. with a snack. Often this type of eating is completely mindless eating. Their body gets used to having snacks at night, and the body craves what it is used to at a certain time. Foods high in sugar, salt and fat are usually the biggest culprits: ice cream, cheese, crackers, chips and dips, Chinese food, pizza, and fast foods/fried foods. The body is craving food, or a certain food, just like “Pavlov’s Dog”. The body wants what it thinks is coming.  By the way, the foods listed above are also not good for the GI system, especially with IBS.
  3. They are tired. When you are tired you get hungry, and because sugar acts as a quick source of energy, being tired can make you crave sugar. So, people go get a snack and feel like they have the extra energy to finish their project, their book, or make the extra updates to their social media outlets. What the body needs most is sleep, but they push the limits and burn the candle on both ends. Lack of adequate sleep is actually linked to obesity and many diseases like heart disease.
  4. It’s so emotional! It can be quite comforting to snack each night with a friend/spouse/kids and people don’t want to break that commitment/relationship or disappoint the other person. If you are lonely, food can be your companion. It can be a reward system to the self, such as “I dieted all day so I deserve it”, “I am so stressed out so it’s OK if I eat this just this once”, or “I’ll just eat this now and start the diet tomorrow”.

How to Avoid the Night Time Snack Attack:

  • Eat a balanced diet during the day. Eat 3 meals a day and plan for a healthy snack in the early evening to prevent cravings. Make sure your meals and snacks have some protein and/or healthy fat.
  • Break bad habits. Keep food in the kitchen, at the table, and at mealtimes. Do not allow yourself to bring food into the TV room or office. Break the sugar cycle by eliminating high sugar foods for 3 weeks. By then you will have kicked the “addiction” and be eating a healthier diet.
  • If you do have a snack, plan in advance what it will be and how big it will be. Something that takes longer to chew will have a longer acting effect in your belly and you will eat less. Things that have fiber, protein, healthy fats will help stabilize your blood sugar throughout the night.
  • Go to sleep. If you are really tired just turn off your mind, turn off the lights, and let your body rest and restore. Seal the meal. After dinner have a small dessert or snack and then brush your teeth (and floss), have a cup of herbal tea ready, and don’t have anything else. You are done.

EPICURED DELIVERY TIPS:

If you have an early delivery window, we don’t have to ring your buzzer – just notate in your delivery instructions to not disturb and to leave in your apartment’s vestibule if you don’t have a doorman.

Make sure if you have specific delivery instructions to include them when you checkout!

 

Tierra Salad with with Feta & Aioli Verde

NEW ADDITION TO THE EPICURED MENU

Tierra Salad is Back!!!

This fresh and beautiful low FODMAP dish features a fresh bed of spinach with a vibrant collection of greens & purples: herbed fennel slivers, purple cabbage, watermelon radishes, delicate zucchini ribbons, boiled purple potatoes, and blanched green beans.


Served with crumbled Feta and creamy Aioli Verde, you’ll find ribboned green squash and amazing Watermelon Radishes which add a seasonal tangy crunch and wonderful color.

Try our vegan Aioli Verde!

The light and creamy dressing is a flavorful blend of “vegenaise,” dijon, cilantro, vanilla oil, and ginger.


Fennel Slivers & Parsley bring you the perfect taste of Spring!

FUN FACT FROM THE EPICURED DIETITIANS!
DID YOU KNOW: parsley is an excellent source of Vitamin K, which is great for bone health.


ATTENTION: COLD BREW COFFEE IS COMING!!!

Coffee lovers! Next month, Epicured will offer a ready-made, cold brew that is dairy-free, low in calories, low in sugar, and of course, low FODMAP.

It has the perfect balance between great coffee flavor and creamy sweet almond milk. Very little sugar needed.  

 


INTRODUCING Martha McKittrick, RDN, CDE, CHWC

A registered dietitian with over 20 years experience and multiple specialty areas. In addition to begin an active member of the Epicured Clinical Network, Martha is on our menu development team where she reviews recipes for low FODMAP compliance.

Martha has always been a serious student of dietary issues: “About 5 years ago, I took a course on the Low FODMAP Diet & IBS by: Patsy Catsos and Kate Scarlata. It was a game changer for my nutrition practice. I remember counseling my first patient on the Low FODMAP diet. She had constipation and severe bloating for much of her life and was eating huge amounts of fiber in attempts to alleviate the constipation. Once we started the Low FODMAP elimination diet, her symptoms literally disappeared in a matter of 2 weeks.”

“The best part was when we did the reintroduction. We were clearly able to tell it was the polyols and oligosaccharide group that caused her symptoms. She wrote me a note saying “you literally changed my life! For the first time in twenty years I was IBS symptom-free all thanks to the nutritional program you made for me.”

AND THE STORY CONTINUED AT EPICURED Martha: “I’ve referred quite a few clients with IBS to Epicured and have gotten great feedback. Not only does it take the stress out of knowing what to eat, but I’ve heard only good things about the quality and taste of the food. I’ve even referred clients who don’t have GI issues, but who are just looking for a healthy meal delivery service.”

FOR MORE MARTHA:

 


FROM THE EVENT CALENDAR:

Epicured is sponsoring the 1st Annual Thought Leaders in GI Motility Symposium May 23rd! We were invited by two members of our clinical network: Bani Roland, MD from Lenox Hill Hospital & Michael Smith, MD from Mount Sinai to take part in the event. The whole team will be on-site serving snacks & smoothies.

The goal of the event is to address the paucity of available information available to internists, nurse practitioners, medical PAs, surgeons, and general gastroenterologists to effectively manage gastrointestinal motility disorders. The topics that will be presented make up a large percentage of the common complaints medical professionals face and are also a cause of significant morbidity and mortality. We aim with this conference to provide clinical pearls as well as updates on the latest diagnostic tools, therapeutic agents and research data available on a wide breadth of motility disorders.

LEARN MORE

 


FASCINATING REWIND

Chef Renee, Fitness Expert Don Saladino, and Gastroenterologist Ed Barbarito shared their insights and took questions on a host of dietary issues…

Dr. Barbarito at Morris County Surgical Center

Edward Barbarito’s journey as a gastroenterologist started well before it was time to even choose his medical specialty. He developed Ulcerative Colitis (or UC, a type of Inflammatory Bowel Disease) in his early 20’s. His own digestive illness inspired him to want to care for those suffering with similar kinds of illnesses. Today, his life experience gives him special and unique insights into the health and potential of his patients.

ED’S STORY

Ed’s ulcerative colitis diagnosis came just before medical school and he suffered from the disease for more than ten years. He was hospitalized numerous times with varying success. He eventually became gravely ill and, when all medical options were exhausted, had no choice but to have a total colectomy and ileal pouch anal anastomosis. “My entire colon was removed and an ‘artificial’ colon was created from my small intestine,” he explains.

“I often wonder had I paid more attention to my diet and food choices would my illness have been so particularly aggressive,” he reflects. The impact of diet on ulcerative colitis was simply not well understood at the time. “I am now disease free and quite healthy, but my digestive system is forever altered and I remain sensitive to different foods.”

Ed with his grandmother at his college graduation, just before the onset of his ulcerative colitis.

FINDING THE RIGHT WAYS TO EAT WELL & STAY FIT

“Over the past 10 years, through personal research, open dialogue with colleagues and patients, and trial and error I have found the foods best suited to my body’s altered digestive system,” he says. “I avoid gluten and wheat products, minimize carbohydrate intake and generally follow a low FODMAP diet plan. Thankfully this has worked well for me, and my personal experience with digestive illness and subsequent recovery has significantly impacted my approach to patients.”

Out for a run with Bingo!

Ed is an Epicured client and an Epicured supporter, who recommends the service to many of his patients. That’s because most of Ed’s patients share his sensitivities. He treats many patients with Inflammatory Bowel Disease, but he estimates that a staggering 50% of his patients come in for Irritable Bowel Syndrome (IBS). Their symptoms are varied, but the most common ones are debilitating bloating and gas, for which there is no conventional treatment and food is a go-to remedy.

Dr. Barbarito has a real appreciation for how food impacts him physically, emotionally, intellectually, but he always preaches patience when encouraging his patients to make dietary changes. “People need to understand that changing your diet can be a gradual process.” He reminds patients that it’s okay to cheat now and again if that’s what you need to stay motivated and feeling good. “For me, I eat ice cream twice a week! Wednesdays and Sundays!” Because he knows he always has this to look forward to, he can limit himself on other days.

“I truly believe that ‘food is medicine’ and gladly share my experience with my patients,” he continues. “I first and foremost encourage my patients to find their way to good health through proper diet and lifestyle choices as the backbone of their treatment. Conventional medicine has its place in improving many digestive illnesses, but it will never replace proper nutrition.”

Epicured lunch is served! Dr. Barbarito (2nd from right), Carena from Epicured (center), and the Morris County Surgery Center team.

FOOD & MEDICINE COMING TOGETHER

Dr. Barbarito sees a bright future ahead for his field. “Historically doctors would just give you a pill to fix your problem. It’s a tradition dating back hundreds, even thousands of years, but it’s limiting and patients should expect more. If they don’t, they are missing the opportunity to make therapeutic lifestyle changes through things like food and fitness that could have great impacts on their health.”

He sees patients looking beyond typical prescriptions. “The more that patients look to medications to fix problems first, the more exposed they are to all sorts of side effects. I have patients coming to me with chronic GI conditions who have been taking the same prescription drugs for years. They come to me and say ‘I don’t want to be on these medications anymore.’ I need to do something else. This is where the idea of ‘food as medicine’ has real power.”

WHERE DOES EPICURED FIT?

“I’d like to see it incorporated more into medical practices, where physicians and dietitians promote it, as well as in the fitness world,” he tells us. “It tastes great, it fits nicely into my life, and I’m going to continue recommending it to my patients. I want them to feel as good as I do.”

Watch Ed, Don Saladino & Chef Renee talk gut health:

Want to learn more?

Dr. Edward Barbarito, a northern New Jersey-based gastroenterologist, has been caring for patients with digestive illnesses for more than 20 years. He is in private practice at Morris County Gastroenterology Associates and sees patients at two hospitals: St. Claire’s and Morristown Memorial Hospital. Dr Barbarito attended New Jersey Medical School (now Rutgers) in Newark from 1993-1997. He did his internal medicine residency and gastroenterology fellowship there as well from 1997-2000 and 2000-2003 respectively, and was chief medical resident at Hackensack University Medical Center 1999-2000.

Check Out: The Morris County Gastroenterology Associates Website

Meet Sharon! A wonderful client and a savvy chef in her own right. Find out why Epicured has been a “game-changer” for this Fairfield County resident.

EPICURED: Tell is a bit about yourself… job, family, hobbies, anything that comes to mind!

Sharon: Married, overly nurturing mother of two grown children and a black mini poodle. I’m the administrative partner for a financial advisory firm and am lucky to be able to work from home most of the time. I exercise regularly, take walks and hikes with my dog daily, and volunteer with a local community service organization helping motivate low-income high school students in my town to connect to their full potential. I enjoy movies, books, creating delicious meals and gathering with family and friends. Oh, and I developed IBS about three years ago – guess I can’t leave that out!

EPICURED: Let’s start with the positive! You’ve found the low FODMAP diet. You’ve found Epicured. What’s it like for you to be able to eat foods that work well for you?

Sharon: It is AMAZING to be able to come home from a busy day and warm up a DELICIOUS, healthy, nurturing meal which is completely safe for me to eat without any risk of feeling badly in hours (or days) to come! The very best part for me, as an accomplished cook, is that there are so many choices for more exotic fare, things I wouldn’t cook for myself. Epicured is a game changer for me: delicious, well prepared, convenient and low fodmap! I couldn’t be more grateful they branched out to Connecticut.

EPICURED: What role has Epicured played in helping you day-to-day?

Sharon: I feel more energetic and have dropped several pounds. I had a feeling this would happen but was impressed by how FAST it happened.

One of the best things about having a supply of various Epicured meals on hand, is when you are invited to a friends home for a gathering and you can say “I’d love to come but since I have some food intolerances, don’t cook for me, I’ll bring myself something.” Then you don’t feel like a burden nor have to choose between going hungry or risking it. All you need is a microwave and you are good to go!

EPICURED: Any favorites from the menu?

Sharon: I love the Thai Green Curry, the Seared Lamb Medallions, the Pad Thai, The Chicken Lettuce Wraps and I always, always, order extra Turkey Chili as it freezes so well and is easy to thaw out if I know I’m going to have a busy day. I was a huge fan of the Warm Autumn Salad as well and look forward to it being added back to the offerings. And the two different kinds of Energy Bites are so delicious! They not only satiate my sweet tooth but they keep me full and are perfect to throw in my bag when I need to pack a snack.

EPICURED: How did you first discover a low FODMAP diet? What was going on in your life?

Sharon: After about 9 months of suffering with constant pain, distress, bloating and the inability to leave my house every morning, I started to do an intensive amount of research into what was going on with me. An Endoscopy and Colonoscopy ruled out any disease so I was diagnosed with the catchall “IBS” and told to give the low FODMAP diet a try. I had some fits and starts with it and wish I had seen a Registered Dietitian but I didn’t know to (my doctor never recommended it) and though I know a few Nutritionists, none of them were as well versed on IBS or low FODMAP as I had already become. Within a few weeks my stomach calmed down and through the elimination diet I was able to identify my triggers. Then came the arduous work of trying to eat at a restaurant (did you know that onion, garlic, shallots or scallion seems to be in almost everything?!?)

It’s been a journey but I will forever be grateful to the amazing dietitians who have some really smart and educational blogs. Additionally, I joined a few closed (meaning our posts to each other can only be seen by members) Facebook groups and IBS sufferers around the world have helped me learn the ins and outs of this way of life – and made me realize I wasn’t crazy! It was on one of those Facebook groups where I learned about Epicured. At that time they didn’t deliver to me yet, I was out of their range but within a few months they got in touch with me and I’ve been a tremendously happy customer ever since.

Credit: Martha McKittrick

EPICURED CLINICAL NETWORK MEMBER SPOTLIGHT: Martha McKittrick, RDN, CDE, CHWC is a registered dietitian with over 20 years experience and multiple specialty areas. In addition to begin an active member of the Epicured Clinical Network, Martha is on our menu development team where she reviews recipes for low FODMAP compliance.

EPICURED: Welcome! To start, tell us a bit about your practice. What do you like to focus on as a dietitian? What about the work gets you most excited?

Martha McKittrick: I’m a registered dietitian, certified diabetes education and Wellcoaches certified health and wellness coach. I have a private practice on the upper east side in NYC where I specialize in weight management, diabetes/prediabetes, heart health, PCOS, IBS and other GI conditions, sports nutrition and overall wellness. As a wellness coach, I take an integrative approach when counseling my clients and address nutrition, exercise, sleep and stress.

My typical client is a busy New Yorker who needs practical advice on how to fit a healthy lifestyle into a hectic schedule. What I love best about my work is being able to make a difference in someone’s life. I also love all the opportunities that are available to an RD – from working in private practice, to blogging, product development, writing, lecturing, virtual counseling, developing online programs to name a few. The profession has come a long way from when I first started 20+ years ago where most RDs worked in hospitals!

EPICURED: From your blog, I can see you’re a New York foodie! What role does eating out- menu selections – vs cooking at home – play in your practice?

Martha McKittrick: I must admit that my kitchen doesn’t see a lot of action! And these tiny NY kitchens aren’t so conducive to cooking. I tend to work long hours so prefer picking up healthy take-out on the way home from the gym or meeting friends for dinner. When I do cook, it tends to be something simple that I can prepare in 15 minutes or less. I find the majority of my clients work long hours as well. The fact that I can relate to them helps me give more practical advice.

EPICURED: Are you an advocate for having your patients use meal services that suit their goals and health needs? If so, what kinds of benefits have you seen from this? How have these services influenced your approach?

Martha McKittrick: I find most of my clients have hectic schedules and don’t have a lot of time to think about food. They often end up grabbing something “not-so-healthy” on the run. I’m a huge fan of meal delivery services… if they are they are healthy of course! It takes the guesswork of what to eat. Ordering greasy Chinese food or a pizza on seamless versus getting a meal made from wholesome ingredients delivered to your door… it’s a no brainer.

I am especially a fan of meal delivery services catered people with medical issues, including GI issues like celiac and IBS. Having these conditions can be stressful enough. Who needs the added stress wondering if your steak has been cross-contaminated with gluten or if your veggies are sautéed with garlic?

EPICURED: Let’s talk FODMAPs! What is your experience with using the low FODMAP diet for IBS patients? What kinds of successes have you seen?

Martha McKittrick: Years ago (before we knew about the Low FODMAP diet), I gave the standard nutrition advice for IBS such as avoid greasy food, no carbonated beverages or gum, etc.

Then about 5 years ago, I took a course on the Low FODMAP Diet & IBS by Patsy Catsos and Kate Scarlata. It was a game changer for my nutrition practice. I clearly remember counseling my first patient on the Low FODMAP diet. She had constipation and severe bloating for much of her life and was eating huge amounts of fiber in attempts to alleviate the constipation. Once we started the Low FODMAP elimination diet, her symptoms literally disappeared in a matter of 2 weeks. The best part was when we did the reintroduction. We were clearly able to tell it was the polyols and oligosaccharide group that caused her symptoms. She wrote me a note saying “you literally changed my life! For the first time in twenty years I was IBS symptom-free all thanks to the nutritional program you made for me.”

This sold me on the Low FODMAP elimination diet and reintroduction process. I use it very often in my private practice and find it helps the majority of my patients with IBS and other GI conditions.

The Epicured Pad Thai: one of Martha’s favorites! Credit: Ben Fink Productions for Epicured

EPICURED: You do such important work with Renee and culinary team reviewing recipes for low FODMAP compliance. Tell us a bit about that process. What are the biggest challenges? What kinds of things do you look out for during the review process?

Martha McKittrick: It’s important that each menu item be compliant with the Low FODMAP standards. So Renee and I review each ingredient closely to make sure they adhere to the [Monash University] standards.

It can be tricky as the foods allowed  – or not allowed – are always changing according to new research. And not all foods have been tested! Another challenge can be portion sizes. For example, TWO Brussels sprouts are considered Low FODMAP, but more than this is not.

EPICURED: How do you see Epicured helping your clients? What has been your experience so far?

Martha McKittrick: I’ve referred quite a few clients with IBS to Epicured and have gotten great feedback. Not only does it take the stress out of knowing what to eat, but I’ve heard only good things about the quality and taste of the food. I’ve even referred clients who don’t have GI issues, but who are just looking for a healthy meal delivery service.

EPICURED: Any favorites from our menu? Anything you’d like to see?

Martha McKittrick: I’ve tried numerous dishes for Epicured and it’s hard to pick a favorite. Two of my favorites are Pad Thai and the Wild Salmon.

Want to learn more?

Read: Martha’s Blog, “City Girl Bites”

Check Out: Martha’s Website

Read: “Healthiest Office Snacks, as Chosen by Nutritionists”: Martha featured on CNN.com