When it comes to ensuring a balanced diet amidst food allergies, the expertise of nutritionists is invaluable. From incorporating diverse protein and calcium sources to providing calcium without lactose in senior diets, here are six experiences shared by Registered Dietitians and other nutrition professionals on how they successfully navigate their clients' dietary restrictions.
I had a vegetarian client who was lactose intolerant and allergic to soy and peanuts, which presented a unique challenge in ensuring she consumed enough protein-rich and calcium-rich foods. We worked together to incorporate alternative protein sources such as lentils, quinoa, chia seeds, and various beans. Additionally, we explored egg options to further boost her protein intake. To address her calcium needs, we included calcium-fortified plant milks and leafy greens. By focusing on a diverse range of whole foods, we were able to meet her protein and calcium requirements while ensuring a balanced diet rich in essential vitamins and minerals. This collaborative approach helped my client maintain her dietary preferences and health goals despite her allergies.
It is easy to navigate a client's food allergies and still ensure a balanced diet. There are always substitutions for those foods that may cause a reaction. For example, substitute a nightshade vegetable, such as green pepper, for zucchini. For an egg allergy, one may consider a tofu scramble instead. Regarding a nut allergy, dried lentils, edamame, or air-popped popcorn are crunchy snacks. All nutrients are available through various foods, so food allergies should not stop anyone from getting a healthy, varied diet.
One tip when navigating a client's food allergies is to focus on nutrient-dense, whole foods that provide the widest range of vitamins and minerals. An example experience was when I supported a client allergic to wheat, dairy, eggs, and peanuts. I recommended aiming for high-protein foods like lean meats, legumes, nuts, and seeds. I suggested upping vegetable intake for fiber, vitamins, and antioxidants. I advised avoiding processed foods full of allergens and instead focusing on fresh produce, gluten-free whole grains, and healthy fats like olive oil. With this balanced, whole-food approach tailored to meet the client's allergies, we were able to ensure an optimal diet for overall health and well-being.
I have had many clients who struggle with lactose intolerance. At first, some are not sure if they are lactose intolerant because they can eat some dairy products without symptoms, while others cause discomfort. After some education and discussion about how various dairy products have different amounts of lactose in them, and that people with lactose intolerance can usually tolerate a small amount, we can make a nutrition plan together. This plan usually includes a list of low-lactose dairy products to try and then record any symptoms, as well as a list of foods and products that are similar in nutrient profile to dairy.
In a balanced diet, if you remove a food or food group, you have to find foods that replace most of those lost nutrients. Dairy is a good source of calcium, protein, vitamin D, and potassium, so I provide a list of foods rich in those nutrients.
I was introduced to a young patient with food protein-induced enterocolitis syndrome (FPIES) who became quite ill 2-4 hours after consuming breast milk. The patient also attempted formulas based on cow's milk. The use of soy milk presented a similar challenge, and we ended up choosing a balanced, amino acid-based formula instead. Luckily, this was enough to manage the patient's nutritional needs, and the hard work of balancing a proper diet was accomplished via a standardized formula after the challenging task of discovering food triggers for FPIES. As much as I wish we had a test for FPIES, the best (and only) test that we have is a patient's response to foods.
Working in senior living, many of our residents have food allergies or dietary restrictions. One of the major food allergens we manage is lactose intolerance. Dairy is a major food group containing calcium, which helps to increase bone density and reduce the risk of bone fractures.
Calcium is critical in senior living because bone loss accelerates after 50 years of age. However, most dairy products containing calcium also contain lactose. For residents who have lactose intolerance, ensuring a balanced diet entails providing alternative food items that contain calcium without lactose. Such examples include calcium-fortified soy milk or orange juice, canned salmon or sardines, calcium-fortified cereals, or tofu made with calcium.
As the nutrition professional at my organization, I provide dietary education to residents who are lactose intolerant, detailing the benefits of calcium and listing the lactose-free food sources that contain calcium. I offer these food suggestions to our culinary team to ensure that calcium-fortified food and beverage items are on our menus and available to our residents.
