Allergies and dietary restrictions are becoming the norm these days. It seems that virtually every reservation I get someone in the party has some kind of special dietary request. Other than asking details and knowing exactly what cannot be consumed, I don’t often question the person about their knowledge of the allergy or dietary restriction, although of late, I’m not certain many actually know why they are or are not eating something. Case in point, recently Jimmy Kimmel did a brilliant bit asking a bunch of people outside a gym if they ate gluten free. The vast majority of them said that yes, in fact they did. When he asked them what gluten was, none of them could answer the question. This is not uncommon. Many people observe various dietary restrictions not because they were diagnosed with an allergy, but because they were told that eating less of one thing or more of another will somehow be healthful to them. Either way, my job is to make sure I create food that is delicious and safe for people to eat.
That being said, however, one of the things that I personally pride myself on is that not only do I know HOW to cook gluten free, dairy free, egg free, sugar free or any other allergen you can name free, I actually understand what these allergies mean from a scientific perspective. I have done research on what gluten is, what typical dairy allergies/intolerances are, what anti-inflammatory diets look like, etc. It is something I find personally interesting, but ultimately it makes me a better chef. It enables me to understand exactly what I’m doing, why and to figure out what substitutes will work to replace what those items may contribute to a recipe, i.e. mouthfeel, binder, leavener, texture.
This morning I had guests who requested “no milk” in their meal, which I happily obliged. When I asked a little more detail about their allergy they were unable to tell me what exactly they were allergic too. I proceeded to discuss the difference between lactose intolerance and milk allergies with them and determined that they are in fact Lactose Intolerant. Lactose is the sugar in milk. It is consumed by the digestive enzyme Lactase in the small intestine, enabling the lactose to be digested and ultimately expelled. Many individuals do not manufacture enough Lactase in their bodies, making the consumption of products made with milk difficult to digest and thereby causing abdominal discomfort. Those who are lactose intolerant can often take a pill replacing the Lactase in their small intestine, thereby allowing them to consume at least small quantities of milk products without a problem. Those with Lactose intolerance can also generally consume goat and sheep’s milk products, hard cheeses and yogurt, as the lactose levels in these are much lower than other dairy products. Some degree of Lactose intolerance is something that generally occurs post infancy in all humans, but the preponderance of severe Lactose intolerance tends to be higher in non European cultures where there is not a long lasting history of dairy consumption which would have necessitated the evolution of more Lactase production in the small intestines of those populations. It is estimated that approximately 65%-75% of the world population suffers from some degree of Lactose intolerance.
A true milk allergy, however, is generally attributed to the protein in milk, of which there are two, casein and whey. While some people are only allergic to one or the other, the vast majority of people with true milk allergies are allergic to both. The problem with a true milk allergy is that milk proteins can be isolated and utilized in a number of different products that would not appear to be dairy products, therefore making it very important to read all the labels of ingredients being used in a recipe prior to using them.
What is the difference between an allergy and an intolerance?? An allergy causes an immune system reaction, which can lead to things like hives, rashes, anaphylaxsis and swelling of the tongue or throat. An allergic response is immediate and can be life threatening. Intolerances do not involve immune system reactions and generally occur over a period of time rather than immediately. Both can cause similar digestive issues, which is why it is often difficult to determine whether one is allergic or simply intolerant without the diagnosis of a medical professional. This doesn’t make either one more or less legitimate in the case of what I do. I make certain I adjust my recipes accordingly. But understanding which I am cooking for may influence whether I utilize something like goat cheese in a recipe or whether I use whey protein to boost the protein content of a shake.
Replacing dairy in recipes is actually quite easy. It is one of the items, particularly in baking, that I have no problem with. There are two factors in replacing dairy, mouth feel and texture. I will often use coconut milk instead of cream or milk because it has a velvety mouthfeel and coats the tongue in a similar manner, making the recipe no less luxurious or rich tasting. For extra leavening, I also may add just a hint of apple cider vinegar, particularly when I am trying to substitute buttermilk in a recipe. That helps make the baked item a little lighter and fluffier and gives it a more airy texture.
As with any dietary restriction, knowing in advance and asking the right questions can help you to accommodate the restriction with ease and to make delicious, safe food that will leave a lasting impact.