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contents
INTRODUCTION
what is Irritable Bowel Syndrome?
possible causes of IBS
diet and IBS
a balanced diet
dietary fibre
high and low fibre
food intolerance or allergy?
milk and dairy products
lactose intolerance
a milk-free diet
wheat
exclusion diets
food reintroduction
other diet-related triggers
the symptom-linked approach
symptom-linked groups
probiotics and prebiotics
some questions answered
RECIPES
breakfasts
light bites
main meals
vegetarian
desserts
cakes and bakes
index
useful contacts and acknowledgements
introduction
Irritable Bowel Syndrome (IBS) is a common bowel condition,
which is said to affect as many as one in five of the adult
populations of Britain and the USA. People of any age can
suffer with IBS, including children, but the most common age
range affected is 20–40 years, and women are twice as likely to
report symptoms of IBS than men.

The cause of IBS is not known, although there are many factors involved,
and often the symptoms are the result of a combination of factors rather
than just one. At present, there is no single cure for IBS, but there are
lots of different ways to manage it, and tailoring your diet to deal with the
symptoms you experience is a good place to start. It is important to
remember, however, that dietary changes will not help everyone, and if
your symptoms persist you should seek medical advice.
 what is Irritable Bowel Syndrome?

Irritable Bowel Syndrome (IBS) is described as a functional

bowel disorder by the medical profession. This means that no
specific cause can be found for an individual’s symptoms after
medical investigations but that the bowel is functioning in an
abnormal way.
Symptoms
The key symptoms for a diagnosis of IBS are that the person should have
suffered abdominal pain or discomfort for at least 12 weeks (this does not
have to be consecutive weeks) during the last 12 months. In addition, two
of the following three symptoms should also be present: □ Relief of pain
or discomfort with passing a bowel motion (defecation)
□ A change in the frequency of stools – an increase or decrease in
bowel motions □ A change in the consistency of stools – looser or
harder motions
Additional symptoms
There is a further group of symptoms that support the diagnosis of IBS,
and two or more of these should be present on at least 25 per cent of
occasions or days when IBS is suspected. These supportive symptoms
are: □ Altered stool frequency: more than three bowel motions a day or
fewer than three bowel movements a week □ Altered stool form: looser
or more watery motions, or hard, lumpy or pellet-like motions □ Altered
stool passage: straining to pass a motion or urgency or the feeling of not
completely emptying the bowel (incomplete evacuation) □ Passing
mucus with stools
□ Abdominal bloating or distension
In addition to the above symptoms, many people with IBS often complain
of flatulence (wind), rumbling noises in the bowel (borborygmi),
indigestion or heartburn, nausea, headaches, persistent tiredness and an
increased need to urinate. Women sometimes also find sexual
intercourse painful.

Is it IBS?
Self-diagnosis of IBS is not advisable. Before a diagnosis is made it is
important that a medical doctor carries out appropriate examinations and
investigations. This is because there are several other, more serious
bowel conditions that have similar symptoms to those of IBS. Further
investigation may be necessary if any of the following are present: □
Recent, unexplained weight loss
□ Rectal bleeding
□ Anaemia
□ Fever
□ Start of symptoms over the age of 50 years
□ Recurrent vomiting
□ A family history of colon cancer, Crohn’s disease, ulcerative colitis
or coeliac disease

OTHER CONDITIONS WITH SIMILAR SYMPTOMS

▪ Diverticulitis
▪ Gallstones
▪ Bile salt malabsorption
▪ Microscopic colitis
▪ Chronic fatigue syndrome
▪ Coeliac disease
▪ Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
▪ Bowel cancer
 possible causes of IBS

There are many different theories about the causes of IBS, and
there are almost as many different ideas about how to treat it.
The main causes are believed to be a bout of bacterial
gastroenteritis, the use of antibiotics, stress and anxiety and
other psychological reasons, abnormal gut motility and
hypersensitivity of the gut, the menstrual cycle in women and
diet.
Post-infective IBS
Some people with IBS can link the start of their symptoms to having had
a bowel infection or gastroenteritis, such as salmonella food poisoning.
Research has shown that people who have had severe gastroenteritis
are almost 12 times more likely to develop IBS than those who have not.
It is not clear why this is the case, although changes to a person’s normal
gut bacteria have been suggested, as have slight changes to the bowel
itself. This type of IBS is known as post-infective IBS.
Antibiotics
Everyone’s large bowel contains billions of bacteria. The bacteria are of
hundreds of different types, some of them beneficial to our health and
others with the potential to cause ill health. In normal circumstances
these bacteria live in a balance together and cause no problems to the
individual. However, a course of antibiotics, prescribed to kill the bacteria
causing a particular infection, can also kill the good bacteria in the bowel.
This leads to an imbalance, which can result in symptoms such as
diarrhoea, abdominal bloating, pain and flatulence.
Stress and anxiety
Many people find that stress or anxiety triggers their IBS, and some
sufferers can link the start of their symptoms with times of change or
upheaval in their life, such as leaving home, starting work, getting
married or going to university. Other upsetting events include relationship
problems, bereavement and physical or sexual abuse.
Stress has been shown to increase the speed at which waste is
moved through the large bowel (colon), so leading to more frequent
bowel motions. It also releases chemicals in the body that stimulate the
colon, which leads to pain. It is not known if stress causes IBS in the first
place, but the symptoms of IBS can certainly make people anxious,
especially if their symptoms are frequent and unpleasant. Some people
with IBS also have psychiatric illnesses.
Abnormal gut movement and hypersensitivity
Research has shown that in some people with IBS waste is moved
through the gut more slowly or more quickly than normal. A slower
movement may result in constipation, whereas a faster movement may
lead to diarrhoea. There is also evidence that some people with IBS are
more sensitive to discomfort in the bowel than people without IBS.
Research is being carried out into the ways in which the brain deals
with pain or the anticipation of pain because there is some evidence that
this does not work normally in IBS sufferers.
Menstrual cycle
IBS symptoms can be affected by the change in hormone levels that
occur in the body over the menstrual cycle. Most women notice a change
in their bowel motions during menstruation. It is not more common in IBS,
but it may have more effect. As with some menstrual disorders, evening
primrose oil may help with IBS symptoms.
 diet and IBS

The way we eat, what we eat and our meal patterns can all
trigger the symptoms of IBS. Unfortunately, there is no one
dietary change that will help everyone who is diagnosed with
IBS. A change that will help one person may make the
symptoms worse in another.
Meal patterns
It is important to have regular meals throughout the day. Missing meals
and then snacking on high-fat, sugary foods or having one huge meal a
day can lead to bloating, abdominal discomfort and wind.
How and what we eat
Eating quickly and rushing meals can lead to air being swallowed at the
same time. This can result in belching or indigestion, and it can cause
abdominal bloating and wind. Eating slumped over a computer keyboard
or dashing around at the same time as eating can also cause problems.
Always take time over your meals and sit up straight when you are
eating.
Many foods have been identified as triggers to IBS symptoms, and
these are considered in more detail on the following pages. However,
simply adopting a balanced diet quite often helps people with IBS to
control their symptoms.
Portion sizes
The bowel is made up of muscles that contract and relax one after
another in sequence to push food through the digestive tract. A large
meal can cause a stronger wave of muscle contraction, resulting in
abdominal discomfort, indigestion and nausea. Keep to moderate portion
sizes and healthy eating guidelines.

DIETARY FACTORS LINKED WITH IBS

▪ Meal pattern
▪ Fluid intake
▪ Dietary fibre intake
▪ Food intolerance
▪ Irritants to the bowel, such as caffeine, alcohol and spicy foods
▪ Abnormal digestion of lactose and fructose
▪ Fatty foods
▪ Excessive intake of intestinal stimulants, such as sorbitol
 a balanced diet

A balanced diet is one that provides the body with all the
nutrients it requires for health. In practice, this means choosing
foods from the five food groups in the recommended amounts.
The five food groups are: proteins, starchy foods, milk and dairy
products, fruit and vegetables, and fats and sugars.

Protein
The body needs protein for growth and to repair cells. Protein-containing
foods can be divided into animal proteins and vegetable proteins. Animal
sources of protein are meat, including poultry and offal, fish and eggs;
vegetable sources are beans, lentils and nuts. These foods are also good
sources of iron, zinc, magnesium and B vitamins.
It is recommended that we include two servings of these foods a day.
Try to choose leaner cuts of meat, trim away visible fat and remove the
skin from poultry. You should also avoid frying meat to keep your fat
intake down. This is recommended for general health, but fatty foods can
also make IBS symptoms worse.
Starchy foods
Starchy foods are good sources of carbohydrates, which provide energy
as well as B vitamins and fibre. Bread, pasta, rice, breakfast cereals and
potatoes are good sources of starchy carbohydrates, and it is
recommended that one-third of our daily diet should come from these
foods – around 7–10 portions a day for women and 8–12 portions a day
for men – so including a starchy food at every meal is important.
Milk and dairy products
Milk and dairy products are an excellent source of calcium, as well as
protein and vitamins A, B12 and D. Included in this group are milk,
cheese, yogurt and fromage frais. Butter and cream are not included
because they are high in fat and are therefore found in the fats and sugar
group. It is recommended that we include three servings of these foods a
group. It is recommended that we include three servings of these foods a
day.
Fruit and vegetables
Fruit and vegetables are good sources of vitamin C, folate, carotenoids,
potassium and fibre. All types of fruit and vegetable are included in this
group except potatoes, which are classed as a starchy food. Fruit and
vegetables can be fresh, frozen, tinned or dried. It is recommended that
we have a minimum of five portions of these foods each day (see
Portions of fruit and vegetables).
Fats and sugars
Fatty and sugary foods tend to be high in calories and low in essential
nutrients, and are often high in salt. Although it is fine to include them in
small amounts in a varied diet, too much of them can lead to weight gain.
It is recommended that only one-twelfth of our daily food intake comes
from these foods. High-fat foods include butter, margarine, oils, fried
foods, crisps and savoury snacks and pastry. High-sugar foods include
sweets, chocolate, cakes, biscuits, soft drinks and drinks and ice cream.
How much fluid?
It is recommended that we have 8–10 cups of fluid a day, which is
equivalent to 1.5–2 litres (2½–3½ pints). It is a myth that this fluid should
be made up of just water. Any type of drink counts towards the
recommended amount (except alcohol). Certain types of drinks, however,
can trigger symptoms of IBS (see dietary fibre).
Fluids
As much as 70 per cent of an adult’s body weight is water. Throughout
the day we lose water in our sweat, breath, urine and faeces, and if we
do not replace the fluid we lose we suffer from dehydration, which leads
to headaches, a lack of concentration, tiredness and dark-coloured urine.
Continued inadequate intakes can lead to constipation and increase the
risk of cystitis.
There are times when your body will need more fluid, such as when
exercising, in a hot environment, if you have a temperature or if you have
frequent diarrhoea or vomiting.
Caffeine As a stimulant caffeine gives us the kick-start we sometimes
need. However, it also acts as an irritant to the bowel and can increase
the need to urinate. Excessive amounts of caffeine can exacerbate the
symptoms of IBS, so keep to a maximum of four or five caffeine-rich
drinks a day and alternate them with caffeine-free drinks or water.
Remember that some foods and pain-killing tablets contain caffeine too.
Alcohol Alcohol is also an irritant to the bowel and it can contribute to
diarrhoea, abdominal discomfort and indigestion (heartburn). Ideally,
keep within the recommended sensible limits for alcohol (14 units a week
for women and 21 units a week for men) and have some alcohol-free
days. Alcohol does help us to relax, and stress is linked with IBS, so a
glass of wine at the end of a busy day can be helpful.
Fizzy drinks The gas in fizzy drinks can give abdominal bloating,
belching and discomfort. Limit your intake of these drinks to one glass of
250–300 ml (8–10 fl oz) a day. These drinks include sparkling water,
lemonade, cola, mixers added to spirits, soda water and sparkling fruit
juice drinks.

GUIDELINE PORTIONS OF PROTEIN FOODS

100 g (3½ oz) lean meat or poultry

100 g (3½ oz) oily fish
150 g (5 oz) white fish
2 eggs
4 tablespoons of cooked pulses or lentils
GUIDELINE PORTIONS OF STARCHY FOODS

1 slice of medium-cut bread

½ roll
½ pitta bread
1 small chapatti
2 egg-sized potatoes
2 heaped tablespoons of cooked rice or pasta
3 crispbreads or crackers
3 tablespoons of breakfast cereal
3 tablespoons of dry porridge oats

GUIDELINE PORTIONS OF MILK AND DAIRY

PRODUCTS

40 g (1½ oz) cheese

200 ml (7 fl oz) milk
125 g (4 oz) yogurt
125 g (4 oz) fromage frais
125 g (4 oz) fromage frais
200 ml (7 fl oz) calcium-enriched soya milk
200 ml (7 fl oz) calcium-enriched rice milk
125 g (4 oz) soya dessert or yogurt
CAFFEINE-RICH FOODS AND DRINKS

▪ Coffee, tea, hot chocolate, performance drinks, cola and chocolate

CAFFEINE-FREE DRINKS

▪ Decaffeinated coffee and tea, herbal and fruit teas, fruit juice, fruit
squashes, still mineral water and flavoured still water, tapwater,
milk and soya milk ALCOHOL UNITS
For the purposes of assessing your intake, one unit of alcohol is:
300 ml (½ pint) standard-strength beer, lager or cider
1 small glass (125 ml or 4 fl oz) wine
1 glass of sherry
1 shot (25 ml or 1 fl oz) of spirits
 dietary fibre

Dietary fibre, sometimes referred to as roughage, is part of

plant foods that our bodies find difficult to digest. It is found in
fruits, vegetables, cereals, pulses, nuts and seeds. It is part of
the carbohydrate family, along with sugars and starches, and is
known as complex carbohydrate or non-starch polysaccharide
(NSP) in the scientific world.

Bacteria
Bacteria in the large intestine are able to break down fibre by a process
called fermentation. This results in the production of gases, which are
removed from the body as wind or are carried by the bloodstream to the
lungs and expired on the breath. They also create substances called
short chain fatty acids, which provide essential energy for the cells of the
large intestine and also for the growth of the bacteria themselves.
Soluble and insoluble fibre
Fibre is divided into two types: soluble and insoluble fibre. Soluble fibre
forms a gel-like substance in the intestine, and it has been shown to
lower blood sugar and cholesterol levels.
Insoluble fibre absorbs water and helps provide bulky, easier-to-pass
stools.
Resistant starch
Starch is found in foods such as potatoes, bread and rice and in some
fruits. It was thought that all starch was digested in the small intestine,
but it is now known that some starch is resistant to this process. It
reaches the large intestine, where it is fermented by gut bacteria.

GOOD SOURCES OF SOLUBLE FIBRE:

▪ Oats, barley, pulses, seeds, fruit and vegetables

GOOD SOURCES OF INSOLUBLE FIBRE:

▪ Skins, peel and pips on fruit and vegetables, wheat, rye and nuts
SOURCES OF RESISTANT STARCH:

▪ Cooked potato, pasta and rice eaten cold or re-heated

 high and low fibre

IBS symptoms can be affected by the amount of fibre in your

diet. Too little fibre can cause constipation and too much can
cause bloating, discomfort and wind. It can also trigger
diarrhoea. Altering the amount and type of fibre you eat can
help control IBS symptoms.

High-fibre diets
A high-fibre diet may benefit people whose main symptom of IBS is
constipation without abdominal bloating or wind.
It is important to increase the intake of both soluble and insoluble fibre
and to have an adequate fluid intake – that is, 8–10 cups or 1.5–2 litres
(2½–3½ pints) every day. Increase your intake of fibre gradually, over
several days, because a sudden increase can give abdominal discomfort
and wind. In addition, there is no benefit from having more than 32 g
(about 1 oz) of fibre a day, and the recommended daily intake is 18 g
(just over ½ oz).
Fibre supplements
Adding wheat bran to the diet to increase fibre intake is not
recommended. Research has shown that it can make the symptoms of
abdominal pain and bloating worse, and bran also interferes with the
absorption of minerals, such as calcium, zinc and iron, from the diet.
Low-fibre diets
Healthy-eating guidelines suggest that we should increase our intake of
fibre to decrease the risk of developing bowel cancer and diverticular
disease. However, some people with IBS find that increasing their fibre
intake makes their symptoms worse. A low-fibre diet can help people
whose symptoms of IBS are either diarrhoea with abdominal bloating and
wind or constipation with abdominal bloating and wind.
Limiting your intake of fibre may help IBS symptoms because it will
decrease the amount of bacterial fermentation that occurs in the large
decrease the amount of bacterial fermentation that occurs in the large
bowel. This will lead to less gas being produced and so reduce bloating.
It will also mean that stools will be less bulky and their movement through
the bowel will be slowed down.
Following a lower-fibre diet for four weeks will be long enough to know
if it is going to help or not. It is a good idea to keep a record of the food
and drink you take and any symptoms you experience, because it will
show if there has been any improvement. If your symptoms do improve it
is advisable to gradually reintroduce higher-fibre food to your diet to find
a level that you can tolerate.
If there has been no improvement after four weeks there is no need to
remain on the diet and you should return to a normal diet.
Vegetarians and low fibre
Vegetarians who depend for their protein on pulses, lentils, nuts and
seeds will have to include small portions of these foods once a day when
they are on a low-fibre diet unless other sources of protein, such as milk,
cheese, eggs and yogurt, are included at each meal.
Bulking agents and low-fibre diets
People who have a tendency to constipation should include a bulking
agent, such as sterculia, psyllium husks, methylcellulose or linseeds, so
that their constipation does not become worse. These agents can be
obtained from health food shops and pharmacies. It is important to take
them with plenty of fluid – say 300 ml (½ pint) – as they form a gel when
eaten, which provides bulk to help stimulate a bowel motion. They should
be taken every day.
Portions of fruit and vegetables
One portion of fruit is equal to 75–100 g (3–3½ oz) or 40 g (1½ oz) of
dried fruit. One portion of vegetables is about 75 g (3 oz). These weights
refer to the edible parts only, so skins and peel of fresh produce that are
not normally eaten and the juice or water of tinned foods are not
included.
Highs and lows of fruit and vegetables
The fibre content of the fruit and vegetables listed below is based on one
standard portion. Fruits and vegetables that are not included in the tables
have a moderate fibre intake. These can be included in the daily diet, but
have a moderate fibre intake. These can be included in the daily diet, but
keep them to one portion a day.
Higher-fibre fruit and vegetables Aduki beans, apricots (dried), baked
beans, baked potato with skin, blackcurrants, black eye beans, cabbage,
cranberries, figs (dried), French beans, gooseberries, haricot beans,
kidney beans and peas.
Lower-fibre fruit and vegetables Apple (peeled), apricots, courgettes,
cucumber, grapefruit, grapes, leeks, lettuce, melon, mushrooms,
nectarine (peeled), onions, peaches (peeled), peppers, radishes,
tomatoes and spring onions.

INCREASING FIBRE INTAKE

Among the best ways of increasing your intake of fibre are:

▪ Choosing wholemeal, granary or seeded breads
▪ Changing to brown rice or wholemeal pasta or mixing half white
and half brown together ▪ Keeping the skins on vegetables and
fruit
▪ Eating wholewheat breakfast cereals, such as Weetabix or bran
flakes, or oat-based cereals, such as porridge ▪ Aiming to have
at least five portions of fruit and vegetables every day
▪ Having seeds, nuts or dried fruit as snacks
▪ Adding pulses to stews and casseroles
DECREASING FIBRE INTAKE

Among the best ways of decreasing your intake of fibre are:

▪ Changing to white bread and rolls
▪ Choosing baked products made with white flour, such as muffins,
scones, crumpets and cake ▪ Having white pasta and rice and
always eating it hot (cold pasta and rice are high in resistant
starch) ▪ Avoiding the skins and peel on fruit and vegetables,
including the skins on baked and new potatoes ▪ Limiting fruit
and vegetables to a maximum of five portions a day and choosing
ones from the lower-fibre list
▪ Eating lower-fibre breakfast cereals, such as cornflakes and rice
crispies
REINTRODUCING HIGHER-FIBRE FOODS

It is important to add higher-fibre foods back to the diet gradually. A

sudden increase can lead to pain, wind, bloating and diarrhoea.
Different people find that they can tolerate different amounts and
types of fibre. Following a reintroduction programme can help to
identify these more easily.
identify these more easily.
Week 1 Keep skins and peel on fruit and vegetables Week 2 Include
one portion of a higher-fibre fruit or vegetable daily; still aim for at
least 5 portions a day Week 3 Include oat products, such as porridge
and oatcakes Week 4 Change to wholemeal bread
Week 5 Try eating wholegrain breakfast cereals

GUIDE FOR ONE PORTION OF FRUIT

2 small fruits, such as fresh apricots

1 medium fruit, such as apples
1 slice of large fruit, such as melon
1 tablespoon dried fruit, such as raisins
2–3 larger dried fruits, such as dates
GUIDE FOR ONE PORTION OF VEGETABLES

3 large tablespoons cooked vegetables

Small bowl of salad
3 tablespoons beans or pulses
 food intolerance or allergy?

The terms food intolerance and allergy mean different things to

different people. Just to confuse things even further there is
also something known as food sensitivity. It is important to
understand the differences between each of them.

Food allergy
An allergic response to food occurs when the body’s immune system
identifies a particular food as harmful to it. In response, the body
produces antibodies, which can be measured by blood tests or skin prick
tests. Only a small amount of the food needs to be eaten to lead to an
allergic reaction. Eating the food and the appearance of symptoms can
be almost immediate, but there are some conditions, such as coeliac
disease, where an allergy to a food occurs much more slowly.
Food intolerance
Food intolerance does not affect the immune system, and in general the
symptoms take longer to occur after eating a particular food. Often, large
amounts of a food have to be eaten to trigger a response. The symptoms
can be similar to those of a true food allergy – rashes, diarrhoea and
vomiting, for example – and for some people symptoms can be quite
severe.
Testing and food intolerance
The tests used to show food allergy, such as blood tests and skin prick
tests, cannot be used to identify food intolerance as it is not the result of
changes in the immune system.
There is a wide range of tests that claim to identify food intolerance,
such as hair testing, pulse testing and measuring muscle weakness.
Many of these tests have not been validated and can lead to people
following restricted diets for long periods, often unnecessarily. The most
reliable way of determining food intolerance is to withdraw a food from
the diet and see if there is an improvement in symptoms.
Causes of food intolerance
There are several different causes of food intolerance as listed below.
Digestive enzymes Some people are sensitive to particular foods
because they lack the right substances in the gut, called enzymes, to
digest them. An example of this would be the lack of the digestive
enzyme lactase, that is needed to break down the milk sugar lactose.
Vasoactive amines These naturally occurring substances cause the
blood vessels to narrow, which can lead to headaches, nausea and
giddiness. Foods rich in vasoactive amines include cheese, yeast extract,
chocolate, red wine and fermented foods.
Monosodium glutamate (MSG) This flavour enhancer is found in
Chinese cooking and many processed foods. Large amounts of MSG can
give headaches, flushing, abdominal discomfort, chest pain and
palpitations.
Irritants Some hot spices irritate the lining of the gut.
Gut bacteria There is growing evidence that the bacteria in our guts play
a role in our health (see Probiotics and prebiotics). Research suggests
that the type of bacteria present in the large bowel may be linked with
food intolerance.
SOME SYMPTOMS OF ALLERGY

▪ Swelling in the mouth and throat

▪ Runny nose (rhinitis)
▪ Watering eyes
▪ Breathing difficulties
▪ Skin rashes
▪ Small, itchy, red ‘nettle rash’ (urticaria)
▪ Diarrhoea
▪ Nausea and vomiting
 milk and dairy products

Milk is one of the most common foods linked to IBS. Research

has found about 40 per cent of IBS patients following an
exclusion diet identified milk as the food that upset them. It is
not clear why this is the case, but some people may have an
intolerance to lactose, which is the sugar found in milk.

Lactose
Lactose is made up of two sugars, glucose and galactose, and is broken
down in the small intestine by an enzyme called lactase.
As infants we produce large amounts of lactase because milk is our
main food. As we get older the production of lactase decreases. If there
is not enough lactase to completely break down the lactose in the small
intestine, it reaches the large intestine intact, where the gut bacteria
ferment it. This can give rise to symptoms of diarrhoea, bloating, pain and
wind.
Ethnic groups
People of Asian, African and Mediterranean descent often have quite low
lactase production, with 40–100 per cent of the population affected.
People from Scandinavia and northern Europe retain the ability to
produce lactase, and the number of people with lactase deficiency in
these areas is less, at around 5 per cent.
Gastroenteritis
A bout of gastroenteritis can cause temporary damage to the lining of the
small intestine and so upset the production of lactase. Some people find
dairy products upset them after they have had a stomach upset.
 lactose intolerance

The symptoms of lactose intolerance are very similar to those

of IBS, and the number of people reported to have lactose
intolerance and IBS ranges from 6 per cent to 24 per cent of the
population. Research has shown that not everyone with a
positive lactose breath test will improve on a low-lactose diet.

Many people with lactose intolerance can manage some lactose,

sometimes as much as 250 ml (8 fl oz) milk a day, in their diet with no ill
effects. A trial of a low-lactose diet for a couple of weeks may help people
who include more than 300 ml (½ pint) of milk in their daily diet or if IBS
symptoms started after a gut infection. In general, a milk-free diet gives
better results than just excluding lactose.
Hard cheeses, such as Cheddar, and butter have only a trace of
lactose and can be included in a low-lactose diet.
Testing for lactose intolerance
There are several tests available to determine lactose intolerance, but the
one most often used is called a lactose hydrogen breath test. A drink
containing a known amount of lactose is taken after an overnight fast.
Breath samples are collected before the patient takes the drink and then
every 30 minutes afterwards for two hours. If the lactose is not digested it
will be fermented by the gut bacteria, which then produce hydrogen. The
hydrogen enters the bloodstream and is eventually released from the
lungs in the breath. A rise in hydrogen levels indicates lactose
malabsorption.

MAIN SOURCES OF LACTOSE

▪ Milk (from a cow, goat or sheep) and foods made with milk, such
as custard, white sauce, milk puddings, yogurts, ice cream and
chocolates ▪ Lactose as a sweetener in foods and medications
 a milk-free diet

Milk, whether from cows, sheep or goats, is found in a wide

range of foods – and often where you would least expect to find
it. It is important to check food labels carefully to make sure that
your food is milk free. This can be difficult because of the
number of different words, all meaning milk, that can be used:
milk proteins (casein, caesinates, lactalbumin and whey), milk
sugar (lactose) and milk fat (buttermilk). You should also keep
an eye out for skimmed milk powder and milk solids.

Trial milk-free diet period

A trial of a strict milk-free diet for two or three weeks can help improve
the symptoms of IBS, and keeping a food and symptoms diary is a
helpful way of recording any changes in your symptoms. If there is no
improvement after this time you should reintroduce milk to your diet.
Reintroduction of milk
If there is an improvement in the symptoms of IBS a gradual
reintroduction of milk is recommended, starting with low-lactose dairy
products, such as cheese or butter, and then moving on to milk itself,
cream and yogurt.
It is important to test one new food at a time and to have that food on
two occasions during the day. Test the food for three or four days to allow
enough time for any possible reaction to occur. If the symptoms return
with the inclusion of milk it does not mean you will always have to avoid
it. Many people find they can include small amounts of milk on an
occasional basis with no problems. It is important to re-test foods after a
couple of months as an intolerance to milk can be temporary and you
might find you can manage it again.
Calcium intake
Milk and milk products are excellent sources of calcium, so it is essential
to include alternative sources of calcium in the diet as well. This can be
done by choosing other good dietary sources of calcium. Calcium-
enriched soya milk or rice milk are a good choice as they contain similar
amounts of calcium to cow’s milk. Aim to include two to three calcium-rich
foods a day. Alternatively take a calcium supplement.

DIETARY SOURCES OF MILK

▪ Butter and margarine

▪ Cakes, biscuits and baked products
▪ Cheese
▪ Chocolate
▪ Cream
▪ Crisps and savoury snacks
▪ Ice cream, milk puddings and desserts
▪ Pre-prepared meals and other convenience foods
▪ Vending machine drinks – hot chocolate, malted drinks and milk
shakes
▪ Yogurt and fromage frais

ALTERNATIVES TO MILK

▪ Cocoa, soya milk shakes, tea, coffee, fruit and herbal teas, fruit
juices and cordials ▪ Milk-free cakes and biscuits
▪ Milk-free margarine
▪ Plain nuts
▪ Ready-salted crisps
▪ Rice milk (calcium enriched)
▪ Soya cheese and soya cream
▪ Soya milk
▪ Soya yogurts, soya desserts and soya ice cream

GOOD SOURCES OF CALCIUM

+ Baked beans
+ Breakfast cereals (some)
+ Broccoli, spring greens, watercress and okra
+ Calcium-enriched soya and rice milks
+ Calcium-enriched soya cheese and soya yogurt
+ Sesame seeds and sesame paste (tahini)
+ Tinned sardines and pilchards (include the bones)
Meal plan for a milk-free diet *

Breakfast
▪ Cereal with calcium-enriched soya milk with a tablespoon of dried
fruit ▪ Small glass of fruit juice
Lunch
▪ Sandwich with milk-free margarine filled with meat or chicken or
fish ▪ Small mixed salad ▪ Fruit or soya yogurt
Evening meal
▪ Meat or chicken or fish or tofu ▪ Vegetables or salad ▪ Pasta,
potatoes or rice ▪ Fruit salad with soya ice cream
Snacks
▪ Fruit ▪ Milk-free bun or biscuit ▪ Plain nuts ▪ Ready-salted crisps
(occasionally)

* Remember to drink 8–10 cups of fluid every day.

 wheat

Wheat is another common food intolerance, and it has been

identified by as many as 60 per cent of people with IBS who
have followed an exclusion diet. It is important not to confuse a
wheat-free diet with a gluten-free diet.

Gluten versus wheat

Gluten is the name given to the protein found in wheat, rye and barley.
Oats contain a protein that is similar to gluten, and should initially be
avoided if following a gluten-free diet. There is, however, some debate
about whether complete avoidance of oats is necessary for everyone
who needs a gluten-free diet. It is important to note that gluten-free foods
are not always totally wheat-free as they often contain wheat starch. This
makes them unsuitable for someone following a wheat-free diet.
Coeliac disease
Coeliac disease is caused by an allergy to gluten, which damages the
lining of the small intestine. This can give rise to a range of symptoms,
such as diarrhoea, abdominal distension, pain, anaemia, weight loss,
fatigue and recurrent mouth ulcers. Treatment is purely dietary through
the long-term use of a gluten-free diet.
The symptoms of coeliac disease and IBS are very similar, and it is
important that coeliac disease is ruled out before a diagnosis of IBS is
given. While sensitive blood tests can indicate gluten sensitivity, they are
not 100 per cent accurate. The most reliable test is for a small piece of
the lining of the small intestine to be removed by a doctor and looked at
for signs of damage. Don’t exclude gluten from the diet before these tests
are carried out as this could give a negative result.
A wheat-free diet
A trial of a strict wheat-free diet can be helpful in IBS, especially if
symptoms include abdominal bloating, diarrhoea and wind. Food labels
can be confusing, and words that also mean ‘wheat’ include wheat
can be confusing, and words that also mean ‘wheat’ include wheat
starch, bran, wholemeal flour, flour, couscous, bulgar wheat, durum,
semolina, spelt and triticum.
Avoiding wheat for two or three weeks is an adequate length of time
to see an improvement. Keeping a food and symptoms diary during this
time will help confirm any changes (see The symptom-linked approach).
If there is no change in your symptoms it is unlikely that wheat is a
problem, and it should be reintroduced to your diet. If there is an
improvement you should reintroduce wheat to see if it causes problems
again. Eat wheat twice during the day. Some people may experience
symptoms within a day, but it can take up to a week for wheat to cause a
reaction.
High-fibre wheat foods can cause abdominal bloating and wind, so try
white bread and white pasta for three or four days before adding
wholemeal varieties.
Meal plan for a wheat-free diet *

Breakfast
▪ Porridge ▪ Fruit smoothie
Lunch
▪ Baked potato with filling and salad ▪ Yogurt or fruit
Evening meal
▪ Meat or chicken or fish ▪ Vegetables or salad ▪ Potatoes or rice or
wheat-free pasta ▪ Sorbet or fruit
Snacks
▪ Rice cakes ▪ Oatcakes ▪ Plain nuts ▪ Fruit

* Remember to drink 8–10 cups of fluid every day.

DIETARY SOURCES OF WHEAT

▪ Batter, such as pancakes and Yorkshire pudding

▪ Bread, including pitta, baguettes, rolls, muffins, crumpets and
bagels
▪ Breadcrumbs
▪ Breakfast cereals (many)
▪ Cakes, biscuits and some confectionery
▪ Crackers and crispbreads
▪ Pasta and noodles
▪ Pastry
ALTERNATIVES TO WHEAT

The following list is not exhaustive, and you should always check the
labels.
▪ Buckwheat pasta, corn pasta and rice noodles
▪ Corn crackers
▪ Oatcakes
▪ Rice cakes
▪ Rye bread (100 per cent rye flour)
▪ Rye crispbreads
▪ Wheat-free cakes and biscuits
▪ Porridge, some muesli, cornflakes and rice crispies
 exclusion diets

There is a group of people with IBS who find that they are
intolerant of several different foods. These tend to be people
who experience symptoms, such as loose or frequent bowel
motions, abdominal bloating, wind and pain, several times a
week or even every day. Food intolerance is more likely in
those people whose symptoms started after a severe bout of
gastroenteritis or after having prolonged courses of antibiotics.
Adopting an exclusion diet
An exclusion diet excludes all the most commonly reported food
intolerances in one go. It is a very restricted diet and should be followed
with caution and preferably with the support of an experienced dietician.
Typically, the basic diet is followed for two weeks, and it is essential
that a food and symptoms diary is kept throughout this time (see The
symptom-linked approach) to record if there has been any improvement
over the exclusion period. If there is no change in symptoms over this
time the diet should be stopped and a normal diet resumed. If there is an
improvement then the excluded foods should be reintroduced back to the
diet one at a time.
Are you prepared?
Although an exclusion diet can be helpful in identifying food intolerance it
should not be undertaken lightly, as it can make life difficult.
Eating out can be tricky, especially during the initial two-week period.
Don't be embarrassed to ask about ingredients used or if a meal can be
adapted for you.
There are few ready-prepared foods available that are suitable for the
basic diet, so be prepared to make meals from scratch – making them in
bulk will save you time. Shopping may also take longer because you
have to check food labels to make sure the product is free from all foods
excluded on the basic diet.
 Ensure your diet is nutritionally balanced by following healthy eating
guidelines (pages 11–12) and by including a variety of foods on a daily
basis. Take the opportunity to try new or unfamiliar foods and recipes.
Finding suitable snacks or eating away from home can be
inconvenient or difficult, so you have to be organized and take suitable
food with you.
Meal plan for a basic exclusion diet *

Breakfast
▪ Rice cereal with sliced banana and calcium-enriched soya milk
▪ Glass of apple juice
Lunch
▪ Cold chicken or ham with salad and rice cakes with dairy-free
spread ▪ Soya yogurt Evening meal
▪ Pork chop with apple sauce ▪ Vegetables and rice ▪ Mixed berries
with soya ice cream Snacks
▪ Fruit ▪ Seeds ▪ Vegetable crisps ▪ Carob bar (check that it is milk-
free) ▪ Sesame snaps
Note The exclusion diet is not suitable during pregnancy or for women who are
breastfeeding. If you are diabetic you should discuss the diet with your doctor before
undertaking it.
* Remember to drink 8–10 cups of fluid every day.

FOODS TO AVOID ON AN EXCLUSION DIET

▪ Beef, processed meats, pies and pâtés

▪ Chocolate
▪ Citrus fruit and their juices and cordials
▪ Coffee, tea, cocoa, fizzy drinks and alcohol
▪ Eggs
▪ Fish in batter or breadcrumbs
▪ Milk (cow, goat or sheep) products including yogurt, cheese and
ice cream
▪ Nuts
▪ Potatoes, onions, sweetcorn and vegetables tinned in sauce
▪ Wheat, corn, rye, barley and oats and all products made with them
▪ Yeast and yeast extract

FOODS ALLOWED ON AN EXCLUSION DIET

▪ All other meat, chicken and game

▪ All other fruit, their juices and cordials
▪ All other vegetables, fresh, frozen and canned
▪ Dairy-free margarine
▪ Fruit and herbal teas
▪ Rice milk (calcium-enriched)
▪ Rice, millet, quinoa and buckwheat
▪ Seeds
▪ Soya milk (calcium-enriched), soya yogurts, soya ice cream and
soya cheese
▪ Sugar, syrup and honey
▪ White and oily fish and shellfish
 food reintroduction

After two weeks on the exclusion diet food should be

reintroduced to your diet. Take two days to test each food, as it
can take 24–36 hours for a food to give a reaction. Wheat
should be tested for seven days, because it can take longer for
symptoms to return. If problems do occur, stop eating the food
being tested and wait for symptoms to clear before trying the
next food.
One food at a time
The amount of food tested is important. Having a small portion of a food
once during the day may not be enough to give a reaction, so it is usually
suggested that two portions of the test food are eaten. Also, don’t test
more than one food at a time, because this can lead to confusion and
prolong the time on the exclusion diet.
Some test foods are found as ingredients in other foods, so it is
important that these are tried first – for example, yeast needs to be tried
before wine or bread and milk before cheese, yogurt or butter.
Once the food reintroduction phase is complete the foods that
provoke symptoms should be avoided for another three to six months.
After this time it is advisable to re-test these foods, because quite often
people find they are able to tolerate them after they have been avoided
for a long period.
It is unusual to find more than three or four foods that cause
symptoms. However, sometimes many foods appear to cause problems.
For this group of people an assessment by a dietician is strongly
recommended to make sure that their basic diet is nutritionally adequate
and to give advice on suitable alternatives to the foods that are being
avoided.
Suggested order of food reintroduction

Food Suggested amount for one portion *

Potatoes 1 large jacket potato; 2–3 egg-sized boiled potatoes;

2 serving spoons of mash (use milk-free margarine); a
small portion of chips cooked in suitable oil;
2–3 egg-sized roast potatoes
Beef 75–100 g (3–3½ oz)

Yeast 3 brewer’s yeast tablets a day

Cows’milk A minimum of 300 ml (½ pint) during the day,

preferably 600 ml (1 pint) a day; can be tested as
whole, semi-skimmed or skimmed milk; use it in
drinks or as an ingredient in dishes such as rice
pudding

Rye 3–4 rye crispbreads; 1–2 slices of rye bread if yeast is

tolerated (check that it is 100 per cent rye flour)

Tea No more than 4–5 cups a day

Butter or 25–50 g (1–2 oz) during the day

margarine
Corn 4 tablespoons of cornflakes; 2 tablespoons of
sweetcorn or 1 corn-on-the-cob; cornflour in sauces;
2–3 corn crackers; vegetable oil can also be included
Eggs 2 during the day; egg as an ingredient in other food
White A maximum of 3 glasses a day if yeast is tolerated
wine

Citrus 1 orange; ½ a grapefruit; small glass of citrus fruit

juice; 2 satsumas, tangerines, mandarins or
 juice; 2 satsumas, tangerines, mandarins or
fruits
clementines; lemon juice in cooking; citrus fruit
squashes

Oats 3–4 oatcakes; 3–4 tablespoons of dry oats for

porridge; 1 piece of flapjack

Chocolate 3–4 teaspoons of cocoa; 3–4 teaspoons of hot

chocolate powder; 50 g (2 oz) chocolate if milk
tolerated

Cheese 25–40 g (1–1½ oz); cheese made with goats’ or ewes’

milk should be tested separately

Wheat 1–2 slices of bread (if yeast is tolerated); 5–6

tablespoons of pasta;
2 Weetabix or Shredded Wheat; 4 tablespoons bran
flakes

Coffee No more than 3–4 cups a day

Yogurt 1 small pot or 3 tablespoons; yogurt made with goats’

or ewes’ milk should be tested separately

Nuts A small handful unsalted or salted nuts; choose the

type you would most commonly eat

Barley Pearl barley in a casserole; barley water squashes;

3–4 tablespoons breakfast cereal containing barley

Vinegar In salad dressing, sauces or added to food

Fizzy No more than 3 glasses (600 ml or 1 pint) a day
drinks
* You need to have two portions a day unless otherwise stated
 other diet-related triggers

Some evidence suggests that some people with IBS are

sensitive to certain sugars found within foods, such as fruit
sugar (fructose) and milk sugar (lactose) and a sugar-alcohol
called sorbitol. Fatty foods can also cause IBS symptoms.

Sorbitol
Sorbitol, often used as a sweetener in sugar-free and diabetic products
and some medications, is also found naturally in certain fruits. An intake
of 30 g (about 1 oz) a day is known to give stomach cramps, flatulence
and diarrhoea, but lower intakes can cause symptoms.
Fructose
Some people with IBS complain of abdominal bloating and discomfort
after being given fructose under test conditions. There is, however, no
evidence that this is due to a true malabsorption of fructose, but it is
thought that some IBS sufferers may have a heightened sensitivity to it. If
foods rich in both fructose and sorbitol are eaten symptoms may be seen
with much smaller portions of food.
Fatty foods
Rich or fatty foods are often linked with bowel problems. When fat is
eaten it causes the body to release a substance called cholecystokinin
(CCK) – a stimulant of colonic motility. This can cause pain, which is
often mistaken for gallstones. Fatty foods can also give indigestion,
abdominal discomfort and diarrhoea.
Spicy foods
Highly spiced foods have also been linked with indigestion, abdominal
discomfort and diarrhoea.

SOURCES OF SORBITOL
▪ Fruit: plums, cherries, pears and prunes
▪ Diabetic products: marmalade, jam and chocolate
▪ Sugar-free products: chewing gum and mints

SOURCES OF FRUCTOSE

▪ Fruit, such as apples, bananas, cherries, grapes and pears

▪ Dried fruit, such as apricots, currants, figs, raisins and sultanas
▪ Fruit juices, such as apple, grape, grapefruit and prune

TIPS FOR CUTTING FAT INTAKE INCLUDE

▪ Grill, bake, steam foods rather than fry them

▪ Change to low-fat products
▪ Trim visible fat from meat and take the skin off chicken
▪ Avoid pastry
▪ Steer clear of creamy sauces and try tomato-based ones instead
▪ Limit your intake of crisps, savoury snacks, chocolate, biscuits and
cakes to a couple of times a week
 the symptom-linked approach

Unfortunately, there is no one treatment for the symptoms of

IBS, and everyone responds differently to different treatments.
However, identifying the main symptoms allows you to follow a
more structured approach in finding the most appropriate way
of controlling them. The use of a food, lifestyle and symptoms
diary can prove helpful in identifying any patterns between diet
and symptoms, stress or a combination of factors. Women can
also find it worth making a note of their menstrual cycles.

Keeping a symptoms diary

A small notebook is ideal for a symptoms diary, but some people prefer
to keep it on their computer. You will need to keep the diary for a
minimum of two weeks, although longer will be necessary if you
experience symptoms less frequently than that or if there is a possible
link to your menstrual cycle. You will need to keep a note of the
information listed.
Using the information
The information recorded in the diary will help you in a number of ways.
First of all, it will identify the main symptoms you are suffering and
how often you are experiencing them. The diary should help you spot a
link between a particular food and your symptoms, perhaps helping you
identify if there is a link with fatty, spicy or rich foods, for example.
It will also reveal if you have an irregular meal pattern or if you eat
differently during the week and highlight if you have a low-or high-fibre
diet or if your intake of fibre alters a lot from day to day.
The diary will help you work out if you are having enough to drink and
show if you are having too many fizzy drinks, caffeine or alcohol. It will
also make you think about the portion sizes of your meals and how you
eat your food.
eat your food.
Noting how you feel will enable you to see if stress or anxiety play a
part, and the diary will also reveal if the amount of exercise – or lack of
exercise – has any effect on your symptoms.
Once you have established which are your main symptoms, you will
be in a much better position to decide on the best way of changing your
diet to help you manage your IBS.

DIARY NOTES

▪ The time of eating, any symptoms or any other event

▪ A general description of the food eaten at each meal – for example,
white pasta with tomato sauce rather than just ‘pasta’
▪ The fluid taken – that is, the type of drink (including alcohol) and
 the amount
▪ A clear description of the symptoms – pain on right-hand side,
loose bowel motion, hard, pellet-like motion, needed to rush to the
toilet, and so on ▪ If you have had a particularly stressful or
emotional day
▪ If you have taken any exercise or have been sitting down all day
Example ‘symptoms’ diary

Date Time Food eaten

Mon 26 7.30 am 2 slices white toast with

butter and jam; cup of tea

During morning 3 cups of coffee and 1

apple

missed lunch

3.00 pm 2 cups of tea and a

chocolate bar

7.00 pm chicken with new

potatoes, peas and
broccoli; yogurt; glass of
red wine

8.00 pm glass of red wine

9.00 pm cup of tea and a biscuit

Date Time Symptoms and

comments

Mon 26
11.00 am busy at work, feel
stressed

2.00 pm headache, tummy pains

 symptom-linked groups

Although the symptoms of IBS vary from person to person,

there are three main groups of symptoms into which most
people fit. The three groups are: mostly diarrhoea; episodes of
diarrhoea then constipation (alternating bowel habit); and
mostly constipation. There may also be other symptoms
present, such as abdominal pain or discomfort, abdominal
bloating, flatulence, urgency to open the bowels, indigestion or
acid reflux, tiredness and headaches.
Before making any radical changes to your diet it is important that you
are following a healthy, balanced diet with an adequate fluid intake. Don’t
forget the importance of regular meals, taking time over eating and
moderating your portion sizes. Quite often symptoms improve just by
making these simple changes. It is also important to allow time for your
body to get used to any dietary changes.
Improvements are unlikely to happen overnight, and it may take several
weeks to notice a change. Continuing with a food and symptoms diary
will be helpful because it will highlight if there has been any improvement
in symptoms or not.
Mostly diarrhoea
If you are in this group your main symptom is loose, frequent bowel
motions at least once a week. Other symptoms may include abdominal
bloating, abdominal discomfort or pain, flatulence (wind) and urgency to
open the bowels.
The first dietary change to make is to follow a lower-fibre diet for three
or four weeks. The addition of a fibre supplement or a bulking agent may
be necessary to prevent constipation. If there is no improvement after
four weeks it is important to return to a normal diet.
If a low-fibre diet is unsuccessful it might be that a particular food is
causing your symptoms. This is more likely if IBS started after
gastroenteritis or a stomach upset, or after a long course of antibiotics,
and diarrhoea is occurring several times a week. Reviewing your
symptoms diary may give you an indication of which food is responsible.
The most common intolerances are milk and wheat, and a trial of a milk-
free or a wheat-free diet – or both – can prove helpful. If your symptoms
occur every day a full exclusion diet might be the best approach.
Alternating diarrhoea and constipation
If you are in this group your main symptom is loose or frequent bowel
motions, followed by several days or weeks of a normal regular bowel
habit. You will then find your bowel motions become less frequent and
the motions become hard and pellet-like and more difficult to pass. Other
symptoms may include abdominal bloating and flatulence (wind).
If you switch from diarrhoea to constipation with no abdominal
bloating and wind, try to gradually increase your fibre intake. At the same
time make sure that you have an adequate fluid intake.
If you find increasing your dietary fibre difficult the use of a fibre
substitute or bulking agent can be helpful. It is important to follow a high-
fibre diet for several weeks and to keep a food and symptoms diary to
monitor any change in symptoms. If increasing fibre intake is not helpful
after about four weeks try an exclusion diet.
For those people who have an alternating bowel habit accompanied
by abdominal bloating and wind a lower-fibre diet is often helpful. Again,
a good fluid intake is essential. To prevent constipation becoming worse
a bulking agent will help regulate bowel motions until higherfibre foods
are reintroduced to the diet (see Reintroducing higherfibre foods). If there
is no improvement after four weeks it is possible that there is a food
intolerance and trying a single-food exclusion or a full exclusion diet can
prove helpful.
Mostly constipation
The main symptom of people in this group is an infrequent bowel motion
that can be painful to pass. Other symptoms may include abdominal
bloating, abdominal pain and flatulence (wind).
One person may say they are constipated if they don’t pass a bowel
motion every day, whereas another may say they are constipated if they
motion every day, whereas another may say they are constipated if they
open their bowels once a week. Generally, it is described as a bowel
motion less than twice a week with the passage of hard, pellet-like or
thin, flat, ribbon-like motions. Straining to pass a stool is often
experienced together with abdominal pain.
Some people have sluggish bowels and need regular laxatives to
stimulate a bowel motion. Such people should be under the supervision
of a doctor. The continued use of laxatives is not recommended as the
body can become dependent on them, and increased amounts are
needed to have the same effect.
Where constipation without bloating and wind is the main symptom it
is important to have an adequate fibre and fluid intake.
If constipation is the main symptom with abdominal bloating and wind,
a lower-fibre diet plus a daily bulking agent, such as psyllium husks or
linseeds (see High and low fibre), can help to improve symptoms.

DIETARY CHANGES FOR ALL SYMPTOM GROUPS

No matter which symptom group you are in, before you make any
major changes to your diet it is important to: ▪ Follow a healthy,
balanced diet
▪ Have an adequate fluid intake (8–10 cups of fluid a day)
▪ Have a regular meal pattern
▪ Keep a food and symptoms diary
▪ Check excessive intakes of caffeine, alcohol, spicy foods, fatty
foods, fructose and sorbitol
MAINLY DIARRHOEA GROUP

▪ Low-fibre diet
▪ Single-food exclusion
▪ Exclusion diet
ALTERNATING DIARRHOEA AND CONSTIPATION
GROUP

Alternating bowel habit without wind and bloating

▪ High-fibre diet with the addition of a bulking agent if needed
▪ Single-food exclusion
▪ Exclusion diet

Alternating bowel habit with wind and bloating

▪ Low-fibre diet with bulking agent if needed
▪ Single-food exclusion
▪ Exclusion diet
MAINLY CONSTIPATION

Constipation without bloating and wind

▪ High-fibre diet
Constipation with bloating and wind
▪ Low-fibre diet with bulking agent if needed
 probiotics and prebiotics

Everyone has billions of bacteria living in their large bowel.

There are hundreds of different types of bacteria that in general
live in a balance together. Certain types of bacteria – ‘good’ or
‘friendly’ bacteria – are beneficial to the body. They also help to
keep harmful bacteria under control.
Upsetting the balance
When the balance of good and bad bacteria is altered it can lead to
problems such as diarrhoea, bloating, wind, constipation, discomfort and
generally feeling below par. This balance can be altered if you take
antibiotics, or after a bout of food poisoning or ‘traveller’s’ diarrhoea. It
can also be affected by a diet that contains little fruit and vegetables but
is high in fat and alcohol.
What is a probiotic?
Probiotic is the name given to live ‘good’ bacteria. These can be taken as
a supplement or added to food items. They are available in a wide range
of products, including yogurts and yogurt drinks, and they are added to
fruit juices and are available in capsule form. There is a lot of interest in
the use of probiotics, and there is growing evidence that they: □ Boost
the immune system
□ Increase resistance to infection
□ Help in the prevention and treatment of diarrhoea resulting from
bacterial infection □ Help to prevent diarrhoea resulting from
antibiotic therapy
□ Improve movement of the bowel
□ May improve mild inflammation of the bowel
At present there are no guidelines on the amount of probiotic that
should be taken. More research is needed to work out how much and
which types of bacteria are needed and the best way that they can reach
the large intestine unharmed.
the large intestine unharmed.
What is a prebiotic?
A prebiotic is a food substance that specifically promotes the growth of
good bacteria in the bowel. These foods need to resist being digested in
the small intestine so that they arrive relatively unchanged in the large
bowel. The most commonly used ones are fructooligosaccharides (FOS)
and inulin. Many probiotic supplements or foods now have prebiotics
added to them as well.
Who needs probiotics and prebiotics?
Research shows that probiotics are a promising therapy for a wide range
of health problems, including IBS, lactose intolerance and gastrointestinal
infections. Probiotics may also lower cholesterol levels and reduce the
risk of cancer.
A trial of a probiotic may be worth undertaking if you have recently
had an upset stomach or have started a course of antibiotics that has
triggered your IBS. In general, they are safe to take for most people of all
ages. However, if your immune system is not working properly or if you
are taking drugs that affect your immune system – some cancer
treatments, for example – you should avoid probiotics.
Capsules that have a combination of probiotics and a prebiotic, which
have a special coating that resists digestion in the stomach, are a good
choice. Yogurts and yogurt drinks must be kept chilled, and the longer
they are kept the more likely it is that the bacteria will die. These yogurts
are not suitable for people with a milk intolerance.

GOOD SOURCES OF PREBIOTICS

+ Barley
+ Green vegetables
+ Jerusalem artichokes
+ Oats
+ Whole grains
A GOOD PROBIOTIC WILL NEED TO:

▪ Contain bacteria that can reach the large intestine without being
damaged
▪ Contain large numbers of bacteria
▪ Be taken on a daily basis
▪ Have more than one type of bacteria, such as Acidophillus and
Bifidobacteria bacteria
some questions answered

Is there any drug treatment for IBS?

There are various types of medication available to help control the

symptoms of IBS; however, they do not cure the problem. These
include:
□ Anti-spasmodics to decrease muscular spasm in the gut
□ Laxatives to treat constipation
□ Medications to slow down the movement of the gut to control
diarrhoea
□ Pain relief to control abdominal pain and discomfort
□ Tranquillizers, which appear to help improve IBS symptoms
Most medications have unwanted side-effects, and not all
medications are suitable for all people. You should discuss
possible drug treatments with your doctor or pharmacist to ensure
it is right for you.

Will I always have IBS?

Most people find that their IBS symptoms come and go and that
the symptoms become less severe with time. Symptoms are often
triggered by a period of illness, stress or upheaval.
It is important not to link all bowel symptoms with IBS. If you
have a change in your symptoms, have rectal bleeding or blood in
your stools, experience sudden unexplained weight loss or a
change to your normal bowel habit, you should have this checked
by your doctor. These can be signs of more serious problems.
 by your doctor. These can be signs of more serious problems.

What is candida and is there a link with IBS?

Candida albicans is a yeast-like fungus, which occurs naturally in

the body. If the normal levels of bacteria in the gut are altered –
which can happen after an infection or taking antibiotics – the
candida can grow rapidly, resulting in thrush. Some people think
this can lead to intolerance of yeast and yeast products and that
avoiding them and sugary foods, which stimulate their growth, will
improve symptoms of abdominal bloating, wind and pain. There is,
however, currently inadequate evidence to support the use of anti-
candida diets in the management of IBS.

Do I need to take any vitamin or mineral supplements?

If you follow a balanced diet it is unlikely that you will require any
vitamin and mineral supplements. However, there are some
instances when a particular vitamin or mineral may be needed,
including:
□ Calcium for people following a milk-free diet
□ Multivitamin and mineral for those on an exclusion diet
□ Iron, folic acid or vitamin B12 for those who are anaemic
□ Evening primrose oil for those whose IBS symptoms are
linked with their menstrual cycle
Multivitamin and mineral tablets often contain lactose (milk sugar),
wheat, corn (maize), yeast and other food items, so it is important
that you choose a make that is suitable for your particular food
intolerance.
Large doses of single vitamins and minerals are not
 Large doses of single vitamins and minerals are not
recommended. Keep to ones that supply no more than the
Recommended Daily Intake (RDI) unless otherwise advised by a
doctor or dietician. Excessive intake of certain vitamins and
minerals can be dangerous or lead to unpleasant side-effects. For
example, vitamin C in levels over 1 g can result in abdominal
discomfort and diarrhoea.

Does stress affect IBS?

Yes, some people find that stressful situations can lead to

diarrhoea and abdominal pain. It can also lead to anxiety and a
faster, shallow breathing pattern. Continued stress can give
disturbed sleep and eating patterns, which in turn make IBS
symptoms worse.
Finding a way to tackle stress, such as learning relaxation
techniques and yoga, will help to decrease stress. Thirty minutes
of moderate exercise five days a week is also helpful as exercise
stimulates the body to produce feel-good substances called
endorphins.
breakfasts
american cinnamon pancakes
mixed grain porridge
carrot and cinnamon muffins
honeyed granola
pineapple, date and sultana bread
minty avocado smoothie
quick cheese bread
brunch special
 american cinnamon pancakes
Avoiding wheat and foods that contain gluten can limit breakfasts
somewhat. Topped with natural yogurt, mixed berries and a drizzle of
maple syrup, these thick, griddle-style pancakes are lovely for a relaxed
weekend breakfast.
Nutrition
Gluten free, wheat free Kcals 298
Fat 13 g
Saturated fat 6 g
Sodium 320 mg
Fibre 4 g
Preparation time 15 minutes
Cooking time 8–10 minutes
Serves 4

+ NUTRITIONAL TIP
Use stewed sliced peaches, nectarines or apples to lower the fibre content.
250 g (8 oz) frozen fruits of the forest
2 tablespoons water
40 g (1½ oz) fine cornmeal (masa harina)
40 g (1½ oz) tapioca flour
½ teaspoon ground cinnamon
1 teaspoon bicarbonate of soda
200 ml (7 fl oz) low-fat yogurt
1 egg
1 tablespoon sunflower oil
Greek yogurt, to serve
maple syrup or clear honey, to serve

1 Put the frozen fruit into a small saucepan with the measured water,
cover and simmer for 4–5 minutes until hot.
2 Put the flours, cinnamon and bicarbonate of soda into a small bowl and
stir together. Add the low-fat yogurt and egg and whisk together briefly
until just mixed and smooth.
3 Lightly oil and heat a large, nonstick frying pan or griddle. Drop 6 large
spoonfuls of the batter into the pan, spacing them well apart, and cook for
about 2 minutes until the top has bubbled and the underside is browned.
Turn over and cook the other side in the same way.
4 Remove the pancakes from the pan, keep hot on a plate, add more oil
if necessary and make 6 more pancakes in the same way. Serve 3
pancakes per portion, each topped with spoonfuls of fruit, some yogurt
and a drizzle of maple syrup or honey.
 mixed grain porridge
Quick and easy to make, this blend of buckwheat, quinoa and millet
flakes gives a finished porridge that has a slightly smoother texture than
one made from rolled oats.
Nutrition
Wheat free, gluten free, high fibre
Kcals 343
Fat 8 g
Saturated fat 4 g
Sodium 127 mg
Fibre 5 g
Preparation time 5 minutes
Cooking time 4–5 minutes
Serves 4

+ NUTRITIONAL TIP
Use unsweetened soya milk instead of dairy milk if you prefer. If you use soya yogurt rather than
Greek yogurt this dish will be suitable for an exclusion diet.
50 g (2 oz) buckwheat flakes
50 g (2 oz) quinoa flakes
50 g (2 oz) millet flakes
600 ml (1 pint) semi-skimmed milk
300 ml (½ pint) water
2 bananas
4 tablespoons Greek yogurt
clear honey or maple syrup, to serve
sprinkling of ground cinnamon, to serve

1 Put the grain flakes, milk and water into a saucepan and bring to the
boil, reduce the heat and cook for 4–5 minutes, stirring until thickened.
2 Mash one of the bananas and slice the other. Stir the mashed banana
into the porridge, spoon into bowls and top with spoonfuls of yogurt, the
sliced banana, a drizzle of honey or maple syrup and a sprinkling of
cinnamon.
 carrot and cinnamon muffins
Serve these muffins straight from the oven either plain or spread with a
little low-fat soft cheese and apricot jam for a special weekend breakfast
treat. Any leftovers can be packed into lunchboxes or frozen for another
day.
Nutrition
Dairy free
Kcals 229
Fat 6 g
Saturated fat 1 g
Sodium 120 mg
Fibre 3 g
Preparation time 15 minutes
Cooking time 15–20 minutes
Makes 10 muffins

+ NUTRITIONAL TIP
Mixing wholemeal and white flour is a good way to get the best of both worlds, but all wholemeal
or all white flour will work just as well – the fibre content either increases or reduces.
125 g (4 oz) self-raising wholemeal flour
100 g (3½ oz) self-raising white flour
100 g (3½ oz) soft dark muscovado sugar
1 teaspoon ground cinnamon
25 g (1 oz) ready-chopped glacé ginger or stem ginger, drained and chopped
200 g (7 oz) carrots, grated
50 g (2 oz) raisins or sultanas
2 eggs
4 tablespoons sunflower oil
grated rind of 1 orange
6 tablespoons orange juice
3 tablespoons golden syrup
2 tablespoons barley flakes or porridge oats (optional)

1 Put the flours, sugar, cinnamon, ginger, carrots and raisins or sultanas
into a mixing bowl.
2 Mix together the eggs, oil, orange rind and juice and add to the dry
ingredients along with the golden syrup. Fork together until just mixed.
3 Line 10 sections of a deep muffin tin with paper cases and spoon the
mixture into the cases. Sprinkle with barley flakes or oats (if used) and
bake in a preheated oven, 190°C (375°F), Gas Mark 5, for 15–20
minutes or until well risen and the tops are slightly cracked. Serve warm.
 honeyed granola
This crunchy, caramelized breakfast cereal is packed with grains, nuts
and seeds. Serve it broken into pieces with dairy, rice or soya milk or a
mix of berry fruits and low-fat yogurt. Try adding a little ground cinnamon
or ginger to the mixture before baking.
Nutrition
Dairy free, wheat free
Kcals 250
Fat 16 g
Saturated fat 2 g
Sodium 7 mg
Fibre 3 g
Preparation time 10 minutes
Cooking time 8–10 minutes
Serves 6

+ NUTRITIONAL TIP
If you have a nut allergy, omit the nuts and add extra grains instead. If you omit the barley flakes
and only use porridge oats, millet and quinoa, this dish is suitable for an exclusion diet.
3 tablespoons clear honey
3 tablespoons sunflower oil
50 g (2 oz) porridge oats or barley flakes
50 g (2 oz) millet or quinoa flakes
50 g (2 oz) mixed seeds, including 2 or more of sesame, sunflower, pumpkin and linseeds
50 g (2 oz) whole hazelnuts, cashew nuts or almonds or a mixture, roughly chopped

1 Warm the honey and oil in a medium-sized saucepan. Stir in the

remaining ingredients and mix well.
2 Tip the mixture into a lightly oiled deep baking sheet or roasting tin and
spread it into a thin, even layer. Roast in a preheated oven, 180°C
(350°F), Gas Mark 4, for 6–8 minutes.
3 Remove from the oven, stir well, moving the paler mixture from the
centre to the outer edges, and cook for 2 more minutes until evenly
browned. Stir well.
4 Leave to cool, then transfer to an airtight storage jar. Keep for up to 7
days.
 pineapple, date and sultana bread
This easy, yeast-free bread keeps well and is useful for those rushed
mornings when you need a breakfast you can take with you. Serve thinly
spread with butter or low-fat spread and have a banana or extra piece of
fruit.
Nutrition
High fibre, milk free
Kcals 246
Fat 1 g
Saturated fat 0 g
Sodium 113 mg
Fibre 4 g
Preparation time 20 minutes, plus soaking
Cooking time about 1 hour 10 minutes
Makes 10 slices

+ NUTRITIONAL TIP
This is a good choice for a low-fat, high-fibre snack or dessert.
220 g can pineapple slices in natural juice
100 g (3½ oz) stoned dates
200 g (7 oz) sultanas
200 ml (7 fl oz) pineapple juice
100 g (3½ oz) caster sugar
150 g (5 oz) self-raising wholemeal flour
150 g (5 oz) self-raising white flour
1 egg

1 Drain the pineapple and pour the juice into a small saucepan. Finely
chop the pineapple slices and roughly chop the dates. Put the pineapple,
dates and sultanas into a mixing bowl.
2 Add the measured pineapple juice to the juice from the can. Bring to
the boil, pour over the fruit and leave to stand for 4 hours or longer if
preferred.
3 Mix the remaining ingredients into the soaked fruit. Spoon into a lightly
oiled and lined 1 kg (2 lb) loaf tin and level the top. Bake in a preheated
oven, 160°C, 325°F, Gas Mark 3, for about 1 hour 10 minutes (check
after 1 hour) or until well risen and a skewer inserted into the centre of
the loaf comes out cleanly.
4 Leave to cool in the tin, then take out and peel away the lining paper.
Wrap in foil or store in an airtight container for up to 7 days. Slice and
serve plain or lightly buttered.
 minty avocado smoothie
If you are a reluctant fruit eater then one of these refreshing, vibrantly
coloured, vitamin-boosting drinks can be the perfect way to start the day.
Nutrition
Dairy free, gluten free
Kcals 227
Fat 14 g
Saturated fat 3 g
Sodium 10 mg
Fibre 2 g
Preparation time 10 minutes
Cooking time none
Serves 2

+ NUTRITIONAL TIP
Use soya milk and soya yogurt to make the drinks suitable for a milk-free diet.
1 ripe avocado, halved, stoned
3 stems of mint
juice of 1 lime
450 ml (¾ pint) apple juice

1 Scoop the flesh out of the avocado skin into a liquidizer or food
processor. Add the mint, lime and half the apple juice.
2 Blend until smooth and then add the remaining apple juice and mix
briefly. Pour into 2 glasses.
ALTERNATIVES
Tropical sunrise Put into a liquidizer or food processor 1 large ripe
mango, stoned and peeled, 1 ripe nectarine or peach, quartered and
stoned, 300 ml (½ pint) orange juice and 1 tablespoon chopped glacé or
stem ginger. Blend until smooth. Pour into 2 glasses.
Spiced banana Put into a liquidizer or food processor 1 large ripe
banana, about 225 g (7½ oz) with skin on, thickly sliced, ¼ teaspoon
ground cinnamon, 2 teaspoons clear honey, 125 g (4 oz) low-fat Greek
yogurt and 200 ml (7 fl oz) semi-skimmed milk. Blend until smooth. Pour
into 2 glasses.
 quick cheese bread
Try this savoury bread warm from the oven with sliced ham and tomatoes
or toasted and cut into fingers with a softly boiled egg for a tasty gluten-
free breakfast. If you don’t have any mustard powder, mix 2 teaspoons
Dijon mustard into the milk, but check that it is gluten free.
Nutrition
Wheat and gluten free, low fibre
Kcals 187
Fat 8 g
Saturated fat 4 g
Sodium 197 mg
Fibre 1 g
Preparation time 15 minutes
Cooking time 30 minutes
Makes 10 slices

+ NUTRITIONAL TIP
If you don’t need to avoid wheat or gluten, use white flour instead for a low-fibre treat.
250 g (8 oz) gluten-and wheat-free white bread flour with natural gum
¼ teaspoon salt
2½ teaspoons gluten-free baking powder
1 teaspoon gluten-free mustard powder
100 g (3½ oz) mature Cheddar cheese, grated
300 ml (½ pint) semi-skimmed milk
2 eggs
50 g (2 oz) reduced-fat spread, melted
1 tablespoon sesame seeds (optional)

1 Put all the dry ingredients into a mixing bowl and add the cheese. Put
the milk, eggs and melted spread into a large jug and fork together.
Gradually mix into the dry ingredients and then stir until smooth.
2 Pour the mixture into a lightly oiled 1 kg (2 lb) loaf tin, level the surface
and sprinkle with the sesame seeds (if used). Bake in a preheated oven,
180°C (350°F), Gas Mark 4, for about 30 minutes or until well risen and a
skewer comes out cleanly when inserted into the centre.
3 Leave to cool for 10 minutes, then loosen the edge of the bread and
turn it out. Serve warm, cold or toasted and spread with a little reduced-
fat spread.
 brunch special
All the flavour of a fry-up but without the calories or fat, not to mention the
indigestion afterwards. Choose deep, well-rounded mushrooms so that
there is a good cavity to drop the egg into. If the mushrooms are quite flat
put a large biscuit cutter over the top of the mushroom or put the
mushroom into an oiled individual tart tin so that the cutter or tin holds the
egg in place.
Nutrition
Wheat and gluten free, low fibre
Kcals 187
Fat 8 g
Saturated fat 4 g
Sodium 197 mg
Fibre 1 g
Preparation time 15 minutes
Cooking time about 15 minutes
Serves 4

+ NUTRITIONAL TIP
If you are serving this dish to a vegetarian, omit the bacon and Worcestershire sauce, drizzling
the mushrooms with a little balsamic vinegar instead. If you are on a gluten-free diet, you might
want to omit the Worcestershire sauce, just in case.
4 deep field mushrooms, each a little over 75 g (3 oz)
25 g (1 oz) reduced-fat spread
8 rashers of smoked back bacon, 250 g (8 oz) in total
4 tomatoes, halved
4 teaspoons Worcestershire sauce
4 eggs
salt and pepper
chopped chives, to garnish
granary toast (or white toast for a low-fibre diet), to serve

1 Remove the stems from the mushrooms and place the tops on a baking
sheet, the black gills uppermost. Add a knob of spread to each and
season. Lay the bacon over the top and arrange the tomatoes around the
mushrooms.
2 Bake in a preheated oven, 200°C (400°F), Gas Mark 6, for 10 minutes,
then lift the bacon off the mushrooms and put it onto the baking sheet.
Drizzle the Worcestershire sauce into each mushroom and break an egg
in the centre of each. Season the eggs, then return the baking sheet to
the oven.
3 Bake for 4–5 minutes or until the eggs are just set and the bacon is
cooked. Transfer to serving plates and sprinkle with chopped chives.
Serve with granary toast.
light bites
carrot and chickpea soup
green pea and coriander soup
oriental vegetable broth
roasted vegetable wraps
trout and new potato salad
couscous salad
oriental salmon salad
white bean, feta and
roasted pepper salad
sweet potato with cottage
cheese and chilli
 carrot and chickpea soup
Quick and easy to make, this soup uses ingredients that you will probably
already have in your storecupboard.
Nutrition
Wheat and gluten free, high fibre
Kcals 270
Fat 13 g (2 g fat per 100 g)
Saturated fat 2 g
Sodium 210 mg
Fibre 5 g
Preparation time 25 minutes
Cooking time about 40 minutes
Serves 4

+ NUTRITIONAL TIP
If you are on a dairy-free diet, stir in 300 ml (½ pint) extra stock instead of the milk.
If eating wheat makes your symptoms worse, make sure you use wheat-free stock cubes or make
your own stock with a chicken carcass.
1 tablespoon sunflower oil
1 large onion, chopped
500 g (1 lb) carrots, diced
1 teaspoon ground cumin
1 teaspoon fennel seeds, roughly crushed
2 cm (¾ inch) root ginger, finely chopped
1 garlic clove, finely chopped
410 g (13¼ oz) can chickpeas, drained
1.2 litres (2 pints) gluten-and wheat-free vegetable stock
300 ml (½ pint) semi-skimmed milk
salt and pepper
GARNISH
40 g (1½ oz) flaked almonds
pinch of cumin powder
pinch of paprika
warm bread, to serve (optional)
1 Heat the oil in a medium-sized saucepan, add the onion and fry gently,
stirring, for 5 minutes or until lightly browned. Mix in the carrots, ground
spices, ginger and garlic and cook for 1 minute.
2 Mix in the chickpeas, stock and a little seasoning, bring to the boil,
cover and simmer for 30 minutes or until the vegetables are tender.
3 Purée the soup in batches in a liquidizer or food processor until smooth
then return to the pan and stir in the milk. Reheat gently.
4 Meanwhile, make the garnish. Heat the oil in a small frying pan, add the
almonds, cumin and paprika and cook for 2–3 minutes until golden-
brown. Ladle the soup into bowls and top with the almonds, cumin
powder and paprika. Serve with warm bread, if liked.
 green pea and coriander soup
Many people have a pack of frozen peas in the freezer, but how often do
we use them for anything but a side dish? This quick and easy lunch is
flavoured with coriander, but if you have some in the garden you might
like to use mint instead.
Nutrition
Wheat and gluten free, high fibre
Kcals 188
Fat 10 g
Saturated fat 4 g
Sodium 270 mg
Fibre 6 g
Preparation time 15 minutes
Cooking time 20 minutes
Serves 6

+ NUTRITIONAL TIP
Peas are a good source of soluble fibre. If you are serving this dish to vegetarians, omit the bacon
garnish.
1 tablespoon olive oil
1 onion, chopped
1 baking potato, about 200 g (7 oz), diced
1 litre (1¾ pints) gluten-and wheat-free vegetable stock
400 g (13 oz) frozen peas
about 25 g (1 oz) fresh coriander leaves
3 rashers of back bacon
6 tablespoons fromage frais
salt and pepper

1 Heat the oil in a heavy-based saucepan, add the onion and potato and
fry gently, stirring, for 5 minutes or until softened but not browned.
2 Mix in the stock and a little seasoning. Bring to the boil, cover and
simmer for 10 minutes. Add the peas and cook for 5 minutes until the
vegetables are tender and the peas are still bright green.
3 Purée the soup in batches in a liquidizer or food processor until
smooth, then return to the pan. Finely chop three-quarters of the
coriander, stir into the soup and reheat.
4 Meanwhile, grill the bacon until crisp and then cut it into strips. Ladle
the soup into bowls, add a spoonful of fromage frais to the top of each,
lightly swirl into the soup and sprinkle with the bacon and remaining
coriander leaves.
 oriental vegetable broth
There’s no need to fry any of the vegetables first: simply add them to the
flavoured stock and simmer for a few minutes. To make this more filling,
you could add some finely diced cooked chicken breast or frozen prawns,
which should be thawed first.
Nutrition
Gluten free, low fat
Kcals 39
Fat 1 g
Saturated fat 0 g
Sodium 465 mg
Fibre 2 g
Preparation time 10 minutes
Cooking time 9 minutes
Serves 4

+ NUTRITIONAL TIP
If you are not avoiding foods that contain wheat or gluten, you could use soy sauce instead of
tamari sauce. If you are preparing this dish for vegetarians, check that the curry paste does not
contain shrimp paste; also, omit the fish sauce and add a little lime juice instead.
1 litre (1¾ pints) gluten-free vegetable stock
1–2 teaspoons red Thai curry paste (to taste)
1 tablespoon tamari sauce
2 teaspoons fish sauce (nam pla)
5 spring onions, thinly sliced
1 garlic clove, finely chopped
1 carrot, about 125 g (4 oz), thinly sliced
100 g (3½ oz) button mushrooms, thinly sliced
75 g (3 oz) broccoli, cut into tiny florets, stems sliced
50 g (2 oz) mangetout, sliced
small bunch of fresh coriander, torn into pieces

1 Put the stock, curry paste, tamari sauce and fish sauce into a
saucepan. Add the white part of the spring onions, the garlic, sliced
carrots and mushrooms and slowly bring to the boil. Reduce the heat and
simmer for 5 minutes, stirring occasionally.
2 Add the broccoli and simmer for 2 minutes. Mix in the remaining green
sliced spring onions, the mangetout and coriander leaves. Simmer for 2
minutes, then ladle the soup into bowls.
 roasted vegetable wraps
Many people find raw peppers rather indigestible, but grilling and then
skinning them solves the problem. Here the peppers are lightly flavoured
with pesto, then wrapped with low-fat garlic and herb cheese and
peppery rocket leaves for a tasty lunch.
Nutrition
Low fat
Kcals 207
Fat 5 g
Saturated fat 1 g
Sodium 222 g
Fibre 3 g
Preparation time 10 minutes
Cooking time 10–12 minutes
Serves 4

+ NUTRITIONAL TIP
To increase the fibre levels in this dish, spread the wraps with hummus instead of the cheese or
spoon the filling into warmed wholemeal pitta breads.
1 red pepper, quartered, cored and deseeded
1 yellow or orange pepper, quartered, cored and deseeded
2 courgettes, about 300 g (10 oz) in total, sliced
4 teaspoons olive oil
1 teaspoon pesto
salt and pepper
4 large plain tortilla wraps
100 g (3½ oz) low-fat soft garlic and herb cheese
50 g (2 oz) rocket leaves
4 teaspoons balsamic vinegar
rocket salad, to garnish (optional)

1 Put the peppers on a foil-lined grill pan, skin side up, and arrange the
courgettes around them in a single layer. Mix together the oil, pesto and
a little seasoning and brush over the vegetables.
2 Cook under a preheated hot grill for 10–12 minutes, turning until the
courgettes are lightly browned on both sides and the pepper skins are
charred. Wrap the foil around the vegetables and set aside for 10
minutes.
3 Peel away and discard the softened skins from the peppers. Cut the
pepper quarters and courgette slices into strips. Warm the wraps
according to the directions on the packet, then spread the cheese in a
strip down the centre of each wrap.
4 Top with the cooked vegetables, arrange the rocket leaves on the
vegetables and drizzle with the vinegar. Roll up tightly, cut in half and
serve immediately or wrap in clingfilm and eat later, with extra rocket
salad, if liked.
 trout and new potato salad
Serve this salad while the potatoes and trout flakes are still warm; or, if
you would rather make it in advance, leave the potatoes and trout to cool
and toss with the dressing and salad leaves just before serving. Flaked
smoked mackerel fillets would taste good in this salad but avoid those
coated in peppercorns or the salad may be too fiery.
Nutrition
Wheat free, gluten free
Kcals 303
Fat 10 g
Saturated fat 3 g
Sodium 83 mg
Fibre 2 g
Preparation time 20 minutes
Cooking time 13–18 minutes
Serves 4

+ NUTRITIONAL TIP
Read the packet carefully when you are buying wasabi for the first time and make sure that it is
gluten free. If you are on a low-fat diet, fromage frais is suitable because it has a very low fat
content.
500 g (1 lb) baby new potatoes, scrubbed, larger ones halved
500 g (1 lb) trout fillets, rinsed and drained
150 g (5 oz) fromage frais
1–2 teaspoons gluten-free wasabi (Japanese horseradish), to taste
2 teaspoons set or clear honey
salt and pepper
100 g (3½ oz) salad leaves

1 Half-fill the base of a steamer with water and bring to the boil, add the
potatoes to the water and put the fish fillets in a single layer in the
steamer above. Cover and cook for 8 minutes until the fish is just cooked
and flakes easily when pressed with a knife. Remove the top of the
steamer, re-cover the potatoes, cook for 5–10 minutes more or until
tender, then drain.
2 Transfer the fish to a plate or chopping board and break it into flakes,
discarding the skin and any bones.
3 Mix the fromage frais with the wasabi, honey and a little seasoning in a
salad bowl, add the warm potatoes and toss together. Add the fish flakes
and salad leaves and toss together lightly. Serve immediately.
 couscous salad
Mix and match ingredients for this quick-to-put-together salad depending
on what you have in the refrigerator. Canned or fresh salmon, diced
cooked chicken, diced ham or crumbled feta could also be added instead
of the tuna.
Nutrition
Dairy free, high fibre
Kcals 318
Fat 17 g
Saturated fat 2 g
Sodium 400 mg
Fibre 4 g
Preparation time 15 minutes
Cooking time none
Serves 4

+ NUTRITIONAL TIP
Couscous is made from Durum wheat, so, if you are avoiding wheat and foods that contain gluten,
add cooked quinoa or millet grains instead.
175 g (6 oz) couscous
450 ml (¾ pint) boiling water
200 g (7 oz) can tuna in spring water, drained
50 g (2 oz) sun-dried tomatoes, drained and thinly sliced
40 g (1½ oz) pitted black olives, roughly chopped
2 teaspoons capers, drained and roughly chopped (optional)
½ red onion, finely chopped
125 g (4 oz) cherry tomatoes, halved
50 g (2 oz) rocket or mixed salad leaves
DRESSING
3 tablespoons olive oil
juice of 1 lemon
small bunch of basil leaves, roughly torn
salt and pepper
1 Put the couscous in a bowl, pour over the boiling water and leave to
soak for 5 minutes.
2 Flake the tuna into pieces and add them to the couscous with the sun-
dried tomatoes, olives and capers (if used). Add the onion and cherry
tomatoes and fork together.
3 Mix together the ingredients for the dressing, drizzle over the salad and
lightly toss together. Sprinkle the salad leaves on top and serve.
 oriental salmon salad
Packed lunches needn’t mean just sandwiches. This tasty rice salad can
be made the night before and taken to work in an insulated lunch box.
Use a large can of salmon instead of freshly grilled salmon if you prefer,
and mangetout or sliced green beans can be used instead of the sugar
snap peas.
Nutrition
Wheat, gluten and dairy free
Kcals 500
Fat 25 g
Saturated fat 4 g
Sodium 913 mg
Fibre 4 g
Preparation time 20 minutes
Cooking time 8–10 minutes
Serves 4

+ NUTRITIONAL TIP
Tamari sauce is the Japanese equivalent of soy sauce and is wheat and gluten free, but soy
sauce can be used if you are not avoiding wheat.
150 g (5 oz) long-grain rice
4 salmon fillets, each about 125 g (4 oz)
3 tablespoons tamari sauce
100 g (3½ oz) sugar snap peas, halved lengthways
1 large carrot, cut into matchstick strips
4 spring onions, trimmed and thinly sliced
100 g (3½ oz) bean sprouts, rinsed and drained
6 teaspoons sunflower oil
3 tablespoons sesame seeds
2 teaspoons fish sauce (nam pla) (optional)
2 teaspoons rice or white wine vinegar
small bunch of fresh coriander or basil, torn into pieces

1 Half-fill a medium-sized saucepan with water and bring to the boil. Add
the rice to the water and simmer for 8 minutes.
2 Meanwhile, put the salmon on a foil-lined grill rack and drizzle over 1
tablespoon of the tamari sauce. Cook under a preheated grill for 8–10
minutes, turning once, until browned and the fish flakes easily.
3 Add the sugar snap peas to the rice and cook for 1 minute. Drain, rinse
with cold water and drain again. Tip into a salad bowl and mix in the
carrot, spring onions and bean sprouts.
4 Heat 1 teaspoon oil in a nonstick frying pan, add the sesame seeds and
fry until just beginning to brown. Add 1 tablespoon of tamari sauce and
quickly cover the pan so that the seeds do not ping out. Take off the heat
and leave to stand for 1–2 minutes, then mix in the remaining tamari
sauce, oil, fish sauce (if used) and vinegar. Add the sesame mixture to
the salad and toss together. Take the skin off the salmon and flake into
pieces – discard any bones. Add to the salad with the herb leaves and
serve warm or cold.
 white bean, feta and roasted pepper
salad
This robust salad can be made in advance, so it’s great for a healthy
packed lunch. Take the salad leaves in a separate plastic bag to keep
them crisp. The feta cheese could be omitted and a 185 g (6¼ oz) can of
drained and flaked tuna in spring water included instead.
Nutrition
High fibre
Kcals 400
Fat 24 g
Saturated fat 7 g
Sodium 750 mg
Fibre 10 g
Preparation time 15 minutes
Cooking time 10–15 minutes
Serves 4

+ NUTRITIONAL TIP
Replace the feta cheese with tuna, salmon or chicken to make a dish suitable for a dairy-free diet.
2 red peppers, halved, cored and deseeded
4 tablespoons olive oil
2 tablespoons balsamic or red wine vinegar
3 teaspoons sun-dried tomato paste
4 teaspoons capers, chopped if large
salt and pepper
2 x 410 g (13¼ oz) cans cannellini or haricot beans or chickpeas, drained
½ red onion, finely chopped
4 sticks celery, sliced
125 g (4 oz) feta cheese, drained
1 cos lettuce

1 Put the peppers, skin side up, on a foil-lined grill rack, brush with a little
of the oil and cook under a preheated grill for 10–15 minutes until the
peppers are softened and the skins charred. Wrap in foil and leave to
cool.
2 Meanwhile, make the dressing by mixing the remaining oil with the
vinegar, tomato paste, capers and seasoning.
3 Stir the drained beans or chickpeas, onion and celery into the dressing.
Peel the skins off the peppers then cut the flesh into strips. Add to beans
and gently toss together. Crumble the feta cheese over the top and serve
the salad scooped over lettuce leaves.
 sweet potato with cottage cheese and
chilli
We all love baked potatoes, but sweet potatoes make a lighter and more
unusual lunch choice and, for those avoiding wheat and gluten, a tasty
and filling alternative to sandwiches.
Nutrition
Gluten free, high fibre
Kcals 365
Fat 5 g (1 g fat per 100 g)
Saturated fat 3 g
Sodium 500 mg
Fibre 7 g
Preparation time 10 minutes
Cooking time 50–60 minutes
Serves 1

+ NUTRITIONAL TIP
These fillings taste just as good served with the traditional jacket potato. If following a gluten-free
diet, check that the sweet chilli sauce and korma curry paste are gluten free.
1 sweet potato, about 300 g (10 oz)
100 g (3½ oz) cottage cheese
1 tablespoon sweet chilli sauce
few fresh coriander leaves
salt and pepper

1 Scrub and prick the sweet potato and cook it in a preheated oven,
200°C (400°F), Gas Mark 6, for 50–60 minutes or until it is tender.
2 Cut the sweet potato in half then half again to make a cross, fluff up the
centre with a fork, then top with cottage cheese, a little seasoning, a
drizzle of chilli sauce and some torn coriander leaves.
ALTERNATIVES
Curried ham Mix together 50 g (2 oz) low-fat natural yogurt and 1
teaspoon korma curry paste in a small bowl. Stir in a little red onion,
finely chopped, and a 2 cm (¾ inch) thick slice of cucumber, finely diced.
Spoon over the top of 1 baked sweet potato and sprinkle with 1 large
slice of ham, roughly diced.
Avocado salsa Mix together in a bowl ½ ripe avocado, stoned, peeled
and diced, the juice of ½ lime, a little red onion, finely chopped, ½ apple,
cored and finely diced, 3 cherry tomatoes, quartered, and a few coriander
leaves, roughly chopped. Spoon the mixture over 1 baked sweet potato.
main meals
sticky chicken with salsa
slow-cooked chicken
yogurt-marinated roast lamb
seared salmon with garden greens
mixed fish kedgeree
chicken en papillotte
cod in Parma ham
peppered beef
hen house pie
tamarind roasted pork
roasted mustard chicken
spicy lamb with aubergine
 sticky chicken with salsa
Refreshingly fruity, this dish makes a lovely summer supper. Cook the
chicken under the grill or on the barbecue. The chicken can also be cut
into cubes and threaded on to 8 skewers if you prefer. Use hot smoked
Spanish pimento instead of paprika for a chilli-like oomph.
Nutrition
Low fibre
Kcals 327
Fat 15 g
Saturated fat 4 g
Sodium 285 mg
Fibre 2 g
Preparation time 25 minutes
Cooking time 12–15 minutes
Serves 4

+ NUTRITIONAL TIP
The salsa can be used with other dishes if you are on a milk-or wheat-free diet.
4 boneless, skinless chicken breasts, about 625 g (1¼ lb) in total
2 tablespoons tomato ketchup
1 tablespoon Worcestershire sauce
1 tablespoon sunflower oil
1 teaspoon Dijon mustard
1 teaspoon set or clear honey
½ teaspoon paprika
salt and pepper
green salad, to serve
new potatoes, to serve
SALSA
1 avocado, peeled and diced
1 small mango, peeled and diced
1 lime, grated rind and juice
2 tomatoes, skinned (if liked), deseeded and diced
½ small red onion, finely chopped
1 Rinse the chicken breasts with cold water, drain well, then put on a foil-
lined grill rack.
2 Mix together the tomato ketchup, Worcestershire sauce, oil, mustard,
honey, paprika and seasoning and brush over the chicken. Cook under a
preheated grill for 12–15 minutes, turning several times, until the meat is
browned and cooked through.
3 Meanwhile, make the salsa. Mix the diced avocado and mango with the
lime rind and juice, then stir in the tomatoes and onion.
4 Slice the chicken into strips and transfer to plates. Serve with spoonfuls
of salsa, with a green salad and some baby new potatoes.
 slow-cooked chicken
This all-in-one supper dish is ideal for weekends. You can prepare
everything, then pop the casserole in the oven, leaving you free to
garden or play with the children without fear of it spoiling.
Nutrition
Dairy, wheat and gluten free
Kcals 372
Fat 13 g
Saturated fat 4 g
Sodium 636 mg
Fibre 9 g
Preparation time 20 minutes
Cooking time about 2 hours 15 minutes
Serves 4

+ NUTRITIONAL TIP
Either pepperoni or chorizo can be used in this recipe, but read the labels carefully if you are
avoiding wheat products to make sure that they are definitely wheat free because some makes
contain wheat.
1 tablespoon olive oil
8 chicken thighs, about 1 kg (2 lb) in total, skinned, boned and quartered
1 large onion, roughly chopped
1–2 garlic cloves, finely chopped
1 teaspoon hot smoked Spanish paprika (pimento)
400 g (13 oz) can chopped tomatoes
450 ml (¾ pint) wheat-and gluten-free chicken stock
410 g (13¼ oz) can borlotti beans, drained
salt and pepper
2–3 stems of rosemary
500 g (1 lb) baking potatoes, peeled and diced
2 carrots, about 250g (8 oz) in total, sliced
75 g (3 oz) pack sliced pepperoni
roughly chopped flat-leaf parsley, to garnish
1 Heat the oil in a large frying pan, add the chicken a few pieces at a
time, until all the pieces have been added, then cook over a high heat for
5 minutes until lightly browned. Drain and transfer to a casserole dish.
2 Add the onion to the pan and cook, stirring, for 5 minutes or until pale
golden. Add the garlic and paprika and cook, stirring, for 1 minute. Mix in
the tomatoes, stock, beans, rosemary and seasoning and bring to the
boil.
3 Add the potatoes, carrots and sliced pepperoni to the casserole dish,
then pour over the hot tomato sauce. Cover and bake in a preheated
oven, 180°C (350°F), Gas Mark 4, for 1½–2 hours until tender, adding a
little extra stock if necessary. Spoon into bowls and serve sprinkled with
parsley.
 yogurt-marinated roast lamb
Inspired by East European cooking, this unusual way of roasting a leg of
lamb keeps it beautifully moist and full of flavour.
Nutritional value
Wheat free, gluten free
Kcals 560
Fat 24 g
Saturated fat 10 g
Sodium 235 mg
Fibre 4 g
Preparation time 20 minutes, plus marinating
Cooking time 1 hour 40 minutes
Serves 4

+ NUTRITIONAL TIP
Cooking the potatoes in stock in a separate dish rather than roasting them around the meat
makes a great low-fat alternative to roast potatoes. You will also need to strain any fat off the
meat juices if you serve these with the dish.
1.5–1.6 kg (3–3¼ lb) leg of lamb
2 garlic cloves, sliced
250 g (8 oz) low-fat natural yogurt
1 tablespoon olive oil
4 teaspoons chopped dill
1 teaspoon caraway seeds
1 teaspoon mild paprika
1 teaspoon black peppercorns, roughly crushed
salt
750 g (1½ lb) small baking potatoes, scrubbed
1 onion, sliced
1.8 litres (3 pints) hot wheat-and gluten-free lamb stock
15 g (½ oz) butter

1 Make slits at intervals over the lamb joint, cutting through the fat into
the meat, and insert a slice of garlic into each slit. Transfer to a large
non-metallic dish.
2 Mix together the yogurt, oil, dill, caraway, paprika, peppercorns and salt
and spread the mixture over the lamb. Marinate for 3–4 hours in the
refrigerator.
3 Put the lamb on a roasting rack in a roasting tin. Thinly slice the
potatoes and layer them in a shallow ovenproof dish with the onion and a
little extra seasoning. Pour in 600 ml (1 pint) hot stock. Dot the top with
butter, cover with foil and put on a high shelf in the oven.
4 Pour 600 ml (1 pint) hot stock into the roasting tin and put the lamb
under the potatoes in the oven. Roast in a preheated oven, 190°C
(375°F), Gas Mark 5, allowing 25 minutes per 500 g (1 lb) plus 25
minutes. Check on the meat from time to time, and spoon stock over the
lamb if it looks dry or cover with foil if it is browning too quickly. Top up
the tin with extra stock as needed. Remove the foil from the potatoes for
the last 30 minutes of the cooking time.
5 Transfer the lamb to a warmed serving plate, then strain the stock and
meat juices from the tin into a jug. Serve with the baked potatoes.
 seared salmon with garden greens
The summery green vegetables in this dish require the same cooking
time, but you could use broccoli, sugar snap peas, pak choi, spinach or
any other vegetable you like. Make sure you put the vegetables that take
the longest to cook in the steamer first.
Nutrition
Wheat and gluten free, high fibre
Kcals 420
Fat 26 g
Saturated fat 7 g
Sodium 180 mg
Fibre 6 g
Preparation time 10 minutes
Cooking time 8–10 minutes
Serves 4

+ NUTRITIONAL TIP
Omit the lime juice and include soya yogurt instead of crème fraîche to make this dish suitable for
a milk-free or an exclusion diet.
4 salmon steaks, each about 150 g (5 oz), rinsed and dried
1 tablespoon olive oil
grated rind and juice of 1 lime
1 teaspoon set or clear honey
salt and pepper
250 g (8 oz) runner beans, stringed, cut into thin slices
250 g (8 oz) bunch of asparagus, trimmed, cut into 5 cm (2 inch) lengths
200 g (7 oz) frozen peas
6 tablespoons half-fat crème fraîche
4 teaspoons chopped mint

1 Put the salmon on a foil-lined grill rack. Mix together the oil, lime juice,
honey and seasoning and spoon over both sides of the salmon. Grill the
salmon under a preheated grill for 8–10 minutes, turning once, until it is
browned on both sides and the fish flakes easily into even-coloured
flakes when pressed with a knife.
2 Meanwhile, steam the runner beans, asparagus and frozen peas for 5
minutes. Mix the crème fraîche with the chopped mint, lime rind and a
little seasoning.
3 Toss the just-cooked vegetables with the minted crème fraîche, spoon
into the centre of 4 serving plates and arrange the salmon on top.
Garnish with extra small mint leaves, if liked. Serve with new potatoes or
rice.
 mixed fish kedgeree
If you have trouble persuading your family to adopt a healthier diet, this is
a good recipe to slip in. Because the brown rice is lightly spiced, they
won’t even realize it is different.
Nutrition
Wheat, gluten and dairy free
Kcals 593
Fat 31 g
Saturated fat 7 g
Sodium 1200 mg
Fibre 3 g
Preparation time 15 minutes
Cooking time 25–30 minutes
Serves 4

+ NUTRITIONAL TIP
Use white rice to make this dish suitable for a low-fibre diet.
1 onion, chopped
600 ml (1 pint) wheat-and gluten-free fish or chicken stock
200 g (7 oz) easy-cook brown rice
½ teaspoon ground turmeric
5 cardamom pods, roughly crushed
salt and pepper
300 g (10 oz) smoked haddock
300 g (10 oz) pack peppered or plain smoked mackerel fillets
4 eggs, hard-boiled, shelled and quartered
small bunch of fresh coriander

1 Put the onion, stock, rice, turmeric and cardamom pods and the black
seeds into a frying pan with a little seasoning. Cut the haddock into 2
pieces and add them to pan. Bring the stock to the boil, reduce the heat,
cover and simmer for 10 minutes until the haddock is just cooked and
flakes easily into even-coloured flakes when pressed with a knife.
2 Lift the fish out of the pan, draining well, and transfer it to a plate. Stir
the rice then re-cover and simmer for 15–20 minutes until it is tender and
most of the stock has been absorbed by the rice. Stir several times
towards the end of cooking so that the rice does not stick to the pan.
3 Flake the smoked haddock into pieces, discarding the skin and any
bones. Do the same with the smoked mackerel. Stir into the just-cooked
rice, add the eggs and serve with torn coriander leaves scattered over
the top.
 chicken en papillotte
Forget about lots of washing up, these tasty chicken parcels, flavoured
with garlic, pesto and sun-dried tomatoes, are baked in foil packets,
which can be thrown away after use.
Nutrition
Wheat and gluten free, low fat
Kcals 357
Fat 16 g
Saturated fat 4 g
Sodium 278 mg
Fibre 2 g
Preparation time 15 minutes
Cooking time 30 minutes
Serves 4

+ NUTRITIONAL TIP
If you are avoiding dairy products, omit the pesto and add some torn basil leaves and a drizzle of
olive oil to the chicken.
300 g (10 oz) baby new potatoes, scrubbed and sliced
150 g (5 oz) courgette, sliced
100 g (3½ oz) mushrooms, sliced
40 g (1½ oz) sun-dried tomatoes in oil, drained and sliced
salt and pepper
4 boneless, skinless chicken breasts, each about 150 g (5 oz)
4 teaspoons pesto
2 small garlic cloves, finely chopped (optional)
½ small red onion, thinly sliced
300 ml (½ pint) hot gluten-and wheat-free chicken stock or red or white wine
basil leaves, to garnish (optional)

1 Cook the potatoes in a small saucepan of boiling water for 5 minutes

until just cooked. Drain.
2 Fold up the edges of 4 large pieces of foil to make 4 containers and put
them in a large roasting tin. Spoon the potatoes onto the foil and top with
the courgette, mushroom and tomato slices. Season lightly, then top
each with a chicken breast.
3 Add a teaspoon of pesto to the top of each chicken breast, sprinkle with
the garlic (if used) and red onion and pour the stock around the chicken.
Fold the foil over the top of the chicken and twist the edges together to
seal well.
4 Bake in a preheated oven, 220°C (425°F), Gas Mark 7, for 25 minutes
or until the chicken is cooked through and the juices run clear when
pierced with a small knife. Transfer the contents of the parcels to serving
plates and serve garnished with basil leaves, if liked.
 cod in Parma ham
This stylish-looking supper dish can be prepared in advance and kept in
the refrigerator until you are ready to bake it.
Nutrition
Low fibre
Kcals 283
Fat 13 g
Saturated fat 3 g
Sodium 730 mg
Fibre 1 g
Preparation time 25 minutes
Cooking time 20–25 minutes
Serves 4

+ NUTRITIONAL TIP
Check the black olive pesto is milk free to enjoy this dish on a milk-free diet.
2 cod loins, about 625 g (1¼ lb) in total, rinsed, drained and each halved crossways
juice of 1 lemon
salt and pepper
4 teaspoons black olive tapenade or black olive pesto
4 slices Parma ham, about 100 g (3½ oz) in total
1 tablespoon olive oil
1 small onion, finely chopped
1 garlic clove, finely chopped
500 g (1 lb) plum tomatoes, skinned, deseeded and diced or 400 g (13 oz) can chopped
tomatoes
2 teaspoons sun-dried tomato paste
2 teaspoons balsamic vinegar (optional)
small bunch of basil
crusty bread, to serve

1 Drizzle the halved fish loins with lemon juice and season, then spread
the top and sides with tapenade or pesto, avoiding the ends of the fish.
Wrap the top and sides with ham, leaving the ends exposed.
2 Heat the oil in a saucepan, add the onion and garlic and fry for 5
minutes or until softened and lightly browned. Mix in the tomatoes,
tomato paste, vinegar (if used) and seasoning. Tear the basil leaves into
the sauce.
3 Spoon the sauce into a shallow, ovenproof dish and arrange the fish on
top. Bake, uncovered, in a preheated oven, 190°C (375°F), Gas Mark 5,
for 15 minutes until the ham has darkened slightly and the fish is pure
white and flakes easily when pressed with a knife. Transfer to plates and
serve with crusty bread and rice or new potatoe
 peppered beef
This hearty and warming supper can be put on to cook, leaving you free
to do other things. If you get delayed the beef will still be fine after 2
hours.
Nutrition
Wheat, gluten and dairy free
Kcals 315
Fat 10 g
Saturated fat 3 g
Sodium 114 mg
Fibre 4 g
Preparation time 15 minutes
Cooking time 2 hours
Serves 4

+ NUTRITIONAL TIP
Some people with IBS can find beef rather indigestible, but long, slow cooking seems to help. If
you do have trouble with it, try not to eat red meat more than once a week and keep the portions
small.
1 tablespoon olive oil
625 g (1¼ lb) well-trimmed stewing beef, diced
1 onion, roughly chopped
1 garlic clove (optional)
2 tablespoons gluten-and wheat-free white bread flour
600 ml (1 pint) wheat-and gluten-free beef stock
1 tablespoon tomato purée
1 teaspoon juniper berries, roughly crushed
1 teaspoon peppercorns, roughly crushed
1 bay leaf
100 g (3½ oz) ready-to-eat prunes, pitted and halved
salt

1 Heat the oil in a large frying pan, add the beef, a few pieces at a time,
until all the pieces have been added to the pan. Add the onion and fry,
stirring, over a high heat until the meat is browned and the onion is just
beginning to brown.
2 Stir in the garlic (if used) and the flour, then mix in the stock, tomato
purée, juniper berries, peppercorns, bay leaf and prunes. Season with
salt and bring to the boil, stirring.
3 Transfer the mixture to a casserole dish, cover and cook in a preheated
oven, 160°C (325°F), Gas Mark 3, for 2 hours or until the beef is tender.
Serve with sweet potato or celeriac mash and green beans.
 hen house pie
Packed with moist pieces of chicken and lots of fresh vegetables, this pie
is topped with cheesy leek and potato mash. It’s a perfect supper to enjoy
curled up in front of a film on television.
Nutritional value
Gluten free, high fibre
Kcals 470
Fat 17 g
Saturated fat 7 g
Sodium 433 mg
Fibre 8 g
Preparation time 30 minutes
Cooking time 35 minutes
Serves 4

+ NUTRITIONAL TIP
If you prefer a thicker sauce, mix with a little water 1 tablespoon of cornflour or arrowroot and stir
into the sauce at the end. If you are avoiding wheat and gluten, check the ingredients list on the
mustard, stock cubes and cornflour before use.
8 chicken thighs, about 1 kg (2 lb) in total
1 tablespoon olive oil
2 rashers of smoked back bacon, diced
2 leeks, about 200 g (7 oz) in total, thinly sliced
600 ml (1 pint) wheat-and gluten-free chicken stock
1 teaspoon Dijon mustard
2 tablespoons chopped sage
2 carrots, about 250 g (8 oz) in total, diced
salt and pepper
875 g (1¾ lb) potatoes, diced
200 g (7 oz) courgette, diced
100 g (3½ oz) frozen peas
4 tablespoons fromage frais
50 g (2 oz) mature Cheddar cheese, grated
1 Cut the skin away from the chicken thighs, cut the meat off the bones
and cut it into chunks.
2 Heat the oil in a large frying pan, add the chicken a few pieces at a time
until it has all been added, then add the bacon and white leek slices. Fry
for 5 minutes, stirring until lightly browned. Add 450 ml (¾ pint) stock, the
mustard, half the sage and the carrots. Season to taste, bring to the boil,
cover and simmer for 25 minutes.
3 Meanwhile, cook the potatoes until tender, add the green leek slices
and cook for 3 minutes more.
4 Add the courgettes, peas and remaining stock to the chicken mixture
and simmer for 5 minutes. Transfer to a shallow, ovenproof dish.
5 Drain the potatoes and leeks and mash them with the fromage frais,
remaining sage, half the cheese and seasoning. Spoon over the chicken
mixture and sprinkle with the remaining cheese. Put under a preheated
grill until the cheese is bubbling. Serve immediately.
 tamarind roasted pork
A stylish roast that is full of flavour. Tamarind has a distinctive, rather
sour flavour, and the paste is made from the dried pod of the tamarind
tree, shaped into blocks. It is used as a souring agent in many Southeast
Asian dishes.
Nutrition
High fibre, wheat free
Kcals 478
Fat 17 g
Saturated fat 6 g
Sodium 200 mg
Fibre 4 g
Preparation time 30 minutes
Cooking time 20 minutes
Serves 4

+ NUTRITIONAL TIP
Pork tenderloin is low in fat so is much easier to digest than a more traditional lamb or beef roast.
1 tablespoon olive oil
4 teaspoons tamarind paste
1 garlic clove, finely chopped
salt and pepper
4 pieces of pork tenderloin, each 175 g (6 oz) and 10 cm (4 inches) long
625 g (1¼ lb) sweet potato, peeled, cut into chunks
2 tablespoons reduced-fat crème fraîche
SALSA
1 dessert apple, cored, diced
½ red onion, finely chopped
½ teaspoon fennel seeds
2 tablespoons cider vinegar
1 teaspoon thick set or clear honey

1 Put the oil, tamarind paste, garlic and seasoning in a plastic bag, add
the pieces of pork and toss together until the meat is coated. Transfer to
a roasting tin and cook in a preheated oven, 190°C, 375°F, Gas Mark 5,
for about 15 minutes until browned and cook through.
2 Meanwhile, steam the sweet potato for 15–20 minutes or until tender.
Take the pork out of the oven, wrap it in foil and leave to rest for 5
minutes.
3 Make the salsa. Place all the ingredients into a small saucepan, cover
and simmer for 3–4 minutes or until warmed through.
4 Mash the sweet potato with the crème fraîche and a little seasoning
and spoon onto the centre of 4 serving plates. Slice the pork thinly and
arrange the slices on top of the mash. Serve with green beans, a
spoonful of the salsa with the remainder in a small bowl and the meat
juices from the roasting tin drizzled around.
 roasted mustard chicken
Glazing the chicken with a mix of honey, wholegrain mustard and spices
means that it cooks to a deep burnished gold. Serve the chicken on its
own with the roasted roots or accompany it with a steamed green
vegetable.
Nutrition
Wheat, gluten free and milk free
Kcals 610
Fat 34 g
Saturated fat 8 g
Sodium 270 mg
Fibre 6 g
Preparation time 25 minutes
Cooking time 1 hour 20 minutes
Serves 4

+ NUTRITIONAL TIP
Carefully read the label on the back of the mustard and the stock cubes to make sure that they
really are gluten free, because some brands may contain wheat flour.
1 chicken, about 1.5 kg (3 lb)
3 tablespoons sunflower oil
2 teaspoons wholegrain mustard
2 teaspoons clear honey
½ teaspoon turmeric
½ teaspoon paprika salt and pepper
½ butternut squash, about 300 g (10 oz), peeled and deseeded
3 carrots, about 300 g (10 oz) in total
2 parsnips, about 250 g (8 oz) in total
300 g (10 oz) baby new potatoes, scrubbed
300 ml (½ pint) chicken or vegetable stock

1 Rinse the chicken inside and out with cold water, drain well and transfer
to a large roasting tin.
2 Mix the oil, mustard, honey, spices and seasoning together in a large
mixing bowl, then brush a little over the chicken. Loosely cover with oiled
foil and roast in a preheated oven, 190°C, 375°F, Gas Mark 5, for 30
minutes.
3 Meanwhile, cut the flesh of the butternut squash into thick slices. Cut
the carrots and parsnips into chunky sticks. Halve any large potatoes.
4 Remove the foil from the chicken and brush with some more mustard
mixture. Add the vegetables to the remaining mustard mix and toss
together in the bowl. Spoon around the chicken and roast for 50 minutes,
turning once or twice and re-covering the chicken after 20–30 minutes or
when the skin is deep brown.
5 Insert a skewer through the thickest part of the chicken leg into the
breast. If the juices run clear, transfer the chicken and vegetables to a
serving plate. If not, return to the oven and retest after 15 minutes. Pour
off half the fat from the roasting tin, add the stock to the remaining juices,
bring to the boil, and strain into a jug before serving.
 spicy lamb with aubergine
This dish has all the flavour of a Greek moussaka but none of the fiddle.
If you prefer not to serve it with rice, it would taste delicious topped with
mashed potato mixed with fromage frais rather than butter and milk and
browned in the oven.
Nutrition
Wheat free, gluten free
Kcals 319
Fat 18 g
Saturated fat 8 g
Sodium 185 mg
Fibre 3 g
Preparation time 15 minutes
Cooking time about 1 hour
10 minutes
Serves 4

+ NUTRITIONAL TIP
If you are on a dairy-free diet, omit the Greek yogurt altogether or use soya yogurt instead.
1 tablespoon olive oil
1 onion, chopped
500 g (1 lb) lean lamb, minced
1 aubergine, about 250 g (8 oz), halved lengthways and thinly sliced
1–2 garlic cloves, finely chopped
400 g (13 oz) can chopped tomatoes
1 teaspoon ground cinnamon
¼ teaspoon grated nutmeg
300 ml (½ pint) wheat-and gluten-free lamb or chicken stock
salt and pepper
4 tablespoons Greek yogurt, to serve
roughly chopped mint or flat-leaf parsley, to serve
paprika (optional)

1 Heat the oil in a flameproof casserole, add the onion and lamb and fry
for 2 minutes. Add the aubergine and fry for 5 minutes or until the lamb is
evenly browned and the onion and aubergine are softened.
2 Stir in the garlic, tomatoes, spices, stock and a little seasoning. Bring to
the boil, stirring, and cover.
3 Cook the lamb mixture in a preheated oven, 180°C (350°F), Gas Mark
4, for 1 hour or until tender. Serve with rice and topped with a spoonful of
Greek yogurt and a sprinkling of mint, parsley and paprika, if liked.
vegetarian
beetroot and blue cheese risotto
special fried rice
falafel
oven-baked ratatouille
bulgar pilaf with mixed roots
mixed vegetable and cashew laska
penne with roasted tomatoes
minted courgette frittata
 beetroot and blue cheese risotto
A vibrant red, soft and creamy risotto is speckled with just-melting blue
cheese. Serve as soon as the rice is cooked or the liquid will quickly be
absorbed because the rice swells on standing. If you’re not a fan of blue
cheese, add a little freshly grated Parmesan instead.
Nutrition
Wheat and gluten free, high fibre
Kcals 380
Fat 15 g
Saturated fat 7 g
Sodium 357 mg
Fibre 4 g
Preparation time 15 minutes
Cooking time about 30 minutes
Serves 4

+ NUTRITIONAL TIP
If you cannot tolerate dairy products, omit the cheese. Check that the cheese you are using is
suitable for vegetarians and is not made with rennet.
1 tablespoon olive oil
1 onion, finely chopped
3 small uncooked beetroot, trimmed weight about 375 g (12 oz), peeled and diced
200 g (7 oz) arborio rice
salt and pepper
few sage leaves, plus extra to garnish
1.2 litres (2 pints) hot wheat-and gluten-free vegetable stock
125 g (4 oz) St Agur, Stilton or other blue cheese, rind removed, and diced

1 Heat the oil in a nonstick frying pan, add the onion and fry gently,
stirring occasionally, for 5 minutes or until softened. Stir in the beetroot
and cook for 2 minutes.
2 Stir in the rice, then add the sage, a little seasoning and about one-third
of the hot stock. Simmer, uncovered, for 15–20 minutes until the rice is
soft and creamy and the beetroot is tender, topping up with the remaining
stock and stirring more frequently towards the end of cooking.
3 Stir in the cheese and sprinkle with extra sage leaves, if liked. Spoon
into bowls and serve immediately.
 special fried rice
Popular with all ages, this tasty supper can be made with whatever
vegetables you have in the refrigerator. Just take care that you cut them
into small pieces so that they cook quickly.
Nutrition
Wheat, gluten and dairy free
Kcals 340
Fat 13 g
Saturated fat 3 g
Sodium 513 mg
Fibre 4 g
Preparation time 20 minutes
Cooking time about 30 minutes
Serves 4

+ NUTRITIONAL TIP
The fibre content of the dish will vary depending on the vegetable you choose and the type of rice.
To reduce the fibre level, use white rice.
200 g (7 oz) easy-cook brown rice
3 eggs
1 tablespoon water
salt and pepper
6 teaspoons sunflower oil
4 spring onions, sliced
125 g (4 oz) courgette, diced
½ red pepper, cored, deseeded and diced
50 g (2 oz) mangetout, sliced
75 g (3 oz) frozen peas
2.5 cm (1 inch) root ginger, peeled and grated
2 tablespoons sesame seeds
2 tablespoons tamari sauce

1 Cook the rice in boiling water for about 25 minutes or according to the
instructions on the packet until just tender.
2 Meanwhile, beat together the eggs, water and a little seasoning in a
bowl. Heat 2 teaspoons oil in a large frying pan, add the eggs and make
a thin omelette. When the underside is golden, turn it over and cook the
other side for a minute more. Slide it out of pan on to a plate and set
aside.
3 Heat 3 teaspoons oil in the frying pan, add the spring onions, courgette,
red pepper, mangetout, peas and ginger. Stir fry for 3–4 minutes or until
tender. Drain the rice, tip it back into the dried pan and stir in the stir-fried
vegetables.
4 Heat the remaining oil in a frying pan, add the sesame seeds and fry for
2–3 minutes, stirring until just beginning to brown. Turn off the heat, add
the tamari sauce and quickly cover the pan so that the seeds do not ping
out.
5 Roll up the omelette, cut it into thin slices and add to the rice with the
sesame seeds. Spoon into bowls and serve.
 falafel
These chickpea patties are traditionally deep-fried, but this shallow-fried
version is healthier. Made in minutes using a can of chickpeas, falafel are
packed with protein and fibre.
Nutrition
Wheat and gluten free, high fibre
Kcals 533
Fat 16 g
Saturated fat 2 g
Sodium 860 mg
Fibre 4 g
Preparation time 15 minutes
Cooking time 8–10 minutes
Serves 4

+ NUTRITIONAL TIP
Use soya yogurt in the tzatziki to make this dish suitable for a dairy-free diet.
1 onion, quartered
small bunch of parsley or chives
2 garlic cloves, sliced
2 x 410 g (13¼ oz) cans chickpeas, drained
2 teaspoons cumin seeds, finely crushed
2 teaspoons coriander seeds, finely crushed
1 teaspoon wheat-and gluten-free baking powder
3 tablespoons olive oil
salt and pepper
TZATZIKI
100 g (3½ oz) cucumber, finely diced
150 g (5 oz) low-fat natural yogurt
few fresh mint leaves
4 pitta breads, to serve
2 Little Gem lettuce leaves, to serve

1 Put all the ingredients for the falafel into a food processor and blend to
make a coarse, thick purée. Alternatively, liquidize in batches or finely
chop the onion, herbs, garlic and chickpeas and mix them with the
remaining ingredients.
2 Use 2 dessertspoons to shape the mixture into 16 oval patties. Heat 1
tablespoon oil in a large, nonstick frying pan, add half the falafel and fry
for 4–5 minutes, turning until golden and crisp on the outside and piping
hot. Add extra oil if needed. Repeat with the remaining falafel.
3 Meanwhile, make the tzatziki by mixing together the ingredients in a
bowl. Warm the pitta breads under the grill and shred the lettuce if liked.
Arrange on serving plates with the hot falafel.
 oven-baked ratatouille
Florence fennel adds a delicate aniseed flavour to this rich ratatouille,
which is speckled with peppers and courgettes and topped with toasted
baguette slices and creamy, just-melting goats’ cheese with chives.
Nutrition
Wheat and gluten free, high fibre
Kcals 285
Fat 10 g
Saturated fat 4 g
Sodium 413 mg
Fibre 5 g
Preparation time 25 minutes
Cooking time about 1 hour
10 minutes
Serves 4

+ NUTRITIONAL TIP
If you are avoiding wheat and gluten and are not on a dairy-free diet, omit the toast and add some
sliced cheese once the ratatouille has been served. You could also serve this with baked potato,
rice or pasta.
1 tablespoon olive oil
1 onion, chopped
2 garlic cloves, finely chopped
1 fennel bulb, about 250 g (8 oz), diced
3 coloured peppers, cored, deseeded and diced
2 courgettes, about 300 g (10 oz) in total, diced
400 g (13 oz) can chopped tomatoes
150 ml (¼ pint) wheat-and gluten-free vegetable stock
1 teaspoon caster sugar
salt and pepper
rocket salad, to serve
TOPPING
1 baguette, about 150 g (5 oz) in total, thinly sliced
125 g (4 oz) goats’cheese with chives
1 Heat the oil in a large, nonstick frying pan. Add the onion and fry,
stirring, for 5 minutes or until lightly browned. Add the garlic and
remaining fresh vegetables and fry for a further 2 minutes.
2 Stir in the canned tomatoes, stock, sugar and a little seasoning. Bring
to the boil, stirring, then transfer to a deep ovenproof dish. Cover the top
of the dish with foil and bake in a preheated oven, 190°C (375°F), Gas
Mark 5, for 45–60 minutes until the vegetables are tender.
3 When the vegetables are almost ready, grill one side of the bread
slices. Slice the cheese and add one slice to each untoasted side of
bread. Remove the foil from the ratatouille, stir the vegetables and top
with the toasts, cheese side up.
4 Put the ratatouille under a preheated grill for 4–5 minutes until the
cheese is just beginning to melt. Spoon into shallow bowls and serve with
a rocket salad.
 bulgar pilaf with mixed roots
An easy store cupboard supper, this can be served as it is or topped with
spoonfuls of yogurt, toasted nuts or torn mint or parsley leaves. Cut the
vegetables into small dice so that they cook quickly.
Nutrition
Dairy free, high fibre
Kcals 305
Fat 5 g
Saturated fat 1 g
Sodium 47 mg
Fibre 5 g
Preparation time 15 minutes
Cooking time 30 minutes
Serves 4

+ NUTRITIONAL TIP
Spicy foods can upset IBS. Choosing milder spices or cutting the amount used may help.
1 tablespoon olive oil
1 red onion, sliced
150 g (5 oz) parsnip, diced
200 g (7 oz) carrot, diced
250 g (8 oz) swede, diced
4 cloves
1 teaspoon ground cinnamon
1 teaspoon mild paprika
½ teaspoon ground cumin
410 g (13¼ oz) can green lentils, drained
125 g (4 oz) bulgar wheat
1 tablespoon tomato purée
salt and pepper
900 ml (1½ pint) vegetable stock

1 Heat the oil in a large, nonstick frying pan, add the onion and fry,
stirring, for 5 minutes or until softened. Stir in the root vegetables and fry
for 2 minutes.
2 Mix in the spices, cook for a further minute, then add the lentils, bulgar
wheat, tomato purée and a little seasoning. Pour in 600 ml (1 pint) stock
and bring to the boil.
3 Reduce the heat, cover and simmer for 20 minutes, stirring and topping
up with extra stock as needed, until the vegetables are tender. Spoon
into bowls to serve.
 mixed vegetable and cashew laska
This light, refreshing and colourful curry can be cooked in under 10
minutes. Vary the vegetables depending on what you have in the
refrigerator.
Nutrition
Wheat, gluten and dairy free
Kcals 389
Fat 20 g
Saturated fat 8 g
Sodium 614 g
Fibre 2 g
Preparation time 10 minutes
Cooking time 10 minutes
Serves 4

+ NUTRITIONAL TIP
The fibre content of this dish will depend on the vegetables you use, so you can adjust the recipe
for either a high-or a low-fibre diet.
125 g (4 oz) medium rice noodles
2 teaspoons sunflower oil
1 onion, finely chopped
75 g (3 oz) cashew nuts
2 teaspoons wheat-and gluten-free red Thai curry paste
1 garlic clove, finely chopped
400 ml (14 fl oz) can reduced-fat coconut milk
300 ml (½ pint) wheat-and gluten-free vegetable stock
100 g (3½ oz) carrot, cut into matchstick strips
1 red pepper, cored, deseeded and diced
50 g (2 oz) mangetout, sliced
100 g (3½ oz) pak choi, sliced
2 tablespoons tamari sauce
small bunch of basil or fresh coriander

1 Cook the noodles in boiling water according to the instructions on the

packet.
2 Meanwhile, heat the oil in a wok or second saucepan, add the onion
and cashew nuts and fry for 3–4 minutes until just beginning to brown.
Stir in the curry paste and garlic, then mix in the coconut milk and stock.
3 Bring the coconut broth to the boil, add the carrot and red pepper and
simmer for 3 minutes. Mix in the mangetout and pak choi and cook for a
further 2 minutes until the leaves have just wilted. Stir in the tamari sauce
and half the basil or coriander, torn into pieces.
4 Drain the noodles and stir them into the coconut broth. Spoon into
bowls and top with the remaining basil or coriander leaves.
 penne with roasted tomatoes
Wholewheat pasta has been used here, but plain pasta or corn pasta can
be used instead. Alternatively, spoon the tomato sauce over the top of a
baked potato.
Nutrition
High fibre
Kcals 404
Fat 11 g
Saturated fat 3 g
Sodium 33 mg
Fibre 11 g
Preparation time 15 minutes
Cooking time 15 minutes
Serves 4

+ NUTRITIONAL TIP
Reduce the fat content even more by using low-fat ricotta or quark cheese instead of the crème
fraîche. If you are avoiding dairy products, omit the crème fraîche altogether.
500 g (1 lb) cherry tomatoes, halved
2 tablespoons olive oil
2 garlic cloves, finely chopped
4–5 stems rosemary
large pinch of smoked paprika or chilli powder
salt and pepper
375 g (12 oz) dried wholewheat pasta twists or tubes
2 tablespoons balsamic vinegar
4 tablespoons reduced-fat crème fraîche
Parmesan shavings, to serve

1 Put the tomatoes in a roasting tin, drizzle with the oil and sprinkle with
the garlic, torn leaves from 3 rosemary stems, the paprika or chilli powder
and a little seasoning. Roast in a preheated oven, 200°C (400°F), Gas
Mark 6, for 15 minutes until just softened.
2 Meanwhile, cook the pasta in a large saucepan of boiling water for 10–
12 minutes or until just tender, then drain.
3 Spoon the balsamic vinegar into the tomatoes, add the drained pasta
and crème fraîche and lightly toss together. Spoon into bowls and top
with Parmesan shavings.
 minted courgette frittata
A quick and easy storecupboard summer supper, this is even easier if
you have fresh mint growing in your garden. If you don’t have any fresh
herbs use a little chopped watercress or rocket leaves or some frozen
parsley. If you like, add some diced chorizo, bacon, salami or ham or
extra vegetables when you fry the courgettes.
Nutrition
Wheat, gluten and dairy free
Kcals 186
Fat 12 g
Saturated fat 3 g
Sodium 118 mg
Fibre 1 g
Preparation time 10 minutes
Cooking time 12–14 minutes
Serves 4

+ NUTRITIONAL TIP
Increase the fibre levels by adding frozen peas or frozen broad beans together with the diced
courgette.
4 teaspoons olive oil
1 red onion, thinly sliced
375 g (12 oz) courgette, diced
6 eggs
2 tablespoons water
2 tablespoons chopped mint
salt and pepper
mixed salad, to serve

1 Heat 3 teaspoons oil in a large, nonstick frying pan, add the onion and
courgettes and fry over a gentle heat for 5 minutes or until lightly
browned and just cooked.
2 Beat the eggs, water, chopped mint and a little seasoning together.
Heat the remaining oil in the frying pan and pour in the egg mixture.
Cook, without stirring, for 4–5 minutes or until the frittata is almost set
and the underside is golden-brown.
3 Transfer the pan to a hot grill (making sure that the handle is away from
the heat) and cook for 3–4 minutes until the top is golden and the frittata
is cooked through. Cut into wedges or squares and serve with a mixed
salad.
desserts
peach melba meringues
lychee and coconut ice
brown sugar pavlovas with berries
cheats’ summer berry sundae
red rice risotto with roasted plums
saffron and ginger poached pears
maple-glazed pineapple
apple and blackberry flapjack crumble
 peach melba meringues
When you’re short of time but really want to make a pudding to impress
your friends, this is the answer. Halved and baked peaches are topped
with a square of melting chocolate and a soft-centred marshmallow
meringue topping before being drizzled with a ruby-red fresh raspberry
sauce.
Nutrition
Wheat and gluten free, low fibre
Kcals 125
Fat 2 g (1 g fat per 100 g)
Saturated fat 1 g
Sodium 33 mg
Fibre 2 g
Preparation time 15 minutes
Cooking time 15 minutes
Serves 4

+ NUTRITIONAL TIP
If you are not on a dairy-free diet, serve the peaches with scoops of vanilla ice cream. Make sure
you use chocolate with 70 per cent cocoa solids if you are avoiding milk and check the ingredients
list to make sure it is dairy free.
2 large peaches, halved and pitted
4 squares of dark chocolate, about 25 g (1 oz)
2 egg whites
50 g (2 oz) caster sugar
200 g (7 oz) raspberries (just thawed if frozen)
a little sifted icing sugar, to decorate (optional)

1 Put the peaches, cut side up, in a shallow ovenproof dish, add 2
tablespoons water to the base of the dish and cover the peaches loosely
with foil. Bake in a preheated oven, 180°C (350°F), Gas Mark 4, for 10
minutes.
2 Add a square of chocolate to the centre of each peach half, re-cover
and return to the oven.
3 Meanwhile, make the meringue. Whisk the egg whites until they form
stiff but moist-looking peaks. Gradually whisk in the sugar, a teaspoonful
at a time, until the mixture is thick and glossy.
4 Spoon the meringue over the peaches and swirl into peaks with the
back of the spoon. Return the peaches to the oven for 5–7 minutes until
the meringue is cooked through and the swirls are tinged with brown.
5 Meanwhile, purée 125 g (4 oz) of the raspberries and sieve to remove
the seeds. Transfer the peaches to serving plates, decorate with the
remaining whole raspberries, drizzle the sauce around and dust with
sifted icing sugar, if liked. Serve immediately.
 lychee and coconut ice
This dairy-free ice cream tastes delicious when it is used to sandwich tiny
pairs of spooned or piped meringues. If you make the ice cream in
advance, leave it at room temperature for about 15 minutes to soften
slightly before scooping.
Nutrition
Wheat, gluten and dairy free
Kcals 249
Fat 9 g
Saturated fat 6 g
Sodium 120 mg
Fibre 3 g
Preparation time 20–30 minutes, plus freezing
Cooking time none
Serves 4

+ NUTRITIONAL TIP
This is much lower in sugar and fat than a more conventional dairy ice cream.
425 g (14 oz) can lychees in natural syrup
50 g (2 oz) icing sugar
grated rind of 2 limes
400 ml (14 fl oz) can reduced-fat coconut milk
500 g (1 lb) strawberries

1 Put the lychees and the juice into a liquidizer or food processor,
reserving 2 for decoration later. Add the icing sugar and purée until
smooth.
2 Stir in the lime rind and coconut milk, then pour into a chilled ice-cream
maker and churn until thick enough to scoop, which should take about 30
minutes. Alternatively, pour the mixture into a shallow stainless-steel
roasting tin and freeze for 4–6 hours, beating 2–3 times with a fork or
blitzing in a food processor to break down the ice crystals and returning
to the freezer until it is firm enough to scoop.
3 Meanwhile, hull and purée half the strawberries. Sieve to remove the
seeds. Slice or quarter the remaining fruits, depending on their size.
4 To serve, scoop the coconut ice into glasses, drizzle with the puréed
sauce and top with the remaining berries and reserved lychees, cut into
slices.
 brown sugar pavlovas with berries
Don’t wait for a special occasion to make this dish. Serve four now and
leave the plain pavlovas in an airtight tin for up to three days, then just
top them with fresh, frozen or canned fruit as and when you need them.
Nutrition
Wheat and gluten free, low fat
Kcals 197
Fat 5 g
Saturated fat 3 g
Sodium 68 mg
Fibre 3 g
Preparation time 30 minutes
Cooking time 45 minutes
Serves 4

+ NUTRITIONAL TIP
Some brands of cornflour contain wheat flour, so read the ingredients list carefully if you are
avoiding gluten. To make this suitable for a milk-free diet, use soya cream or yogurt.
3 egg whites
100 g (3½ oz) soft light muscovado sugar
75 g (3 oz) caster sugar
1 teaspoon gluten-free cornflour
1 teaspoon white wine vinegar
TO DECORATE
200 ml (7 fl oz) reduced-fat crème fraîche
150 g (5 oz) raspberries (just thawed if frozen)
250 g (8 oz) strawberries, sliced
sifted icing sugar (optional)

1 Whisk the egg whites until they form stiff but moist-looking peaks.
Gradually whisk in the sugars, a teaspoonful at a time, and continue to
whisk for 1–2 minutes or until thick and glossy.
2 Mix the cornflour with the vinegar and fold into the meringue. Grease
and line a large baking sheet and spoon the meringue on to the sheet in
6 mounds, spreading it into circles about 10 cm (4 inches) across.
3 Bake in a preheated oven, 140°C (275°F), Gas Mark 1, for 35–40
minutes or until crisp on the outside and they can be lifted easily off the
paper. Leave to cool.
4 Peel the pavlovas off the paper and transfer them to serving plates.
Spoon the crème fraîche over the top and decorate with the berries. To
serve, dust with a little sifted icing sugar, if liked.
 cheats’ summer berry sundae
This really speedy dessert is made in a matter of seconds and is just
bursting with flavour. Crème de cassis could be used in place of the
cordial if you prefer, and dainty soft amaretti biscuits or biscotti could be
served alongside if you are not avoiding wheat.
Nutrition
Wheat free, high fibre
Kcals 109
Fat 2 g
Saturated fat 1 g
Sodium 73 g
Fibre 7 g
Preparation time 10 minutes
Cooking time none
Serves 4

+ NUTRITIONAL TIP
To reduce the fibre content, make up your own bags of fresh strawberries and raspberries only.
Soya yogurt will make this dessert suitable for a milk-free and exclusion diet.
500 g (1 lb) frozen mixed summer berries, partially thawed
3 tablespoons blackcurrant cordial (undiluted)
250 g (8 oz) low fat Greek yogurt
4 teaspoons clear honey
2 tablespoons chopped mint

1 Put the fruit and cordial into a food processor or liquidizer and blitz until
crushed and sorbet like.
2 Mix the yogurt with the honey and chopped mint. Add alternate
spoonfuls of puréed fruit and yogurt to 4 glasses, then swirl together with
the handle of a teaspoon to give a marbled effect.
3 Decorate with extra mint leaves or a tiny sprig of mint dusted lightly with
sifted icing sugar, if liked.
 red rice risotto with roasted plums
Spoon down through the hot roasted plums to a generous spoonful of
crème fraîche and then into the warmth of the nutty red rice scented with
vanilla and cinnamon. Use pitted cherries in season or try stirring a little
cocoa powder into the rice along with the sugar for a change.
Nutrition
Wheat free, gluten free
Kcals 332
Fat 6 g
Saturated fat 4 g
Sodium 89 mg
Fibre 3 g
Preparation time 20 minutes
Cooking time 40–45 minutes
Serves 4

+ NUTRITIONAL TIP
To reduce the fibre level, use white arborio rice and cook for 20 minutes until tender. To lower the
fat levels, use reduced-fat yogurt. For a dairy-free version, use soya milk or rice milk to make the
risotto. This will make it suitable for an exclusion diet.
200 g (7 oz) red rice
450 ml (¾ pint) semi-skimmed milk
450 ml (¾ pint) water
¼ teaspoon ground cinnamon, plus extra to sprinkle
250 g (8 oz) ripe red plums, quartered and pitted
2 tablespoons caster sugar
1 teaspoon vanilla extract
4 tablespoons reduced-fat crème fraîche

1 Put the rice, half the milk and water and the cinnamon into a saucepan.
Bring to the boil, reduce the heat and simmer for 40–45 minutes, stirring
occasionally and topping up with milk and water as needed until the rice
is soft and creamy.
2 Towards the end of the cooking time for the rice, put the plums into a
shallow, ovenproof dish, sprinkle with a little extra cinnamon and add a
tablespoon of water to the base of the dish. Bake in a preheated oven,
180°C (350F), Gas Mark 4, for 10 minutes.
3 Stir the sugar and vanilla extract into the rice. Spoon into shallow
dishes, top with spoonfuls of crème fraîche, sprinkle with a little extra
cinnamon and arrange the plums to the side of the crème fraîche.
 saffron and ginger poached pears
Quick and easy to prepare, these light and refreshing poached pears
taste just as delicious served warm or chilled. They also freeze well, so
why not make up a double quantity in advance of a supper to share with
friends?
Nutrition
Wheat, gluten and milk free
Kcals 108
Fat 0 g
Saturated fat 0 g
Sodium 7 mg
Fibre 3 g
Preparation time 10 minutes
Cooking time 15–20 minutes
Serves 4

+ NUTRITIONAL TIP
If you are not avoiding dairy products, serve the pears with spoonfuls of reduced-fat crème
fraîche, Greek yogurt or fromage frais drizzled with a little extra honey. This dish is suitable for an
exclusion diet.
300 ml (½ pint) apple juice
2 large pinches of saffron threads
1 cm (½ inch) root ginger, peeled and cut into thin strips
1 tablespoon set or clear honey
4 conference pears, each about 150 g (5 oz)

1 Put the apple juice, saffron, ginger and honey into a medium-sized
saucepan and heat gently for 5 minutes.
2 Meanwhile, peel the pears, leaving the stalks on, and remove the calyx
from the base. Add the pears to the saucepan and press below the
surface of the apple juice. (If necessary change to a smaller pan.)
3 Simmer gently for 15–20 minutes, turning the pears from time so that
they colour evenly and are just tender. Spoon into a small pedestal dish
and serve warm or chilled.
 maple-glazed pineapple
Speedy enough to prepare while someone else clears the main course
plates, this colourful dessert is just the thing to make for a last-minute
meal to share with friends.
Nutrition
Low fat, gluten free
Kcals 155
Fat 1 g
Saturated fat 0 g
Sodium 16 mg
Fibre 3 g
Preparation time 10 minutes
Cooking time 4–5 minutes
Serves 4

+ NUTRITIONAL TIP
Anyone on a milk-free or exclusion diet could use soya yogurt instead of fromage frais.
6 slices fresh pineapple, peeled, cored and halved
125 g (4 oz) blueberries
8 teaspoons maple syrup
1 banana, about 200 g (7 oz) with skin on
100 g (3½ oz) low fat fromage frais
2 teaspoons chopped glacé ginger or stem ginger, drained and chopped

1 Arrange the pineapple slices in a single layer on a deep baking sheet.

Sprinkle the blueberries over and around the pineapple, then drizzle the
pineapple with 4 teaspoons maple syrup.
2 Cook the fruit under a preheated grill for 4–5 minutes until the
pineapple is beginning to brown and the juices have begun to run from
the blueberries.
3 Meanwhile, peel and mash the banana and mix it with the fromage frais
and ginger.
4 Arrange the pineapple on serving plates. Spoon the blueberries and
their juices over the top and the banana fromage frais to one side. Drizzle
with the remaining maple syrup and serve immediately.
 apple and blackberry flapjack crumble
A homely pudding, this is perfect after a Sunday roast or slow-cooked
casserole. The crumble topping can be made in larger batches and kept
in the freezer. Simply sprinkle it over cooked fruits while still frozen and
transfer to the oven. You might also like to try this with apples only, plums
or a mix of plums and pears.
Nutrition
High fibre
Kcals 386
Fat 14 g
Saturated fat 2 g
Sodium 90 mg
Fibre 7 g
Preparation time 20 minutes
Cooking time 25–30 minutes
Serves 4

+ NUTRITIONAL TIP
If you are avoiding dairy products, use soya margarine and do not serve with custard or ice cream
unless made with soya milk. To reduce the fibre content, omit the oats and seeds from the
crumble and make up the flour to 100 g (3½ oz).
2 cooking apples, about 500 g (1 lb) in total, quartered, cored and peeled
100 g (3½ oz) blackberries
100 g (3½ oz) soft light muscovado sugar
75 g (3 oz) plain flour
50 g (2 oz) reduced-fat spread
40 g (1½ oz) porridge oats
2 tablespoons flaked almonds
2 tablespoons sunflower seeds
finely grated rind of ½ small orange
custard or ice cream, to serve

1 Thinly slice the apples and put them in a saucepan with the
blackberries, 2 tablespoons sugar and 6 tablespoons water. Cover and
simmer for 5 minutes or until partly cooked.
2 Meanwhile, put the remaining sugar in a bowl with the flour. Add the
spread and rub in using your fingertips until the mixture resembles fine
breadcrumbs. Stir in the remaining ingredients.
3 Turn the hot fruit into a 900 ml (1½ pint) ovenproof dish, spoon the
crumble mixture over the top and bake in a preheated oven, 180°C
(350°F), Gas Mark 4, for 25–30 minutes or until golden-brown. Serve with
custard or ice cream.
cakes and bakes
cherry and orange roulade
chocolate cinnamon digestives
banana and fig gingerbread
chocolate and raspberry layer cake
apple sauce cake
 cherry and orange roulade
Just because you may be intolerant to wheat flour doesn’t mean that you
must avoid cakes. This wheat-free roulade uses ground almonds instead.
Nutrition
Wheat free, gluten free
Kcals 327
Fat 14 g
Saturated fat 1 g
Sodium 166 mg
Fibre 3 g
Preparation time 30 minutes, plus cooling
Cooking time 15 minutes
Serves 8

+ NUTRITIONAL TIP
If you are allergic to nuts but not wheat or gluten, then fold in 100 g (3½ oz) sifted plain flour
instead. Check the tinned cherries and cream cheese are gluten free.
5 large eggs, separated
250 g (8 oz) caster sugar, plus extra for dusting
100 g (3½ oz) ground almonds
grated rind of 1½ oranges
40 g (1½ oz) flaked almonds
300 g (10 oz) low-fat cream cheese
425 g (14 oz) can stoned cherries, drained
a few fresh cherries (optional)

1 Put the egg yolks and 175 g (6 oz) sugar in a large bowl set over a
saucepan of simmering water. Whisk until light and pale. Take the bowl
off the saucepan and gently fold in the ground almonds and the rind from
1 orange.
2 Put the egg whites in a separate bowl and whisk until stiff, moist-
looking peaks form. Fold a large spoonful into the yolk mixture to loosen
it slightly, then gently fold in the rest.
3 Grease and line a 23 x 30 cm (9 x 12 inch) baking tin with a piece of
nonstick baking paper. Make diagonal cuts into the corners of the paper,
then press it into the tin. Pour in the mixture and ease it into the corners.
Sprinkle with the flaked almonds and bake in a preheated oven, 180°F
(350°F), Gas Mark 4, for 15 minutes until the roulade is well risen and the
top feels spongy. Remove from the oven and leave to cool.
4 Beat the cream cheese with the remaining orange rind and half the
remaining sugar. Put a large piece of baking paper on the work surface,
dust it with the remaining caster sugar and turn the roulade out on it.
Remove the lining paper.
5 Spread the cream cheese mixture over the top, then sprinkle with the
cherries. Roll up the roulade, starting from the short edge, using the
paper to help. Transfer to a serving plate, remove the paper and cut into
thick slices to serve.
 chocolate cinnamon digestives
Lower in fat and higher in fibre than most shop-bought biscuits, these
crumbly biscuits are drizzled with a little chocolate for those moments
when you crave something sweet.
Nutrition
Low fibre
Kcals 66
Fat 3 g
Saturated fat 1 g
Sodium 69 mg
Fibre 1 g
Preparation time 20 minutes
Cooking time 10 minutes
Makes 24 biscuits

+ NUTRITIONAL TIP
For a dairy-free version, use soya margarine and unsweetened soya milk instead of the low-fat
spread and dairy milk. You will also need to omit the chocolate topping.
175 g (6 oz) wholemeal flour
2 teaspoons baking powder
1 teaspoon ground cinnamon
50 g (2 oz) medium oatmeal
100 g (3½ oz) reduced-fat spread
40 g (1½ oz) soft dark muscovado sugar
3 tablespoons semi-skimmed milk
50 g (2 oz) dark chocolate

1 Put the flour, baking powder, cinnamon and oatmeal into a bowl. Add
the spread and rub in with fingertips until the mixture resembles fine
breadcrumbs.
2 Stir in the sugar, add the milk and mix to a soft but not sticky dough.
3 Knead lightly, then roll out on a lightly floured surface to 5 mm (¼ inch)
thick. Cut out 6 cm (2½ inch) rounds with a fluted or plain biscuit cutter.
Transfer the biscuits to an oiled baking sheet, then knead and re-roll the
trimmings until all the mixture is used. Prick the biscuits with a fork, then
bake in a preheated oven, 200°C (400°F), Gas Mark 6, for 10 minutes or
until browned. Leave to cool.
4 Melt the chocolate in a bowl set over a pan of gently simmering water.
Drizzle or pipe squiggly lines of chocolate from a spoon over the top of
the biscuits. Leave to harden for 20 minutes, then serve. The biscuits will
keep for up to 5 days in an airtight tin.
 banana and fig gingerbread
This moist, golden gingerbread is flecked with naturally sweet bananas
and chopped dried figs, so that only syrup has been added to the cake
rather than the more usual mix of syrup and sugar. This cake keeps well
in an airtight tin, so is ideal for adding to packed lunchboxes.
Nutrition
Dairy free
Kcals 194
Fat 7 g
Saturated fat 2 g
Sodium 157 mg
Fibre 3 g
Preparation time 25 minutes
Cooking time 30–35 minutes
Makes 16 squares

+ NUTRITIONAL TIP
To lower the level of fibre, use white flour rather than a mix of white and brown and omit the seeds
on top. If you are not avoiding dairy products, use reduced-fat spread and semi-skimmed cows’
milk instead of the soya products.
100 g (3½ oz) soya margarine
175 g (6 oz) golden syrup
150 g (5 oz) figs, chopped
150 ml (¼ pint) unsweetened soya milk
2 tablespoons chopped glacé ginger
125 g (4 oz) self-raising flour
125 g (4 oz) plain wholemeal flour
3 teaspoons ground ginger
1 teaspoon bicarbonate of soda
2 ripe bananas, about 175 g (6 oz) each with their skins on, peeled and mashed
2 eggs, beaten
2 tablespoons sunflower seeds (optional)

1 Put the margarine, syrup, figs, milk and ginger in a saucepan and heat
gently until the margarine has melted.
2 Mix all the dry ingredients together in a bowl. Beat the eggs in a second
small bowl.
3 Take the saucepan off the heat, then mix in the bananas and dry
ingredients with a wooden spoon. Gradually beat in the eggs.
4 Grease and line a 20 cm (8 inch) square cake tin and pour the mixture
into the tin. Sprinkle with the seeds (if used) and bake in a preheated
oven, 180°C (350°F), Gas Mark 4, for 30–35 minutes until the cake is
well risen and the top springs back when pressed with a fingertip. Leave
the cake to cool in the tin.
5 Remove from the tin, peel off the lining paper and cut into 16 squares.
Store in an airtight tin for up to 7 days.
 chocolate and raspberry layer cake
This wheat-free cake is perfect for a birthday celebration. Alternatively,
serve it as a dessert with a drizzle of puréed raspberry sauce. The cakes
can be frozen on their own or fully assembled with the raspberries and
chocolate curls.
Nutrition
Wheat and gluten free, low fibre
Kcals 380
Fat 21 g
Saturated fat 11 g
Sodium 82 g
Fibre 2 g
Preparation time 40 minutes, plus cooling
Cooking time 15–18 minutes
Serves 8

+ NUTRITIONAL TIP
Choose chocolate that is 70 per cent cocoa solids, as it should be completely wheat free and
gluten free, but always check the label.
200 g (7 oz) plain dark chocolate, chopped
6 eggs, separated
175 g (6 oz) caster sugar, plus extra for dusting
2 tablespoons warm water
150 ml (¼ pint) whipping cream
150 g (5 oz) Greek yogurt
250 g (8 oz) raspberries
chocolate curls, to decorate

1 Put the chocolate in a bowl set over a saucepan of gently simmering

water and leave for 5 minutes until melted.
2 Lift the chocolate bowl off the pan, set a second large bowl on top of
the water, add the egg yolks and sugar and whisk for 5 minutes until very
light and pale and the whisk leaves a trail when lifted out of the mixture.
Take the bowl off the pan and gently fold in the chocolate and measured
warm water.
3 In a clean bowl whisk the egg white until stiff but moist-looking peaks
form. Fold a large spoonful into the yolks mixture to loosen it, then fold in
the remainder.
4 Grease and line 2 round 20 cm (8 inch) sandwich tins and divide the
mixture equally between them. Bake in a preheated oven, 180°C (350°F),
Gas Mark 4, for 15–18 minutes until well risen and the tops are crusty
and cracked and softly set in the centre. Remove from the oven. Leave to
cool in the tins.
5 Whip the cream until it holds its shape, then fold in the yogurt. Turn out
the cakes and put one on a serving plate. Top with half the cream mixture
and half the raspberries. Add the second cake, the remaining cream and
raspberries and then complete with a few chocolate curls. Cut into slices
to serve.
 apple sauce cake
No one will guess that this cake is wheat free. Serve while it’s still warm
on its own or with a spoonful of reduced-fat crème fraîche or soya yogurt
for a dairy-free alternative. Drizzled with custard, it doubles as a pudding.
Nutrition
Wheat and gluten free, low fibre
Kcals 323
Fat 11 g
Saturated fat 3 g
Sodium 164 mg
Fibre 2 g
Preparation time 30 minutes
Cooking time 30–35 minutes
Serves 8

+ NUTRITIONAL TIP
White flour can be used if you are not on a wheat-or gluten-free diet. Use soya margarine to make
this cake suitable for a dairy-free diet.
2 cooking apples, each about 250 g (8 oz), cored, peeled and thinly sliced
little lemon juice
250 g (8 oz) wheat-and gluten-free white bread flour with natural gum
2½ teaspoons wheat-and gluten-free baking powder
1 teaspoon ground cinnamon
½ teaspoon ground ginger
¼ teaspoon grated nutmeg
3 eggs
150 g (5 oz) reduced-fat spread
175 g (6 oz) caster sugar

1 Put half the apple slices in a small saucepan with 2 tablespoons water,
then cover and simmer for 5 minutes until pulpy. Put the remaining apple
slices in a bowl of cold water with a little lemon juice.
2 Mix the flour, baking powder, half the cinnamon and all the ginger and
nutmeg together in a second bowl. Beat the eggs in a jug.
3 Cream the reduced-fat spread with 150 g (5 oz) sugar in a bowl.
Gradually mix in alternate spoonfuls of egg and flour mix to the creamed
mixture until both have been added and the mixture is smooth. Stir in the
cooked apple.
4 Pour the mixture into a lightly oiled 23 cm (9 inch) spring-form cake tin
and smooth the top. Drain the remaining apples well and arrange the
slices in rings on top of the cake mixture. Sprinkle with the remaining
sugar and cinnamon. Bake in a preheated oven, 180°C (350°F), Gas
Mark 4, for 35–40 minutes until well risen and a skewer inserted into the
centre of the cake comes out cleanly.
index
abnormal gut movement
alcohol
alcohol units
allergy 1, 2
american cinnamon pancakes
antibiotics
anxiety
apple and blackberry flapjack crumble
apple sauce cake
aubergines, spicy lamb with
avocado smoothie, minty
bacteria 1, 2, 3
balanced diet
banana and fig gingerbread
beans: white bean, feta and roasted pepper
beef, peppered
beetroot and blue cheese risotto
bowel conditions, other 1, 2
bread
pineapple, date and sultana
quick cheese
breakfasts
broth, oriental vegetable
brown sugar pavlovas with berries
brunch special
bulgar pilaf with mixed roots
bulking agents
caffeine
cakes
calcium
Candida albicans
carbohydrate, complex
carrot and chickpea soup
carrot and cinnamon muffins
causes
cheats’ summer berry sundae
cheese bread, quick
cherry and orange roulade
chicken
en papillotte
hen house pie
roasted mustard
slow-cooked
sticky chicken with salsa
chickpeas
carrot and chickpea soup
falafel
chocolate cinnamon digestives
chocolate and raspberry layer cake
coconut: lychee and coconut ice
cod in Parma ham
Coeliac disease
complex carbohydrate
constipation
courgettes, minted frittata
couscous salad
crumble, apple and blackberry flapjack
curry, mixed vegetable and cashew laska
dairy products
desserts
diagnosis
diarrhoea
diary, symptoms
diet
balanced
changes
exclusion
food reintroduction
high-fibre 1, 2, 3, 4
low-fibre 1, 2
meal plans 1, 2
milk-free
wheat-free
dietary changes
dietary fibre
digestive enzymes
digestives, chocolate cinnamon
drinks
eating
ethic groups
exclusion diets
exercise 1, 2
falafel
fats
fatty foods 1, 2
fibre
supplements
fizzy drinks
fluid
food allergy
food intolerance
food reintroduction
frittata, minted courgette
fructose
fruit
portions
fruit sugar
gastroenteritis 1, 2
gingerbread, banana and fig
gluten
granola, honeyed
green pea and coriander soup
gut bacteria 1, 2, 3
gut movement, abnormal
hen house pie
high-fibre diets 1, 2, 3, 4
honeyed granola
hypersensitivity
ice-cream, lychee and coconut
insoluble fibre
irritants
kedgeree, mixed fish
lactase
lactose 1, 2
lactose intolerance
lamb
spicy lamb with aubergine
yogurt-marinated roast
laksa, mixed vegetable and cashew
laxatives
light bites
low-fibre diets 1, 2
lychee and coconut ice
main meals
maple-glazed pineapple
meal patterns
meal plans
exclusion diet
milk-free diet
meals
medication
menstrual cycle
meringues, peach melba
milk 1, 2, 3
milk-free diet
milk sugar see lactose
mineral supplements
minted courgette frittata
minty avocado smoothie
mixed fish kedgeree
mixed grain porridge
mixed vegetable and cashew laksa
monosodium glutamate (MSG)
muffins, carrot and cinnamon
non-starch polysaccharide (NSP)
oriental salmon salad
oriental vegetable broth
oven-baked ratatouille
pancakes, american cinnamon
Parma ham, cod in
pasta, penne with roasted tomatoes
pavlovas: brown sugar
pavlovas with berries
peach melba meringues
pears, saffron and ginger poached
peas: green pea and coriander soup
penne with roasted tomatoes
peppered beef
pilaf with mixed roots, bulgar
pineapple
date and sultana bread
maple-glazed
plums: red rice risotto with roasted plums
pork, tamarind roasted
porridge, mixed grain
portion sizes 1, 2, 3
post-infective IBS
potatoes: trout and new potato salad
prebiotics 1, 2
probiotics
protein
quick cheese bread
ratatouille, oven-baked
red rice risotto with roasted plums
resistant starch
rice, special fried
risotto, beetroot and blue cheese
roasted mustard chicken
roasted vegetable wraps
roughage
roulade, cherry and orange
saffron and ginger poached pears
salads
couscous
oriental salmon
trout and new potato
white bean, feta and roasted pepper
salmon
oriental salmon salad
seared salmon with garden greens
seared salmon with garden greens
self-diagnosis 1, 2
slow-cooked chicken
smoothie, minty avocado
soluble fibre
sorbitol
soups
carrot and chickpea
green pea and coriander
 oriental vegetable broth
special fried rice
spicy foods 1, 2
spicy lamb with aubergine
starch
starchy foods
sticky chicken with salsa
stress 1, 2
sugars
summer berry sundae, cheats’
sundae, cheats’ summer berry
sweet potato with cottage cheese and chilli
symptom-linked approach
symptom-linked groups
symptoms 1, 2
diary
tamarind roasted pork
testing
food intolerance
lactose intolerance
thrush
tomatoes, penne with roasted
trout and new potato salad
vasoactive amines
vegetables
portions
vegetarian dishes
vegetarians
vitamin supplements
water
wheat
wheat bran
wheat-free diet
white bean, feta and roasted pepper
wraps, roasted vegetable
yogurt-marinated roast lamb
USEFUL CONTACTS

Britain
IBS Network
Helpline: 0114 272 3253
www.ibsnetwork.org.uk
A national charity, providing the only dedicated support in the UK to
people with IBS, helping them and their families and carers to manage
their IBS and achieve an improved quality of life. For the fact sheet ‘IBS
Information and Advice’ send a SAE to the above address.
Allergy UK
Helpline: 01322 619898
www.allergyuk.org
British Dietetic Association
www.bda.uk.com
Access to an informative fact sheet on a range of diet-related issues
written by registered dieticians on their website.
British Society of Medical and
Dental Hypnosis
Tel: 07000 560 309
www.bsmdh.org
To search for a health professional with expertise in hypnotherapy.
Dieticians Unlimited
www.dieticiansunlimited.co.uk
To search for a dietician with expertise in IBS via their website.
Health Professions Council (HPC)
Tel: 020 7582 0866
www.hpc-uk.org
Check your dietician is registered by logging on to the HPC website.
Australia
Irritable Bowel Information and Support Association of Australia (IBIS
Australia)
Tel: 0061 (0)7 3907 0527
www.ibis-australia.org
Dietitians Association of Australia (DAA)
Tel: 0061 (0)2 6282 9555
www.daa.asn.au
You can find an Accredited Practising Dietician (APD) who has expertise
in treating IBS.
Canada
IBS Association
www.ibsassociation.org
USA
IBS Association (IBSA)
www.ibsassociation.org
IBS Self-help Group (IBS Group)
www.ibsgroup.org
American Dietetic Association
www.eatright.org
Tel: 001 800 877 1600
You can find a registered nutrition professional with expertise in IBS
through this site.

ACKNOWLEDGEMENTS

Tracy Parker would like to thank

Alex Riordan BSc (Hons) RD,
Dr David Preston, Dr Ed Stoner
and Helen Francis for their
helpful comments and advice.

Executive editor: Nicola Hill

Editor: Camilla Davis
Executive art editor:
Darren Southern
Home economist: Sara Lewis
Designer: Colin Goody
Picture research: Jennifer Veall
Picture research: Jennifer Veall
Production: Nigel Reed

PICTURE CREDITS
Special photography:
© Octopus Publishing Group Ltd/William Lingwood

Other photograpy:
Corbis UK Ltd 1. Getty Images/Pierre Bourrier 1. Octopus Publishing
Group Ltd/Frank Adam 1; /Jean Cazals 1; /Stephen Conroy 1, 2, 3,
4, 5; /David Jordan 1; /Sandra Lane 1; /William Lingwood 1, 2, 3, 4,
5; /David Loftus 1; /Neil Mersh 1, 2, 3; /Peter Myers 1; /Lis Parsons 1,
2; /William Reavell 2, 3, 4, 5; /Craig Robertson 1; /Russell Sadur 1;
/Gareth Sambidge 1, 2; /Simon Smith, 1; /Ian Wallace 1, 2, 3, 4.
Photolibrary 1. Photodisc 1.
CAUTIONS
People with known nut allergies should avoid recipes containing nuts or nut derivatives, and
vulnerable people should avoid dishes containing raw or lightly cooked eggs.
If you are avoiding wheat and gluten, double-check the ingredients list on items, such as mustard
and stock cubes, before use. In addition, some brands of cornflour contain wheat flour to keep it
free flowing, so read the ingredients list carefully if you are avoiding gluten.
Many of the recipes can be adapted for either a high-or low-fibre diet by using brown or white rice,
pasta and flour or by using different combinations of vegetables, and recipes can be adapted for
milk-free diets by the inclusion of soya milk and yogurt instead of cows’ milk, yogurt and fromage
frais.
Part of the nutritional information provided is sodium. These amounts only cover added salt when
a specific amount is stated in the recipes.
Nutritional analysis is provided for each recipe and given per serving.
This book is not intended to replace medical care under the direct supervision of a qualified
doctor. Before embarking on any changes in your health regime, consult your doctor. While the
advice and information are believed to be accurate and true at the time of going to press, neither
the author nor the publisher can accept legal responsibility or liability for any errors or omissions
that may have been made.
Ovens should be preheated to the specific temperature. If using a fan-assisted oven, follow the
manufacturer’s instructions for adjusting the time and temperature. Grills should also be
preheated.
Both metric and imperial measurements are given for the recipes. Use one set of measurements
only, not a mixture of both.
An Hachette UK company
www.hachette.co.uk
First published in Great Britain in 2007 by
Hamlyn, a division of Octopus Publishing Group Limited
Endeavour House, 189 Shaftesbury Avenue,
London WC2H 8JY
www.octopusbooks.co.uk
This edition published in 2015
Copyright © Octopus Publishing Group Limited 2007, 2015
All rights reserved. No part of this work may be reproduced or utilized in any form or by any
means, electronic or mechanical, including photocopying, recording or by any information storage
and retrieval system, without the prior written permission of the publisher.
and retrieval system, without the prior written permission of the publisher.
Tracy Parker and Sara Lewis assert the moral right to be identified as the authors of this work.
eISBN 978-0600-63076-0