What do you eat when you can't eat at all?

With food allergies and intolerances on the rise, the biggest challenge for sufferers is dealing with social contexts

Seven-year-old Dennis William Hogfors is allergic to a lot of things: milk, wheat, gluten, egg, nuts. practically everything most of us wouldn't think twice about before popping into our mouths. His mother, Heidi, always has three adrenaline pens at the ready. That's because his allergies are so severe, the reactions are life-threatening. Three epipens give them 45 minutes to get to a hospital in case he accidentally consumes something he's allergic to. And the list of things he needs to stay clear from is enough to make anyone's jaw drop. Bread, pastas, rice, biscuits, chocolates, cakes - they're all out of the question for the Finnish second grader who lives in Dubai with family. Unthinkable? Perhaps. Especially since most of us take great pleasure in our very Caesarian I-came-I-saw-I-conquered approach to food. But for those living with food allergies and intolerances, this is their daily reality. And it's a veritable battle for them to find sustainable ways to eat.
In the UAE, specialists say the number of people asking for food allergy or intolerance tests has seen a definite spike in the last few years. Katharina Elbracht, clinical director at Beyond Nutrition in JLT, notes that Dubai, in particular, seems to be leading this trend in the country. The expert believes the main reason for food intolerances these days is because of the increased consumption of processed foods and ingredients, instead of natural, whole foods. "The body cannot cope with many of the unnatural foods and additives we consume these days, making us susceptible to food intolerances."
Compared to allergies, however, intolerances are far more difficult to diagnose because the onset of symptoms in the latter is delayed. "In a food allergy, the food triggers an immune reaction and the symptoms start immediately after consumption of the allergen," says the dietician. "With an intolerance, however, the food in question could be consumed on one day, but the symptoms - which are less severe and can range from bloating, constipation and skin rashes to anxiety or just feeling unwell in general - might only appear after a couple of hours or days."
In the case of British expat Hywel Ward, it took a week of hospitalisation and five days of various tests for doctors to establish why his second daughter, Evie, who was just a few months old at the time, had started vomiting regularly after meals. Then came the diagnosis of coeliac disease and lactose intolerance. It was one that would drastically alter the lives of the family of five.
Initially, it was just Evie who was put on a special gluten-free diet, but when cross-contamination - such as if Hywel buttered her gluten-free toast with the same knife he used to butter his own (regular) bread - quickly resulted in the same symptoms of vomiting and bloating for her, everyone else decided to overhaul their diets too. The family even shifted emirates, from Ras Al Khaimah to Dubai, because the availability of gluten-free products in the former was so limited. Now, more than two years on, they're learning to bake gluten-free cakes and "finding ways to make food taste nice", but it hasn't been easy.
One of the biggest challenges of trying to maintain a gluten-free diet is the "killer" expenses involved. "Our shopping bill has trebled in some aspects," says the 35-year-old. "A loaf of regular bread, for instance, costs Dh6, but a loaf of gluten-free bread costs Dh30." Those kinds of bills would be understandably difficult to sustain, which is why the family does have regular meals at times too - but they have to be prepared in a part of the house that Evie doesn't go, using totally separate equipment.

IN THE BATTLE TO EAT: Heidi Hogfors with her son Dennis; Hywel Ward with his daughters, Evie (foreground) and Grace; Justine Dampt, founder of Encas; Katharina Elbracht, clinical director at Beyond Nutrition in Dubai
When in public.
But more than the dramatic personal transformation, sufferers of food intolerances usually have an even bigger concern to grapple with: social contexts. Food has long been the great social connector - you eat together with family or colleagues at mealtimes, catch up with friends over coffee or dinner. and if you're throwing a party or wedding, guess what a key talking point will be? Food, of course! But what do you eat when you can't eat anything on the menu at all?
"We've lived abroad for a long time and often dined out as a way to explore different cultures," explains Hywel. "We can't do that anymore. Even though there are more options in Dubai, the level of knowledge in restaurants is not guaranteed. People may say something is gluten-free but may have contaminated the food by using the same utensils they did for other dishes." As a result, spontaneity - unfortunately - is no longer on the menu. If the family ever does eat out now, Hywel says, it would be after a lot of advance planning.
The dad-of-three says they've just started to introduce the word 'gluten-free' to the toddler, so she can ask her nursery teacher if something is safe to eat; Evie also knows not to eat off other people's plates. But he predicts the real struggle will be once she grows up and hits her teens or goes off to college. "At the moment, we're in control, so it's okay. But we do worry about when she's older. The social aspect is going to be very challenging if she can't engage in activities just because of food."
That need to keep social ostracism at bay is something Heidi Hogfors can relate to too. Like Hywel, she too has provided her son Dennis' school teacher with a box of candies for him to choose from, when other kids bring cakes to class for their birthdays. "It's always a bit scary when he goes somewhere without me but, thankfully, he is very careful about what he eats," she says. "He normally doesn't eat things he doesn't recognise. Also, his brother is very protective and always informing people that Dennis can't have anything suspicious!" If they go out to eat, Heidi says she demands access to the kitchen to see how they make his food in order to ensure its quality - and restaurants have, to date, been very accommodating when they understand the seriousness of Dennis's allergies. "As his mother, it's very important to me that he feels like a normal kid - and I'm ready to do anything to ensure that."
Dubai-based entrepreneur Justine Dampt used to find decision-making at the table fairly stressful, when out with friends - but not anymore. She'd recently switched to a "mostly vegan" diet after discovering she was intolerant to refined sugars. Because it's an intolerance that's not too severe - save for the bloating and lethargy - she's able to relax her diet a bit at social events. but not too much, because she knows she'll pay the price afterwards. "Now, if I'm going out, I go prepared by first looking up the restaurant's menu online and selecting what the best compromise will be between a good night out and my diet. Then, when I arrive at the venue, I simply order the pre-decided dish and focus on my friends. That's been a very useful trick for me - because it eliminates the stress of trying to choose between a kale salad and a burger on the spot!"

Call to educate
The UAE actually has an exhaustive list of places that can cater to the needs of those with intolerances (just look up www.fitnessdorks.ae that has put together a most impressive - and exhaustive - list of all such places around the city). Most of the folks we spoke to noted that people are generally very accommodating of their dietary restrictions, save for the odd insensitive comment or two. "Some people think going gluten-free is a fad diet, like a 'flavour of the month'," rues Hywel. "In Evie's case, it's for genuine health reasons, so even though some may think we go over the top with watching out for cross-contamination, we're really just trying to keep her from falling ill. That's just our reality."
For those with dietary restrictions, education is the only way to make their lives easier - because, with it, restaurants will understand that catering to this segment goes beyond offering a couple of items annotated 'GF' on their menus, schools will be more accommodating of kids' allergies at their events, and stores will start offering more products at more affordable prices. The proof of the pudding will be in the eating though, so the day a coeliac doesn't need to think twice about stepping out for a meal at his/her favourite restaurant in town, we'll know we've truly gotten there.

Necessity, that mother of invention
Finding out you have to cut certain foods out of your life for good can be quite overwhelming - and gutting, especially if those foods are your favourite sweet treats. Entrepreneur Justine Dampt suffered numerous recurring health problems before discovering her body was intolerant to refined sugars. Her first alarming thought was that she'd never be able to eat sweets again.
"I'm French, so I grew up eating a lot of white chocolate, crème caramel and chocolate fondant. I used to be able to eat a bottle of Nutella in 20 minutes," she adds, with a laugh. "I thought the diagnosis was the worst thing that could happen to me!" But then the 30-year-old began researching the subject more. After months of working together with a baking consultant, she decided to open her own brand of "natural sweet escapes" called Encas (French for 'snack'), which produces paleo- and vegan-friendly mini bites called 'carrés' (French for 'squares').
Heidi Hogfors tells a similar story of discovering an aptitude for baking - despite never really liking the activity before - and it's all thanks to her son. "A lot of gluten-free products in stores look good but taste like paper. Also, the combination of egg and gluten allergy is very difficult to handle. After seeing my son so often disappointed with the taste of these items, I started baking for him myself. He was so pleased with my attempts that my self-confidence grew and I started experimenting and creating new products. I even entered the Master Baker Dubai 2015 competition with a couple of my gluten-free breads - and won over all the 'normal' products!"
The important thing to remember is to eat in a positive way, says Justine, sagely. "If you love white rice, try to switch to brown. If you love fish, skip the fryer and go with fish fillets. I always encourage people to make a colourful plate too, because your food needs to appeal to the eyes as well as the palate if it's going to motivate you to eat. So, mix up the textures and experiment. There is always a fun alternative to the things you like and can no longer have - you just need to find it!"

Attending a social do? Go prepared
Sufferers of food intolerances should always be prepared before attending a social event. Beyond Nutrition's Katharina Elbracht suggests the following:
- Try to find out what type of food will be served and ask if the host/location can cater to the intolerances.
- If the sufferer is invited to an event where he/she can bring food, I would recommend preparing a big serving of one of his/her favourite dishes that's safe to consume and sharing it with the other guests.
- Else, the safest option is to have a meal at home before heading to the event and to take along some 'emergency' snacks... just in case!
karen@khaleejtimes.com

• Food and Dining