Food Allergy Counseling

Food Allergy Counseling
Sloane Miller, MFA, MSW, LMSW, Psychotherapist; Specialist in Food Allergy Management, Speaking At Mylan Specialty / EpiPen Event (© Noel Malcolm 2013)

Monday, April 26, 2010

Another Trust Post


Trust is earned over time, that’s one. Two, sometimes you have a gut feeling that something isn’t right. Three, without trust and with a gut feeling of doom, dining outside of your safe zone with food allergies can all break down into a puddle of anxiety, fear, distrust and non-socialized eating.

That was me this weekend.

I went on a meditation retreat in the Catskills Mountains. My dear friend Kate (and wonderful artist, here’s her site ) attends weekly meditation with Banyan Education. She’s told me about it for years and I hadn’t ever gone. I have an occasional meditation practice at home; through a steady practice of yoga, I have seen meditation come into play in surprising ways (like during a MRI). So when Kate told me about this retreat I said, “Yes,” not knowing anything about it.

Pre-trip, I did my usual travel steps:

-Worked with the program administrator to talk with retreat chef,

-Emailed a detailed food allergy and food intolerance list,

-Emailed meal suggestions with what would probably be easiest for kitchen (steamed rice, steamed veggies, plain cooked beans),

-Brought non-perishable food and perishables, like fruit,

-Brought multiple medications - all up to date, and

-Checked on Google Maps for the nearest hospital.

And there was the rub.

The local hospital is about thirty minutes away. This gave me pause. Growing up across the street from a world renowned teaching hospital and emergency room (one that I visited often as a child) being thirty minutes away from help made me anxious. As I drove drive deeper and deeper into the mountains and away from civilization (I’m such a city-girl) my anxiety increased ten-fold.

When I checked in early, I headed straight into the kitchen to talk with the cooks at Menla. They couldn’t have been sweeter, and my emailed food allergy list was posted on their bulletin board – great. My system totally worked, natch – it’s a very solid system.


I didn’t trust them. They seemed lovely, professional and said they deal with special requests all of the time. They said, “Just tell us what you want and we’ll make it.” They were totally transparent about what the ingredients they use, cooking methods, where they keep their tree nuts (it’s vegetarian, so no fish at all). Again, the steps totally had set up a great trusting environment. They were so thankful that I had told them my food allergic needs ahead of time so they could prepare.


Here we were in the mountains thirty minutes away from the nearest hospital and I just didn’t feel safe enough. So I ate the food that I brought. In my room, alone. I felt like a goofball, I felt separated from the group and I felt like it wasn’t my finest food allergic girl and coach hour. However, without doing those steps, without recognizing that I wasn’t feeling the trust and if I had tried to eat food that was making me nervous, I would have been in a different quandary (or just left the retreat altogether). I forgave myself. I stayed ("I'm Still Here" by Sondheim was my theme song: ), I ate my safe food thus allowing me to engage other aspects of the meditation retreat.

I wanted to tell all of you about this – this version of punking out and self-forgiveness. I'm not exactly clear why. Maybe it's because I have a hunch that some of you reading this blog think I don’t run into food allergy trouble. (Ahem, of course, I do like here.) Maybe it's because like many of you, I have a lifetime of not trusting others to help with my food allergies and a lifetime of getting burned when I did. Or maybe, you're the parent working hard to trust those around you for your allergic child and are coming up short.

Now, my trajectory now is to say, Yes" as often as possible. Now, I set up an environment where trust can be formed or created or earned and I step into it (posts about about how I do that are on the right, just scroll down). When in that environment, after doing the steps, I make a determination. Nine times out of 10, I go for it and am richly rewarded. And then there's something like this: setting up an environment and not being able to step into it.

I'm here to tell you (and myself) that that is OK too.

Sunday, April 25, 2010

Weekend Retreat

I'm posting these pictures still in a blissful state from a weekend away from technology, in the mountains of the Catskills at Menla Mountain retreat. (I was sleeping in the room that his Holiness the Dalai Lama has often used, so I was told.) I went with a group called Banyan Education that my dear friend Kate regularly meditates with. Maybe, more on that later. Now, I wanted to share some pictures from Saturday as I took a walk around the property and found peace.

Thursday, April 22, 2010

Kikoman Soy Sauce

Was it the soy?

Was it the wheat?

It was a two day stomach issue (blech) regardless.

Need to do more research on the separate components. For now though, really no soy sauce. That one doesn't get crossed off the food challenge list.

Monday, April 19, 2010

Jared Koch, Clean Plates NYC

A few weeks back, I saw Jared Koch, author of CleanPlatesNYC, read at the inaugural Enlightened Eaters series at The James Beard House. (PS: This new series is going to be very cool, “...featuring readings, workshops and other programs focusing on health, nutrition, sustainability, and environmental issues.” Can’t wait to see more.) After the event, I had a chance to correspond with Jared about his first year, what’s he’s learned and what’s coming up for CleanPlatesNYC (Here's my review of the book from last year).


Allergic Girl: What’s one thing you’ve learned through publishing CleanPlatesNYC?

Jared Koch: I learned a lot throughout the whole process and continue to learn. One thing that stands out is the diversity of people that are interested in and concerned about the health and sustainability of the food they are eating.

AG: What’s one restaurant that didn’t make the book during the first go around but might make it now and why?

JK: We are in the process of working on the next edition and one restaurant we are reconsidering for the featured list is Jane. Their sourcing has improved and I have eaten there a few times over the past several months and it is consistently very good.

AG: Where have you been dining lately?

JK: I really like variety and my schedule is really varied so I find myself all over the city. I try and eat at a lot of the places in CleanPlatesNYC. That being said, lately I have been enjoying Peacefood Cafe (a fairly new UWS vegan spot), Counter (new chef and menu), and Northern Spy (a new spot we just reviewed and it should be going up on our online database soon).

AG: What changes are you seeing in the restaurant industry that affect your listings?

JK: I have been very pleased that more and more restaurants are concerned about the quality of animal foods they are sourcing and more are at least taking steps to source better animal foods free of hormones and antibiotics and preferably grass-fed etc. There is definitely a growing demand for it.

AG: What's one change can we expect from CleanPlatesNYC in year two?

JK: I think you can definitely expect a much greater web presence and more timely and informative data to make it easier to find what you are looking for when dining out. And a lot more!


Thanks Jared. Check out CleanPlatesNYC for more.

Tuesday, April 13, 2010

FDA, Survey, Gluten-Free Food Labels

The U.S. Food and Drug Administration (FDA) is seeking adults diagnosed with celiac disease or gluten-intolerance or caregivers to such individuals to participate in a research study on their grocery shopping habits. Participants will be asked to take an Internet survey, which will take approximately 10 minutes to complete.

The survey is available at: and will be valid until APRIL 30th, 2010.

Monday, April 12, 2010

Allergy-Free Desserts, Elizabeth Gordon

A few weeks back, Publishers John Wiley & sons sent me a copy of Elizabeth Gordon’s Allergy-free Desserts to peruse. Gordon, a sister social worker, came on the food allergy food scene with Betsy & Claude, an online bakery that is now "...available for wedding cakes and special events. Prices available upon request". Her book is beautifully produced, easy to read with enticing pictures. I can be a sucker for a coffee table baking cookbook: it all looks scrumptious.

However, before I could dive in and bake there were two glaring issues that stopped this newbie allergen-baker in her tracks. Gordon's recipes rely on Lyle’s Golden Syrup. Huh? Lyle’s Golden Syrup, a lovely product I used when I lived in England but even then sparingly, is pure cane sugar syrup. OK. But buying it here in the US means buying an imported product i.e. increasing the cost for allergen-free goodies which are already costly. I don't love (nor understand) that choice for many of these recipes.

Additionally, Gordon relies upon Bob’s Red Mill gluten-free flour mixes for her cookie recipes. Bob’s Red Mill, although, a lovely product as well, may not be appropriate for every allergen-free baker and eater (as of now, as far as I know, Bob’s Red Mill still processes tree nuts in their gluten-free facility-I've spoken with them directly). Gordon assumes you have alternative or personal gluten-free, allergen-free mixes with which to make the cookie recipes. (I don't.) Later in the book, for cakes only, she gives two basic flour mix recipes, which begs the question: why not do that for all recipes?

A third issue (more on my end probably) is that my I need an allergen-free baking book that offers a list of suppliers, resources and substitutions for ingredients. I think Gordon's book assumes that we have all of those things in place. Because I don't, and couldn't proceed to test any recipe without some substitutions, I emailed Gordon, who kindly sent me the following ideas. NB: Gordon's recipes were not tested with these substitutes. Bake at your own risk.

Readers could try any manufactured gluten-free blend that DOES NOT contain a leavening agent. There are several on the market-- usually people have their favorites.

I have used corn syrup in place of Lyle's (not the healthiest, but it is cheaper and it keeps the recipes very white). One reader just wrote that she used agave in the peppermint patties and they turned out very well. I have not tested the recipes with the agave, but I always encourage readers to try it out and let me know how it goes.

I love to use Better Than Milk powdered, vanilla rice milk instead of prepared rice milk. It saves money since it's shelf stable even after being opened, and I love the flavor.

I just found that Sunspire is now making a "bittersweet" chocolate chip that people could use instead of the Enjoy Life brand or kosher chocolate chips. They will be very intensely, dark chocolate, but I see this brand in the stores more often than the others.


There are peppermint patties on the back cover that require no baking and no flour mix of any kind. To test drive the book, I made a version of her version, substituting light organic agave for Lyle’s golden syrup. Here’s a copy of the recipe and a picture courtesy of Wiley Publishing:


Makes about 3 dozen patties

1 pound confectioners’ sugar, sifted
5 tablespoons organic palm fruit oil shortening
21⁄2 teaspoons peppermint extract
1⁄2 teaspoon vanilla extract
6 tablespoons Lyle’s Golden Syrup (I USED LIGHT AGAVE)
12 ounces gluten-, soy-, dairy-,egg-, and nut-free semisweet chocolate chips

In a large bowl, combine the sugar, 3 tablespoons of the shortening, and the peppermint and vanilla extracts. Add the Lyle’s Golden Syrup and mix thoroughly with a large spoon.

With a very small ice cream scoop or tablespoon measure, scoop out the dough and roll it into balls. Place on a wax paper–lined baking sheet and chill for 30 minutes. Remove from the refrigerator and press the balls with the bottom of a glass to form 1⁄4-inch-thick patties. Return the patties to the baking sheet and chill for another 30 minutes.

After the patties have chilled, combine the chocolate and the remaining 2 tablespoons of shortening in the top of a double boiler set over simmering water. Stir until the chocolate is completely melted. Allow the chocolate mixture to cool for 10 minutes. Dip the patties in the chocolate mixture so they are completely coated, then place the patties on wax paper–lined baking sheets. Place the baking sheets in the refrigerator and let the peppermint patties dry for at least an hour before serving.

Store the completely dried patties, covered and refrigerated, for up to 1 week.


They came out pretty darn fabulous, as in "please stop me from eating 12 in one sitting" good. The recipe is a fun easy project for kids on a rainy day (or an adult during a rainy Erev Passover). A non-food-allergic eater test tested them for me and proclaimed them, “Yummy”. I served them at a party to a roomful of non-allergic omnivores who were impressed that I made "Peppermint Patties". Eyes-rolled in happiness as they enjoyed a second and third. What is it that Michael Pollan says? You can eat junk food if you make it yourself. That's what this recipe is: candy (not so junky) you make yourself.

Gordon's Peppermint Patties have entered my canon of recipes.


Upshot: unlike other baking books that are for the newbie allergen baker, Allergy-Free Desserts seems like a baking book for a more experienced allergen-free baker, one who has their favorite suppliers and whose shelves are stocked with specialty flours, sugars, syrups, gums and chocolates ready to go. I'm not that baker, yet: I'm a newbie who needs resources, suppliers and substitutions.

What is most thrilling is that the trade marketplace is meeting our allergen-free cooking and baking needs with beautifully published tomes for all baking and cooking levels. Allergy-Free Desserts happily joins the bookshelves.

Thursday, April 08, 2010

Lactaid Milk, Organic

Was someone listening to (or rather, reading) my requests for organic, lactose-free 2% milk?

I found one carton of Organic Lactaid 2% milk the other day at my local supermarket. Just one. (Had they already sold out their stock?) So I grabbed it. Lactose-free and organic. Woo hoo!

Keep going Hood, make more organic lactose-free dairy stuff!

Tuesday, April 06, 2010

The Conscious Cook, Tal Ronnen

In one of those funny zeitgeist-y coincidences, the same week Tal Ronnen was on Oprah to talk about his new vegan cookbook, The Conscious Cook, friend and colleague Fran Costigan emailed me to tell me that I absolutely had to check out this guy and his book. Yup, Tal Ronnen.

The publisher sent me a copy of this coffee table cookbook and it’s been sitting on my review pile for far too long. It’s well-laid out without being too fussy or text heavy; there’s a brain behind the food; yes, the recipes have steps and different ingredients but this isn’t your mother’s Moosewood and it’s full of great ideas to up the ante on your vegan lifestyle.

Not a vegan? That’s cool. I sense that Ronnen wants to hit everyone (meat eaters, vegetarians and vegans alike) with his clever chefy suggestions, interviews with chefs and suppliers and luscious pictures of ingredients. He’s a true flexitarian without ever saying the word. It’s how I eat and the lifestyle that suits me at this point in my life and so I definitely gravitated toward his philosophy.

The first recipe that struck me was in apps. Every now and then I’ll make avocado sushi rolls at home: nori seaweed, white rice, avocado, cucumber, sesame seeds and umeboshi paste. During college, my best friend Vivi (still my BFF) taught me how to hand roll the nori (it’s always looked so complicated) and I’ve been making them ever since. This Maki roll of Ronnen’s uses quinoa instead of rice. Duh, why didn’t I think of that? Turns a avocado roll into a power house of vegan protein. Here's a picture (copyright Linda Long) and the recipe (courtesy of William Morrow Publishers).



If there's any downside of The Conscious Cook for the food allergic community it's two ingredients. Ronnen relies upon cashew cream in many recipes (raw cashews pulsed into a paste that substitutes for cream and cheese etc.) and a faux-meat product Gardein, a mix of soy, wheat and pea proteins. That may knock out many of you – it did me as I’m tree nut allergic and wheat and soy intolerant. However, I still found much that was interesting and useful in The Conscious Cook to play with, new ways of using ingredients or new views of old standbys. If you’re dairy free and have no nut allergies you might love this tome. If you’re a meat eater, have no wheat/soy protein issues, and thinking about going vegan, you may want to check The Conscious Cook out. Or if you’re like me, you may still find much that’s useful here to incorporate into your diet: more veggies, more grains, more legumes. Keep in mind: there’s always room to add more, even for someone with a restricted diet.

Monday, April 05, 2010

Smart Silk

I’m not a huge believer in barrier bedding.

According to a recent New York Times article on environmental allergies: “Several studies show that there are no significant improvements from using mattress and pillow encasements and other allergy-fighting products. The best thing to do is to take the necessary steps to remove allergens like the ones discussed above.” I wish the New York Times quoted which studies, but generally speaking, I agree. At home, I’m not allergic to my own bedding, pillows nor mattress. I have wood floors that are cleaned weekly, and bedding washed weekly in hot water with a low-to-no fragrance detergent. Traveling is when I need allergen-free bedding. Traveling, at least for me, can be my worst allergy enemy. Dusty, musty, moldy rooms and bedding can equal not only a sneeze and wheeze fest but a horrible night’s sleep. That's when I need a barrier.

Asthma & Allergy Friendly’s partner, Smart Silk sent me some barrier bedding to try at home: pillow encasements, mattress encasement and a duvet (comforter).

The Smart Silk duvet is lightweight and thin, it has the crunchy feather sound (it's silk, not feather) while being cozy and very warm. I’ve been told by the Smart Silk guys that during the summer, the silk will keep me equally cool because it wicks moisture away. Look forward to seeing that. However, the best part is that the Smart Silk duvet is a luxurious feeling product that is also allergen-friendly. I’ve been using this duvet since the fall and I love it.

Have I noticed any allergy difference or decrease? Nope. I didn't expect to for the above reasons i.e. I keep a *really* environmental allergen-free home space.

What I'd need, I told Smart Silk , is Asthma & Allergy Friendly and certified travel bedding. "We have that in development," they said. Oh yes! Here are the details about their travel product. Given how often I'm allergic/asthmatic mess when I travel, I'd appreciate a travel bedding solution that was compact and easy to tote.

From Smart Silk: “The pack contains a duvet as well as a mattress pad which is a scaled down version of our current mattress protector. The case for the travel pack acts as a pillow protector which will hold regular hotel pillows. We will be running the travel pack in 2 sizes. The twin / double pack will retail for $174.99. The queen / king pack will retail for $199.99." The Smart Silk travel product will be available and on the website by end of May, perfect for spring/summer allergies and traveling.

Overall, as an allergy-free duvet (as any duvet, really), I love the Smart Silk product. It’s warm and light, has no odor (sometimes silk or poly-blends can outgas) and it's certified Asthma & Allergy Friendly (meaning that it's guaranteed to be less allergenic). I was so thrilled with the sample that I donated my old duvet.

I'm curious, allergy peeps, where do you find allergen bedding most helpful or where would you use it most?

Thursday, April 01, 2010

Spoon Fed, Kim Severson


At the suggestion, rather the model of, colleague Terri (who ran the International Foodservice & Restaurant Show), I've been working my way through some food-related memoirs. (But I put down Judith Jones’ Tenth Muse after the shellfish thing . Unreliable narrator, and all.)

Spoon Fed by New York Times food writer, Kim Severson is a memoir, yes, but instead of a chronological, “This is how I become me” book, it cleverly tropes around eight women that have shaped Severson as a writer, food lover, mother, professional and woman. The structure helped to make Spoon Fed a brisk read - I finished it over the first day of Passover.

When I look back at the lessons that I underlined (in pencil), there’s a recurring theme: to push through. Even when you doubt, even when you see no hope, even when you feel you simply can’t: push through. The book could have been called: Perseverance. Or even, Tenacity.

Here are some lessons learned:

“Giving someone a taste of something delicious at exactly the right moment is a fail-safe way to start a good relationship.”

“Know matter where you find yourself in life, no matter how badly you stumble, you can start over.”

“And over the years, [Alice Waters] has come to show me that an unwavering hand on the rudder, coupled with patience, can change things. No matter what anyone says.”

“At the end of the day, I’m a tough kid. Scared out of my mind but tenacious.”

Severson writes about, but doesn’t delve into: coming out (she’s gay, married and they have a small child) and past substance abuse. There’s no wallowing here, nor is this a book about becoming clean and sober, hardly. It’s about food. Our connection to food, her connection to food - how food is a connection to, well, everything.

I couldn’t help but think of many members of the food allergic community who may feel disconnected to food because of adverse or life-threatening reactions. As a food allergy coach, I encourage clients to read self-help books (if that's their interest). However, "self-help" titles aren’t always in the personal growth aisle. I believe many of you would enjoy Spoon Fed by Kim Severson: the stories about perseverance, about family, about food memories are universal, yes, even (if not especially) to us.