1. You are here:
  2. Home
  3. Resource library
  4. Four food elimination diet (FFED) for eosinophilic oesophagitis

Four food elimination diet (FFED) for eosinophilic oesophagitis

27 January 2026

Download the PDF version here.

In this resource:

What is eosinophilic oesophagitis (EoE)?

EoE is a condition seen in children and adults in which the oesophagus (food pipe or gullet) has become inflamed, resulting in a range of symptoms. Symptoms may include:

  • Feeding difficulties in children
  • Faltering growth in children or weight loss in adults
  • Vomiting
  • Abdominal discomfort
  • Difficulty swallowing
  • Food getting stuck (‘food impaction’) in older children and adults
  • Heartburn and pain
  • Strictures or narrowing of the oesophagus.

This condition can only be diagnosed by taking a biopsy (sample of tissue) of the oesophagus during an endoscopy (a flexible tube which is passed down the throat). The tissue samples are then studied for the number of eosinophils (specific cells involved in inflammation), which your doctor or dietitian will refer to as your ‘eosinophil count’.

To diagnose EoE, the number of eosinophils needs to be more than 15 in a high-power field under the microscope (or more than 15 in 0.3 mm²).

Other eosinophilic disorders

Some people have higher than normal eosinophils in the stomach (eosinophilic gastritis EG), small intestine (eosinophilic duodenitis, eosinophilic enteritis) and large intestine/colon (eosinophilic colitis EC). These eosinophilic disorders are not as well studied as EoE, but there is consensus in paediatrics on cut-offs for eosinophils in conjunction with a clinical history.

Dietary management for non-EoE eosinophilic gastrointestinal disorders is not as well established, but there is consensus that for children, an elimination diet is worth trialling. This diet sheet may therefore be used with help form a dietitian for those conditions in children.

What is the link with diet and EoE?

Although the process is not yet well understood, food allergens such as cow’s milk, egg, wheat and soya may be involved in the development and worsening of the symptoms of this condition.

EoE is classified as a ‘non-IgE-mediated allergy’ so allergy tests (skin prick tests and specific IgE blood tests) are not able to identify the foods (allergens) causing the EoE. However, your doctor may still wish to carry out some of these tests, as they can help to find out whether these or other foods or pollen are related to symptoms and how foods should be retried after they have been avoided.

The best way to identify the allergens causing EoE is to take them out of the diet and monitor for improvement in eosinophil count. Your doctor may repeat the endoscopy to count the eosinophils again after the foods have been avoided. Eliminating foods one at a time does not always work, as it is hard to identify the correct food and there may also be more than one offending allergen. It can take up to 8 to 12 weeks to notice a change in eosinophil count. There may not be a change in symptoms. Also, symptoms do not always reflect what is happening in the oesophagus, so even if symptoms improve, there could still be active disease. Your doctor may therefore want to assess this with regular endoscopies.

One of the recommended treatments for EoE is a six-food elimination diet (SFED). Because this can be hard to follow and not all six foods may be triggers for you, your dietitian may suggest other options. These could include avoiding just cow’s milk, or trying a two-food elimination diet (TFED) or four-food elimination diet (FFED). The choice will depend on your medical history and what you feel able to manage.

Any exclusion diet for EoE should be followed under the supervision of a dietitian usually for 8–12 weeks. After the 8–12 weeks, a repeat endoscopy may be completed to understand if the eosinophil count has improved (<15 hpf). Following this, your dietitian will tailor the order and timing of food reintroductions to suit your individual dietary needs. Only one food should be reintroduced at a time and a repeat endoscopy may be performed after this food has been back in the diet for 8–12 weeks.

You should continue to take all medication unless advised to stop taking it by your allergist or gastroenterologist.

Although the role of diet is much less clear in people with EG, EGE or EC (see definitions on previous page), your doctor may also recommend trialling a four-food elimination diet for these conditions.

The following websites provide further information on EoE.

The four food groups to be excluded

 

Those are:

  • Cow’s milk and cow’s milk products
  • Wheat – Note: a full gluten-free diet, avoiding rye, barley and oats in addition to wheat may also be recommended. Your Dietitian will advise whether this is necessary.
  • Egg
  • Soya – such as hydrolysed vegetable protein, tempeh, tofu, miso, edamame beans – but soy lecithin and refined soya bean oil do not need to be avoided

Important:

Even if a food is listed as safe in this diet sheet, it is still very important to read labels, as ingredients can change.

If there are foods listed in the allowed columns of this diet sheet that have caused you immediate reactions in the past, continue to avoid them and report these to your Dietitian at your next review.

You will need to follow the diet for as many weeks as your dietitian recommends and then follow a structured reintroduction process (to be agreed with your dietitian).

Tips to avoid foods getting stuck

  • Eat slowly in a calm environment
  • Avoid eating standing up
  • Chew food well
  • Drink plenty of liquids with meals
  • Choose softer or liquid-based foods (e.g. soups, stews)
  • Avoid or take extra care with any foods you find difficult to swallow (common examples: steak, dry chicken/turkey, thick chips, bread, rice).
  • You may find having a written food obstruction action plan helpful. See link below to the Eosnetwork plan: https://www.eosnetwork.org/food-obstruction-patient-action-plan

Food labelling

UK food allergen labelling law requires that common food allergens used as ingredients or processing aids must be declared on the packaging or at the point of sale. The list of 14 common food allergens includes milk, egg, wheat, soya, fish, shellfish, peanuts and tree nuts. 

These laws apply to all packaged and manufactured foods and drinks sold throughout the UK. They also apply to foods sold loose (e.g. from a bakery, delicatessen, butcher or café) and foods packed or pre-packed for direct sale (e.g. café, sandwich bar, food outlets, market stall, some catering products). If you travel outside the UK, be aware that labelling laws are different so check ingredients carefully.

For pre-packed products (e.g. made in a factory), allergens must be listed in one place on the product label (in the ingredients list) and highlighted (e.g. in bold or underlined). 

As of autumn 2021, Natasha’s Law came into effect. This states that foods which are pre-packed on the same site where they are sold (pre-packed for direct sale) such as in a café, sandwich shop, deli or food outlet preparing food in their own kitchen must display the full list of ingredients.

Foods sold without packaging such as in a bakery, café or pub: allergen information has to be provided either in writing or verbally. If provided verbally, the business must be able to provide further written information if requested (in the UK only).

Carefully check the ingredients list on food items. By law, you must be able to clearly tell that a product contains these ingredients e.g. if casein is listed, it should tell you in brackets that this is ‘from milk’.

Example of food label containing cow’s milk, egg, wheat and soya below:

Chocolate sponge cake:

Ingredients:

Wheat Flour, Sugar, Buttercream (17%), Pasteurised Whole Egg, Water, Rapeseed Oil, Humectant (Glycerol), Milk Proteins, Soya Flour, Raising Agents (Disodium Diphosphate, Sodium Bicarbonate), Emulsifiers (Mono- and Di-Glycerides of Fatty Acids, Polyglycerol Esters of Fatty Acids), Buttercream contains: Sugar, Unsalted Butter (Milk), Glucose Syrup, Water, Invert Sugar Syrup, Maize Starch, Preservative (Potassium Sorbate), Dried Egg White.

Allergy Advice
For allergens, see ingredients in bold

The four food elimination diet: what should I avoid?

General recommendations

You will need to avoid foods and ingredients which contain milk, egg, wheat and soya. Detailed information for each of those foods is listed on the tables below.

Always check the food labels: manufacturers change their ingredients from time to time e.g. ‘new improved recipe’. It is always safer to check the ingredients list every time.

May contain…’ or ’Made in a factory…’ labelling statements:
These warnings are used by food manufacturers to highlight a possible risk of an otherwise milk/egg/wheat/soya/fish/shellfish/peanut and tree nut-free product being accidentally contaminated by these ingredients during manufacturing, including on vegan products.

You do not need to avoid foods with ‘may contain’ labelling unless advised by your Dietitian.

Milk ingredients

  • Buttermilk
  • Cow’s milk (fresh, UHT)
  • Condensed Milk
  • Cream/artificial cream
  • Evaporated milk
  • Butter, butter oil
  • Ghee
  • Margarine
  • Cheese
  • Fromage Frais
  • Ice Cream
  • Yoghurt
  • Casein (curds), caseinates
  • Calcium or sodium caseinate
  • Hydrolysed casein
  • Hydrolysed whey protein
  • Lactoglobulin
  • Lactoalbumin
  • Lactose*
  • Milk powder, skimmed milk powder
  • Milk protein
  • Milk sugar
  • Milk solids, non-fat milk solids
  • Modified milk
  • Whey, whey solids, hydrolysed whey
  • Whey protein, whey syrup sweetener

*Lactose: discuss with your dietitian to what extent you will need to avoid lactose. 

Note: Milk-free foods may also be referred to as being ‘dairy free’.

Egg ingredients

  • Egg (all bird eggs)
  • Dried egg
  • Whole egg
  • Egg powder
  • Egg white
  • Egg yolk
  • Egg protein
  • Egg albumin
  • Lecithin or E322 (may be derived from egg or soya)
  • Frozen egg
  • Pasteurised egg
  • Ovalbumin
  • Globulin
  • Ovoglobulin
  • Livetin
  • Ovomucin
  • Vitellin/Ovovitellin
  • Lysozyme or E1105 (may be derived from egg or soya)

Wheat ingredients

  • Batter
  • Breadcrumbs
  • Bulgar Wheat
  • Codex/gluten-free wheat starch
  • Couscous
  • Durum wheat
  • Einkorn
  • Emmer
  • Freekeh
  • Hydrolysed wheat protein
  • Kamut
  • Malt
  • Modified wheat starch
  • Raising agent e.g. baking powders
  • Rusk
  • Semolina
  • Triticale
  • Wheat bran
  • Wheat flour
  • Wheat germ
  • Whole wheat

Ingredients to check with your dietitian: wheat, barley, rye and oats

Wheat*

  • Gluten free/Codex wheat starch 
  • Wheat germ oil

Barley

  • Pearl barley
  • Robinson’s barley water
  • Barley Malt supermarket brand cereal
  • Barley Malt Kellogg’s

Rye

  • Rye flour, rye bread, rye crisp bread
  • Any rye product

Oats

  • Ready-made oat cereals, porridge oats, granola, baby cereal, Oatibix™
  • Oatcake cakes and biscuits e.g. flapjacks, oat-based cereal bars
  • Oat milk, oat cream

*Wheat in medication and supplements: always check labels, including prescribed medication as they may contain wheat – discuss with your doctor or pharmacist.

Soya ingredients

  • Soy/soya
  • Soya bean
  • Soya albumin
  • Soya milk
  • Soya flour
  • Soya protein isolate
  • Soya protein products
  • Textured vegetable protein
  • Hydrolysed vegetable protein
  • Soya oil**
  • Lecithin*** (soya) E322
  • Tempeh
  • Tofu
  • Edamame beans
  • Soya shortening
  • Soya flavouring
  • Soya sauce
  • Miso
  • Soya nuts
  • Soya margarine
  • Soya bean sprouts
  • Soya beans

** Refined soya oil has had the protein removed, which is the part that causes allergic reactions so does not need to be avoided. Unrefined soya oil (sometimes referred to as soya bean oil) may contain small amounts of soya protein so should be avoided.

*** Soya lecithin is an emulsifier which may only contain traces of soya so does not need to be avoided.

Examples of foods to include and exclude

The following gives examples of foods to avoid and foods which will be suitable. Please note this is not an exhaustive list.

  • Always check food labels, as ingredients in the products may change.
  • Always consider appropriate textures e.g. raw fruits, vegetables, whole seeds, dried or hard fruits, popcorn could be a choking hazard for some.

Foods Allowed

Foods to check

Foods to avoid

Cereals, grains/flours

Amaranth seed/flour/flakes, banana flour, bean flours,buckwheat flour, grain/flake (also called sarrasin flour), carob flour, chestnut flour, coconut flour/ desiccated coconut, fava/broad bean flour, flaxseed flour, fufu flour, gram/chickpea/garbanzo flour, hemp flour,lentil, urid/urd/urad flour, maize/corn flour/corn meal, polenta, millet flour, grain/flakes, mustard/seed, powder, plantain flour, potato flour, starch, gluten-free oats, quinoa flour/grain/flakes, rice flour/flakes/ground, sago, sesame flour, sorghum flour, sweet potato flour, tapioca flour/grain, teff, yam flour, pre-blended flours containing above e.g. Doves FarmTM, OrgranTM.

Baking powder, modified or hydrolysed starch, binders, thickeners, edible starch, cereal proteins.

 

 

Wheat (bulgur, durum, farina, Graham flour, Kamut, matzah, seitan, spelt, sprouted wheat, triticale, wheat berries, wheat germ oil), farro grain, hydrolysed wheat protein, wheat malt, couscous, semolina.

 

Barley, Rye

Your Dietitian will advise whether you need to avoid barley and rye as well as wheat.

  

If advised to avoid:

Barley

Rye, rye breads

Barley based breakfast cereals

Breakfast cereals containing barley malt

Fruit/barley squashes

MarmiteTM (as it contains barley)

Vitamin supplements containing barley malt extract.

Breads / Bread products

Breads and bread mixes made from permitted ingredients (check for egg/soya/dairy/nuts in wheat-free products) e.g. BarkatTM, B freeTM, BionaTM, Just Gluten FreeTM, ProceliTM

Some supermarket own brands.

Tip: use egg replacer to make up bread mixes where required.

Crackers/Crispbreads

Rice cakes, corn cakes, gluten-free crispbreads/crackers e.g. AmisaTM, OrgranTM, ScharTM supermarket own brands.

Certain brands of gluten-free oatcakes e.g. NairnsTM (except cheesy flavour), Rude HealthTM (except spelt variety).

Pastries

Jus Roll gluten-free puff pastryTM Some supermarket own brand mixes e.g. Asda, Morrisons

See recipes.

  

Breads / Bread products

Wheat breads (e.g. white, wholemeal, granary, ciabatta, focaccia, French, soda, sourdough, spelt bread), brioche, chapattis, croissants, crumpets, English muffins, naan, pitta, tortillas, wraps.

Wheat/gluten-free breads that also contain egg/soya/nuts/milk

Crackers/Crispbreads

Communion wafers

Cream crackers,

Bread sticks,

Crispbreads

Pastries

Pies, quiche, pasties, sausage rolls.

Breakfast Cereals

Breakfast cereals made from rice, corn/maize, gluten-free oats, buckwheat, millet, quinoa, sorghum

Gluten-free oats and products e.g. AmisaTM,  NairnsTM, OrgranTM, PerkierTM, supermarket own brands.

  

Wheat-based cereal wheat bran/germ

If advised to avoid:

Non-gluten-free oats, instant oat cereals (e.g. Ready BrekTM), baby cereals

Rusks or other baby biscuits/snacks

OatibixTM.

Pasta, pizza, noodles, rice, potato

Buckwheat, amaranth, corn, pea or rice noodles/pasta, polenta e.g.
Amisa TM, BarkatTM, Doves FarmTM, OrgranTM, OrgranTM Gluten-free tinned spaghetti.

Supermarket own brands

Pizza bases and mixes: BFreeTM, Doves FarmTM, ScharTM, Venice BakeryTM, supermarket own brands

Some ready to cook noodle pots or stir-fry packet noodles made with rice or buckwheat

Potato products e.g.
Albert Bartlett Rooster Fries, Aunt Bessie’sTM Crinkle cut and homestyle chipsTM, Bird’s EyeTM potato waffles, McCainTM Naked oven chips, McCain SmilesTM, some supermarket own brand waffles and chips,

Leon Waffle FriesTM (contain gluten-free oat flour).

Savoury rice

Ready– made rice dishes

Pasta/Noodles made from wheat/egg: Dried or fresh wheat pasta, tinned spaghetti in tomato sauce, ready-made pasta meals

Pizzas, pizza bases, dough balls

Dried, fresh, processed egg noodles e.g. Pot noodlesTM, super noodles, udon, ramen, chow mein

Potato products: potato salad, potato products containing wheat: waffles, croquettes.

Potato products: e.g. frozen potato wedges/chips/processed shapes

Instant mashed potato

Dairy alternatives

Milk alternatives made from:

Coconut: e.g. AlproTM, KokoTM

Nut: e.g. Almond, Hazelnut, Cashew: e.g. AlproTM, KokoTM, CalifiaTM, Supermarket own brands

Pea: e.g. Mighty PeaTM, QwrkeeTM, SproudTM

Rice: (not for children under 4½ years) e.g. Rice DreamTM

Potato: e.g. DugTM

Gluten-Free Oat milk: e.g. Califia Farms OatTM, Oat Dream TM, Glebe Farm TM, Plenish Enriched TM

Try to choose calcium fortified

Yoghurt/dessert alternatives made from:

Coconut: e.g. Coconut CollaborativeTM, CoyoTM, Gu Free From Chocolate MousseTM, KokoTM, Little BanditsTM, Oykos dairy-free yoghurtTM, Tesco Free From CheesecakesTM

Nut: NushTM, Petits Filous Dairy freeTM

Cheese alternatives made from:

Coconut: e.g. Applewood VeganTM, Follow your heartTM, KokoTM ViolifeTM, VitaliteTM

Pea: e.g. CheezlyTM soya free

Rice: e.g. MozzarisellaTM

Nut: e.g. VegustoTM

Cream alternatives made from:

Rice: e.g. Rice Dream CuisineTM, Soyatoo Rice WhipTM

Coconut: Coconut cream, Coconut CollaborativeTM

Palm: Food HeavenTM.

Non gluten-free oat milks: Check with your Dietitian if suitable:

e.g. Oatly TM, Alpro TM, supermarket own brands

Coconut milk (check for soya/nuts) e.g. Alpro professional coconut milkTM, AlproTM coconut & almond milk, Califia FarmsTM coconut & almond

Oat yoghurts and desserts: OatgurtTM, Oatly Vanilla custardTM, Blancmange powders

Coconut desserts (check for soya)

Oat: e.g. Oatly Creamy OatTM, Oatly Creamy Oat FraicheTM, Oatly Whippable Creamy OatTM.

All animal milks and products:

Fresh, long-life, dried, evaporated, condensed, lactose-free. This includes cow’s, goat’s and sheep’s milk, A2 milk, milk shakes, tinned milk,

Cream, sour cream, yoghurt, fromage frais, mousse, buttermilk, custard, ice cream

All dairy cheeses, processed cheeses, cheese spreads, cheese sauce

Soya products: milk, desserts, ice cream, custard, cheese, mayonnaise, tofu, miso, tempeh.

Meat, fish, beans

Any fresh meat: poultry, red meat game: chicken, turkey, duck, quail, pheasant, lamb, pork, beef, veal, venison, rabbit, boar, goat

Fish & Shellfish: Plain fresh or frozen white or oily fish.

Pulses e.g. borlotti beans, chickpeas, dahl, kidney beans, lentils

Some QuornTM vegan products e.g. ham slices, chicken free slices (check for wheat/gluten).

Processed meats

Vegetarian pâté, cutlets, sausages, burgers, mince and ready meals

Fish paste, fish stock, pate and spreads, dishes containing fish/ seafood, shrimp paste, taramasalata

Pulses in sauces e.g. baked beans

QuornTM products (check for egg, wheat).

Sausages/burgers made with wheat/breadcrumbs,

Fried chicken, poultry in breadcrumbs/batter,

Processed meat products containing soy protein or hydrolysed vegetable protein

Fried fish, fish fingers, fish cakes.

Ready meals or baby meals containing milk, egg, wheat, soya.

Eggs

Commercially available egg replacers:

Ener-G Foods Egg ReplacerTM OrgranTM Gluten Free ‘No Egg’ Natural Egg ReplacerTM Crackd The No Egg EggTM

Egg free mayonnaise/salad cream:

Asda Free From salad cream TM

Heinz Vegan salad cream TM

Sacla vegan salad cream TM

Tesco Free from salad cream TM

Follow your Heart Soya free

Vegenaise TM

Heinz Seriously Good Vegan MayoTM

Hellmann’s vegan mayoTM

Inspired Vegan Mayonnaise TM Really Not DairyTM mayonnaise.

Check vegan cheeses

Check pesto (needs to be dairy and egg-free).

All bird eggs (boiled, fried, poached, scrambled egg, omelette)

Dried egg, whole egg, egg powder, egg white, egg yolk Pasteurised egg, frozen egg, egg protein, egg albumin, ovalbumin, globulin, ovoglobulin, livetin, ovomucin, vitellin, ovovitellin

Biscuits/cakes containing eggs, Meringue

Scotch eggs, quiche, flan

Many wheat/gluten-free breads contain egg: check labels.

Nuts

Peanuts:

beer nuts, cacahuete, Chinese nuts, earth nuts, ground nuts, goober nut/pea, mandelonas, monkey nuts)

Tree nuts:

almond, betel, Brazil, cashew, cobnut, hazelnut, goober, macadamia, pecan, pistachio, walnut

Chestnut*

Coconut*

Pine nuts*

*Note: botanically, those are not nuts but people often think of them as nuts

Nut butters, Nut oils

Nut-based cheese alternative: e.g. VegustoTM

Nuts coated in a flavouring/spice/ chocolate

Bombay mix.

Vegan yoghurts

Vegan desserts

Vegan cheese

  

Fruit

Any fresh, stewed, bottled, tinned, dried, plain frozen.

Note: If raw fruits are not tolerated: try to include in cooked/tinned form.

 Fruit pie fillings, Glacé fruits. Fruit pies, crumbles, fritters.

Vegetables

Most fresh, plainly frozen, dried without sauces, canned in brine only

Water chestnut

Seaweed

Prepared vegetables, raw, steamed, juiced, roasted, fried.

Pre-packed vegetables for roasting, roast parsnips/potatoes etc.

Vegetables in sauces,

Check stir-fry packs for soya/edamame beans.

Vegetables in butter, cream, mayonnaise or salad cream. Fresh e.g. ready-made coleslaw, frozen and tinned vegetables in batter, breadcrumbs e.g. fried mushrooms, onion rings, cauliflower cheese,

Dried stew mixes.

Crisps, savoury snacks

Seeds: sesame, sunflower, sesame, pumpkin, poppy, linseeds, pine nuts, chia, coconut

Dips/paste: Hummus, tahini

Plain popcorn

Crisps: all ready-salted, plain Pom BearsTM, those made with chickpeas or quinoa, e.g. Eat RealTM range, sesame sticks.

Check labels for milk, cheese, wheat

Crisps: some varieties of flavoured crisps- e.g. salt and vinegar, sweet chilli.

Bombay mix,

Crisps containing wheat/milk.

Confectionary

Boiled sweets, chews, honeycomb, mints, chewing gum, marshmallows

Some free-from chocolates e.g. Nomo TM, Pico Fairtrade TM, Topic Vegan Gluten Free Chocolate TM.

Seaside rock, chewy sweets

Chocolate, supermarket free-from chocolates.

 Fudge, toffee.

Cakes, Biscuits, Snacks and Desserts

Cake/biscuits that are free of the four allergen ingredients. See recipes provided in this diet sheet and websites for ideas.

Sesame snaps,

Halva,

Pancakes made with suitable ingredients (see recipe)

Ice creams made from:

Coconut e.g. Alpro Coconut ice creamTM, Blue SkiesTM, Cecily’sTM, Coconut Collaborative SnowconutTM, Coconuts OrganicTM, Sainsburys Free From Iced DessertsTM, Swedish Glace CoconutTM, Tesco Free From Split Ice LolliesTM, Yorica TM

Nut: e.g. Alpro almond TM, Magnum almond TM

Chia seed pudding made with suitable milk alternative (see recipe)

Jelly, plain fruit juice ice lollies,

Wheat free ice cream cones e.g. BarkatTM, EskalTM.

Flavoured crisps, nuts, popcorn

Sorbet, Ice lollies, Cecily’s ice creamTM, Supermarket own free from ice creams.

Biscuits, buns, cakes, scones, pastries, croissants, doughnuts, pancakes, muffins, rusks

Pretzels, Japanese rice crackers

Semolina, crumbles, pastries, flans, tarts, cheesecake, sponges, éclairs, steamed/suet puddings, trifle, soufflé, mousse, meringue, sago, tapioca, rice pudding, blancmange, ready-made custard, instant custard

Ice cream cones and wafers,

Soya ice-creams: e.g. Swedish GlacéTM.

Herbs, spices, flavourings,

Sauces

Salt, pepper, herbs, spices, ginger, garlic, monosodium glutamate powder, vinegar, pickles in vinegar, home-made curry powder, tomato puree, BovrilTM, tomato ketchup, brown sauce, dairy-free guacamole, salsa, hummus

Many tomato-based pasta sauces, curry pastes, chilli con carne, sweet and sour sauces

Home-made soups, sauces and gravies made with vegetable or meat stock thickened with wheat-free flour

Suitable stock cubes:

KnorrTM stock cubes or stock pots (except fish) KalloTM Organic Stock Cubes, Marigold Organic Swiss BouillonTM

Gravy:

Marigold OrganicTM gravy powder Bisto BestTM beef gravy powder ComptonsTM Gravy salt

Supermarket own brands

Soya sauce alternative:

Coconut AminosTM.

Oyster sauce

Seasoning mixes e.g. chilli con carne, casserole, fajita

Dried yeast

Tomato based pasta sauces, curry pastes, sweet and sour sauces

Curry powder containing wheat, meat tenderiser, bottled sauces, mayonnaise, salad cream, thickened pickles and chutneys, mustard containing wheat soy sauce

Creamy or cheese-based sauces, pesto (contains dairy, egg, nuts)

Most tinned, packet or powdered soups

Gravy or stock cubes containing wheat/milk/egg e.g. BistoTM gravy granules, OxoTM cubes.

Fats and oils

Spreads e.g. PureTM Sunflower, PureTM Olive, VitaliteTM

StorkTM Margarine block, Flora 100% naturalTM Flora plant ButterTM.

Olive oil, rapeseed oil, sunflower oil, sesame oil, highly refined peanut oil, soya bean oil

Lard, beef dripping.

 Margarines (check for milk).

Wheat germ oil. Vegetable oil of unspecified origin (blended). Margarine containing wheat germ oil.

Cold pressed nut/soy-based oils (walnut, groundnut).

Drinks

Hot drinks:

Tea, tea bags, cocoa

freshly ground coffee. 100% instant coffee

Soft drinks:
Water, mineral water

fruit juice, fruit squash,

fizzy drinks, coconut water

Alcohol:

Wine, Champagne, Sherry, Brandy, Vodka, Rum, Cider, Tequila, Whisky, Gin, Vermouth.

Some brands of coffee are produced using wheat flour – check label

Always check protein shakes (some are soya-based)

Gluten-free beer (may still be made from wheat/ barley),

Cocktails (may contain egg, dairy, nuts, wheat or fish).

Malted milk drinks: e.g. OvaltineTM, BournvitaTM, HorlicksTM,

Milkshakes,

Instant drinking chocolate,

Most coffee whiteners, instant specialty coffee drinks, e.g. cappuccino, latte sachets

Liquors, Ale, Beer, Lager, Stout.

Miscellaneous

Jam, marmalade, syrup, honey, sugar, vanilla essence, glucose syrups made from wheat, wheat derived maltodextrin, dextrose

Wheat-free baking powder e.g. supermarket brands, BarkatTM, Doves FarmTM, Dr OetkerTM

Xanthan gum, bicarbonate of soda, tartaric acid, gelatine, yeast, arrowroot, monosodium glutamate.

 Play DoughTM. Foods containing wheat protein isolates, sweet and savoury spreads, toppings e.g. chocolate nut spread, BiscoffTM spreads, yeast extract, MarmiteTM.

Helpful tips

  • Eat regular meals and snacks.
  • The first 2–3 days are the most difficult to get used to the diet. It is important to go shopping and stock up on all the foods you/your child are allowed to have.
  • Eat simply. Cook simply. Plan your meals and have supplies of staples such as rice and potatoes.
  • Prepare meals or snacks in advance so that you have food available that you can grab quickly.
  • Batch cook and freeze meals so that you have easy to grab options for a quick meal or snack.
  • Vegan recipes will be free from fish, egg and milk and may be useful but check for wheat, nuts and soya as some of them may contain these allergens.
  • Always be prepared and carry food with you when you leave the house. That way you will have what you need and not be tempted to stray off the plan when you are hungry.
  • Try to achieve your 5 a day fruit/vegetables by eating at least three servings of fresh vegetables each day and two fruits. Choose at least one serving of dark green or orange vegetables.
  • If appropriate, ensure that you have child friendly free from snacks available for your child and discuss with the nursery/school to stock some of these for your child.
  • Adults are recommended to drink a minimum of 8 glasses of non-caffeinated and non-alcoholic fluids each day.

Medicines

Many medications and nutritional supplements contain lactose. If this is medical grade lactose, the cow’s milk protein content will be minimal. You do not therefore need to avoid products containing medical grade lactose. Soya oil in medications is medical grade and also does not need to be avoided. Contact your Pharmacist and Dietitian if you think you have reacted to a certain medicine.

Hens egg lysozyme (E1105) and lecithin (E322) which may be derived from egg are used as preservatives and emulsifiers in a few medicines. Your Dietitian or Pharmacist should be able to tell you which products contain egg. 

Do I need to take supplements?

Children:

  • Most will need an amino acid formula/feed prescribed to replace cow’s milk. Ensure that these are consumed as recommended by your dietitian.
  • Most will require a multivitamin with Vitamin D and may also require calcium depending on how much amino acid feed/formula they are consuming.
  • Some children a combination supplement that also contains minerals, like iron and zinc may be recommended.

Adults:

  • Your dietitian will evaluate your diet and advise whether you need a multivitamin and/or a supplement drink.
  • It can be challenging to have enough calcium, as the main source of calcium is from dairy foods. The following tables show you how much calcium you need and some suitable sources of calcium. If you/your child struggles to take enough, your dietitian may recommend a calcium supplement.

Calcium

Calcium requirements by age and gender (see table below)

Children

0–12months

525 mg

 

1–3years

350 mg

 

4–6years

450 mg

 

7–10years

550 mg

 

Boys 11–18 years

1000 mg

 

Girls 11–18 years

800 mg

Adults – Males

19+ years

700 mg

Adults – Females

19+ years

Pregnant

Breastfeeding

Post-menopause

700 mg

700 mg

1250 mg

1200 mg

Sources of calcium

Food

Portion Size

Calcium (mg)

Amino Acid Formulas

Necoate LCPTM

Neocate JuniorTM

Neocate SyneoTM

Nutramigen PuraminoTM

SMA AlfaminoTM

Elemental 028 TM

100 ml

77

90

79

76

70

45

Alternative Dairy Products

Calcium Fortified milk alternatives made from: oat, coconut, pea, rice* e.g. Alpro TM (not Alpro Oat BaristaTM), OatlyTM, KokoTM, QwrkeeTM CalifiaTM, Mighty PeaTM, Rice DreamTM, Plenish EnrichedTM

100 ml

120–240

Calcium fortified coconut or oat yoghurts or desserts e.g. Andros TM, Koko TM, Little Coconutters Coconut Collaborative pouchesTM, Little Bandits TM, Oatly creamy oat fraiche TM, Oatgurt TM

100 g

120-211

Calcium fortified cheese alternative e.g.
Koko TM cream cheese and
Koko TM cheddarTM,
Vitalite TM cheese TM

 

30 g
30 g
30 g

 

60
221
 84

Other sources of calcium

Fruit and vegetable

Broccoli

Kale

Spring cabbage

Orange

Orange juice

 

135 g (3 spears, boiled)

100 g boiled

90 g (1 medium portion)

160 g (1 medium)

300 ml (1 large glass)

 

60

150

50

75

32

Fish/seafood

Sardines (with bones)

Pilchards (with bones)

Tinned salmon (with bones)

 Prawns

 

60 g (½ tin)

60 g

52 g) (½ tin)

 80 g (3 tablespoons)

 

258

150

  47

120

*Rice milk is not suitable for children under 4 ½ years as main milk drink.

Iodine

Milk is a good source of iodine which is needed to make thyroid hormones and also for the development of a baby’s brain during pregnancy and early life. Some milk alternative products are now fortified with iodine.

Iodine requirements by age and gender

Age

Iodine/day (μg)

Age

Iodine/day (μg)

0–5years

90

Pregnancy

250

6–12years

120

Breastfeeding mums

250

Adults over 12 years

150

 

 

Sources of iodine

Food

Portion

Iodine/portion* (μg)

Fish and seafood

Haddock

Cod

Plaice

Salmon fillet

Canned tuna

Prawns

Scampi

 

120 g

120 g

130 g

100 g

100 g

60 g

170 g

 

390

230

30

14

12

6

160

Seaweed

Wakame

Sea moss

Nori e.g. ClearspringTM, YutakaTM sushi nori

Seaweed thins e.g. ItsuTM

 

5 g

10 g (serving)

2 – 2.5 g (1 sheet)

5 g packet

 

73.5

40 – 70

14 – 42

92
Some fortified plant-based milks (oat, coconut, pea) e.g.OatlyTM, Alpro Oat Milk TM, Plenished Enriched Oat MilkTM, M&S Plant Kitchen CoconutTM, QwrkeeTM 100 ml 22.5 – 30
Meat/Poultry 100 g 10
Fruit/Vegetable 80 g (1 portion) 3

Nuts

25 g

5

Actual iodine content will vary

Recipes

The following websites have a very good range of wheat/egg/milk-free products and some interesting recipe ideas:

Free From Bread

 

Ingredients

Method

450 g (1 Ib) pre-mixed wheat/gluten-free bread flour containing xanthan gum or pre-mixed plain flour plus 2 tsp xanthan gum

2 tsp egg replacer (mixed with 4 tbsp water) (optional)

3 tbsp caster sugar 

2 tsp salt

2 tbsp sunflower or olive oil 

1½ tbsp dried yeast

570 ml (1 pint) warm water

Mix all the dry ingredients together, add the warm water and egg replacer if using and mix thoroughly.

Leave in the bowl to rise for about an hour. The mixture should now be around twice its original size and will be fairly runny.

Transfer to either an oiled large loaf tin, or use a small loaf tin and make rolls from the remaining mixture using oiled spoons to separate the mixture.

Bake at 190 °C, 375 °C, Gas 5 for 45–60 mins (rolls will take 30–45 mins).

Pancakes

 

Ingredients

Method

115 g (4 oz) blended gluten-free flour e.g. Doves FarmTM

2 tsp egg replacer (mixed with 4 tbsp water)

300 ml (½ pint) milk substitute (or less if you want them thicker)

Sunflower oil

Gradually incorporate the egg replacer into the flour with a whisk.

Add in the milk substitute gradually until all combined.

Heat oil in a frying pan and when hot, pour sufficient batter into pan.

Cook both sides until lightly browned.
  

Chocolate Cake

 

Ingredients

Method

250 g (8 oz) plain gluten-free flour blend

3 tbsp cocoa

170 g (6 oz) caster sugar 

1 tsp bicarbonate of soda

½ tsp salt

1 tsp white wine vinegar 

1 tsp vanilla extract

5 tbsp sunflower oil

200 ml (⅓ pint) water

Preheat the oven to 180 °C/gas mark 4.

Grease and line an 8″ square baking tin or line a muffin tin with 12 muffin cases.

Sieve the flour, bicarbonate, salt and cocoa into a bowl.

Add the vinegar, vanilla extract and sunflower oil and mix well. Then add the water and beat well until smooth.

Pour into the tin and bake for 20–25 minutes until a skewer comes out clean.

Top with chosen frosting or serve with tolerated yoghurt or cream alternative.

 

Pastry

 

Ingredients

Method

225 g (8 oz) gluten-free plain flour blend

120 g (4 oz) chilled dairy free margarine 

Optional - 2 tbsp caster sugar (for sweet pastry)

2–3 tbsp cold water

Sift the flour into a bowl and rub in the margarine until the mixture resembles breadcrumbs. Add the sugar if using.

Gradually add the cold water whilst stirring with a knife, then pull together with your hands to form a dough.

Wrap in cling film and chill in the fridge until ready to use.

To roll out, place between two sheets of cling film to stop it sticking the rolling pin and use as required.

Chia Seed pudding makes 4 ramekin dishes

Ingredients

Method

180 ml (⅓ pint) coconut, rice or oat milk

30 g (1 oz) chia seeds

1–2tbsp maple or golden syrup

½ tsp vanilla extract

30 g (1 oz) cocoa or chopped fresh fruit e.g. strawberries, banana.

Add chia seeds, milk alternative and cocoa if using to a mixing bowl and whisk vigorously to combine.

Leave overnight or for at least 3–5 hours (or until it has achieved a pudding-like consistency).

Add fruit if using. Add to a blender and blend until completely smooth and creamy.

Sweeten to taste with the syrup. Serve chilled.
Return to listing