Six Food Elimination Diet Food Substitutes

Wheat

Wheat is one of the most common allergens, or triggers, associated with eosinophilic esophagitis in both children (2nd most common trigger) and adults (most common trigger).

Wheat includes 4 proteins that may cause the allergic reaction associated with symptoms of EoE. The 4 proteins are albumin, globulin, and gluten (gliadin and glutenin). Unfortunately, there is limited and conflicting research as to how other grains that include these same proteins react with eosinophilic esophagitis.

You may have heard that if you are following an SFED diet, that you should also exclude barley and rye. This rumor, however, has very limited and inconsistent research to support it. Because barley and rye have similar proteins as wheat, you should discuss whether elimination is best for you with your healthcare provider or dietician. These grains are also often packaged in the same factories with wheat and may have some wheat in them.

You should be careful with some gluten-free products on the market, as they have been refined in a manner that eliminates their nutritional content of iron, B vitamins, and trace minerals.

Quinoa and brown rice are particularly popular as wheat substitutes.

Cow's Milk

Cow’s milk has been identified as another of the most common triggers associated with eosinophilic esophagitis in both children (most common trigger) and adults (second most common trigger).

The protein in milk that causes reactivity with EoE is known as casein. Aside from cow’s milk, other foods that commonly have the same protein includes: cheeses, ice cream, coffee creamer, whey protein, chocolate, and marinades.

It is important to take notice that almond milk or cashew milk cannot be used as a substitute for cow's milk, as they are both tree nuts that are eliminated from an SFED.

Eggs

Replacing egg can be a little trickier due to the number of reasons we use eggs in food preparation. Here are a few ideas that you can use to replace eggs in your cooking needs.

Flaxseed Flour Substitute for 1 Egg – Great for Binding

• 1 Tablespoon Flaxseed Flour
• 3 Tablespoons Water
• Stir until egg-like

Chia Seed Substitute for 1 Egg – Great for Leavening

• 1 Tablespoon Chia Seed
• 1/3 Cup Water
• Stir and set for 15 minutes.

Agar Agar Substitute for 1 Egg – Great for Binding

• 1 Tablespoon Agar Agar
• 3 Tablespoons Water

Ripe Bananas Substitute for 1 Egg – Great for Moisture

• 1/2 Cup Mashed Bananas

Applesauce Substitute for 1 Egg – Great for Moisture

• 1/4 Cup Applesauce (unsweetened)

Mashed Potatoes Substitute for 1 Egg – Great for Binding

• 2 Tablespoons Mashed Potatoes (White or Sweet)

Peanuts and Tree Nuts

Peanuts and tree nuts are difficult to replace in cooking recipes. Tree nuts include many different types of nuts. Here are a few of the more common tree nuts that should be eliminated:

• almonds
• cashews
• macadamia nuts
• Brazil nuts
• pine nuts
• pistachios
• walnuts

Peanuts and tree nuts are usually used for taste and texture rather than a basic need for the recipe. These can usually just be skipped in the recipe, or you can try replacing with rice cereal or a gluten-free whole grain.

Seafood

Fish and shellfish are great sources of protein and Omega-3 fatty acids, which are good for the health of your heart. Like peanuts and tree nuts, you are unlikely to find a similar replacement for the seafood. However, for the protein, you can use other low-fat meats like poultry. Likewise, as a replacement for the Omega-3 fatty acids, you can increase your consumption of flaxseed and canola oil.

Soy

Soy is difficult to match in taste and you may have to add salt. However, there are a few options for replacing soy in recipes.

Substituting Foods

Ensuring that you maintain a well-balanced diet will ensure that you do not suffer from malnutrition while following an SFED diet. Using allergen food substitutes in your cooking will allow you to still use your favorite recipes. Finding which substitute works best for you is a very personal choice. Experiment with these suggestions to find what you like best.