Read an Excerpt
I first learned about food allergies when I was six years old. The family that lived across the street had four children; the youngest was nicknamed “Eggs.” I didn’t know who first called him Eggs; all I knew was that he couldn’t eat eggs and that he was constantly itching his arms and legs, which were covered with thick, scary-looking skin that scabbed. I didn’t know anybody else like that; in fact, I was actually more familiar with kids with polio. It wasn’t until I was a third-year medical student working in pediatric dermatology that I saw a second person with food allergies. Three years later, when I worked in the Bronx during my residency, I saw more cases of food allergy, mostly in children rushed to the emergency room with hives or wheezing after eating a food they were allergic to.
After moving to California, I seemed to see such cases even more frequently. During my first week of training in allergy and immunology at UCLA, I was asked to consult on an eleven-month-old boy from Arizona who weighed only ten pounds. He looked malnourished and had a rash around his mouth. My attending professor suspected child neglect or abuse, and we all expected him to thrive within days of being in the hospital. Time passed and he remained ill, with vomiting and diarrhea to boot. I checked up on him while a nurse was feeding him a cow’s milk—based formula from a sippy cup. He knocked the cup over and the formula poured onto his legs. Red blisters formed where the milk had spilled. At this point it became clear that he was allergic to the very milk with which we were trying to nourish him back to health. We stopped all forms of dairy and took him off all meds. Within forty-eight hours he was a different kid–no vomiting, happier disposition, clearer skin, and increased appetite. He returned to the clinic two months later on no medications and was unrecognizable, weighing twenty-one pounds with no skin rashes.
These anecdotes show different manifestations of food allergy, and they illustrate how food allergy, once an esoteric condition, is becoming much more prevalent. The nation has seen a mysterious rise since the 1990s in the number of children with food allergies, now estimated to be three million, or one in every twenty-five children. In the past decade alone, the prevalence has increased by 18 percent. Being a busy allergist “in the trenches,” I diagnose five or more new food allergy cases each week.
So why are food allergies rising? There’s no good answer, but a lot of decent guesses. One theory is that we get exposed to nuts or other foods too early. I can remember well how some children with severe food allergies had mothers who ate large quantities of that same food while pregnant and while nursing. Could in utero exposure be the culprit?
For years, allergists have been recommending that allergenic foods be introduced to children at a later age to reduce the risk of allergy. However, a 2008 study of British children found that early exposure to peanuts actually lowered the risk of future peanut allergies.
Another theory explaining the increase in food allergies is that food in the United States is processed differently. For example, there is a much higher peanut allergy rate in the United States than in China; in the United States, peanuts are mostly dry roasted while in China they are mostly boiled, which decreases the amount of the allergenic protein in the peanut. Also, the processing of peanut butter in the United States involves whipping it to prevent the oil from layering out of the solid fraction; this spreads more of the peanut protein into the oil and may result in more peanut allergies. Another theory is that some people are actually allergic to the mold that grows in peanuts, and not the peanut itself.
There is also speculation that the increasing prevalence of food allergy is related to the increase in the amount of our food that is genetically engineered. One study examined a group of people who seemed to develop a new “soy allergy” even though they had previously tolerated soy products. It was discovered that the new allergy was only to soy that was genetically engineered from Brazil nut protein. Sure enough, all the affected people had severe Brazil nut allergy.
Whatever the reason, it is undeniable that the number of people with food allergies is on the steep rise. From a scientific point of view, allergies are the result of the body launching an exaggerated immune response against a particle it recognizes as foreign. We evolved this response to fight off infection, but the allergic immune system is so sensitive that it reacts to proteins in foods as though they were viruses. The body attempts to destroy the foreign protein by releasing histamine, prostaglandins, and leukotrienes. These chemicals are responsible for the symptoms of an allergic reaction. These symptoms, which usually occur almost immediately after exposure to the problematic food, can vary in intensity from a little itch on the tongue or skin to full-blown anaphylaxis, a swelling in the throat and lung airways that may be life-threatening. Allergies can also present with hives, a total body rash, vomiting, diarrhea, shortness of breath, wheezing, and shock, with a severe drop in blood pressure, loss of consciousness, a lack of air exchange, and ultimately, a heart arrhythmia.
Although everyone knows that food allergies run in families, surprisingly, different family members are often allergic to different foods. And it happens that only a few foods are responsible for the great majority of food allergies. In fact, only eight foods account for more than 90 percent of all food-allergic reactions. These are milk, eggs, peanuts, tree nuts (walnuts, cashews, and so on), fish, shellfish, soy, and wheat.
These two concepts underlie the elegance and relevance of an allergy cookbook. By featuring recipes that omit all of the least-tolerated foods, a family can share these meals even if one child has a peanut allergy and another has a soy allergy and the celiac neighbor comes over with his lactose-intolerant girlfriend. As a well-known chef and the mother of a food allergy—ridden boy, Cybele Pascal is uniquely qualified to develop recipes that meet all the common food restrictions without compromising any taste. In 2006 she wrote the popular Whole Foods Allergy Cookbook that reinvented all our favorite home-cooked foods minus the common allergens. I consider this to be the best collection of recipes for people with food allergies, and my patients and colleagues all seem to agree. It is user-friendly with real-life stories, and best of all, the food tastes great. Pascal now follows up that meal of a book with this dessert, the answer to the child in all of us who wants to eat his cake, too.
This new book could not have come at a better time. Now, those of us with food restrictions won’t have to sacrifice our favorite treats. Families will be able to eat together, sharing the same foods. And children will not be forbidden that slice of birthday cake.
Pascal has embarked on a formidable task: to bake that cake without wheat, milk, or eggs. To be able to pull that one off, as she has, is exemplary. Kudos to you, Cybele.
—Robert Eitches, MD, FAAAAI, assistant clinical professor at the David Geffen School of Medicine at UCLA, attending physician at Cedars-Sinai Medical Center in Los Angeles, and head of the Allergy Foundation Medical Group
This book is for everyone. It’s for all of you out there who’ve ever had to say, “No thanks, I can’t eat that, I’m allergic to ____.” It’s for anyone with food allergies or intolerances, for people with celiac disease, those on GF/CF diets, vegans, those wanting cholesterol-free baked goods and baked goods without hydrogenated fat, people wanting alternatives to refined sugar, and those who want wholesome, delicious, decadent baked goods that are free from additives, preservatives, artificial flavors, and artificial colors.
So what is in this cookbook, if it excludes all that? Dairy-free, soy-free chocolate chips and chocolate chunks, pure vanilla extract, sprinkles, decorating sugar, SunButter, raisins, molasses, brown sugar, cinnamon, and just about every other classic baking ingredient you can imagine. And all without the use of wheat flour, butter, or eggs! Yes, it is possible. A whole book full of yummy, normal baked goods that can be fed to just about anyone, no matter what his or her specific dietary needs.
This book is a baker’s basket full of allergen-free versions of all your traditional favorites: muffins, scones, biscuits, quick breads, cakes, cookies, pies, tarts, crumbles, buckles, betties, and more. Every single recipe is made without wheat, dairy, peanuts, tree nuts, egg, soy, fish, shellfish, sesame, and gluten. Although the majority of these treats are made with traditional sweeteners, 30 percent of them are made with natural unrefined sweeteners, such as agave nectar, for those seeking healthy alternatives to refined sugar. For those seeking nutrient-dense baked goods, I’ve included recipes made with the newer gluten-free flours on the market, such as protein-packed sorghum and quinoa. For those who don’t like sweets, there’s a whole chapter of savories. There’s something in this basket for everyone, food allergic or not, so that all the kids (or kids inside us) who’ve ever been the one with the “weird” food will feel like they’re finally included, and can dig their hands deep inside the cookie jar.
And believe me, I know firsthand just how many of our children have experienced that alienation. My son Lennon was diagnosed with severe dairy and soy allergies in his first four months of life, and our family was thrust headfirst into the confusing, confounding, and rapidly expanding world of food allergies. When Lennon was diagnosed in 2002, food allergies were still “off the radar,” but in the years that followed, the number of people in the United States with food allergies has now climbed to more than twelve million. Three million of them are children (about one in twenty-five kids has a food allergy). These rates are double what they were a decade ago. Clearly, this is a matter of increasing urgency and one that has hit the mainstream. For so many of us, food allergies are a part of our everyday life.
Given these rising numbers of food-allergic people, it’s wonderful that companies such as Enjoy Life and Cherrybrook Kitchen have emerged with ready-made treats and baking mixes. But they can only make so many products, leaving those of us with food allergies feeling, well, rather short-changed. Our list of choices has heretofore been limited by what these fantastic companies can turn out. What about the hundreds of other baked items that we crave? What about allergen-free muffins, scones, quick breads, pies, tarts, and freshly baked bread? Unless you’re lucky enough to live next
to an allergen-free bakery, you’ve just had to do without.
But necessity is the mother of invention, right? Out of lemons you make lemonade! I dabbled with allergen-free baking in my first cookbook (The Whole Foods Allergy Cookbook), but have since embraced it with a passion. They say cooking is an art form, baking is science. Well, allergen-free baking is a little of both. It is most certainly an exacting science getting batters to bind without gluten, rise without eggs, taste rich without butter, or taste sweet without sugar. But it’s also uncharted territory, leaving the doors wide open for creative expression. I love baking, but in particular, I love allergen-free baking. Perhaps it’s the challenge of learning to bake “without” that ultimately inspires me the most. It has opened up a wealth of new ideas and flavors that are delicious and safe for those with food allergies and intolerances; but if you don’t want to let on that these treats are “special,” nobody ever has to know.
I hope you will find baking these recipes as satisfying as I do and that they provide you with templates to create your own allergen-free goodies to share, because it is the act of sharing and nurturing that is most satisfying of all. I love baking for people who haven’t had a good cake in literally years because they can’t eat gluten or dairy. And I love baking for people who aren’t on restrictive diets and watching their faces light up with delighted wonder that a vegan, wheat-free, dairy-free, egg-free dessert could taste so sublime that it’s often yummier than its traditional counterpart. I’ve converted my entire neighborhood. The better part of Laurel Canyon in Los Angeles has helped me taste-test this book. But my best and favorite taste-testers are my two sons, Lennon and Monte. If I get the “thumbs up!” from them, I know I’m good to go.
We still have food allergies in my family. Lennon, now seven, has outgrown his dairy and soy allergies, but has since been diagnosed with allergies to shellfish, tree nuts, and kiwi (in addition to just about every environmental allergen possible!). I, too, have discovered new food allergies (not surprising, given that allergies run in families). After a weeklong case of severe total body hives, I finally got myself over to Tower Allergy and Asthma at Cedars-Sinai Medical Center in Los Angeles, where the excellent Robert Eitches, MD, and Maxine Baum, MD, practice. Through testing, we confirmed that I’m allergic to certain tree nuts, fish, and shellfish, and to a lesser extent wheat, yeast, stone fruits (peaches, apricots, and so on, which interestingly enough are related to almonds), citrus fruits, and pineapple. My husband then went to Tower Allergy and Asthma, and he, too, was finally diagnosed with a long-suspected allergy to dairy, in addition to nearly every environmental allergen on the planet. The only member of my family who is not a hyperallergic individual is my son Monte. Yet, he too suffers from allergic asthma, and when it flares, he must stay away from dairy. And so, you see, we avoid a lot of foods at my house. As an adult, I’m okay with that. But kids with food allergies just want to feel normal. I can’t tell you how many times I’ve been asked by my son Lennon, “When can I eat that?” Well, if it’s baked goods they’re asking for, the answer is “Now!”
From the Trade Paperback edition.