Special diets and dietary needs: vegetarian and vegan diets, religious and cultural diets, and medical needs including coeliac disease, lactose intolerance, nut and other allergies and diabetes, and how to adapt recipes to meet them.

What this dot point is asking

Eduqas wants you to plan and adapt food for people whose diet is restricted by choice, belief or medical need, and to keep those meals safe and nutritionally balanced. Questions often give you a named person or family and ask you to suggest and justify suitable dishes.

Vegetarian and vegan diets

People choose these diets for ethical, environmental, religious or health reasons.

The main nutritional challenge is protein and a few micronutrients. Plant proteins are mostly low biological value, so vegans use complementation (combining foods such as beans on toast or rice and peas) and the plant HBV proteins soya (tofu, soya milk) and quinoa. They also need to watch vitamin B12 (found naturally only in animal foods, so from fortified foods or supplements), iron, calcium and vitamin D. To adapt a dish, replace meat with beans, lentils, tofu or Quorn, and replace dairy with fortified plant milks and spreads.

Religious and cultural diets

Many diets follow religious or cultural rules. For example, halal food is permitted under Islamic law and pork and alcohol are avoided; kosher food follows Jewish law, which keeps meat and dairy separate and forbids pork and shellfish; many Hindus are vegetarian and avoid beef; and some groups fast at certain times. In a question, respect the rule, suggest dishes that comply, and avoid forbidden ingredients and cross-contact with them.

Coeliac disease

To adapt a recipe, remove all wheat, barley and rye (bread, pasta, normal flour, many sauces thickened with flour, batter, biscuits) and use naturally gluten-free foods: rice, potatoes, maize (polenta, cornflour), and certified gluten-free flour and pasta. Watch for hidden gluten in stock cubes, soy sauce and processed foods, and avoid cross-contamination with wheat flour.

Lactose intolerance and food allergies

Lactose intolerance is when the body cannot digest lactose (the sugar in milk) because it lacks the enzyme lactase, causing bloating and stomach upset. Adapt dishes with lactose-free or plant milks and dairy-free spreads.

A food allergy is a reaction by the immune system to a food protein. Severe allergies, such as to nuts, can cause anaphylaxis, a rapid, life-threatening reaction needing adrenaline, so even a trace is dangerous. By law, the 14 major allergens (including cereals containing gluten, eggs, milk, fish, crustaceans, molluscs, peanuts, tree nuts, soya, sesame, celery, mustard, lupin and sulphur dioxide) must be emphasised in ingredient lists. Safe practice means reading labels and preventing cross-contamination with separate equipment, clean surfaces and careful storage.

Diabetes

People with diabetes must control their blood glucose, so they limit free sugar and energy, choose low glycaemic index wholegrain starchy foods that release energy slowly, eat regularly, and keep to a healthy weight. To adapt a recipe, reduce added sugar, use fruit for sweetness, choose wholegrain carbohydrate and watch portion sizes.

Try this

Q1. Name the protein that a person with coeliac disease must avoid, and give two foods that contain it. [2 marks]

• Cue. Gluten; in wheat (bread, pasta), barley and rye.

Q2. Suggest one way to adapt a dairy-based dessert for a vegan. [1 mark]

• Cue. Replace dairy with a fortified plant milk and a dairy-free alternative (e.g. coconut or soya yoghurt).