Food Substitutes for Children with Allergies

What can I use as a substitute if my child is allergic or intolerant to foods? This question comes up often – especially if kids suffer from food allergies, celiac disease, or if a family chooses a vegan, gluten-free, or other alternate food regime out of personal choice.

No matter what the circumstance, we want to avoid nutrient deficiencies in our growing kids (and in ourselves, for that matter.) Although food allergies, celiac disease, or personal choices may present a challenge, healthy eating still needs to happen.

If you ask any registered dietitian or nutritionist what is essential for growth, you’ll hear the same thing. Macronutrients (food you can see,) which include protein, carbohydrates, and fats. All are essential to support growth of muscle, bone and other organ systems. Micronutrients (vitamins and minerals) are essential to “fire up” our cellular machinery, and now phytonutrients (aka antioxidants) are considered an essential part of our immune army – protecting us inside and out.

If you are embarking on a new nutritional plan for your child or yourself, start first with a basic template. Imagine a plate divided in 4 parts. A typical meal should fill half the plate with veggies and fruits, one quarter with a healthy carb, and one quarter with a source of protein. Beverage on the side should be a dairy or dairy alternative to provide calcium and vitamin D, as well as protein.

For perspective here’s what a typical pre-school aged child requires each meal to support growth:

  • 3 oz grains
  • 2 cups dairy or alternative
  • 2 oz protein
  • 1 cup each fruits and veggies
  • 3 tsp. oil or equivalent

So here are some alternate sources of top nutrients essential for your growing child:

Fats – essential fatty acids and omega-3 fatty acids support brain development. Good sources of fat besides oils include avocado, chia, flax (seed or meal), and pumpkin seeds. Stick with healthy oils like avocado, olive, and grapeseed oils. Be mindful that coconut oil should be used in careful moderation – ½ of its fat content are unhealthy fats.

Calcium – children typically require about 500 mg calcium/day. Good alternatives to dairy products include calcium-fortified orange juice, sesame and chia seeds, dark green leafy vegetables (spinach 120mg/serving, kale 100mg), dried figs, tofu (if processed with calcium salts; read the label), legumes (pinto beans 45mg/serving) and fortified cereals. Alternate milks on the market include soy, almond, cashew, rice, coconut, hemp, and soon, even Peanut. For growing bodies, rice milk has negligible protein, where as the rest listed have more. Look for Calcium and Vitamin D on the label – key for your child’s bone growth. Alternate milks can be used 1:1 to substitute in cooking or baking – some may add a different flavor profile in the end result.

Vitamin D – heading out into the sun (in the early morning or very late afternoon) for 10-15 minutes without sunscreen will promote vitamin D synthesis in the skin and good bone and immune health. The flesh of fatty fish and lish liver oils, beef liver, cheese and egg yolks are also excellent sources.

Vitamin E – good sources include wheat germ, nuts (almonds and sunflower seeds), vegetable oils, leafy greens and fortified cereals.

Wheat Allergy or Celiac Disease

Good tasty substitutes, thank goodness, are available now: brown rice, quinoa pasta, sweet potatoes, and many baked goods using alternate flours. Recipes abound on the internet and ingredients are now easily obtained. But continue to read labels as wheat or gluten can be present in many things: candy, lunchmeat, sauces and salad dressings, as well as some vegetarian protein sources like seitan.

Wheat equivalents (1 cup wheat = 5/8 cup potato starch OR 7/8 cup rice flour OR 1 cup corn flour)

Fish Allergy

Omega-3 fatty acids are also found in chia and flax seeds, walnuts, and canola oil.

Peanut Allergy

Avoid cold pressed or extruded oils as they contain protein. A good clue that a peanut oil is risky is if there is residue at the bottom. That’s likely protein – what kicks off the allergy. However, highly processed commercial peanut oil is FDA approved, however it’s a personal choice and one to discuss with your allergist. Alternates: sunflower seed butter, soy butter, other nut butters can provide flavor and protein for your little ones.

If your child has a peanut allergy be aware of gluten-free goods, like pastas and other baked goods that have lupin as an ingredient. This is a European flour that is high in protein, and often added to gluten-free goods, but cross reacts at a pretty high rate in peanut allergic individuals and can cause unexpected anaphylaxis. Its popularity is increasing in the U.S., and it’s very important to ask before eating!

Egg Allergy

Eggs are tricky, as they’re used for many purposes – to moisten ingredients, bind them, or make them rise. If your child is egg allergic, here are a few substitutes:

1.5 Tbsp water +1 Tbsp oil + 1 tsp. baking powder = 1 egg for baking

Chickpea “water” – take an ounce or so of the liquid remaining from canned chickpeas, and whisk into a foam – this works very well in baked goods, even meringues! And can bind a protein very well (think meatballs without the egg.)

1 Tbsp vinegar + 1 tsp. baking power + 1 tsp. other liquid (broth, juice, etc) = 1 egg for baking

For binding: bars and cookies just need a fruit puree to do the trick – applesauce, prune, or apricot purees lend flavor and nutrients without egg protein.

And one last note, especially if your child has food allergies: “allergy friendly” foods don’t necessarily equate to healthy foods, so continue to read labels, and try your best to cook fresh healthy food at home – that way you know exactly what goes into your child!

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About Dr. JJ Levenstein

Dr. JJ Levenstein is a board-certified pediatrician and fellow of the American Academy of Pediatrics and in 2012 retired from her thriving private pediatric practice in Encino, California. She served on the staff of CHLA and Encino Tarzana Hospitals for 20 years and was consistently voted one of the Best Doctors in America® from 2003 through 2012. Drawing from her experience as a pediatrician and mom, Dr. Levenstein serves as president and co-founder of MD Moms, makers of Baby Silk, the first personal care line for babies developed by pediatrician moms. She serves on the board of United Cerebral Palsy LA, is an active writer and sits on the advisory boards of several child-centered websites. She is an accomplished chef and completed culinary school in 2013! She has had a lifelong interest in child nutrition and all things related to preventive health.

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