Dietary diversityin the care sectorA guide to catering for people with allergies,intolerances, and religious, philosophical and culturaldietary beliefs

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ContentsIntroduction 3Service users with allergies, intolerancesand autoimmune diseases 4 Coeliac disease 6 Wheat allergy vs sensitivity 6 Top 10 gluten-free products 6Religious, philosophical and cultural dietary requirements 8 How veganism is protected by the law 8 Islamic faith 10 Hindu faith 10 Jewish faith 10 Sikh faith 11 Buddhist faith 11 Jain faith 11 Rastafari faith 11 Seventh-day Adventist faith 11 Vegetarian and vegan philosophical beliefs 11 Top 10 vegan products 13 Dairy-free vs vegan 14Loss of capacity and requests for‘unusual’ foods 14 The Vegetarian for Life memory care pledge 15 Case study: Learning from advanced care decisions 16Fortification agents for special diets 17

RecipesSpicy courgette and pea fritters 19Falafel burger with tomato salsa 20Szechuan black-eyed pea salad 21Vegetarian ‘chicken’ in chilli and black bean sauce 22Asparagus, potato and broccoli quiche 24Battered tofu and nori seaweed ‘fish’ and chips 26Stewed beans with sadza 28Jollof rice 30Yellow moong daal and spinach curry 31Moong masoor di dhal 32Sholay saag 33Banana pancakes with fruit 34Apple and blackberry rice pudding 35Fruity tea loaf 36Raw chocolate truffles 37

Useful resources 38

Please see page 18 for key to symbolsused in this guide

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Vegetarian for Lifeinfo@vegetarianforlife.org.uk | 0161 257 0887 | vegetarianforlife.org.uk83 Ducie Street, Manchester M1 2JQ @VfL_UK /VfLUKVegetarian for Life is a charity registered in England and Wales, number 1120687Company number 6294709 © Vegetarian for Life 2019

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IntroductionThis guide is designed to make it easierto cater for any service users whorequire a ‘free-from’ or ‘special’ diet. Itwill introduce the various reasonspeople may need, or want, to excludecertain foods from their diet. At theback of the guide is a collection ofrecipes suitable for a variety of thesedietary requirements.

There are many reasons why peoplemay exclude foods from their diet.These include allergies, intolerances,autoimmune diseases, personal beliefs,and religious, philosophical andcultural beliefs.

Catering for service users’ dietaryrequirements is an important aspect ofhonouring equality and diversity withinyour care establishment. Your serviceusers are individual people. You shouldalways strive to ensure that theirdiverse needs are met and that they

have equal access to the services youprovide – whether that is appealingvegan food at a summer barbecue, ora slice of gluten-free cake as part of abirthday celebration.

With a little thought and planning,catering for those with dietaryrestrictions needn’t create extra work. Itcan be an opportunity to create new,exciting and innovative dishes.

This is of course a guide only – thebest way to find out what is suitable fora service user is to ask them! No oneknows more about their dietary,religious or philosophical needs thanthey do.

Around one third of theUK population willdevelop an allergy atsome point in their lives.A significant proportionof these – around amillion people – suffersevere symptoms

(Allergy UK).

44% of Brits either donot eat meat, havereduced the amount ofmeat they eat or arewilling to cut down

(Eating Better Alliance 2017).

Older people (65 to 79years) are twice as likelyto have reduced theirmeat consumption as18- to 24-year-olds

(2014 British Social Attitudessurvey).

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Any principle that is central to aperson’s belief system should berespected, and the law reflectsthis. Preventing or limiting the lifechoices of vegans through indirectdiscrimination could be seen asacting unlawfully.

11 Peanuts – are actually a legumeand grow underground (which iswhy they are sometimes calledgroundnuts). They are often used asan ingredient in biscuits, cakes,curries, desserts, sauces (such assatay sauce), as well as ingroundnut oil and peanut flour.

12 Seasame seeds – often found inbread (commonly sprinkled on top),breadsticks, hummus, sesame oiland tahini.

13 Soya is a staple ingredient inOriental food. It is used to maketofu. It can also be eaten in theform of edamame beans, and canbe found in miso paste, texturedsoya protein, soya flour, desserts,ice cream, processed meatproducts, sauces and vegetarianmeat alternatives.

14 Sulphur dioxide is often used indried fruits such as raisins, driedapricots and prunes. You might alsofind it in meat products, soft drinks,vegetables, as well as wine andbeer. If someone has asthma theyhave higher risk of developing areaction to sulphur dioxide.

We have attempted to label the 14major allergens in the recipes in thisguide, though ingredients will ofcourse vary, depending on the exactbrands that you use to make a recipe. Ifyou have a service user with allergies,you can get more information from theAnaphylaxis Campaign website:anaphylaxis.org.uk.

Kitchen hygiene Depending on the diet that you arecatering for, work surfaces,chopping boards, utensils and otherequipment should either be keptseparate from those used for thepreparation of ‘forbidden’ foods, orcleaned thoroughly beforehand.Cross contamination should beavoided between vegetarian andvegan foods, and also betweenthose that are ‘forbidden’ andpermitted on other diets. Pleaseensure that fryers, grills andgriddles used for meat and fish arethoroughly cleaned. Fryers must befilled with fresh, uncontaminated oilbefore vegetarian or vegan food iscooked, in the same way as youwould for other religious orphilosophical beliefs.

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Service users with allergies and intolerancesAnaphylaxis is an extreme and severeallergic reaction. The whole body isaffected, with symptoms includingflushing of the skin, swelling of thethroat, alterations in heart rate, andasthma. For some people, this iscaused by eating peanuts, sesame,fish, dairy products and eggs. But itcould be anything; it depends on theindividual.

There are 14 major food allergenscovered by EU Allergy Law. Theseallergens must legally be listed on foodpackaging and will be highlighted inbold.

1 Celery includes celery stalks,leaves, seeds and the root calledceleriac. Celery can be found incelery salt, salads, some meatproducts, soups and stock cubes.

2 Cereals containing gluten –wheat, rye, barley and oats areoften found in foods containingflour, such as some types of bakingpowder, batter, bread andbreadcrumbs, cakes, couscous,meat products, pasta, pastry,sauces, soups and fried foods thatare dusted in flour.

3 Crustaceans include crabs,lobster, prawns and scampi. Also bemindful of shrimp paste, often usedin Thai and south east Asian curriesor salads.

4 Eggs often found in cakes, somemeat products, mayonnaise,mousses, pasta, quiches, saucesand pastries or foods brushed orglazed with egg.

5 Fish – found in fish sauces, somepizzas, relishes, salad dressings,stock cubes and Worcestershiresauce.

6 Lupin seeds are normally crushedand used to make lupin flour, whichcan be used in different types ofbread, pastries, pies and pasta.Some people with a peanut allergyare also allergic to lupin.

7 Milk is used in butter, cheese,cream, milk powders and yoghurt. Itcan also be found in foods brushedor glazed with milk and inpowdered soups and sauces.

8 Molluscs include mussels, snails,squid and whelks but can also befound in oyster sauce or as aningredient in fish stews.

9 Mustard includes liquid mustard,mustard powder and mustardseeds. These ingredients can alsobe found in breads, curries,marinades, meat products, saladdressings, sauces and soups.

10 Nuts – this refers to nuts thatgrow on trees, such as cashew nuts,almonds and hazelnuts. You canfind nuts in breads, biscuits,crackers, desserts, nut powders,stir-fried dishes, ice-cream,marzipan, nut oils and sauces.

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ALLERGIES, INTOLERANCES &AUTOIMMUNE DISEASES

Here are roving chef Ollie’s top 10 gluten-free products:1 Ugo Thrive Chickpea Fusilli. I love

this pasta – it’s high in protein,cooks in moments, and avoidsbeing too tough unlike some otherchickpea pastas.

2 BFree sweet potato wraps. Versatileand delicious wraps! Great filledwith vegan chilli, beans, guacamoleor crispy marinated tofu and salad.

3 Marigold low-salt vegetablebouillon. Gluten-free and vegan.

4 Kallo organic dark chocolate ricecake thins. A great snack on the go.

5 Clearspring tamari soy sauce. Richand flavoursome soy sauce.

6 Nairns gluten-free oatcakes.Perfect for dipping or topping withyour favourite things. Try them withhummus or vegan cheese andchutney.

7 Doves Farm – range of gluten-freeflours. All their flours are organicand excellent for cakes and breads.

8 Gram flour/besan is rich in proteinand gluten-free because it’s madefrom chickpeas. Most commonlyused in Indian dishes such as bhajis,pakoras and sometimes sweetdishes. It’s vegan too and makes agreat substitute for eggs in dishessuch as quiche and pancakes.

9 Baileys Almande Almond MilkLiqueur. What more can I say – acreamy vegan Baileys!

10 Free from fellows gummy bears –gelatine-, gluten- and sugar-freeyummy sweets.

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Coeliac disease Coeliac disease is not a food allergy orintolerance, but rather an autoimmunedisease where eating gluten causes thelining of the small intestine to becomedamaged. Therefore, people withcoeliac disease must follow a gluten-free diet. It affects 1 in 100 people inthe UK. Most people diagnosed withcoeliac disease are over 50 years old.

Gluten is a protein found in the cerealswheat, rye and barley. Pastas and breadsare common examples of foods thatcontain gluten. You can however easilyfind gluten-free alternatives in mostmajor supermarkets and wholesalerssupplying the care sector. People withcoeliac disease must also avoid barleyand rye, and some are sensitive to oats.To find out more about which ingredientsand recipes are gluten-free, visit theCoeliac UK website: coeliac.org.uk

Wheat allergy vssensitivityWheat allergy (antibody mediated) isthought to be rare, but the number ofpeople self-reporting an allergy orsensitivity to wheat is increasingdramatically. You may therefore comeacross a service user with a wheatsensitivity (and in rarer cases, a true,antibody-mediated allergy) who avoidswheat. A wheat sensitivity won’t causedamage to the gut in the same way ascoeliac disease, but it may causeunpleasant symptoms such as bloating,diarrhoea, cramps and sickness.

A wheat allergy should of course becarefully managed.

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ALLERGIES, INTOLERANCES &AUTOIMMUNE DISEASES

be incompatible with human dignity,and reflect a weighty and substantialaspect of human life and behaviour.

Based on such reasoning, anapplication to the Court for theprotection for a belief in fox huntinghas been rejected. On the other hand,the Commission of the Court found in1992 that veganism was within thescope of Article 9. In this case, it isnotable that the UK Government didnot contest that veganism was withinthe scope of protection.

The implication of leaving theEuropean Union or the development ofa specific British Bill of rights does notmean that vegans no longer have avoice.

This is because if we look at thestructure of human rights obligationswe see that in addition to beingobliged by the European Conventionand the equality regulations thatemerge from the European Union, theUK is also a signatory to theInternational Bill of Rights.

The International Bill of Rights is theUniversal Declaration of Human Rights

and the two Covenants that give legaleffect to its terms.

One of these Covenants is theInternational Covenant on Civil andPolitical Rights.

The right to freedom of belief mustbe broadly construed and not limited inits application to traditional religions orbeliefs with institutional characteristicsor practices.

To conclude, though the UK isobligated by human rights and equalitymeasures from its membership ofEurope and the European Union, thedevelopment of a specific British Bill ofRights and Brexit do not remove theobligation to recognise andaccommodate qualifying, non-religiousbeliefs that require practicalmanifestation.

The right to freedom of belief ininternational law is sufficiently definedand explained to support therecognition and protection ofveganism.

With thanks to Jeanette Rowley, Founding Memberof the International Vegan Rights Alliance.

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Religious, philosophical and cultural dietary requirements The main religion in the UK isChristianity at 60% of the population,however there is now a wide range ofreligious beliefs in the UK, which will bereflected in your service users.

Almost 5% of the UK population areMuslim, 1.5% Hindu, 0.8% Sikh and0.5% are Jewish. It is essential forcaterers to recognise and cater fordifferent religious, philosophical, andcultural needs. Dietary practicesbetween and within different faiths canbe diverse, so it’s important not tomake assumptions.

Some service users may excludecertain foods from their diet or havespecific dietary requirements such ashalal or kosher food. They may chooseto fast at certain times of the year ormay change their diet during religiousfestivals. Communication is key. If aresident does choose to fast, certainchanges in routine would need to beaccommodated. For example, if fastingfor Ramadan, food would need to beprovided before sunrise and aftersunset. Being able to celebratereligious days and festivals is likely tobe important to the service user.

How veganism is protected by the lawThe Equality and Human RightsCommission states that human rightsprotect a wide range of non-religiousbeliefs, including veganism.

When we talk about veganism as aprotected belief in human rights, weare referring to a specific area ofhuman rights law known as the right tofreedom of thought, conscience andreligion. The origin of this right withinthe European system of human rightsis Article 9 of the European Convention.It grants an absolute right to think andbelieve; to work out and develop our

own moral orientation. And it grants aqualified right to manifest in everydaylife associated practical ethicalconvictions.

The meaning of ‘belief’ for thepurposes of granting a protectedstatus to the manifestation of ethicalconvictions is particularly welldeveloped. A qualifying non-religiousbelief will be a philosophical belief thatattains a certain level of cogency,seriousness, cohesion and importance.In addition, a qualifying belief will beworthy of respect in a democracy, not

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RELIGIOUS, PHILOSOPHICAL ANDCULTURAL DIETARY REQUIREMENTS

• Dietary practice requires theseparation of meat and milkproducts which must not be servedat the same meal or cooked together.

• For Jewish service users who keepkosher, it is often advisable topurchase specially prepared andsealed kosher meals from a certifiedsupplier to avoid complications. Afood guide listing all foods certifiedas kosher is available from theLondon Beth Din: kosher.org.uk

SIKH FAITH*• Some Sikhs are vegetarians, and

may avoid all meat, fish and eggs.• Other Sikhs may eat meat but will

not eat meat slaughtered accordingto the guidelines of other religions(halal or kosher) and some do noteat beef or pork.

• Observant Sikhs will not consumealcohol.

*Text reproduced with permission fromqcs.co.uk/meeting-service-users-religious-dietary-needs

Vegetarianism is particularly importantin the Hindu, Buddhist, Rastafarian andJain faiths. It’s always good practice toprovide a vegetarian option atmealtimes.

BUDDHIST FAITHBuddhists try to do no harm (or as littleharm as possible) to animals and showloving kindness to all beings. There areno set dietary laws and a great deal ofdiversity. Not all Buddhists arevegetarian, but many are. Many

Buddhists practice vegetarianism on thebasis of ‘do not harm’ and/orreincarnation principles. Some arevegan. Other groups, often from Chinaor Vietnam, will not eat onion, garlic orleek (‘pungent spices’), and Tibetans willrarely eat fish and often avoid chicken.

JAIN FAITHJains are strict vegetarians. Jainsbelieve that animals and plants, as wellas human beings contain living souls.Each of these souls is considered ofequal value and should be treated withrespect and compassion.

RASTAFARI FAITHRastafarians eat a diet containing lotsof fruit and vegetables and refrain fromeating meat.

SEVENTH-DAY ADVENTIST FAITHSeventh-day Adventists believe infollowing a healthy lifestyle andpromote a well-balanced vegetariandiet including consumption oflegumes, wholegrains, nuts and fruitsand vegetables:adventist.org/en/vitality/health

VEGETARIAN AND VEGANAn estimated 350,000 people agedover 65 in the UK are vegetarian andvegan, and this number is rising. Ofthese, over 7,000 already live in UKcare homes.

The main reasons why someone maychoose to be a vegetarian or vegan areanimal welfare, the environment,health or religious, spiritual and moral

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As well as considering religion andphilosophical beliefs, it’s important tothink about catering for a diverse rangeof cultures. For example, you could findout what meals a service user wouldhave traditionally cooked and eaten athome and try and provide some ofthese dishes. It might be a nice idea toget the service user or their family toprovide a recipe that could be cookedfor them or allow the family to bringfood in for them. The other serviceusers may enjoy trying a dish fromanother culture too. You could provideingredients or dishes that may be morefamiliar to the service user such asyam, plantain, okra, dhal, curries,chapati or rice and peas.

Below is a summary of dietaryrequirements of different religions,philosophical beliefs, and cultures.Remember, though, that the best wayto find out what is suitable for a serviceuser is to ask them.

ISLAMIC FAITH*• A halal diet is followed by people of

the Islamic faith typically originatingfrom Pakistan, Bangladesh, MiddleEast, Malaysia, Indonesia, Sri Lankaand Africa.

• Unlawful foods for observantMuslims include: pork and porkproducts; meat not slaughtered byproper halal methods; foodscontaining ingredients or additivesfrom a pig or non-halal meat; foodscontaining gelatine, animal fats oremulsifiers from animal derivatives;blood and its by-products and

alcohol. The acceptance of shellfishvaries by community.

• Queries about manufactured foodsthat have been certified as halal canbe addressed to the Muslim FoodBoard UK: tmfb.net/home

HINDU FAITH*• A Hindu diet is followed by people

from the Gurajat and Punjab areasof India and also east Africa.

• Dietary practices and foodrestrictions of the Hindu diet varydepending on the individual. ManyHindus practice vegetarianism,eating largely plant-based foods –fruit, vegetables and pulses – andavoid all meat, poultry and seafood.

• Eggs are not usually eaten, butcakes or biscuits containing eggsare mostly considered acceptable.

• An increasing number of Hindusresiding in the UK, particularly men,eat meat such as mutton, lamb,chicken and fish. However, the cowis considered sacred andconsumption of beef is rare.

JEWISH FAITH*• Observant Jews never eat pork and

pork products, and will onlyconsume kosher meat, i.e. meatsfrom ruminant animals with splithooves and that chew the cud (e.g.beef, lamb, mutton or goat), orpoultry (chicken, duck, turkey andgoose) that has been slaughteredaccording to religious guidelines.

• Only fish with scales and fins areeaten (not shellfish or eels).

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RELIGIOUS, PHILOSOPHICAL ANDCULTURAL DIETARY REQUIREMENTS

Below our roving chef Maggie shares her top10 vegan products:1 Yeast flakes are a good source of

vitamin B12 – just make sure youbuy the fortified version. They havea savoury taste, similar to cheese,and can be used as a topping forpasta, soup or added to popcorn ormashed potato.

2 Henderson’s Relish is the veganversion of Worcestershire sauce –Henderson’s contains no fish! It hasa rich umami flavour and works wellto add deep flavours.

3 Alpro soy yoghurt is readilyavailable at most supermarkets,from plain through to fruit and noweven ‘protein’, which is similar tothick set Greek yoghurt.

4 Silken tofu is a versatile ingredientthat has been used in Easterncooking for many years. It has abland jelly-like consistency that canbe used to replace eggs in bakingand in other dishes such as mousseand cheesecake. Adding a fewherbs and spices can create ‘tofuscramble’, a dish similar toscrambled eggs. Can be found inmost large supermarkets, onlineand in Eastern food shops.

5 Bournville chocolate* has been aUK favourite for many years, and iscurrently made to a vegan recipe.

6 Bird’s custard powder contains noeggs. Simply add a non-dairy milksuch as oat or soya to create vegan-friendly custard.

7 Jus-Rol pastry has a range ofproducts that use vegetable fatinstead of butter. Their shortcrust,puff and filo pastry, as well as theirvol au vents, cinnamon swirls,croissants and pizza bases arecurrently vegan. Just check thepackaging because their all butterpastry does contain real butter.They also do a range of gluten-freepastry.

8 Bisto original gravy – another UKfavourite doesn’t contain any meat.Their original gravy powder andonion gravy granules are vegetarianand vegan.

9 Vitalite is a non-dairy spread madeusing sunflower oil and added Bvitamins. It is 75% lower insaturated fat than regular butterand works well as a spread and inbaking.

10 Cadbury’s hot chocolate* is madeto a vegan recipe, so making it upusing regular non-dairy milks canmean it is vegan friendly.

* May contain traces of milk.

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beliefs. There are also many olderpeople who choose to reduce theirmeat consumption for health reasons,or because they struggle to eat meat.Observationally, chewing teeth canalso become worn after many years ofuse, making it difficult for the olderadult to chew foods well enough toswallow without harm. There areperceptions that cutting down on meatmay also save them money.

VEGETARIAN DISHES MUST NOTCONTAIN:• Animal flesh (meat, fish or shellfish)• Meat, fish, or bone stock, or stock

cubes containing same • Animal carcass fats (including suet,

lard or dripping) • Gelatine, gelatine-based jelly, or

aspic (jelly made from meat stock) • Products with ingredients derived

from slaughterhouse e.g. animalrennet in cheeses such as Parmesan

• Battery or intensively producedeggs should be avoided whereverpossible. Please consult individualresidents regarding their opinionabout egg

VEGAN DISHES MUST NOT CONTAIN:• Dairy products including cheese,

milk, butter, cream, yoghurt andwhey

• Eggs • Products with ingredients derived

from eggs or dairy, e.g. albumen,casein, ghee, lactose or whey

• Honey • Shellac

While this may sound a littlerestrictive, there are still plenty of foodsthat vegetarians and vegans can eat.Most recipes can easily be adapted.You can find vegan alternatives formost products such as milk, butter,cream and cheese in mostsupermarkets and wholesalerssupplying the care sector. Somevegetarian and vegan service usersmay enjoy ‘mock meat’ products whileothers may not.

All service users can enjoy vegan,and often vegetarian food – and youmay find that replacing meat proteinwith vegetables and grains can reduceyour overall menu costs. The vegandiet is the most universally acceptable.If you hosted a party with arepresentative from each of the world’sreligions and cultures, you could befairly sure of not offending any dietarycodes by offering vegan food. So whynot feed everyone a vegan meal oncein a while? It’s genuinely healthy; you’lladd to variety; and you’ll be well withinbudget.

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If service users are no longer ableto communicate clearly, it isimportant to take advice fromrelatives or friends and to try torespect principles held in healthiertimes without over-riding theresidents’ right of choice. Seepages 14 to 16 for a fullerdiscussion of this topic.

RELIGIOUS, PHILOSOPHICAL ANDCULTURAL DIETARY REQUIREMENTS

may be that someone desires the foodthat they see others eating, notrealising that it is meat, or somethingthat would otherwise go against theirdietary beliefs or make them ill.

A wealth of alternatives to meat anddairy are now available, and thesealternatives are commonly eaten byvegans and vegetarians in their ownhomes. In the comfort of familiarsurroundings where food preferencesare known, the shorthand of ‘sausage’,rather than ‘vegan sausage’, or ‘pie’rather than ‘vegetarian pie’ is incommon use. A person with vegetarianor vegan philosophical beliefs is highlyunlikely to be imagining meat whenthey eat these products – meat isusually now seen as a ‘non-food’. Butthey may simply enjoy the convenienceof products that are shaped to easily fitinside a sandwich. So in a mixedenvironment, when meat sausages areon the table, it is easy to see howmistakes in choice could be made.

HOW MIGHT THIS BE AVOIDED?Vegetarian for Life recently launched aMemory Care Pledge that will be takenby care homes up and down the UK.

This is to help ensure that vegetariansor vegans who have capacity issues, orcognitive losses, will be offered achoice of meals, drinks and snacks thatuphold their ethical beliefs.

You can sign-up and request up-to-date best practice guidance and trainingby visiting our website:vegetarianforlife.org.uk/pages/pledgeor by calling the charity on 0161 257 0887.

HOW MIGHT THIS BE MANAGED?People with dementia and their carershave the right to be able to enjoyhuman rights and fundamentalfreedoms in every part of their dailylives, and wherever they are. Thisincludes full respect for their dignity,beliefs, and individual circumstances.Personal profiles such as the ‘This isme’ document (Alzheimer’s Society)help staff to know and understand aperson’s wishes. Please also see thesuggestions on page 16.

There is a challenge, however, if aperson’s current wishes come intoconflict with their previously heldconvictions – e.g. they are now‘requesting’ meat.

For an older person whoseconvictions will have been at the coreof their identity for many years, a moveaway from their vegetarian/veganbeliefs may further undermine a senseof identity already threatened bycognitive impairment.

Many people would be reluctant tocompromise religious beliefs or allergies.You would expect care providers to thinktwice before offering a bacon roll to aRabbi with dementia, or regular toast tosomeone living with coeliac disease,even if a refusal causes distress. A long-standing vegetarian or vegan’s beliefsshould be similarly respected.

There is legal protection for this, too(see page 8). Preventing or limiting thelife choices of vegans – or anyone on aspecial diet – through indirectdiscrimination could be seen as actingunlawfully.

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Loss of capacity and requests for ‘unusual’ foodsWHAT DOES DEMENTIA MEAN FORPEOPLE ON SPECIAL DIETS, ANDTHOSE WHO CATER FOR THEM? The decision to be vegetarian or veganoften reflects deeply-held ethical,environmental, or religious convictions.But Vegetarian for Life is currently onlyaware of two fully vegetarian carehomes in the UK, offeringIndian/Gujarati food.

This means that people withvegetarian or vegan philosophicalbeliefs are likely to be a minority groupin your care. They are already found inat least one in every five UK carehomes, according to Vegetarian forLife’s 2019 survey.

Some years ago an older woman, whohad been a dedicated animal rightscampaigner, entered care afterdeveloping dementia. While in care, shewas given food containing meatproducts – a practice consideredacceptable by staff because she‘wouldn’t know any different’. Yet in spiteof this she still identified as a vegan. Wewould hope that something like thiswouldn’t happen today, but staff can stillbe daunted by the challenges ofcatering for vegetarians and vegans.

Recently, care providers havehighlighted instances where avegetarian/vegan with dementia hasdemanded meat, or tried to take it fromsomeone’s plate.

In such circumstances, those whocare for them are faced with a difficultethical dilemma.

Why might this be happening?

A STEP BACK: IS YOUR VEGETARIANOR VEGAN SERVICE USERDEFINITELY ASKING FOR MEAT?It seems unlikely that a service userwith dementia or cognitive loss willhave reconsidered their philosophicalbeliefs while in care.

In addition to communicationdifficulties, people with dementia canexperience specific issues aroundrecognising food types, as well assensory changes (including taste). It

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DAIRY-FREE VS VEGANAn important note about thedifference between vegan anddairy-free diets. Someone with amilk allergy would need to avoidall foods containing dairy,including those made in a factoryproducing dairy-containingproducts. Many vegans, on theother hand, would eat productsmade to a vegan recipe in afactory also producing dairy-containing products. Therefore,many vegans do eat dairy-freeproducts labelled ‘may containtraces of milk’.

RELIGIOUS, PHILOSOPHICAL ANDCULTURAL DIETARY REQUIREMENTS

reminding Mrs F of what her wisheswere and the reasons for them.

3 Language used should be carefullycrafted, e.g. “In the future, if mydecision-making capacity isquestionable and I appear to wantmeat, please consider providing mewith mock meat products in theirplace”. Although we cannot ignore aperson’s current wishes, and anadvanced plan cannot be completely‘fixed’, such a statement couldprovide family and caretakers withguidance about how to proceed. Itcould also be that crucial piece ofclear information that makes a carerfeel assured in their decision toquestion or deny a resident's present

demands for meat, and instead tryto advocate for them to eat avegetarian or vegan meal.

Order a free advance-care planningguide from Vegetarian for Life by calling0161 257 0887.

Final noteBecause appetite may lesson with age,potentially leading to weight loss, it canbe helpful to enrich the calorie contentof food. This guidance can be used inconjunction with other fortificationadvice, and is intended to illustrate theenergy and protein content of plant-based fortification agents.

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Furthermore, a vegetarian or veganwho has not consumed meat or fish –or, in the case of a vegan, dairy products– for perhaps 50 years or more, maywell find such foods hard to digest.

CASE STUDY: LEARNING FROMADVANCED CARE DECISIONSA key ethical problem is what happensif someone with dementia makes adecision that contradicts their previouswishes?

Consider the case of a 75-year-oldwoman with Alzheimer’s, Mrs F. WhenMrs F started to lose capacity, shechanged her mind about issues that hadonce been extremely important to her.Her husband wanted to respect herprevious wishes, and so reminded Mrs Fabout what she had wanted when shehad full capacity. Her carers wanted torespect her current wishes, and did notremind Mrs F about her previous wishes.

Is reminding someone with dementiaabout decisions they made when theyhad full capacity coercive, or helpful?Should care workers respect thedecisions an individual made beforethey lost capacity; or should theyuphold the decisions a person makessince living with dementia? This is a bigdebate with no clear answer, and it is adebate that will continue to grow asdementia figures rise in the UK.

For vegetarians and vegans, this is apressing issue. Many people want toavoid eating meat or animal productsat all costs for the remainder of theirlives – but right now, there is noguarantee that these wishes will be

respected in the case of dementia.For those who are adamant that they

want their previous, full-capacitydecisions to be respected, there maybe some useful lessons:

1 It is important to have theconversation about one's futurewishes. This conversation should behad with witnesses, with allimplicated parties, and if possible,everyone should agree to supportthe decision. If a vegan or vegetarianhas had these importantconversations ahead of time, thenpeople will remember this convictionand should take it into account.

2 Advanced care planning – nomatter how many contingencies weplan for, we cannot foresee themall. Words, whether written or oral,are subject to varyinginterpretations. Still, written, audio,or video documentation of Mrs F’swishes might have proved helpful.They might have proved helpful infortifying Mr F’s resolve, inconvincing her caretakers of whather wishes were, and perhaps theymight even have proved helpful in

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FORTIFICATION AGENTS FOR SPECIAL DIETSFood Measure Energy (kcal) Protein (g)Soya protein powder (soya) 30g 116 27Pea protein powder 30g 107 23Gram (chickpea) flour 30g 106 7Peanut butter (peanut) 25g 152 6Almond nut butter (nuts) 25g 163 6Cashew nut butter (nuts) 25g 165 5Higher protein soya yoghurt (soya) 125g 89 8Soya yoghurt (soya) 125g 63 5Creamed coconut 15g 105 1Vegan mayonnaise (mustard) 15g 66 0Cream cheese alternative

(may contain soya) 20g 48 0Syrup 15g 45 0Vegetable oil Teaspoon 25 0Dairy-free spread (may contain soya) 5g 25 0Soya cream (soya) 15g 23 0Oat cream (oats) 15ml 22 0.1

Our suggested good practice is toconsider providing foods that looksimilar but that allowvegetarians/vegans to eat inaccordance with their beliefswithout feeling excluded.Vegetarian or vegan meatalternatives (‘mock meats’) are anobvious example.

RELIGIOUS, PHILOSOPHICAL ANDCULTURAL DIETARY REQUIREMENTS

Spicy courgette and pea frittersSERVES 4

Make this gluten-free by using gramflour and gluten-free baking powder.

l 2 medium courgettes, gratedl 100g plain flour ( or gram

flour)l 1 tsp gluten-free baking powderl 1 small onion, finely choppedl 50g frozen peas, defrostedl 2 cloves of garlic, finely choppedl Salt to tastel 1 green chilli, choppedl Handful coriander, choppedl 1 tsp chilli powderl 1 tsp garam masalal 1 tsp cumin seedsl Oil for cooking

1 Grate the courgette and sprinkle withsalt and leave for as long as you can.Place it in a colander in the sink,squeezing out any excess water.2 In a bowl mix together the flour andbaking powder.3 Add the grated courgette, onion, peas,garlic, salt, chilli, coriander, chilli powder,garam masala and cumin seeds.4 Squeeze and mix everythingtogether. If it’s a little dry add a touchof water.5 Heat 2 tablespoons oil in a non-stickfrying pan.6 Take a large spoonful and place inthe hot pan. Gently press to flatten (itwill be sticky) and shallow fry fritters.Reduce the heat if it gets too hot.

7 Cook on the first side until goldenthen flip and cook the other side.

Reproduced with kind permission from HariGhotra harighotra.co.uk

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RecipesWe have attempted to label the 14major allergens in the recipes thatfollow, though ingredients will ofcourse vary, depending on the exactbrands that you use to make a recipe.

All of the recipes featured can bemade using vegan ingredients thatsatisfy most other religious andphilosophical beliefs.

As a safeguard, you can if you wishmake these dishes using ingredientsthat are approved by the Vegan Societyor Vegetarian Society. Productsdisplaying these societies’ logos will befree from meat products – and from allanimal products, in the case of theVegan Society. However, they maycontain alcohol, because alcohol* ispermissible for vegetarians and vegans.There is a possibility that alcohol may bepart of a flavouring, flavour enhancer, orprocessing aid. This alcohol might notbe declared on the ingredients list –making it unsuitable for a halal diet.

While every care has been taken toensure that the recipes featured in thisguide can be made suitable for a veganor other featured special diet at the timeof going to press, we recommend thatyou satisfy yourself that the dishes willmeet the dietary requirements of theservice user that you are catering for.

KEY TO SYMBOLS USEDCan be egg-freeCan be gluten-freeCan be halalCan be milk-freeCan be mustard-freeCan be oat-freeCan be soya-freeCan be wheat-freeContains celeryContains glutenContains milkContains mustardContains nutsContains oatsContains sesameContains soyaMay contain crustaceansNot halalH

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*Some alcoholic drinks may not besuitable for vegetarians or vegansbecause of the filtering process priorto bottling.

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Szechuan black-eyed pea salad SERVES 4–6This salad tastes great wrapped intortillas or served over baby spinachthat’s been sautéed in a small amountof olive oil.

l 2 (400g/14oz) cans black-eyedpeas, rinsed and drained

l 1 medium green bell pepper,chopped (1 cup)

l ½ cup red onion, chopped l 1 jalapeno pepper, seeded and

finely minced (2 tbsp) l 1 garlic clove, minced (1 tsp) l 1 avocado, cubed (1 cup) l 2 tbsp lemon juice l ¼ cup olive oil l 3 tbsp red wine vinegar l 1 tbsp Szechuan sauce l 2 tsp sugar

1 Toss together black-eyed peas, bellpepper, onion, jalapeno pepper, andgarlic in large bowl. 2 Toss avocado with lemon juice in aseparate bowl. 3 Then add the avocado to the black-eyed pea mixture. 4 Whisk together oil, vinegar, Szechuansauce, and sugar in bowl used foravocado. 5 Toss black-eyed pea mixture withSzechuan sauce dressing.

Original recipe submitted by Laura McAllister.Reproduced with kind permission fromInternational Vegetarian Union ivu.org

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Falafel burger with tomato salsaSERVES 4This burger is really satisfying – plus thechickpeas pack a fibre and protein punch.

l 2 tbsp olive oill 1 onion, peeled and dicedl 1 carrot, peeled and gratedl 4 garlic cloves, crushedl 1 tsp lemon juicel 1 tsp ground cuminl 1 tsp ground corianderl Salt and pepper to tastel 1 can chickpeas, drainedl 50g gram (chickpea) flourl 3 tbsp fresh coriander, choppedl 3 tomatoes, choppedl ½ red chilli, deseeded and chopped

(optional)l Brown seeded gluten-free burger

buns or ( use egg-free regularburger buns )

l 1 gem lettuce

1 Heat 1 tablespoon of the oil on amedium heat in a small frying pan. Add¾ of the diced onion (reservingthe other ¼ for the salsa) andfry for 3–4 minutes withoutbrowning the onion. Add thegrated carrots and ¾ of thegarlic (again reserving the restwith the saved onion for thesalsa) and cook together for afurther 5 minutes.2 Remove from the heat andadd the lemon juice, cumin,and ground coriander. Season

with salt and pepper.3 Blend the drained chickpeas so theyare chopped finely, then add them tothe onion mix with the chickpea flourand 2 tbsp of the fresh coriander. Mixtogether so it’s all combined, and thendivide and shape into four equalpatties. Refrigerate until needed.4 To make the salsa, add the choppedtomatoes into the onion and garlicreserved earlier. Add the remaining 1 tbsp fresh coriander (and chilli ifusing) and combine.5 Pan-fry the falafel burgers in atablespoon of oil for 3–4 minutes eachside or until cooked through.6 Serve in a toasted brown seeded bun,with fresh lettuce and the tomato salsa.

This recipe goes perfectly with polentachips. Find the recipe online atcoeliac.org.uk/polentachips

Reproduced with kind permission from CoeliacUK coeliac.org.uk

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Other ingredients: l 2 tbsp fermented black beans

(douchi)l 2½ tbsp sunflower oill 1-inch (2.5 cm) piece fresh ginger,

peeled and cut into small piecesl 2–3 cloves garlic, finely mincedl ½ small green pepper, deseeded

and cut into largish piecesl ½ small red pepper, deseeded and

cut into largish piecesl 2 red finger-length chilis, deseeded

and cut into thin roundsl 1 small onion, cut into largish pieces

(or a handful of spring onions,chopped into large pieces)

l Salt, to taste

1 Marinate the ‘chicken’ with the ricewine and cornflour. Refrigerate for 20minutes.2 Prepare the black beans: soak themfor 15 minutes, rinse and drain, thensquash with the back of a spoon toform a rough paste.3 Mix all the ingredients for the saucein a small bowl. Set aside.4 Heat ½ tablespoon of the oil in a wokor skillet over high heat. Add the‘chicken’ and stir-fry until the piecesturn golden (approx. 2–3 minutes). Dishout and set aside.5 Heat the remaining 2 tablespoons oilin a wok over a high heat. Add thegarlic and ginger and stir fry until theyturn light brown.6 Stir in the fermented black beans,peppers, onion and red chilli. Stir fry forabout 1–2 minutes.7 Return the ‘chicken’ to the wok, stirand blend well with the otheringredients, about 1 minute.8 Add the sauce and stir until the‘chicken’ is cooked through – approx. 5minutes. Add salt to taste.9 Transfer to a serving dish then dishup into bowls on top of steamed rice.

Reproduced with kind permission from JewishVegetarian Society jvs.org.uk

Vegetarian ‘chicken’ in chilli and black bean sauce

SERVES 2Can be gluten-free. For a list of

gluten- and soya-free meatalternatives, check out our list at:vegetarianforlife.org.uk/pages/meat-alternatives

For the marinade:l 1 tbsp rice wine (e.g. sake) l 1 tsp cornflour

For the ‘chicken’:l 250g/8oz (approx.) seitan , tofu

or meat-free ‘chicken’ (e.g.VegiDeli ‘Chicken Style Pieces’ )cut into bite-sized cubes

For the sauce:l 1 tbsp light soy sauce l ½ teaspoon sesame oil l a generous sprinkle white pepperl 2 tbsp sugarl 4 tbsp waterl 2 tsp cornflour

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Asparagus, potato & broccoli quicheSERVES 6

Can be made gluten-free by usingJus-Rol™ gluten-free pastry andgluten-free vegetable stock such asMarigold vegetable bouillon.

l 1 packet shortcrust vegan pastry , e.g. Jus-Rol™ ( or gluten-free

vegan pastry) l 120g chickpea flour (this cannot be

substituted for any other kind offlour)

l 600ml hot vegetable stock

l 3 heaped tbsp nutritional yeastl 1 tsp dried oreganol ½ tsp dried basill ½ teaspoon turmericl ½ tsp black salt (Kala Namak).

Optional, but will give the mixture ataste of egg

l 5 jersey royal potatoes, steamed orboiled until just cooked, and slicedinto small pieces

l 4 broccoli florets, steamed or boileduntil cooked, and cut into quarters

l 10 spears asparagus, uncookedl 1 large tomato, slicedl Vegan cheese for topping, e.g.

Sheese Mature Cheddar Style( optional)

1 Preheat oven to 180°C/350°F/gasmark 4.2 Grease and line a 20cm/8-inchquiche pan.3 Roll out pastry to 0.5cm thicknessand line quiche pan.4 Blind bake for 15 minutes. Removeand set aside for later.5 In a bowl combine the chickpea flourand half the stock. Whisk together welland set aside.6 In a wide-bottomed saucepan, addthe remaining stock, nutritional yeast,spices and black salt then bring to theboil. The mixture should begin tothicken quite quickly. When boiling,slowly add the chickpea mixture andstir continuously for 2–3 minutes.7 Remove from the heat. Addvegetables apart from asparagus to themixture and combine well.8 Pour into the prepared pastry case.Top with asparagus spears and slicedtomato in a spiked flower shape. Addoptional vegan cheese at this point.9 Bake in the oven for 30–40 minutesor until cooked. If cooking too quicklyplace foil on top until cooked throughcompletely.

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Battered tofu & nori seaweed ‘fish’ & chipsSERVES 2

Can be made Halal by replacing thelager with sparkling water.

For the chips:l 4 medium sized potatoes such as

Maris Piper or Arran Victoryl A good glug of olive oill 1 tbsp rice flourl Good sprinkle of sea salt

For the batter:l 1 cup plain flour l 1 cup rice flourl 1 tsp gluten-free baking powder l 1 tsp turmericl 1 pinch sea saltl ½ cup lager ( or use sparkling

water)l 1½ cups sparkling water

For the ‘fish’:l 1 block tofu (390g) l 2 Nori sheets (may have been

harvested in an area where shrimpsare present)

l Squeeze of lemon juicel 1 litre rapeseed or vegetable oil

For the chips:1 Peel and cut the potatoes into chip-sized pieces.2 Run cold water over them for acouple of minutes to try and get rid ofsome of the starch.

3 Bring a pan of salted water to boilthen put the chips in. Boil until theyalmost fall apart.4 Drain and pat dry, then cool beforeputting in the fridge until cold.5 Preheat the oven to 180°C/350°F/gasmark 4. Scatter the chips evenly on abaking tray, sprinkling the flour, oliveoil, sea salt and mix over the top.6 Bake for 20 minutes, or until goldenand crispy.

For the battered ‘fish’:1 Mix the dry ingredients together in amixing bowl. Add the lager and sparklingwater, and mix to form a batter.2 Cut the tofu into 10x5cm pieces witha thickness of 1.5cm. Squeeze as muchwater as you can out of the tofu usinga couple of tea towels to wrap it in andpress down.3 Cut Nori sheets to fit one side of eachpiece of tofu. Attach with a squeeze oflemon juice.4 Heat oil in a deep pan. It is readywhen you drop a small amount of batterinto it, and it floats back to the top.5 Submerge the tofu pieces into thebatter until covered, and lower into thehot oil.6 Fry for 30–40 seconds until goldenand crispy. Remove and drain onabsorbent paper to remove excess oil.7 Serve with the chips, mushy peas andketchup.

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Stewed beans with sadza SERVES 2 AS A FULL MEAL OR 4 AS ASIDESadza is a cornmeal porridge that is adietary staple for Zimbabweans. It’sknown by different names in differentparts of Africa such as ugali, mieliepap,nshima or sima.

l 300g pinto beans l 2 onions, choppedl ½ tsp curry powderl Salt and pepper to taste l 2 fresh chillies, finely choppedl ½ can tinned tomatoesl 3 mixed peppers, dicedl 4 spring onions, slicedl 200g mealie meal (sadza) l Water

1 Wash and sort the beans, discardingany shrivelled or broken ones. 2 Soak the beans for 8–12 hours orovernight in cold water three timestheir volume. 3 Once soaked, drain and rinse thebeans and place in a large saucepan.Add cold water to come an inch abovethe level of the beans4 Bring to the boil and boil rapidly for10 minutes. Lower the heat and simmerfor 60–90 minutes until the beans aretender. Use a ladle to remove any foamwhen the beans are boiling 5 In a large frying pan, sauté theonions. Next add the curry powder,black pepper and chillies. Add thetinned tomatoes and mix well. Bring

the mixture to the boil then let itsimmer for 30 minutes. 6 Finally add the diced peppers, springonions and the cooked beans to themixture. Cook for another 10 minutesand serve with the sadza.

To make the sadza:1 Put 200g mealie meal in a mediumpot. Add enough water to cover.2 Place saucepan over a medium heat,stir continuously and add more water ifrequired. 3 As the mixture heats up, the texturechanges from rough to smooth.Continue to add water to loosen themixture. It should start to look likeporridge. If it’s too thin add moremealie meal. 4 Allow the mixture to simmer on amedium heat for 5 more minutes.Gradually add more mealie meal until itresembles mash potato. Be careful notto make it too thick as it will becometoo hard. 5 Once the sadza reaches the desiredtexture and is well mixed, turn the heatoff and let it sit for a few minutesbefore serving.

Reproduced from the Flavours of AfricaCookbook produced by Manchester PublicHealth Development Service

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Yellow moong daal & spinach currySERVES 4

Can be gluten-, milk- andmustard-free.

l 4 cups chopped spinach leavesl 200g yellow moong daall 2 tbsp sunflower oill 2 tbsp ginger pastel 2 tbsp garlic pastel 1 tsp chopped green chilliesl 1 tbsp lemon juicel 1 tbsp coriander powderl 1 tsp turmeric powderl 1 tsp red chilli powderl 1 tsp mustard seeds ( use

cumin seeds if allergic to mustard)l Salt to tastel 1 tsp chopped tomato and an onion

ring for garnishing (optional)

To serve:l Naan bread ( optional)l Roti ( optional)l Basmati rice (optional)

1 Soak the yellow moong daal in abowl of hot water for 15 minutes.2 Heat oil in a pan and add mustardseeds, garlic, ginger, chopped chilli and turmeric powder. Sauté untilgolden brown.3 Rinse the yellow moong daal andadd to the pan. 4 Add two cups of water to the pan andleave on a medium heat for 5 minutes.5 After 5 minutes, add the choppedspinach to the pan and leave on amedium heat for 5 minutes6 When the spinach is cooked, add saltto taste, coriander powder, red chillipowder and lemon juice.7 Serve hot with naan/roti or basmati rice.

Reproduced with kind permission from KarunaManor Care Home tlccare.co.uk/karuna-manor

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Jollof rice SERVES 4–6You could add vegetables to the jollofrice to make it more colourful – such aspeas, sweetcorn or finely choppedpeppers. Simply add them when therice is almost cooked.

l 60ml vegetable oill 1 tin of chopped tomatoes l 1 large red pepper, choppedl 2 medium sized onions, finely

choppedl 450g American long grain rice l ¼ tsp thyme l ½ tsp curry powderl ¼ tsp chilli powderl 1½ tbsp tomato puréel Salt to taste

1 Add the oil to a large saucepan andheat for a few minutes 2 Meanwhile, blend a tin of tomatoestogether with the chopped pepper andthe onions. Once blended, add to thepan. 3 Next add the thyme, curry powder,chilli powder, tomato purée and salt tothe pan and cook for approx. 5 minutes. 4 Add the washed rice and 670ml ofboiling water 5 Allow the rice to boil for 6–8 minutes,then cover the pan and cook on a lowheat until the rice is tender and thewater has been absorbed.

Reproduced from the Flavours of AfricaCookbook produced by Manchester PublicHealth Development Service

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Sholay saag – Kale & chickpea currySERVES 4l 1–2 tbsp rapeseed oill ½ tsp mustard seeds l 1 tsp cumin seedsl 1 large onion, dicedl 4 garlic cloves, crushedl 4 plum tomatoes or 200g plum

tomatoes l 800g/2 tins chickpeas, drained

and rinsedl 1 tsp salt, or to tastel 1 heaped tsp coriander seeds, crushedl 1 green chilli, choppedl 1 tsp red chilli powderl 1 tsp turmericl 200g kale, choppedl 1 green chilli, sliced for garnish

To serve:l Poori ( optional)l Plain yoghurt ( or soya

yoghurt )

1 Heat the oil in a lidded pan over amedium heat and when it’s hot addthe mustard seeds and then the cuminseeds. 2 Stir for a minute until you can smellthe aroma of the cumin seeds and themustard seeds stop sizzling, then addthe diced onions.3 Fry the onions for 15 minutes untilthey start to brown, then add thegarlic. Fry together for 4 minutesbefore adding the tomatoes. Stir andleave to cook for a few minutes. Add alittle water if required.

4 Add the tomatoes, crushedcoriander, green chilli, chilli powder,turmeric and salt and leave to cook ona gentle heat until the tomatoes startto break down and create a thickmasala sauce (about 10 minutes).5 Turn the heat up to thicken the saucea little if required.6Add the chickpeas and stir to coatthem with the masala. Add a splash ofwater and let them simmer for 5 minutes.7Add the chopped kale, a handful at atime, stirring in between. Leave this tocook for 5 minutes until kale is soft andtender. Top with the sliced chilli and servewith poori with some fresh plain yoghurt.

Reproduced with kind permission from HariGhotra harighotra.co.uk

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Moong masoor didhal – Red lentil &split mung lentil dhal SERVES 6

Can be milk-free.

l 100g split red lentils, washedl 100g split mung beans, washedl 900ml water l 1 tsp salt

Masalal 1 tbsp ghee , butter ( or oil)l 1 tsp cumin seedsl 1 bay leafl 1 small onion, choppedl 1 garlic clove, choppedl 2 tomatoes, finely choppedl 1 tsp ginger, gratedl 1 tsp turmericl 1 chilli, finely choppedl 1 tsp garam masalal 1 or 2 whole red chillis to garnishl Handful of coriander, chopped

1 Place the red lentils in a pan with thesalt, cover with the water and bring tothe boil.2 Remove the froth and add the splitmung beans.3 Reduce the heat and put the lid on thepan. Leave to simmer for 15 minutes.4 Check the lentils are cooked bycarefully squeezing them betweenyour fingers (caution: the water will bevery hot, so allow to cool slightly first).Once soft remove from the heat.

5 In a frying pan heat the oil or butter.6 Using a fork pierce the red chilliesand add to the pan with a bay leaf andthe cumin seeds. When the seedssizzle, remove the chilli and set to oneside for your garnish.7 Add the onion and garlic and fry untillightly browned.8 Reduce the heat and add thetomatoes, ginger, turmeric, and thechopped chilli. Gently let theingredients cook down to make a thick,dry paste (10 minutes).9 Add a ladle full of the cooked lentils(dhal) to the masala paste in the fryingpan and stir together, then empty allthe contents back into the pan with thelentils and stir.10 It should have the consistency of athick soup but if it’s too thick just add alittle boiling water and remove fromthe heat.11 Stir in the garam masala, corianderand top with the whole chillies to serve

Reproduced with kind permission from HariGhotra harighotra.co.uk

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Apple andblackberry ricepuddingSERVES 4

There are many varieties of dairy-free milks including soya, oat, coconut,rice, and almond milk. When choosinga dairy-free milk, consider allergenssuch as soya or nuts, as well asindividual preference, when selectingthe best choice of milk to use for anindividual service user.

l 60g pudding ricel 200ml apple juicel 400ml alternative to milk l ¼ tsp ground cinnamonl 1 tbsp honey (not for vegans) or

maple syrupl 2 dessert applesl 100g blackberries or any other berryl Additional 1 tsp honey or maple

syrup (optional, if blackberries arenot sweet)

1 Wash the rice and then place in aheavy-based pan with the apple juice.Bring to the boil and simmer with thelid off.2 Add the dairy-free milk, cinnamonand honey (or maple syrup). Bring backup to the boil and simmer with the lidoff for 30 minutes, stirring occasionally(more often in the last 5 minutes) untilthickened. (You may need to add acouple of spoonfuls of water if it is too thick.)

3 While the rice is cooking, peel, coreand slice the apples. Add to a pan withthe blackberries and honey (or maplesyrup, if using). Cover and simmer for10 minutes, until the apples ‘fluff’ up.Keep covered until required. You canblend the topping at this point to makeit smooth.4 To assemble, spoon a quarter of therice pudding into a small dish and topwith the apple and blackberry mixture.Serve hot or cold. 5 If you are not eating this straightaway, cool and chill rice quickly and eatwithin 24 hours of cooking.

Reproduced with kind permission from PureFamily Food purefamilyfood.com

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Banana pancakes with fruitSERVES 2 Fluffy banana pancakes, easy to whiskup for a sweet treat after dinner, aweekend breakfast or great forPancake Day!

Can be milk-free Can be egg-free/vegan

l 1 bananal 125g gluten-free self-raising flourl 1 egg ( or use egg replacer)l 150ml milk ( or use a dairy-

free/vegan alternative)l Oill 160g frozen fruit

1 Mash the banana with the back of afork, until it resembles a purée.2 Add boiling water to the frozen fruit.3 Put the flour into a large bowl andmake a well in the middle.4 Beat in the egg (if using) and add themilk to make a smooth batter.5 Add in the mashed banana andwhisk until smooth.6 On a medium heat, heat a little oil ina non-stick frying pan, enough to coverthe bottom.7 Pour the batter into the bottom of thefrying pan to make 8–10cm circles.8 When bubbles start to appear on thesurface, flip the pancake and cook for 3more minutes. 9 Repeat until the batter is used up.10 Drain the fruit and serve with thepancakes.

Reproduced with kind permission from CoeliacUK coeliac.org.uk

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Photo © Pure Family Foo

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Raw chocolate trufflesMAKES 15–20You can whip these up in under 10minutes and make them your own byadding your favourite flavour –coffee/coconut/lime/chilli… orwhatever you fancy.

l 15 large unsulphured medjooldates, pitted

l 110g raw nuts – of your choice(may contain sesame seeds andpeanuts and other nuts )

l 2 tbsp extra virgin coconut oil, atroom temperature

l 4 tbsp cacao (raw cocoa) powderl 1 tbsp waterl 1 tsp ground cinnamon

1 Mix all the ingredients in a foodprocessor for about 1 minute or until aball is formed. Place the mixture in thefridge for 15 minutes. 2 Next, use your hands to form 15–20small, bitesize round truffles. Roll thetruffles in anything you like: cocoapowder, finely chopped almonds,shredded coconut, cacao, chia seeds,goji berries. Place in the fridge for 20minutes before serving.3 You can make these without a foodprocessor. Simply use a fork to mashthe dates on a plate until they aresmooth. Incorporate the remainingingredients and knead by hand untileverything is well combined. Place inthe fridge and follow the steps above.

Reproduced with kind permission from JewishVegetarian Society jvs.org.uk

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Fruity tea loafMAKES 10 SLICES

Can be gluten-free

l 150ml tea – black tea, or yourfavourite herbal tea

l 150g unsulphured dried prunes,chopped to the size of the raisins

l 75g unsulphured dried dates,chopped to the size of the raisins

l 75g unsulphured dried apricots,chopped to the size of the raisins

l 75g unsulphured raisinsl 1 tsp gluten-free baking powderl 125ml dairy-free milk (note as page 35)l 110g vegetable oill 1 banana – ripe works best herel 350g self-raising flour (

gluten-free if required) OR speltflour with gluten-free bakingpowder according to packetinstructions

l 2 tbsp orange marmalade, or anyvariety. Ginger would also work well

1 Preheat the oven to 160°Cfan/180°C/gas mark 4. Line and greasea 2lb or 900g loaf tin.2 Add the pre-prepared tea to asaucepan with the dried fruits andbring to a low simmer. Simmer for 1minute, then turn of the heat and addthe teaspoon of baking powder. It willfizz as you stir it in.3 Blend the banana, dairy-free milkand oil together, and add to the pan.Stir in the flour and marmalade.4 Pour into the tin, and bake for 50minutes, or until a skewer comes outclean.

Reproduced with kind permission from PureFamily Food purefamilyfood.com

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ORGANISATIONSAllergy UK01322 619 898info@allergyuk.org allergyuk.org

Anaphylaxis UK01252 546 100info@anaphylaxis.org.uk anaphylaxis.org.uk

Coeliac UK, the national charity forpeople who need to live gluten free0333 332 2033catering@coeliac.org.uk coeliac.org.uk

The Interfaith Network for the UK020 7730 0410ifnet@interfaith.org.ukinterfaith.org.uk

Jewish Vegetarian Society 020 8455 0692info@jvs.org.uk jvs.org.uk

Muslim Food Board UK0116 273 8228info@halalce.com tmfb.net/home

Pure Family Food katie@purefamilyfood.com purefamilyfood.com

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Useful resourcesPUBLICATIONSFood Allergy Survival Guide by Vesanto Melina (Author), JoanneStepaniakBook Publishing Company, 2004Presents a thorough discussion of themajor food allergies and how to dealwith them in a positive, affirming way.Readers will learn about testing forallergies, safety measures for life-threatening conditions, hiddenallergens, shopping and kitchen basics,and a host of resources for continuedenjoyment of life with allergies.Features over 100 recipes by‘uncheese’ specialist, Jo Stepaniak.

Vegetarian Cooking Without: AllRecipes Free from Added Gluten,Sugar, Yeast, Dairy Products, Meat,Fish and Saturated Fatby Barbara Cousins Thorsons, 2000Contains recipes that are well balancedand delicious but without the use ofingredients such as gluten, dairyproduce, sugar, yeast and saturatedfats.

Healthy Diet and Lifestyle for ethnicminority older people, June 2015Produced by the Older People ServicesDevelopment ProjectAvailable from:equalityscotland.com/assets/Healthy_Diet_and_Lifestyle/English.pdf(Accessed April 2019)

WEBSITESAllergyWise, Anaphylaxis Campaign’sfree and accredited online e-learningcoursesallergywise@anaphylaxis.org.ukallergywise.org.uk

asian-recipe.comSource of Asian recipes from variouscountries.

harighotra.co.ukA collection of Indian recipes includingstarters, sides, mains and sweet dishes.

International Vegetarian Unionivu.org/vegan-recipes-around-the-world.htmlVegan recipes from around the world,with over 3,000 – so far – in English,and lots more in other languages.

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Vegetarian for Life (VfL) is the leading authority on diet andhealthy living advice for older vegans and vegetarians. VfLoffers training and support for care caterers.

Vegetarian for Life recently launched aMemory Care Pledge that will be takenby care homes throughout the UK. Thisis to help ensure that vegetarians orvegans who have capacity issues, orcognitive losses, will be offered achoice of meals, drinks and snacks thatuphold their ethical beliefs. For moreinformation please get in touch.

We hope this guide has provided agood overview of various special diets.If you would like to find out more, wecan provide a half-day equality,diversity and inclusivity training inhouse for your care setting. Thetraining covers in more detail what a‘special’ diet is, the 14 allergens, thelaw around protected beliefs, where tofind alternative products such asgluten- and dairy-free and a practical

cookery demonstration using some ofour favourite ‘free-from’ products. Ifyou’d like to find out more, pleasecontact us.

While every care has been taken toensure that the recipes featured in thisguide can be made suitable for avegan or other featured special diet atthe time of going to press, werecommend that you satisfy yourselfthat the dishes will meet the dietaryrequirements of the service user thatyou are catering for.

© Vegetarian for Life 2019