How to Go Primal with Food Allergies, Intolerances, and Restrictions

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We Primal folks love our giant omelets, guacamole burgers, and dark chocolate smeared with coconut butter — but what about when those foods don’t love us back? Over the years, I’ve heard from countless readers with food allergies, food restrictions, and simple food preferences who worry that Primal might not be for them.

These folks are interested in giving the Primal Blueprint lifestyle an honest shot, but they can’t eat certain foods, many of which enjoy an exalted place (real or imagined) in our community. So what’s the verdict? Can you go Primal without eating red meat? Coconut products? Avocado? Can it be done as a vegetarian? Are almonds essential?

Food allergies and intolerances frequently represent nothing more than minor speed bumps in your path, but some are more tedious than others. How hard will it be for you to eat Primally with your specific dietary needs? Let’s find out. Then scroll to the bottom for some general food allergy FAQs.

Tree Nut and Coconut Allergies — Wait, Are Coconuts Tree Nuts??

I’m allergic to tree nuts…and they are such a big part of the Primal Blueprint diet. Is it possible to still succeed on the plan in a healthy way without eating nuts?

Definitely. I actually wouldn’t say that tree nuts are a “big part” of the eating plan. The centerpieces of Primal eating are animal products (meat, fish, fowl, eggs, and dairy products if tolerated) and produce (vegetables and in-season fruit). Nuts, seeds, and their derivative butters are extras that you can add as desired. They certainly aren’t necessary.

Many people who are just starting out with Primal turn to nuts as their go-to snacks, because they’re low-carb, high-fat, and relatively convenient. This gives nuts the allure of essentiality. They are not. Nuts make a fine snack, sure, but they also tend to run pretty high in omega-6 fats. It’s also easy to overdo it on the nut butter and unintentionally undermine weight-loss goals.

You won’t be missing much by avoiding nuts. You certainly won’t be missing anything that you can’t get from other foods. And the good news is, you can probably still consume coconut products. Technically, the FDA categorizes coconuts as tree nuts, but they’re more accurately classified as drupes, a kind of fruit. It’s possible to be allergic to both, so don’t pound a stack of coconut flour pancakes if you’re not sure about your coconut allergy status. Get tested by your allergist first.

My daughter is allergic to almonds. What almond flour substitutes can I use in my recipes? Can I just substitute coconut flour for almond flour in Primal/paleo recipes?

Coconut flour is probably going to be your best option, but it’s nothing like almond flour. Coconut flour is far drier, with more fiber and less fat than almond flour. You can’t substitute coconut flour 1:1 for almond flour without getting a very different final product. I always recommend looking for a recipe that has been tested with the flour you want to use rather than trying to substitute a different flour.

If coconut flour isn’t your jam, there are alternatives. Cassava flour is the most recent darling of the grain-free baking community. Tigernut flour sounds the coolest, but it’s perhaps not your best bet for baking. Check out this post for more options: 8 Primal-Friendly Flours.

You can also buy gluten-free baking blends that are usually built on a base of rice flour. Despite what you might think, I don’t think white rice is terrible, especially not for insulin sensitive or highly active folks who don’t mind the carbs. These baking blends are convenient because they can usually be subbed into any recipe that calls for regular all-purpose flour.

However, I’m obligated to remind you that even Primal-friendly baked goods are still baked goods. Nutrition-wise, they’ll never stack up against a Big-Ass Salad or juicy steak with a side of grilled veg. Be mindful about over-relying on them.

I have been intermittently following a Primal lifestyle, but have had difficulty transitioning my household to it because my husband is allergic to coconut in all its forms. How do you go Primal when you can’t have coconut milk, coconut cream, coconut flour, etc.?

Although coconuts are popular with this crowd, they are not essential either. Yes, they taste good and provide healthy medium-chain saturated fats, but so do palm oil and dairy fat. Both can be worthy replacements. Go with grass-fed dairy fat and ethically sourced unrefined red palm oil, and you get extra vitamins and nutrients along with your medium-chain triglycerides.

“No coconut” isn’t a dealbreaker. Here’s how you swap out coconut in recipes:

• Instead of coconut flour: See my answer to the question above. Look for recipes that use almond or other nut flours, cassava flour, tapioca starch, green banana flour, or a gluten-free baking mix (check the ingredients, though).
• Instead of coconut milk or coconut cream: Full-fat milk, half-and-half, heavy cream. Nut milks might work too depending on the recipe, but they are usually more watery and contain less fat.
• Instead of coconut butter: Cocoa butter is probably your best bet, but it has a higher melting point and will impart a slightly chocolate-y flavor. That might work in your favor if you’re making something like fat bombs.
• Instead of coconut aminos: Use gluten-free soy sauce. Yes, it’s soy, but it’s fermented. Presumably, you’re not drinking glasses of it anyway.

Avocado Allergy… Or Histamine Intolerance?

I didn’t know this was possible, but I’ve discovered I’m allergic to bananas and avocados. What are good substitutes for these in any recipes?

You can definitely be allergic to avocados and bananas. The fruits actually share a protein in common with latex, so some people who are allergic to latex might develop allergies to bananas and avocados as well. Certain pollen allergies can also be triggered by bananas and avocados.

It’s also possible that you’re actually suffering from histamine intolerance. Symptoms are similar to an allergic response: hives, vomiting, congestion, and/or headaches. Histamine intolerance can also lead to gastrointestinal distress when you eat high-histamine foods. Pay close attention to how your body reacts to things like fermented foods (sauerkraut, pickles, kimchi, yogurt, vinegar, kombucha, etc.), bone broth, and cured meats. You might need to limit those, as well.

In terms of substitutes, in smoothies try yogurt (assuming an allergy and not a histamine intolerance), frozen fruit, or coconut cream. This may sound odd, but frozen macadamia nuts tossed in a smoothie provide a buttery texture that, while not perfectly analogous to that of a frozen banana or avocado, stands up well on its own merits. In Primal baked goods, unsweetened applesauce can replace mashed bananas. If you’re missing the fat content of the avocado, both olive oil and macadamia oil contain similar amounts of monounsaturated fats.

Now let’s talk guacamole. Apparently, you can make a very decent guacamole substitute with tomatillo and squash such as chayote. Recipes abound online. Let me know if you try it!

My kid is allergic to avocados. Avocado oil used to be my go-to cooking oil. What do I use instead??

Olive oil, coconut oil, tallow, lard, duck fat, recycled bacon grease, butter, ghee.

What About Folks with Multiple, Diverse Food Allergies or Intolerances?

I am allergic and/or intolerant to eggs and dairy and coconut (in addition to wheat, soy, yeast, etc.). Do you think it is possible for me to go Primal in that circumstance?

Yes. In some ways, it’s simpler. You just eat meat, vegetables, fruit, and nuts.

Before you start feeling deprived, sit down with this Primal Shopping List and write out your own list of foods you enjoy or are willing to try. I bet you’ll end up with quite a lot. But let’s say you’re a picky eater, and you find this way of eating too restrictive. You always have the option of adding back some “borderline foods” like legumes, quinoa, and rice, assuming they work for you.

Since you’re not eating yogurt or kefir or some other fermented dairy, which is how many people work fermented foods in their diets, you should look into lacto-fermented vegetables, like sauerkraut, kimchi, or pickles.

I Can’t (Or Won’t) Eat Meat. Can I Still Be Primal?

I can’t stand red meat. I know grass-fed beef and lamb are the bee’s knees, but I just can’t do it. Am I making a huge mistake?

Since you asked – yes. I can’t imagine voluntarily giving up a grass-fed, bone-in ribeye or perfectly prepared lamb chops with mint chimichurri. But that’s sheer hedonism. As far as nutrition goes, you’ll largely be fine.

Incorporate grass-fed dairy fat and you’ll make up for the lack of conjugated linoleic acid. Eat oysters a couple times a week and you’ll take care of the missing zinc. Make sure the animal products you do eat come from quality sources. I’m talking grass-fed and -finished, pastured, and/or wild-caught as budget allows. You may have trouble getting enough carnitine, an important amino acid found almost exclusively in red meat. While the body both conserves carnitine quite well (indicating, perhaps, its importance in the body) and manufactures it internally, more carnitine has been shown to be helpful, especially in athletes and the elderly. If you’re not eating red meat, you’re likely getting far less carnitine than most traditional Primal eaters.

If I could make one suggestion, it would be to eat a quarter pound of pastured ruminant liver every week. I know that’s a tall order, seeing as how you can’t stand the taste of red meat, but try to do it if you can. The benefits are many (it isn’t called “nature’s multivitamin” for nothing), and since carnitine is synthesized in the liver, a small weekly dose might make up for the overall lack of red meat. At the very least, include chicken, duck, or turkey livers.

All of a sudden, I get really sick when I eat meat. My doctor thinks I have alpha-gal syndrome. What does this mean in terms of being Primal?

As you know, alpha-gal syndrome is a severe allergic reaction to foods that come from mammals. This includes meat and organs for sure and often dairy products as well. Some people with alpha-gal syndrome also need to avoid things like gelatin, carrageenan, and other mammalian byproducts. Alpha-gal syndrome develops following a tick bite, usually, but not exclusively, from the Lone Star tick.

Don’t take any chances until you consult with your doctor, who can help you determine your level of sensitivity. You can still be Primal eating seafood, fowl, and eggs as your main sources of protein. Talk to your doctor about supplemental carnitine, too. Good luck!

I don’t eat fish. It’s not because I do not want to, but I simply cannot get over the taste after having a bad run-in with raw catfish in my less-than-primal-healthy eating days. Outside of the obvious (grass-fed meats, free-range eggs, supplementation), what are other steps I need to take to keep optimal and Primal?

Can you eat shellfish? Oysters and mussels would take care of all your sea-related needs, if you can tolerate them. Canned, smoked oysters are pretty mild, and I’m of the opinion that oysters are the most nutritious of the edible sea creatures. Hopefully, you can keep them down.

If not, exclusively eating grass-fed meats, pastured eggs (which have a decent amount of omega-3s, believe it or not), and supplementing with a high-quality fish oil will get you on your way.  I would also try incorporating some seaweed a couple days a week, if only for the iodine (which can be tough to obtain if you’re abstaining from seafood). A good way to do it is to add pieces of kelp/kombu to soups or cooking bone broth. I don’t find it influences the flavor too much, but it definitely influences the nutritional content of the dish. Seaweed salad, the kind you find in Japanese or Korean cuisine, is also great.

I’m a vegetarian for ethical reasons. Is it possible to go Primal and not eat meat?

Yes, though it wouldn’t be ideal.

As long as you’re avoiding grains, refined sugar, and processed seed oils—and liberally eating the high-quality animal products you do feel comfortable consuming—it can be done. Hopefully you really like eggs and dairy. Make sure the dairy and eggs you eat are of the utmost quality. Get eggs with dark orange yolks from pastured hens who ate grass, weeds, and bugs. Get dairy from cows, goats, or sheep who ate grass. Include some fermented dairy in there as well. A quality whey protein may also help with protein needs.

If you’re the kind of “vegetarian” that eats fish, this won’t be nearly as difficult. Even if you are not, I urge you to at least consider eating bivalves like oysters, mussels, and clams. They don’t seem to have a central nervous system or experience pain as we understand it, plus bivalve farming is neutral-to-beneficial for the local ecosystem.

I would also look into eating insects. Research shows that they experience “pain” differently than most other animals, and they’re a good source of protein, fat, and multiple micronutrients. They’re also extremely eco-friendly, sporting the largest biomass of all terrestrial animals. Most hunter-gatherer societies with steady access to bugs utilize them as a useful source of calories. Why not us?

I’m a vegan. I don’t eat any animal products. Is there any way to be Primal and a vegan?

I’m not going to lie, it’s very, very difficult to do without compromises and extensive supplementation. Where are you going to get creatine? Carnosine? Carnitine? DHA? Zinc? You’re going to have to supplement.

That said, you can certainly be a far healthier vegan by implementing many Primal principles. Avoiding sugar and vegetable and seed oils will be hugely beneficial, but you’ll also need to steer clear of grains to be truly Primal. In their place, you’ll probably have to include more starch, like yams, sweet potatoes, potatoes, and other roots and tubers, as well as fruit, simply for the calories, because you can’t live on leafy greens alone. You don’t have the enlarged intestines of a silverback gorilla. That means you’ll probably end up eating more carbs than the average Primal adherent, but that’s not a bad tradeoff, all things considered.

For protein, consider incorporating:

• Nuts
• Lentils (generally considered the least offensive legume)
• Quinoa, a high-protein pseudo-grain (though it contains saponins, which may have antinutrient qualities)
• Protein powders

And once again, please, please consider the lowly bivalve. Yes, they are technically animals, but they don’t come with any of the objections that drive most people to become vegans in the first place.

Thanks for reading!

Food Allergy and Intolerance FAQs

What is the difference between a food allergy and a food intolerance?

Food allergies are characterized by an immune system reaction to a particular food or ingredient. Allergic reactions can be life-threatening. Food intolerances usually involve the digestive system. While intolerances might make you feel crummy, they aren’t acutely dangerous. Still, you should avoid foods you don’t tolerate.

What are common food allergies and intolerances?

It’s possible to be allergic to or intolerant of pretty much any food. The most common allergens are milk and dairy products, eggs, peanuts, tree nuts (including almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, pecans, pine nuts, pistachios, walnuts), soy, wheat, fish, and shellfish.

Is coconut a tree nut?

According to the Library of Congress, coconuts are a nut, fruit, and seed. What an overachiever! The FDA classifies coconuts as tree nuts for food labeling. However, you won’t necessarily be allergic to coconut just because you have a tree nut allergy. Have your doctor test you.

How do you test for food intolerances?

Some lab tests exist, but their reliability is questionable. The best way is a simple elimination test. Stop eating the food(s) you suspect you don’t tolerate for several weeks. See if your symptoms improve. Then, optionally, slowly reintroduce one food at a time and see if symptoms return.

Can I eat according to the Primal Blueprint if I can’t (or won’t) eat _____?

The Primal Blueprint is infinitely adaptable to your food tolerances and preferences, budget, and locale. Primal eating focuses on animal products (meat, fish, fowl, eggs, dairy) and produce (vegetables, fruit). You should be able to craft a well-rounded diet out of the many options available to you.

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