Elimination Diet
A systematic approach for diagnosing food allergies.
An elimination diet is the systematic elimination of different foods and food groups from the diet as a means of diagnosing food allergies. While people of all ages can develop an allergic sensitivity to certain foods, such allergies are especially common among children. In the United States, one child in six develops an allergic reaction to certain substances, and foods are among the prime offenders. (Many food allergies are outgrown during adolescence.) Common symptoms of food allergies include hives, angioedema (swelling), respiratory congestion, and gastrointestinal problems. Food allergies are also known to play a secondary role in many chronic conditions, such as asthma, acne, ear infections, eczema, headaches, and hay fever. The most effective means of treating food allergies is to avoid the foods that produce allergic reactions.
There are two main ways of diagnosing food allergies by the elimination method. A casual approach involves eliminating, one at a time, foods from the diet suspected of causing allergic reactions, and observing the allergic person to see if there is a reduction in symptoms in the absence of particular foods. The more rigorous method (which is a true elimination diet) reverses this strategy by eliminating many foods at the outset and then adding suspected allergens (allergy-producing substances) one at a time. Elimination diets often include a rotation component, by which even the limited foods allowed at the beginning are allocated in such a way that no single food is eaten more than once within a three-day period. This feature has two purposes. First, it alleviates the monotony of a limited diet. Second, it allows for the possibility that some persons may even be allergic to the relatively safe foods allowed initially. If there is an allergic reaction at this stage, rotating foods makes it possible to identify the cause of the problem.
An elimination diet is divided into two parts: the elimination and reintroduction phases. During the elimination phase, which generally lasts between one and two weeks, as many known allergy-producing foods as possible are eliminated from the diet. Foods commonly known to cause allergies include citrus fruits, corn, chicken, oats, eggs, wheat, soy products, milk, vinegar and other products of fermentation, coffee and tea, cane sugar, chocolate, tomatoes, peanuts and other legumes, and food additives. In one very strict diet, the elimination phase includes only two foods known to be virtually allergy-proof: lamb and rice. Another, more liberal, diet allows a range of 56 different foods (although 12 of the items on the list are spices and a number of the others are relatively uncommon foods such as tapioca, carob, millet, rhubarb, and artichokes).
During the elimination phase of the diet, which clears the body of allergens, ingredient labels for all processed foods should be carefully scrutinized to make sure that none of the proscribed foods make their way into the diet. Persons with chronic food allergies should see their symptoms subside during this phase of the diet unless they happen to be sensitive to any of the normally non-allergenic foods allowed on the list at this point. A child with food allergies may breathe more easily and feel more energetic. Red, itchy eyes may improve, and congestion may clear up. Different diets handle the réacute;introduction phase differently. In some cases, the "test" foods are introduced at three-day intervals. In one diet, a new food is reintroduced every day for 15 days. Foods should be reintroduced in as pure a form as possible (for example, cream of wheat rather than bread) for maximum certainty that the resulting effects are produced by the substance in question rather than by some other ingredient added during the manufacturing process.
In a less rigorous diagnostic diet, food intake remains normal except that one suspected food or food group at a time is eliminated for a period of one to two weeks and the reaction observed. A strict elimination diet should not be undertaken without the supervision of a physician. The elimination phase of the diet should not last more than two weeks, since this restricted regimen will lack some essential nutrients. Another way to identify food allergies is to keep a food diary, recording everything eaten for a period of three or four weeks and noting any allergic reactions during that period.
For Further Study
Books
Cook, William. Tracking Down Hidden Food Allergies. Jackson, TN: Professional Books, 1980.
Feldman, B. Robert. The Complete Book of Children's Allergies. New York: Times Books, 1986.
Postley, John E., and Janet Barton. The Allergy Discovery Diet: A Rotation Diet for Discovering Your Allergies to Food. New York: Doubleday, 1990.
Walsh, William. The Food Allergy Book. St. Paul, MN: ACA Publications, 1995.
Yoder, Eileen Rhude. Allergy-Free Cooking: How to Survive the Elimination Diet and Eat Happily Ever After. New York: Addison-Wesley, 1987.
Organizations
American Allergy Association
Address: P.O. Box 7273
Menlo Park, CA 94025
American Dietetic Association
Address: 430 North Michigan Avenue
Chicago, IL 60611
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