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DESCRIPTION
The Elimination Diet is designed for those
individuals who have expressed sensitivities to certain foods, and are
attempting to identify those foods. Atypical reactions to food can either be a
result of a true food allergy or a hypersensitivity reaction. Adverse responses
to gluten in wheat or casein in milk may be considered an allergic response,
whereas reactions to bisulfite, tyramine, or erythrosine dye (coloring) in
foods may be considered a non-immunologic hypersensitivity reaction. The food
elimination diet allows for the recognition of both these types of adverse
atypical reactions to food.
Symptoms which may suggest the need for
use of the elimination diet include:
| Itching of the eyes or nose after
eating |
Runny nose |
| Headaches |
Hay fever-like symptoms |
| Eczema |
Nausea |
| Bloating after meals or diarrhea |
Vomiting |
| Congestion or phlegm of the bronchial
tubes after certain foods |
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The Elimination Diet is prescribed for
five to seven days and is composed of foods known to have a low
hypersensitivity. Food intake is limited to such foods as rice, lamb, gelatin,
peaches, pears, carrots, lettuce, artichokes, sesame oil, apples, salt, sugar,
jams, and jellies. All medications are usually eliminated, including vitamin
pills and aspirin, as well as products such as beer, coffee, and chewing gum.
By the end of the seventh day, all symptoms should be relieved, after which new
foods are added one at a time at regular intervals, usually one to four days.
The patient is instructed to keep a food diary, recording the time new foods
are consumed, as well as any allergic reactions which might occur.
Hypersensitivity is confirmed by correlating repeated appearance and
disappearance of symptoms with consumptions and exclusion of the suspected food
at one to four day intervals. From this information, a rotation or exclusion
diet can be developed for management of the problem.
Specialized Elimination Diets which limit
protein intake exclusively to animal or vegetable sources have also been
devised.
The nutritional adequacy of the
Elimination Diet depends upon the duration of the diet, as well as the number
and types of food sensitivities.
If a severely restricted diet is followed
for an extended time period, serous vitamin, mineral and caloric deficiencies
can occur without supplementation. Diets of this type are usually prescribed
for only five to seven days.
With a less restrictive Elimination Diet
which permits foods from all food exchange groups, it may be possible to
consume adequate amounts of all nutrients, though supplementation with
additional vitamins and minerals is recommended once it is been determined that
these are not a source of the reaction.
SAMPLE MENU FOR ONE DAY
Breakfast
| 1/2 grapefruit |
2 ounces of lamb liver, sauteed |
| 2 teaspoons sesame oil |
1/2 cup brown rice |
| 1 tablespoon maple syrup |
|
Lunch
| 1/2 cup grapefruit juice |
3 ounces ground lamb patty, broiled |
| 1/2 cup raw carrots |
1/2 cup steamed spinach |
| 1/2 cup lime gelatin |
|
Dinner
| 1/2 cup grapefruit juice |
4 ounces lamb leg, roasted |
| 1 baked sweet potato |
1 pear |
| 1 rice biscuit |
1 tablespoon grapefruit
marmalade |
| 1 cup romaine lettuce |
2 teaspoons sesame oil and lemon juice
dressing |
Nutrient Content:
| Calories: 1,467 |
Fat: 30% |
| Cholesterol: 250 mg |
Protein: 17% |
| Fiber: 15g |
|
| Carbohydrate: 53% |
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FOOD EXCHANGE MENU
The foods which are most commonly reported
to cause allergic reactions are:
| Milk |
Eggs |
Beef |
Chicken |
| Fish |
Pork |
Wheat |
Strawberries |
| Nuts |
Chocolate |
Corn |
Tomatoes |
| Shellfish |
Oranges |
Cola drinks |
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Certain food additives and artificial
coloring agents have been implicated as well.
The following Elimination Diet is
presented for information and comparative purposes only. It should not be
considered appropriate for all persons with suspected food allergies.
The number of food exchange list units
listed below apply only to the sample Elimination Diet.
Bread and Cereal Exchange List:
Recommended:
| Rice |
Tapioca |
| Rice biscuit |
Rice bread |
| Sweet potato |
Plain, lemon or lime flavored
gelatin |
Avoid:
• All wheat and corn products
Fat Exchange List:
4 or more servings per day
Recommended:
Avoid: All others
Fruit Exchange List:
3 or more servings per day
Recommended:
Avoid: All others
Meat and Meat Substitute Exchange
List:
8 servings per day
Recommended:
Avoid: All others
Milk Exchange List
Recommended:
Avoid: All
Vegetable Exchange List:
2 servings per day
Recommended:
- Lettuce
- Swiss Chard
- Spinach
- Carrots
Avoid: All others
Miscellaneous Exchange List
Recommended:
| Sugar cane |
Salt |
| Royal baking powder |
Baking soda |
| Cream of tartar |
Lemon extract |
| Vanilla extract |
Maple syrup (made from sugarcane
flavored with maple extract) |
Avoid:
All others not noted above
Note:
Include six to eight cups of fluids, such
as purified water, per day.
BIBLIOGRAPHY
Alpers, D.H., R.E. Clouse, and W.F.
Stenson. 1983. Manual of Nutritional Therapeutics. Little, Brown, & Co.,
Boston, 457 pp.
Lowlor, G.J. Jr., Fischer, T.J., "Manual
of Allergy & Immunology". Little, Brown & Co., Boston, 1981.
Pennington, J. 1978. "Nutritional Diet
Therapy", Bull Publishing Co., Palo Alto, Ca., 106 pp. |
