How to Conduct a Food Elimination/Food Challenge Diet

Last week, in an email I sent out to my weekly newsletter subscribers titled "Simple Rules for Healthy Eating," I mentioned that there's no one diet that's universally correct for everyone. That's because of food allergies and food sensitivities.

Food allergies manifest as severe physical symptoms such as difficulty breathing or itchy hives. Food sensitivities are far more common. Instead of producing allergic reactions with physical symptoms, food sensitivities provoke inflammatory responses in the body and the brain that provoke mental and behavioral symptoms that can take anywhere from six to 72 hours to appear. Although this is particular concern for parents of children with functional disconnection syndromes such as autism spectrum disorders and attention deficit disorder/hyperactivity disorder (see my blog article titled "Functional Neurology is a Great Alternative to Psychiatric Drugs for Handling Functional Disconnection Syndromes"), anyone can benefit from getting a better handle on his or her food sensitivities.

Symptoms of Food Sensitivity

The gradual appearance of the symptoms can make it hard to discern food sensitivities. However, any of the following symptoms can be caused by food sensitivities (it should be obvious that some are unique to children):

• Irritability and occasional meltdowns
• Inability to focus or concentrate
• Impulsive actions
• Aggressive behavior
• Fatigue
• Bedwetting
• Sleep disturbances, such as bad dreams and frequent awakening
• Learning disabilities
• Hyperactivity

Steps for Conducting an Elimination and Food Challenge Diet

There are three basic options for discovering and eliminating sensitive foods: 1) enlisting the help of a certified nutritionist, 2) having lab tests done, and 3) following an elimination and food challenge diet. This email, of course, explains the third option; and while it takes some effort and discipline, it's free!

STEP1: START A DIET JOURNAL (7-10 DAYS)

Use either a notebook or a formal diet log, which is available in most bookstores, to write down everything you eat for the next 7 to 10 days. At the start, do not change anything in your diet. Simply observe.

Organize the journal by meals and snacks and note the approximate time foods are eaten. Write down everything, because it will help you sort out which foods might be contributing to your food sensitivities. For prepared or processed foods, check the list of ingredients on the box and write them down also if you believe it is necessary.

The other important part of this is writing down all the symptoms you experience—when they happen and for how long.

STEP 2: IDENTIFYING THE SUSPECTED FOOD SENSITIVITIES

Here’s where you get to practice your detective skills! Review the diary and look for patterns. Reactions to problem foods occur anywhere from two hours to three days after they are consumed. Compare the foods eaten to the symptoms observed and see if and how they relate. Use the following list of common food offenders as a guide:

• Anything containing wheat (gluten or gliandin)
• Apples
• All dairy and milk products (casein), including goat milk
• Chocolate
• Tomato
• Corn
• Oranges and all citrus fruits and juices
• Eggs
• Legumes (peas, beans, peanuts, soy)
• Refined sugar
• Baker’s and brewer’s yeast
• Soy

List the foods you suspect could be causing symptoms. If you can’t see a pattern, don’t get frustrated. It’s important to remember that reactions to problem foods can take up to 72 hours to manifest and often don’t produce terribly obvious physical signs.

STEP 3: THE FOOD ELIMINATION PROCESS (4 OR MORE WEEKS)

This step involves eliminating completely from your child’s diet the foods shown in the list above for at least four weeks. Concurrently, you should be taking steps to make your child’s diet healthier in general. Do your best to include the rest of the family in this concurrent effort. It makes sense to do so not only from a health perspective, but also out of solidarity for the child with the functional disconnection syndrome.

This will not be easy. It requires the cooperation of those who help look after your child, such as teachers, relatives, babysitters, etc. If you count on others to look after your child, please have them read this document so that they understand why you are doing this and what’s at stake.

In addition to common food suspects, you must also eliminate:

• Junk food—this includes all fast food, soda pop, candy, etc.
• Processed foods—this includes pressed meets, processed cheeses and cheese spreads, and most packaged fast-to-the-table foods.
• Food additives—this requires careful checking of labels. There are many food additives, and you should familiarize yourself with them. The following website contains an alphabetical list of food additives as well as a glossary of food additive terms:

http://nutritiondata.self.com/topics/food-additives

• In general, avoid any ingredients that contain the words agents, enhancer, regulator, gums, and ingredients ending in ant (for example: fumigant, lubricant, humectant, propellant, sequestrant, etc.)
• Other foods—in addition to those listed as common food offenders—detected in step 2 as possible offenders.

It is possible to experience withdrawal symptoms as these foods are eliminated from your diet. These symptoms include the following:

• Irritability
• Depression
• Lethargy
• Difficulty sleeping

If the diet is done correctly, you should see dramatic improvements in general health and behavior within about four weeks. If not, one of the following things has occurred:

• You've cheated and eaten forbidden foods.
• You haven't yet identified all the foods to which you are sensitive.
• You do not have any food sensitivities.
• You may not have designed the elimination diet properly. You may need to do it again and include more foods.

STEP 4: THE FOOD CHALLENGE

Start this step only if the first three steps have resulted in noticeable improvements. The idea here is to reintroduce those foods that you have isolated as suspected food culprits in a controlled way, one at a time (in no particular order). Record which foods you introduce and the results in the food journal.

Here are the guidelines for conducting the food challenge:

• Eat the reintroduced food at breakfast, lunch, and dinner, increasing the amount with each meal.
• Record the quantity of the food eaten and the time at which it was eaten.
• Record all the symptoms you observe, the time they occurred, and for how long.
• At the beginning of each day, make a note in the food journal regarding the quality of your sleep the prior night and general behavior during the day (lethargy, moodiness, stuffy nose, etc.).
• Reintroduce each food for only one day and then remove it again from the diet completely, even if it does not produce any symptoms, until all of the eliminated foods have been tested. Milk should be considered separate from other dairy products.
• Wait three days or until any symptoms are gone for at least 24 hours before reintroducing the next food on the list. Test each food, one-by-one, until all the foods have been evaluated.
• If you become ill with a cold or an infection during this step, suspend the step until after you recover.

STEP 5: DRAWING CONCLUSIONS FROM THE FOOD CHALLENGE

You should have observed that certain symptoms subsided during the elimination diet and returned when a particular food or foods were reintroduced. These are the foods to which you are sensitive, and you should eliminate them from your diet. It is possible that with improved health many of the sensitivities may abate over time. So, you might consider, after a period of time—6 months, one year, whatever—going through the food elimination/food challenge process again.

Functional Neurology is a Great Alternative to Psychiatric Drugs for Handling Functional Disconnection Syndromes

Because of my interest in helping kids with behaviorial and developmental disorders, I was asked by the Oregon Chapter of the Citizen's Commission on Human Rights (CCHR) to make some introductory comments yesterday evening to help kick off Parent's Night at a CCHR exhibit called "Psychiatry: An Industry of Death."  This exhibit is a traveling version of a permanent installation established in 2005 at CCHR International’s headquarters in Los Angeles. The Museum and the Touring Exhibit comprise 14 documentaries, based on interviews with more than 160 experts in the fields of medicine, psychiatry, psychology, law, justice, history, science, education and more. The exhibit's primary concern is the high death rate and abuse in the mental health field.

I was introduced to CCHR about three years ago by friends in Southern, California. I watched a video documentary that had the same title as the exhibit. To put it as politely as possible, the documentary painted an extremely vivid picture of the inglorious history of the psychiatric profession and the shortcomings of its methods of diagnosis and treatment. On the whole, it can leave you with the impression that psychiatrists are, well...evil. The video was hard for me to confront, actually. It messed with my world view. After all, my brother-in-law is a psychiatrist by training; and not only is he not evil, but he's decent and kind and ethical. And I've met other people in the profession who I have also thought to be very decent, well intentioned people.

However, the fact that there are some very decent people out there who happen to be psychiatrists doesn't mean that there aren't flaws in the way that psychiatrists go about diagnosing and treating problems--especially children's problems.

As I mentioned in my last blog entry, I have spent the last 17 months studying principles of functional neurology. This discipline makes it possible not only to diagnose problems related to central nervous system dysfunction, but also to devise treatment strategies for their handling without the use of drugs. One of the most promising applications of functional neurology is in the treatment of children diagnosed with what neural scientists refer to as functional disconnection syndromes such as:

• Attention deficit/hyperactivity disorder (ADHD)
• Autism spectrum disorders
• Asperger's syndrome
• Childhood disintegrative disorder (CDD)
• Dyslexia and processing disorders
• Obsessive-compulsive disorder (OCD)
• Oppositional defiant disorder (ODD)
• Tourette syndrome
• Nonverbal learning disability

What all these childhood behavioral and developmental disorders have in common is an imbalance of electrical activity in the brain, especially between the right and left hemispheres. Because neurons are plastic--or capable of altering their connections based on changes in stimuli received--it is possible to design therapies that rebuild functionally deficient areas of the brain and the neurological pathways that connect them. That, in a nutshell, is the functional neurological approach to treating functional disconnection syndromes.

By contrast, I want to review how I believe these conditions typically get handled. It often starts with a teacher or a school administrator encouraging you to have your child evaluated by a specialist. The specialist is usually a psychologist or a psychiatrist who administers some kind of symptom survey based on diagnostic criteria listed in the Diagnostic and Statistical Manual of Mental  Disorders (DSM). Based on subjective interpretation of the survey results, a course of treatment is recommended. In the great majority of cases, the treatment includes psychiatric drugs.

I came across a great passage in the first chapter of Robert Melillo's book, Disconnected Kids, that I want to share with you:

Last year, doctors in the United States wrote an estimated 20 million prescriptions for Ritalin. And this estimate is considered conservative. ADHD is the leading childhood disorder in the world, and Ritalin is the most widely prescribed medication for children. The use of Ritalin increased a staggering 800 percent between 1990 and 1998, even though it has severe side effects and its long-term consequences on the developing mind are still unknown. It is effective in less than 70 percent of cases. The drug is becoming so commonplace it is even being prescribed for children as young as age four.

Melillo's book was published in 2009, so the numbers may actually be higher now. In any case, please don’t misunderstand me. I’m not a fanatical anti-drug crusader. There’s an appropriate time for using drugs therapeutically. It’s just that there’s a toxic burden associated with taking any drug. This is not an opinion, it's a fact; any medical doctor or pharmacist will confirm it. And any responsible medical physician knows that when you prescribe a drug, you have to weigh its clinical efficacy against its potentially harmful side effects. In my opinion, the clinical efficacy of psychiatric drugs is spotty, the severe side effects are very well documented, and the long-term effects on developing young minds are simply not at all well understood.

I have an acquaintance whose child was eventually diagnosed with an autism spectrum disorder about five years. Thankfully, he's doing quite well now, but only after being taken off drugs, which transformed him in ways that his mother told me were quite disturbing. I'm hoping that his mom will either make a comment after reading this blog entry or allow me to interview her for a future story.

Drug treatment is so widespread in treating childhood developmental and behavioral disorders due to the widely held but erroneous belief that no cure is possible for these problems. But the problems are, in fact correctable.

They’re correctable, because, as I mentioned earlier, brain cells are plastic--or in other words, capable of altering their connections based on changes in stimuli they receive from the environment. What this means is that if you can safely and objectively evaluate which parts of the brain are functionally deficient--and I know firsthand that it’s possible to do this--then you can design treatment therapies that rebuild the functionally deficient areas and the neurological pathways that connect them, re-balance the brain, and correct the problem.

Dr. Melillo reported in Disconnected Kids that he has data showing successful treatment in about 1,000 children with Functional Disconnection Syndromes. In my own growing practice at Beeson Chiropractic Center in Portland, I've started to have some wins treating kids with these types of challenges.I look forward to having a lot more wins, as well.

The Root Cause of ADHD in Children

I spent a day at Cannon Beach on the Oregon Coast this past Labor Day Weekend. I took lots of long walks, enjoying the ocean breeze, the feel of the sand under my feet, and mostly, the sights and sounds of children playing--digging holes, playing catch, running, wrestling, flying kites, riding bikes, and many other activities as well. It occurred to me that it's rather unusual to see kids doing this in their normal day-to-day lives. It takes a trip to beach, I think--away from television, computers, and video games--to get back to the kinds of basic, fundamental activities that are so vital to a child's healthy development.

What a difference a few decades make. When I was growing up in Detroit and Southfield, Michigan in the  1960s and 1970s, I used to spend hours and hours outside. I have fond memories of playing kick the can or capture the flag on warm summer evenings until well past twilight. Summer mornings, before it got too hot, my best friend, Brian Salesin, and I often rode our bikes to the tennis courts on the grounds of the elementary school we attended. Brian, who was already an expert tennis player at the age of eight, taught me how to play well enough not to embarrass myself.

When school was in session, we played floor hockey in gym class and street hockey on the playground version at recess. After school, pickup games of street hockey often lasted for hours. Depending on the season, there were also pickup football, baseball, and basketball games. And if there weren't enough friends available for a pickup game of baseball, for example, no problem; my next door neighbor John could always be persuaded pretty easily to play curb ball. Curb ball is a game with its own intricate rules in which the players take turn smacking a rubber ball against the curb, trying to make hits and score runs.

I'm not just waxing nostalgic here. As I write about these things, they evoke very vivid sense memories. I can still hear the thwack of the rubber ball against the curb. When we played street hockey, we used a hollow plastic puck that was filled with maybe a dozen or so BBs to give it some weight. I can still hear it skittering across the pavement; I can still see the little piece of black electrical tape covering the hole drilled into the puck so that the BBs could be placed inside it; and I can still remember how the chill of the late Autumn air felt against my face and the dexterity of my movements as I moved the puck toward the goal, passed it, or maneuvered to accept a pass from a teammate. There are also olfactory memories I took for granted at the time but that currently surprise me because they evoke the time and place so vividly--anything from the cherry scented pipe tobacco that my father used to smoke to the smells of stuffed cabbage, stew, or roast brisket diffusing through the air from an open kitchen window.

All sensory perceptions are vital to the health of a developing brain. But the sensory perception most critical to healthy brain development is the input the brain gets from sensory receptors embedded within muscles.

For the past 17 months, I've been taking post-graduate courses in functional neurology through the Carrick Institute of Graduate studies. A phrase that is etched permanently in my mind at this point is this: The brain is a receptor-driven system.

As we move through our lives, holding ourselves upright against gravity, sensory receptors called muscle spindle cells monitor the stretch of muscles and provide a constant barrage of electrical stimulation to the brain. The brain's 30 billion neurons requires this input to maintain existing connections and establish new connections among each other. This is the key to survival, development, learning, and adaptation.

When children spend excessive amounts of time watching television and playing video games (in other words providing neural input that completely or mostly bypass normal pathways over which signals from muscle spindle cells travel), it affects the ability to maintain existing connections and establish new ones. Likewise, anything that diminishes the ability to send, receive, and initiate normal cellular responses to such input affects the ability to maintain connections and establish new ones.

Lack of regular play time diminishes stimulation to the developing brain. Injuries during birth can diminish stimulation by inhibiting the motion of the bones and muscles of a child's neck. Anything that negatively affects a pregnant woman's hormone levels and the normal function of her central nervous system can have a negative impact on the brain of the developing fetus. Toxins in the soil, air, and water supply as well as poor nutrition in general can be detrimental to a developing brain. And childhood obesity, which is associated with decreased muscle mass and muscle tone, also results in decreased brain stimulation.

I don't believe it's a coincidence that children's attention spans have grown shorter and classroom discipline more challenging over the past two or three decades as technological innovations and social changes have made us more passive as a society and more susceptible to environmental and emotional stresses. Over this period of time we have seen

• Higher divorce rates
• Increased consumption of processed and fast foods
• Inadequate day care resources available to single mothers or families where both parents work
• Greater numbers of women having children past the age of thirty-five 

Robert Melillo talks about all these influences and more in his excellent book Disconnected Kids. One statistic cited in Dr. Melillo's book that should give you pause: "The average high school graduate will have spent 15,000 to 18,000 hours watching television but only 12,000 hours in school."

The title of Melillo's book speaks to the growing body of evidence from neural science research that attention deficit/hyperactivity disorder, as well as many other childhood behavior and developmental disorders, are really just different manifestation of the same basic problem: lack of stimulation to the developing brain leads to imbalances in electrical activity between different parts of the brain. What makes the human species so unique is that our brains are so specialized, with different functions residing in different parts of the brain--often on different sides. But when the various parts of the brain cannot communicate freely, it is, in effect, functionally disconnected and thus cannot integrate its functions properly: thus, you get "disconnected kids."

I encourage anyone with young children to read this book. One of the book's chapters includes a checklist that allows you to identify whether your child has a right brain or a left brain deficiency and the level of severity of the imbalance. Much of the rest of the book from that point on tells you how to go about handling the imbalance. I found it interesting to go through the book from the perspective of what I remember about myself as a child. It was clear to me that although I had some symptoms of disconnection, the endless hours I spent playing outside were a blessing that I had no way of fully appreciating at the time.

In fact, as I grow older and spend more time in front of the computer and less time engaged in physical activity, I notice how much more fragile the state of my central nervous system has become--perhaps in ways that only someone who studies this stuff closely would be aware of--but fragile nonetheless. And that's why I'm turning the computer off now and going out for a run!