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.