Food Allergy Elimination Diet
If you or your physician suspect that you might have a food allergy you can follow these basic guidelines to best determine the food that is the culprit.
Symptoms of food allergies can be insidious or immediate and include symptoms such as: skin rashes, dermatitis, eczema, psoriasis, seborrheic dermatitis, irritable bowel syndrome, fatigue, suppressed immune system, autoimmunity, rheumatoid arthritis, depression, brain fog, neurological symptoms and much more.
Because 70% of our immune system surrounds our gut in the form of GALT (Gut Associated Lymphatic Tissue) it only makes sense that food allergies and intolerances easily place a burden on our immune system.
Blood testing for food allergies may be helpful for children or patients that are unable to follow this regimented of a diet such as those with a history of eating disorders. However, blood testing for allergies is truly only 60-70% accurate.
The immune system creates either IgA or IgE responses to food. IgE reactions are immediate and typically result in anaphylactic shock whereas IgA allergies are insidious and most patients only notice improvement once the food has been eliminated for at least four days. Food allergy testing only identifies foods that create these IgA or IgE immunological responses; and not those that an individual is intolerant to. Lactose intolerance for instance is a classic example of a food like milk causing a problem such as diarrhea without the presence of allergy.
The gold standard for determining food allergies/intolerances is therefore the Elimination Diet. Be sure to follow the specific diet prescribed to you by your physician.
As with any health care suggestions given here be sure to check with your physician before attempting a food allergy elimination diet. Those with history of eating disorders whether active or dormant for instance are not candidates for this regimented of a diet. If you are suffering from any chronic health complaints you absolutely should not attempt this on your own and should be under the supervision of a licensed health care provider.
To identify foods that may be causing some or all of your symptoms. During the elimination period, foods that commonly cause symptoms are completely eliminated from the diet for one to two weeks. After your symptoms improve, foods are added back one at a time to determine which foods provoke symptoms. The following is a basic template used by many health care providers and may need to be modified to suit your specific needs.
FOODS YOU MAY EAT:
Cereals:Hot: cream of rice, quinoa cereal (Quinoa Flakes).
Dry: puffed rice, puffed millet
Grains: Rice: no wild rice but all kinds of other rice including rice products such as pasta (Brands: Pastariso, Lundberg), plain rice cakes, rice bread without yeast (Brand:Energy), mochi (found frozen or fresh in Asian stores), buckwheat (kasha), millet, quinoa (a quick cooking grain), amaranth, and teff
Flours: Rice, millet, quinoa, amaranth, teff, bean flours, and tapioca
Fruit: All fruits except citrus fruits (oranges, lemons, limes and grapefruit)
Protein: Meat: lamb and wild game meats such as venison
Beans/legumes: all beans and legumes, except soy and peanuts. Check labels of canned beans, dips and soups for sweeteners, spices and additives (Brand: Taste Adventure dried refried beans and split pea soup). Do not eat canned beans with chemical additives (EDTA)
Vegetables: All vegetables except tomatoes, eggplant, peppers, potatoes, and corn
Nuts/Seeds: All nuts and seeds except peanuts
Oils/fats: All oils except peanut oil, corn oil and soybean oil
Sweeteners: Maple syrup (pure) and brown rice syrup
Beverages: Water (plain, mineral or sparkling), rice milk (plain or vanilla – check labels for ingredients, gums are allowed but barley malt or corn syrup are not allowed), all fruit juices except citrus juices are allowed and all herbal teas are allowed
Condiments: All condiments are allowed except for chocolate, tomato products (catsup), pepper products (Tabasco, hot peppers), and vinegars that contain malt or other ingredients requiring elimination. Black pepper is allowed. Check all condiments to make sure that the ingredients are allowed.
Elimination Diet Guidelines
1. Do not eat any food that you suspect is causing symptoms even if it is on the list of acceptable foods.
2. Use only those foods allowed unless you check with your health practitioner. READ LABELS! “Flour” usually means wheat flour, “vegetable oil” may mean corn oil or soybean oil, casein and whey are dairy products, and potato and soy flour is in some gluten free foods.
3. Withdrawal symptoms may occur during the first few days or week on the diet. Some or all of your symptoms may increase temporarily. You also may experience symptoms that you do not usually experience. The symptoms usually subside within 10 days. The following may help you feel better: drinking at least 8 glasses of water a day, buffered vitamin C, baths with Epsom salts or baking soda, naps and mild exercise such as walking.
4. The elimination diet may be followed for up to 4 weeks. When you have had 5 days in a row, without symptoms or your symptoms have decreased you are ready to challenge.
5. If no improvement occurs in 4 weeks, then the food substances were probably not the cause of your problem and you can gradually return to a normal diet.
HOW TO CHALLENGE
Start: Begin challenging when you have been on the elimination diet for at least 2 weeks and when you have had at least 5 days in a row without symptoms or at least your symptoms have decreased.
Challenge: Challenge one food or food group at a time, eating the recommended amount of food for 3 days in a row. For instance if you are challenging dairy you should have a glass of milk three times a day for three days. Try to use the purest form of the food possible. Cream of wheat is a better choice than bread when testing wheat for instance in order to ensure that the problem is the wheat in the bread and not the yeast or any other additives.
Stop: If symptoms occur, stop the challenge. Do not start the next challenge until you have had 1 full day free of symptoms.
When you challenge, keep a record of both your physical and behavioral symptoms.
Be patient, reactions can take up to 48 hours to begin. If you hurry your challenges, you are likely to end up getting confused and having to start again. If a reaction is doubtful, wait until the end of the challenge period and repeat the challenge to confirm a reaction.
Food Challenges: When challenging individual foods, eat one serving three times a day along with the elimination diet foods. Challenge for at least three days.
Occasionally some patients will have severe “anaphylactic” reactions to a food they are challenging. If you experience extreme symtpoms such as shortness of breath, sensation of your airway closing, swollen tongue or lips, redness or swelling of your entire body, or any other symptoms of an urgent nature do not hesitate to call 911. These symptoms can come on quite suddenly and it is better to be safe than sorry.
• Mochi with cashew butter, peeled pear or apple
• Rice toast with cashew butter, pear
• Rice cereal and rice milk
• Rice pudding with soy milk
Lunch and Dinner Ideas
• Lamb, rice and green beans
• Lentil soup and rice crackers
• Cabbage soup and rice bread toast
• Beans and rice, lettuce salad
• Rice cakes with cashew butter, celery sticks
• Lamb, cabbage and rice soup
• Lettuce salad with cashews, celery, shallots and mung bean sprouts
• Rice pasta with parsley and green beans
• Bean soup and rice cakes
• Split pea soup and rice bread toast
Eat as much as you want.
Add cold pressed oil to vegetables and rice for flavor and calories.
Read a good book (not a cookbook!)
Hearty Morning Cereal
1/2 cup amaranth
1/2 cup millet
1/2 cup teff
1/4 cup cashews
Sweet Rice Cereal
1 cup brown rice
1 cup sweet brown rice
Cashew Millet Cereal
1 cup millet
1 cup brown rice
1 cup cashews
Millet and Quinoa Cereal
1 1/2 cup millet
1 cup amaranth or quinoa
Place all grains and nuts in a fine strainer; rinse and drain. Toast grains in one of two ways:
Preheat oven to 350? F. Spread grains on a cookie sheet and toast in oven until they give off a nutty aroma (12-15 minutes).
Place washed grains in a large skillet on burner and toast on medium heat, stirring constantly, until grains give off a nutty aroma (5 – 8 minutes).
Let toasted grains cool and store in sealed container. You can toast a big batch of several different grains at one time and store them in separate jars.
For the best nutrition, grind grains just prior to using in a small electric grinder or food processor. Once a grain is ground it begins to lose nutritional value within 24 to 48 hours. Store the whole toasted grains in labeled, sealed containers and grind the amount you need before cooking.
To cook ground grains into cereal use 1/3-cup ground cereal and 1 cup water per person. Combine cereal and water in a pot; bring to a boil. Reduce heat to low and simmer, covered, for 10-12 minutes. Using a flame-tamer or heat deflector on the burner while simmering the cereal helps prevent scorching or sticking.
Top plain cooked cereal with a little fruit sauce topping.
Amaranth Breakfast Cereal
1 cup amaranth
2 cups water
1 pear, peeled and chopped
In a small saucepan, bring the amaranth, water and pear to a boil. Lower heat to simmer, and cook for 20-30 minutes, or until all water has been absorbed. Garnish cereal with maple syrup, vanilla or rice milk.
2 cups rice flour
4 tsp. baking powder
2 cups rice milk
3 tbsp. safflower oil
Sift the dry ingredients together. Add the milk and oil gradually, stirring the mixture constantly until smooth. Bake in a hot oiled waffle iron. Serves 4
1/2 cup ground cashews
1 1/2-Cup amaranth, quinoa or rice flours 1 1/4-cup water
1 tsp. baking powder 2 tbsp. oil
Combine dry ingredients, mix well. Combine liquid ingredients in small bowl, mix well. Stir into dry ingredients. Cook pancakes on preheated, un-greased, non-stick griddle or fry pan. When bubbly and brown, turn. As batter thickens, add water, a tablespoon at a time to keep cakes thin.
1 head cabbage, chopped
3-4 cloves garlic
2 tbsp. sunflower oil
16 oz can white beans, drained
In a large pot, steam cabbage with a small amount of water. Cook until soft. Remove cooked cabbage from pot and add oil and garlic. Sauté garlic for 2-3 minutes. Add the cabbage back to the pot with enough water to cover the cabbage by 1 inch. Add bean to cabbage and let cook for 30 minutes on low heat. Add salt to taste.
Nutty Drizzle (serve over grain, vegetables or pasta)
1/4 cup cashew butter
1/3 cup water
Place all ingredients in a small saucepan on low heat. Stir with a whisk until mixture is smooth and warm. Serve over your favorite grain, vegetables or pasta.
1 cup quinoa
1/2 cup red lentils
1/4 cup chopped parsley
3 cups water
Combine all ingredients in a medium saucepan on high heat. When quinoa comes to a boil, lower heat to simmer and cook for 20 minutes. Fluff with a fork. Option: This mixture can be eaten warm as is or cold as a salad with added chopped vegetables.
Lentil Stew (6 servings)
1 lamb leg bone or 4 oz lamb blade steak, trimmed of fat and chopped (optional)
2 tsp. canola oil
1/2 green cabbage, chopped
6 cloves garlic, coarsely chopped
2 cups green lentils, washed and checked for stones
Heat canola oil in large saucepan over medium-high heat. Add lamb bone or steak (optional). Sauté until brown on all sides. Add cabbage and garlic. Sauté until soft and just beginning to brown. Add lentils and water. Bring to a boil. Turn heat to low and simmer with a lid on until lentils and lamb are very tender, 1-2 hours. After cooking, add parsley to taste.
3-4 cups cooked garbanzo beans
5 cloves minced garlic
1 cup parsley
2-3 tbsp. safflower oil
3-4 tbsp. water
1 tsp. cashew butter
garbanzo bean flour
Mix all ingredients in food processor except the flour. When smooth, add flour until a thick batter/thin dough consistency is reached. Fry in oil in skillet until browned/crisp on both sides. Top with tofu dressing.
Black Bean Garlic Stir Fry
4 cloves garlic, minced
chopped vegetables (cabbage, scallions, leeks, celery, green beans)
chives and parsley, to taste
2 cups cooked black beans
4 cups cooked rice
Sauté garlic in a wok or large skillet. Add chopped vegetables and sauté until soft. Add chives and parsley and black beans and cook until heated thoroughly. Serve over rice.
1/2 cup chopped leeks
2 cloves garlic, minced
16 oz cooked beans (Garbanzo, black, kidney or white)
1 tbsp. cashew butter
3 tbsp. chopped fresh parsley
1 tbsp. oil
In a small skillet, heat oil on medium heat. Add leeks, shallots and garlic. Sauté for 5-10 minutes or until leeks are soft. While vegetables cook, add remaining ingredients to a food processor. When vegetables are cooked, add to bean mixture in food processor. Process until all ingredients are well mixed and texture is creamy. Allow to cool before eating.
Split Peas and Rice (serves 4)
3 tbsp. oil 2 cups brown rice
1 leek chopped 6 cups water
1 clove garlic minced 1 cup yellow split peas
2 tsp. chopped chives
2 tsp. chopped parsley
In a large heavy pot, heat 3 tbs. oil and sauté leeks, garlic, chives and parsley until leeks are tender. Stir in rice and cook for 5 minutes or until rice begins to turn white. Add water and bring to a boil. Reduce heat and cook covered for 20 minutes. Add split peas to the cooking rice and cook 30 minutes more.
Split Pea Delight
1/4 cup dried green split peas
1/4 carrot, sliced
1 1/4 cups water
Wash peas and scrub carrot. Put peas, carrot, and water in a small pan; bring to a boil. Reduce heat and simmer, covered, for 20-30 minutes. Puree in a blender.
2 cups cooked beans (lentils, black, kidney, chick peas)
1/2 cup celery, chopped
1/2 cup parsley, chopped
2 shallots chopped
2 cloves garlic, minced
1-2 tbsp. oil
Combine the beans and chopped vegetables in a large bowl and toss until well mixed. Add oil and salt to taste and mix until beans and vegetables are evenly coated.
Rice Pasta and Vegetables
1 package rice pasta cooked according to package directions
2 leeks, chopped
3 shallots, chopped
2-3 cloves of garlic, minced
2 tbsp. fresh parsley, chopped
2 tbsp. fresh chives, chopped or 2 tsp. dried
2 tbsp. safflower oil
Heat oil in a skillet over medium heat. Add leeks, shallots and garlic and sauté for 5-7 minutes until leeks are soft. Add fresh parsley and chives and cook 1 minute longer. Remove vegetables from heat. Add rice pasta to vegetables, mix well. Add salt to taste.
4 cups cooked brown rice
1 cup celery
2 tbsp. fresh chives
1 cup chopped red cabbage
1 cup chopped parsley
1/3 cup cashews
2 tbsp. oil
Toss brown rice with chopped vegetables and cashew nuts until evenly mixed. Add oil and salt to taste. Optional: add 1/2 cup to 1 cup canned beans or lentils.
* this recipe can be made with cooked leftover rice or uncooked rice
1 cup cooked rice
1 cup rice milk
1 tsp. vanilla
Place cooked rice in a pan with the rice milk. Heat on medium heat until most or all of the rice milk has been absorbed. Remove pan from heat. Add vanilla. If consistency is too hard, add more rice milk and return to stove.
To make this recipe with uncooked rice, add I cup uncooked rice with 2 cups rice milk and 1 cup water. Cook like ordinary rice. When rice is cooked, add vanilla.
Millet and Pears
1 cup millet
2 cup water or rice milk
1 pear, peeled and chopped
In a pan, bring millet, water and pear to a boil over high heat. Lower heat to simmer and cook for 30 minutes. remove from stove top. Mix well. If desired, add some rice milk for a creamier texture.
Use 1 cup water per 1/4 cup cut-up pear or apple. Peel and slice the fruit. Place cut-up fruit and water in a pot; bring to a boil. Reduce heat and simmer until the fruit is tender and water has cooked off (about 15 minutes). Puree in a blender.
If you are in need of support while on a food elimination diet feel free to leave your questions or challenges in the comments section. If you have a favorite tip or recipe for those on this diet please attach it as well for all to enjoy!
Just a note: Next month we’ll be focusing on food allergies – so stay tuned!
~Dr. Nicole Sundene
Read more articles on allergies
References: Food Allergies and Food Intolerances