12/12/1999

This Elimination/Rechallenge Diet is a short-term diet for diagnosis and assessment only; it is not a long term treatment diet. The purpose of this diet is to discover and uncover those foods that may be responsible for some, many or all of your symptoms. Whether this test diet is used alone or in combination with skin or blood tests, the results will determine what food allergy treatment diet is best for you. The treatment diet usually consists of the elimination of the worst offending foods and then rotating mild and non reactive foods on an every 3-4 day basis. This treatment diet is called an Elimination/ Rotation Diet and is described in a separate monograph.

Part I: The Elimination Phase

If you or your child are better in a week or less, begin part 2 of the diet on day 8. Improvement noted on day 2 may greatly increase by day 7. The object is to see the maximum amount of improvement which can be noted during the first 7 days.
If you want to help your entire family, urge everyone to try the diet at the same time. Typically, several family members will note improvement in how they feel or act when this is done.

If you or your child are not better within 1 week, recheck the diet records for the initial week of foods eaten: were only the allowed foods eaten? If you or your child repeatedly forgot and ate the wrong foods or drank the wrong beverages at school, work or at home, the item which was not deleted or omitted from the diet may be the culprit. Try Part I of the diet again, but this time try much harder to adhere strictly to the diet. It's best to do the diet only one time, but do it right. This fast, inexpensive method of food sensitivity detection can some times provide rapid, safe relief of many chronic medical and behavioral complaints.

Occasionally, a person is worse during Part I of the diet. This may be from a "clearing out effect" of prior food sensitivities or it may be that you or your child has begun to ingest an excessive amount of an unsuspected offending food or beverage. If this happens, immediately stop the diet. A child who substitutes apple or grape juice for milk, for example, may act or behave much worse if the apple or grape juice is the cause of this child's symptoms. Retry Part I of the diet, but stop the suspected food or beverage which you think made your child worse.

Sometimes, a person who was not helped during the first week will dramatically improve with a more prolonged diet. Continue Part I of the diet for two weeks, not one week. If Part I of the diet is tried and has not helped by the 14th day, this particular diet is probably not the answer for you or your child. The medical problems may not be related to foods or are possibly due to other frequently eaten or craved items, ie, mushrooms, cinnamon, yeast, tobacco, molds, chemicals, etc., which were not removed from the diet.

NOTE: If an infection occurs during the diet, stop the diet until you or your child is well. It is too difficult to interpret the results if it is continued.

During Part I of the diet, the following foods are omitted in all forms:

• Milk and dairy products, (yogurt, cheese, ice cream, casein, sodium caseinate, whey)
• Wheat (bread, cake, cookies, baked goods)
• Citrus (orange, lemon, lime, grapefruit)
• Eggs, corn, sugar, chocolate (cocoa or cola)
• Food coloring, additives, preservatives
• Peas (peanut butter, peanuts)
• Luncheon meats, sausage, ham or bacon
• Caffeine- coffee, tea, cola (yes, even decaf)
• Vitamin and nutritional supplements and over the counter medications. Continue all prescription medication unless directed otherwise by your doctor.

If there is some question about a specific food, do not eat it. Also, exclude any other food or beverage that is craved in excess because such items are frequently unsuspected causes of various medical or emotional problems.

MAJOR CAUTION: Do NOT eat any food you already know causes a severe allergy. This diet is to detect foods that you eat frequently but that are NOT presently recognized as a possible cause of certain medical, behavior, activity or learning problems.

Table of Allowed and Forbidden Foods During Part I

Food Type	Allowed	Forbidden
Cereals/Grains	Rice- rice puffs, rice Oats-oatmeal made with honey Barley	Foods containing wheat flour- most cakes, cookies, bread, baked goods
Fruits	Any fresh fruit, except citrus Canned-if in their own juice and without artificial color, sugar, or preservatives	Citrus- orange, lemon, lime, grapefruit
Vegetables	Any fresh vegetables, except corn and peas French fries (home made only) Potatoes	Any frozen or canned vegetables Corn, peas or mixed vegetables
Meats	Chicken or turkey (non-basted) Louis Rich ground turkey Veal or beef Pork Lamb Fish, tuna	Luncheon meats, wieners, bacon Artificially dyed hamburger/meat HamD yed salmon, lobster Breaded meats, meats with stuffing
Beverages	Water (preferably spring water) Single herb or plain tea & honey Grape juice, bottled Frozen apple juice Pure pineapple juice (no corn or dextrose)	Milk or dairy drink with casein or whey Fruit beverages except those so stated Kool-Aid Coffee Rich (yellow dye) 7-UP, Squirt, Teem, cola, Dr. Pepper, ginger ale Coffee, black teas (even decaf)-be sure to wean slowly off caffeine to prevent headaches
Snacks	Potato chips without additives Ryekrisp crackers and pure honey Raisins (unsulfured)	Corn chips (fritos) Chocolate/cocoa Hard candy, ice cream or sherbet
Miscellaneous	Pure honey Homemade vinegar/oil dressing Sea salt Olive Oil (cold pressed) Pure maple syrup Homemade syrup	Sugar, dextrose Bread, cake, cookies (except special recipes) Eggs Dyed (colored) vitamins, pills, mouthwash, toothpaste, medicines, cough syrup, etc. Jelly or jam Jell-O Margarine or diet spreads (dyes and corn) Peanut butter/peanuts Sorbitol (corn) Cheese All nonessential medications, food/vitamin supplements Red pepper (cayenne)

Be sure to read all labels first! Refer to page 8 for more details on food groups.

Special Tips for the Multiple Elimination/Challenge Diet

The "allowed" foods can be selected, combined and eaten in any quantity. If you are a bit suspicious, start with a tiny amount and increase it during the day if no symptoms are revealed.

For a beverage, you can mix the allowed fruits in the blender with spring water and honey or pure maple syrup.

You or your child's medications can be taken during the diet. If improvement is seen, you may find that certain medicines such as antihistamines are needed less often by the end of the first week. Try to use only white pills (crushed for small children and placed in applesauce or potatoes) or colorless liquids. Most liquid medications contain corn, sugar, artificial flavors, and artificial dyes which can cause symptoms in many children. Check with our office or your or your child's physician about any questions you may have regarding this.

Once you determine which foods cause specific symptoms, you must discuss the problem with us or your physician. Some foods cannot be omitted for indefinite periods of time if proper nutrition if to be maintained.

Do not try the diet when you or your child has an infection or is receiving antibiotics which contain dyes, sugar, flavoring, or corn. Holidays and vacations are also not a good time to start this diet!

Although symptoms from a single food vary, food sensitivities are often evident in several family members. One child might have headaches, another a stuffy, congested nose, a third family member hyperactivity, and another child might wet the bed. The same food, ie., milk, can be a problem for several generations of a family. For this reason, make cooking easier by placing the entire family on the diet. A fringe benefit may be that you relieve some "emotional or learn-to-live-with-it" health problems caused by certain foods or beverages in several family members.

If your child refuses the diet, try offering rewards. Promise a gala party if there is no cheating and if it is obvious that the child is truly trying very hard to cooperate in every way. The party should take place AFTER both parts of the diet are completed. At that time, give your child the foods which caused the symptoms providing they were not severe and incapacitating. This will be a double check confirming the effect of these foods on your child. Alka-Aid (from health food store) will prevent or stop reactions in many children in 10-15 minutes depending upon whether it is given before or after a problem food is eaten. Alternatively, you may offer a reward at the end of each completed day, ie. a hobby item (new stamp, coin, fishing lure, etc) and then an additional gift at the end of the week. Younger children often respond well to a gold star chart. Make a chart with a space for each meal of every day of the week. Give a star for every meal successfully completed. You might even suggest that for every x number of stars (2,3 etc) the child earns a special treat- a trip to the park, a small toy, etc). Be sure to let the child in advance know what are the goals and stick to them. In the end, you must realize, that if your child does not want to go on this diet, he or she won't! Hopefully you can convince them to at least meet you half way.

If your child has asthma, add the test food back into the diet with extreme care. It is possible that an unsuspected food could precipitate a sudden severe asthma attack. Have asthma medications on hand during Part II of the diet and use the Pocket Peak Flow Meter to help find out exactly what is causing your child to wheeze.

You may have some difficulty finding suitable substitutes and foods during your elimination and challenge phases of this diet at conventional grocery stores. If so, try your local health food or gourmet stores for various foods and food products. It is also helpful to plan your diet for the whole time and then purchase exactly what is needed for each day; this way you won't get caught short at the last minute looking for a particular food item to be added or substituted.

Admittedly, this diet is not the easiest to follow; it requires patience and discipline. However, once hidden food sensitivities are discovered, you can take the first step to free yourself or your child from symptoms and problems that have up to now been only partially or even ineffectively treated. Do the best you can, never give up, and the results will follow.