Sugar free? Additive free? Yeast free? Wheat free? Milk free? Low FODMAPS? Amine free? Low salicylate? No MSG? All suspect food chemicals [salicylates, amines, glutamates]? The blood group diet?
When we think about it we realize that we cut foods out of our diet to see what foods we should cut out of our diet!
In fact no one knows exactly what elimination diet we should begin with as each person has their particular sensitivities. The diet you need is the diet you find by doing diet investigation in yourself. To find this we do need to think about the best elimination diet to start from.
People who suspect they react to food often cut out the single foods they are fairly sure are causing definite reactions, or exclude foods someone suggests.
Two things can happen. One is that the symptoms are completely solved and their action was wise. The other is that the distressing symptoms may be reduced but they are still there, or reactions still occur but what is causing them is no longer clear. As well cravings, that happen in some, make diet management even more difficult. It is not surprising that they try cutting out more foods but this may not help take away the symptoms, with the diet getting harder the more they cut out. As well they may be minimising additives which often do cause reactions. It can all become a frustrating muddle.
If you have done this you are not alone. But you are now sure at least that you do react to foods. At some time it is important that you start again by excluding enough that you do not blame a new food when it may be some food you are still eating. Having the help of an Accredited Practicing Dietitian is wise with any sort of Diet Detective work. As nutrition can be affected it is even more important. As well the dietitian can help with gradual testing of various foods from the best tolerated to the highest risk ones.
Let’s think about all the foods listed above. What is already known from past Diet Detective work? If you exclude sugar you are also excluding many additives, and many commercial foods so you are probably also reducing wheat. In fact only 2% of food sensitive people react to ordinary cane sugar when it is added to home-made foods.
Additives are almost always a problem to food sensitive people. There is a huge variety of them so the most suspect ones – additive colour, flavours, glutamates, and most preservatives – should be minimised for effective diet investigation. Later they can be tested for tolerance one at a time in some food you would like to try. They are discussed in detail in my book Are You Food Sensitive?
What about yeast? Sometimes it is grouped with sugar, dairy and wheat as an initial diet to try. Years ago dried yeast powder was eaten with breakfast by some and this large dose was sometimes reported a problem. But the amount of yeast you eat in a few slices of bread is low, and it has been cooked at a very high temperature in crusty bread so reactions to this low dose of well cooked yeast are very few.
Where milk is excluded it can make a very big difference to the diet nutritionally as well as causing big changes in managing your usual foods. You have to find different sources for the protein, calcium, Vitamin B2: riboflavin, and the contribution to energy intake that dairy foods provide. Some ideas are important here. One is that fortunately dairy tolerance in small children often improves with age. Another idea is that sensitivity to food chemicals [ additives, salicylates, amines and glutamates] often aggravates the underlying symptoms so, after foods high in additives and other food chemicals have been reduced for a month, some milk products may be more successfully reintroduced. See Are you Food Sensitive? for detail on trialing different milk products such as cheese or butter. In food sensitive people around one third of those sensitive to food chemicals do need to reduce dairy foods, but only half of these need to exclude dairy completely.
Remember that where lactose intolerance is suspected it can be solved using a lactose free dairy milk. If the symptoms are still present then the person is dairy sensitive and all dairy products need attention. Lactose intolerance only causes gut symptoms. If symptoms are in another part of the body, eczema on the skin for example, then it is whole milk, not just, lactose, the sugar in milk, that is the problem.
Many people begin diet investigation by excluding wheat. This means using many less commercial products, so some of the improvement can be to reduction in additive intake. Around one quarter of those sensitive to food chemicals need to limit wheat [see how in Are You Food Sensitive?] and half of these, only one eighth, need to exclude it completely. If you seriously suspect wheat it is a good idea to discuss this with your doctor so you can have a test to ensure you are not a coeliac. If you are a coeliac you need to be much more careful about excluding all gluten than if you are wheat sensitive. Remember sensitivity to wheat may relate to particular parts of the wheat. There is the protein – gluten part, the starch itself – well cooked starch, and toast are better tolerated, and the fibre, if it is wholemeal, so all of these need separate attention. The FODMAPS, fructose intolerance, diet also excludes wheat. See the article with that title for where FODMAPS can be seen as one part of the big picture of food intolerance.
Now that food intolerance is better understood What do we know about where we should start. From clinical research we now know that reducing food chemicals is the place to start. But, like additives, just beginning by attending to amines, or salicylates or glutamates, on their own, is not wise. Of people who react to additives nearly 90% also react to amines, shown by chocolate, and 80% to salicylates shown by tomato, and 50% react to MSG shown by soy sauce.
An important but little known idea is that much of what you need to attend to in your initial diet is available to you from your own family. The idea of a blood group diet is not as useful as collecting information from your own family. See Chapter 4 in Are You Food Sensitive? to learn all about the Family Sensitivity History. Using the information from your family as well as all the suspect food chemicals allows you to have your own Family Elimination Diet. This is the best diet to start with.
By using the Diet Detective Method, which attends to the known suspect chemicals, family sensitivities, and any allergy testing, you have the best chance of investigating your own diet to find the foods that you react to yourself. Diet detective work helps you decide what to minimise or exclude for the elimination diet you begin with, and then you can begin to reintroduce foods and additives one at a time and see what you tolerate. The trick is to manage to have the diet minimise the most likely suspects, which does include your own suspect foods, but adds all that has been found from research with large numbers of food sensitive people.