If you are very sensitive ANY change in food, in yourself, or in your environment, is a diet challenge. Some people cannot do the usual food challenges as they are so sensitive a reaction would make them very sick maybe even for day, and take up to two weeks to clear. What can they do? Fortunately the book Tolerating Troublesome Foods has over 300 foods in ascending order of riskiness beginning at risk rating 1/10 and up to 10/10.
There are five aspects to consider.
- You have had a significant change with your elimination diet trial so you do not need to do high dose challenges just to prove diet has a role. As you do trials you will gradually learn which food chemicals are a problem to you.
- Each food you test is still a separate trial as it may contain very low amounts of salicylate, amines, natural glutamates, flavours, additive, or some combination of these;
- The Family Sensitivity History will be a guide to food chemicals most likely to cause reactions so can be a guide about which foods to be cautious when testing;
- Foods you like and want to try, or would make your diet much easier to manage. Perhaps this should be listed as number 1. as it is your diet and your lifestyle you want to manage, and you really only need to test foods you want, or need, to add to your diet;
- Any need to eat away from home is a challenge. Avoid if possible by eating safe food at home and enjoying the company you see on your outing. You will still be dealing with different smells and that is one important challenge for you if you are very sensitive.
Remember to read the early chapters in Tolerating so you understand adverse reactions and how individual they can be, with your own first changes to look for when reacting, and the chapter on tolerance varying in factors in you, in your environment and in the foods you want to try. Then look up the food you are interested in, in the Best Guess Food Guide. There are notes on how to do careful challenges and information on ideas that mean you have the maximum chance of tolerating the food. It is wise to have the help of a dietitian while doing this. One important rule is ‘the more scared you are of a reaction the smaller the amount you begin your diet trial with’. You can increase the amount only very gradually over the seven day trial.
Of course you need to have your usual meds ready for any reaction. I remember many mothers who trialed very low risk foods and began medicine as soon as any wheezing began. They stopped the trial food and used the medicine until symptoms returned to their baseline diet level. If you have life-threatening conditions such as bad asthma or anaphylaxis you need to discuss doing any challenges at all with your doctor.
Don’t be too scared to do low risk challenges as you have reduced many likely suspect foods when you went on the elimination diet, and you are now testing only one low risk food. And remember that people vary in what they react to so a reaction to one food does not predict whether you will react to another food, tested in a different week, when you feel more robust, and your environment has changed.
Yes, I know it is tricky but if you use all the ideas in Tolerating and feel gradually more confident in what smells and tastes are indicators of likely suspect foods you will even surprise yourself at how good you become at managing your own diet. I wish you confidence in becoming a gourmet with regard to managing your own diet. Joan
Thank you Joan and I hope you are all well.