Tag Archives: allergies

How To Do An Elimination Diet: Discovering Food Sensitivities

by Miraallergiesallergies, elimination diet, food sensitivities

The elimination diet is considered the gold standard for identifying food allergies or sensitivities. The process consists of removing suspected foods from the diet for a specified time and then slowly re-introducing them back in a controlled fashion. Through the process, you pay close attention to how your body reacts with each re-introduction; using a food journal can be very helpful.

Elimination Diet Benefits

The biggest benefit of an elimination diet is that it can help you determine specific foods that you may be allergic, sensitive, or intolerant to. Food sensitivities can produce a wide range of symptoms such as ADD/ADHD, brain fog, depression, pain, rashes, bloating, diarrhea, constipation, fatigue, headache, obesity, and stomach aches just to name a few. Knowing which foods you are sensitive to can help you make better food choices for your overall health.

Phases of the diet

There are two phases in an elimination diet. Phase one is where the diet gets its name – elimination. The second phase is the reintroduction phase. It is important to understand each phase and the process for completing it.

Elimination Phase

In this phase foods common trigger foods are eliminated from the diet. Foods that you suspect your body can’t tolerate can be eliminated as well the common trigger foods. These trigger foods include:

Beverages – Alcohol and caffeine should be avoided. Sources of caffeine include soda, coffee, tea, and cocoa
Citrus fruits – Avoid all citrus fruits including lemons, limes, oranges, grapefruit, tangerines, and pomelos
Corn – This is one the nine top allergens and therefore is part of the elimination. Conventionally grown corn tends to be treated with glyphosate which can disrupt the gut, another good reason to include it in this phase
Dairy – All forms of dairy from all animal sources are eliminated
Eggs – These are another top nine allergen, avoid eggs from all sources
Fats – Eliminate less than desirable fats including margarine, hydrognated oils, spreads, and mayonnaise
Gluten – Avoid all sources of gluten, wheat, barley, rye, spelt, oats, kamut, and farro. In highly sensitive individuals a complete grain free elimination may be necessary
Legumes – Beans, lentils, and peas should all be avoided
Nightshade vegetables – These contain a plant alkaloid called solanine which people can be very sensitive to. Avoid tomatoes, potatoes, eggplant, and peppers including paprika and cayenne. This does not include sweet potatoes or black pepper as those are not from the nightshade family
Nuts and seeds – Nuts are part of the top nine allergens as are sesame seeds. All nuts and seeds are avoided during the elimination phase
Peanuts – Not a nut, peanuts are a fatty legume which is part of the top nine food allergens and should be avoided during this phase
Processed meats – These tend to have a lot of additives in them which may be contributing to food sensitivity issues. Avoid all processed meats, canned meats, cold cuts, and bacon
Shellfish – All shellfish should be avoided
Soy – Another food that is highly contaminated with glyphosate, soy is also phytoestrogenic and goitrogenic making it potentially problematic for people with hormone or thyroid issues
Sugars – All sugar should be avoided during the elimination phase including table sugar, honey, maple syrup, corn syrup, high fructose corn syrup, and agave nectar

Remember this is just for a short time period to allow your body to rest from potential inflammatory foods. The elimination diet is not meant to be a lifestyle. It is important to remember this.

What Do I Eat on an Elimination Diet?

The most important point here is to eat real food! Health and nourishment come from real, unadulterated food.

Animal Protein: These proteins are best obtained from pasture-raised or wild caught sources and can include fish, chicken, turkey, lamb, wild game, and fish. Processed fish and meats should be avoided.
Fruit: Any fruit except for citrus can be eaten. Between one half to one and a half cups per day.
Gluten-free grains: Any gluten-free grain which can include quinoa, wild rice, amaranth, buckwheat, millet, and teff can be eaten.
Healthy Fats: Cold-pressed olive oil, coconut oil, and avocados are great sources of healthy fat
Herbs and Spices: Any can be consumed except cayenne, red pepper, and paprika as these are all nightshades. White and black pepper are okay to use during an elimination diet. Herbs and spices not only add flavor to our food, they are little powerhouses of healing potential.
Vegetables: Three to four cups of leafy greens plus two to three cups of colorful veggies. Remember, nightshade vegetables should not be eaten during the elimination period. Think about eating a rainbow of colors when it comes to fruits and vegetables.

Eating these health-promoting foods allows your body to not only be nourished but also gives it a rest from foods that may be aggravating. At the end of the elimination period (your symptoms should have improved during this time), it is time to reintroduce foods back into your diet. This is done slowly, one at a time.

Reintroduction Phase

After successfully completing the elimination phase you slowly bring foods back into your diet. It is helpful to work with a holistic nutrition professional to do this in order to make sure you’re getting the support and guidance you need.

The point of this process is to eliminate and then slowly reintroduce foods one at a time. This is so you can monitor your reactions/symptoms. You want to pay careful attention to your sleep, mood, energy, digestion, bowel habits, skin challenges, and so on.

Bloating, gas, or cramping
Diarrhea or constipation
Fatigue or low energy
Headaches or migraines
Issues with sleep
Joint pain
Rashes or itching

3 Day Reintroduction Process

Day 1 you will reintroduce one food, eating two servings of it during the day at different times.
Day 2 and Day 3 stop eating the new food. Watch for any reactions from it
Day 4 and beyond will depend on what happened on day 2 and 3. If no disturbance occurs, move on to the next food; repeating the three-day cycle.

Even if there is no reaction to a food, it is important to not eat that food again until all foods in that category have been tested. If you experience any reaction on day 2 or 3, you will need to wait until those symptoms subside before reintroducing another food.

It’s best to work through the foods you had eliminated, determining which foods produce a reaction and which do not. For any food that does produce a reaction that is moderate to severe, it is best to eliminate that food for a longer period, such as four months. After that time, you can retest to see if your body has adjusted and gained a tolerance to the food. If a food produces no reaction, it is advised to eat the food only occasionally or only as long as no disturbance is noted.

If there is a known anaphylactic allergy to any food, DO NOT try to reintroduce it.

By now you realize an elimination diet may not be easy, but can be worth it in the end. The diet is a beneficial way to help you determine which foods may be trigger foods. You can then eliminate them for a period and see if this helps restore gut health and overall sensitivity

Studies have shown that an elimination diet has been helpful with conditions such as IBS, eczema, migraines, and more. Using an elimination diet can also help you learn which healthy foods you can continue to eat and enjoy. It is always in your best interest to eat real, whole, organic foods if at all possible and eliminate processed foods, sugars, and artificial sweeteners.

After going through an elimination diet it may be helpful to use the Rotation Diet Theory in order to help reduce over-exposure to proteins and support gut integrity. The Rotation Diet Theory is based on the thinking that the more you are exposed to certain proteins the higher the potential to develop sensitivities to them. Most humans tend to have a preference for their top 20 foods and those are the ones they eat over and over and over. It is not uncommon for those favorite foods to be the ones that show up on a food sensitivity test or which are revealed through an elimination diet to be the ones causing the issues.

When you are doing an elimination diet, it can be helpful to work with an experienced health educator or coach. If you would like to learn more about doing an elimination diet, please reach out to me.

[expand title="Sources"]

Alpay K, Ertas M, Orhan EK, Ustay DK, Lieners C, Baykan B. Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomised, cross-over trial. Cephalalgia. 2010 Jul;30(7):829-37. doi: 10.1177/0333102410361404. Epub 2010 Mar 10. PMID: 20647174; PMCID: PMC2899772.

Chey, W.D, MD, AGAF, FACG, FACP, RFF. The American Journal of Gastroenterology 114(2):p 201-203, February 2019. | DOI: 10.14309/ajg.0000000000000099
Pacor ML, Peroli P, Nicolis F, Bambara LM, Givanni S, Marrocchella R, Lunardi C. Eczema e allergia alimentare nell'adulto [Eczema and food allergy in the adult]. Recenti Prog Med. 1990 Mar;81(3):139-41. Italian. PMID: 2359866.
Smith, Erin, Foxx-Orenstein, Amy, Marks, Lisa A. and Agrwal, Neera. "Food Sensitivity Testing and Elimination Diets in the Management of Irritable Bowel Syndrome" Journal of Osteopathic Medicine, vol. 120, no. 1, 2020, pp. 19-23. https://doi.org/10.7556/jaoa.2020.008

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Top Food Allergens And Hidden Sources

by Miraallergiesallergies, allergy, food allergens, food allergy, top food allergens

Food allergies are a very serious issue. Thirty-two million Americans have food allergies (I’m one of them). That equates to 1 in 10 adults and 1 in 13 children -- and the numbers of people appear to be increasing. That's why people with food allergies should read labels to avoid food allergens.

Food Allergy & Food Intolerance

Food intolerances are often confused with food allergies. These intolerances, or sensitivities, don't involve the immune system are not typically life-threatening.

On the other hand, true food allergies are caused by your immune system wrongly recognizing some of the proteins in food as harmful. These allergies can be significant, possibly requiring hospitalization, and sometimes can be fatal. Unfortunately, there is no cure for this.

The only way to avoid an allergic reaction is to avoid the item. This can be difficult to do with some food allergens as they are used as ingredients in other foods, beverages, or supplements.

That’s why food allergen labeling is so important when purchasing prepared items. For those with a food allergy it’s critical to tell people what your allergies are so they can let you know if they make something with one of those ingredients.

Latest News on Food Allergen Labeling

On April 24, 2021, the president signed legislation making sesame the 9th identified food allergen. Because of lead times required to change packaging and labeling, companies are being given until January 1, 2023, to comply with mandatory labeling for sesame.

Even after sesame appears on the label as an identified allergen, those 1.5 million Americans who struggle with the allergy need to be aware of foods that may contain sesame or sesame-derived products.

Sesame derived products include:

Sesame oil
Tahini - sesame seed paste
Falafel - may contain sesame seeds and tahini
Hummus - may contain tahini
Sushi - the oil and seeds may be used in this
Halva - sesame based Middle Eastern/Mediterranean sweet
Chikki - an Indian sweet
Sesame seeds also feature in several dry condiments such as furikake or gomashio
Cosmetics (found in many lip balms, ointments, eye products, soaps, oils, creams)
Pharmaceutical products (check the package insert)

Top Eight Food Allergens

While over 160 foods can cause allergic reactions in people with food allergies, the law identifies the eight most common allergenic foods.

Milk/Dairy

Allergy to cow’s milk affects 2.5% of toddlers under the age of 3. Most of these children develop allergies when exposed to cow’s milk protein in their first year of life.

However, about 90% of them can outgrow this allergy when they turn three, making it less common in adults.

Lactose intolerance is commonly confused with milk allergy, but this condition is not an allergy.

Dairy products can be a source of protein, calcium, vitamin D, and vitamin B12. Here are some safe food sources to replace these dietary needs:

Protein - meat
Calcium - leafy green vegetables, broccoli, collards, kale
Vitamin D - fatty fish or supplements (It is recommended to speak with a board-certified allergist before adding this to your diet)
Vitamin B12 - Organ meat, poultry, meat, fortified foods (Read the label)

Cow’s milk in unexpected places:

Chewing gum
Cold cuts
Cereal
Non-dairy products
Processed and canned meats
Frozen and refrigerated soy products
Sheep & goat’s milk
Deli meats (due to cross-contact from slicing cheese)
Cosmetics
Supplements & medicines

Eggs

Egg allergy is among the most common causes of food allergies in children. About 68% of them can outgrow this allergy when they turn 16.

Most allergenic proteins are found in egg whites, but it is recommended to avoid egg whites and egg yolks.

An egg is an excellent source of dietary fat and protein. Here are some alternatives:

Protein: meat
Fat - avocado, meat, vegetable oils

Eggs in unexpected places:

Shiny coats/glazes on pastries/candies. These may be egg washes.
Many egg substitutes may contain eggs.
Pasta sold in stores may contain eggs.
Marshmallows, marzipan, and nougat may contain eggs.
Foams on coffee drinks may also contain eggs.

Peanuts

Allergy to peanuts is one of the leading causes of fatal food allergies in the United States. Peanut allergies affect around 4–8% of children and 1–2% of adults. However, only about 20% of children with this allergy may outgrow it. Therefore, the treatment is lifelong and requires complete avoidance of peanuts and peanut-containing products.

Here are some foods that may contain peanut as an unexpected ingredient:

Egg roll (used binding agent)
Pet food
Bird Seed
Crepe filling
Mole Sauce
Glazes and marinades
Graham cracker crusts
Chili & hot sauces
Pesto
Gravy

Tree Nuts

This is one of the most common food allergies in adults and children. Around 1% of the US population is affected by tree nuts allergy. Approximately 9% of patients outgrow this allergy.

As you know, tree nuts are not the same as peanuts. Tree nuts grow on trees, while peanuts grow underground and are part of the legume family.

Tree nuts in unexpected places:

Cereals
Crackers & cookies
Trail mixes
Candy
Flavored coffee
Frozen desserts
Marinades
Nutritional supplements
Medications
Cold cuts like Mortadella

Shellfish

About 60% of people with this allergy experience their first allergic reaction as adults.

Allergy to crustacean-type shellfish (shrimp, crab, and lobster) is more common than allergy to mollusks (clams, mussels, oysters, scallops, and octopuses).

Shellfish in unexpected places:

Asian dishes and in stuffing (i.e., oyster stuffing)
Pet food (for those that may have problems even touching it)
Nutritional supplements
Fertilizers
Imitation shellfish (surimi) may contain shellfish or used shellfish as a flavoring.

Wheat

Two-thirds of children with this allergy outgrow the wheat allergy by age 12. Unfortunately, some individuals remain allergic to wheat throughout their lives.

Wheat allergy is often confused with Celiac disease since both involve a reaction to gluten. However, a wheat allergy causes an immune response to one of the hundreds of proteins found in wheat. In contrast, Celiac disease is caused by an abnormal immune reaction to gluten and is not life-threatening.

Wheat in unexpected places:

Ale & Beer
Candies
Cereals
Crackers
Gravy or roux (often thickened with flour)
Ice cream products
Hot dogs and processed meats
Salad dressings, sauces, and soups (usually thicker soups)
Soy sauce
Surimi (a paste made from fish or other meats)

Soy

Soy allergies are common in infants and young children. Although it occurs in roughly 0.5% of children under three, around 70% of them outgrow the allergy.

Like peanuts, soybeans are a member of the legume family. Being allergic to soy does not necessarily mean that you are also allergic to another legume.

Where to find soy:

Asian cuisine
Baked goods
Canned meats, including canned tuna
Processed meats
High protein energy bars
Infant formulas
Protein shakes

Fish

Allergy to finned fish (cod, flounder, salmon, tilapia, tuna, etc.) affects nearly 1% of the population and is more common in adults.

Since shellfish and fish with fins have different proteins, people who are allergic to shellfish may not be allergic to fish.

Finned fish in unexpected places:

Caesar dressing
Caesar salad
Bouillabaisse
Imitation crab
Fish stock
Seafood flavorings
Worcestershire sauce

Always read labels closely, communicate with foodservice professionals clearly, and constantly carry at least two (2) epinephrine auto-injectors.

Checking for Food Allergens

While some of the body's responses to food allergies can be similar to food intolerances, with allergies the response can, over time, become more severe. This makes knowing whether it is an intolerance or a true food allergy important. Because the body mechanism for food allergies is different than food sensitivities it’s best to see a board-certified Allergist and have proper testing.

The testing usually starts with Skin Prick Testing. Depending on the results your doctor may also decide to do a blood test to confirm the findings of the skin prick test.

[expand title="Sources"]

"With The Stroke Of President Biden’S Pen, FASTER Act For Sesame Labeling Becomes Law". Food Allergy Research & Education, 2021, foodallergy.org/media-room/stroke-president-bidens-pen-faster-act-sesame-labeling-becomes-law.

"Facts And Statistics." Food Allergy Research & Education, 2021, foodallergy.org/resources/facts-and-statistics.

"Skin Prick Tests". Food Allergy Research & Education, 2021, foodallergy.org/resources/skin-prick-tests.

"Sesame | Description, Uses, & Facts". Encyclopedia Britannica, 2021, britannica.com/plant/sesame-plant.

“US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up.” The Journal of Allergy and Clinical Immunology, 2010 jacionline.org/article/S0091-6749%2810%2900575-0/abstract.

“Common Food Allergens.” Food Allergy and Anaphylaxis Connection Team, 2021 foodallergyawareness.org/food-allergy-and-anaphylaxis/food-allergens/the-top-8-food-allergens/.

“Common Allergens.” Food Allergy Research and Education. foodallergy.org/living-food-allergies/food-allergy-essentials/common-allergens.

“The 8 Most Common Food Allergies” Healthline, 2017. healthline.com/nutrition/common-food-allergies.

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Food Allergy Awareness: Raising A Child With Peanut Allergy

by Miraallergies, immune system, legumes, nutsallergies, peanuts

This article by Ned Newton shares his experience as a parent who has had to learn to deal with the issues of food allergy, his young child's health and safety, and how it has changed the nutritional plan in their home.

It seems pretty ridiculous now, but I have always remembered the one kid in my elementary school class who was allergic to chocolate. Me? I liked chocolate. A lot. But this one allergic reaction meant that any cupcakes that were brought in for birthday parties were always, to my disappointment, chocolate free.

Peanut Allergies

When my four year old son was diagnosed with peanut allergies, my first thought was about Joey from middle school. I was afraid that my son would be stigmatized, even if it was not in an overt way, for being different. Then I learned about EPI-pens and anaphylactic shock, and I had a new set of almost overwhelming concerns.

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How To Do A Rotation Diet

by Miraallergies, health, transitionallergies, rotation diet

When diagnosed with food sensitivities you may find yourself feeling overwhelmed. Especially since the foods you are most likely to develop a sensitivity to are the ones you eat most often. Once diagnosed, either by a doctor or through testing, it's important to have a rotation diet.

What is a Rotation Diet?

In simple terms, a rotation diet means that you are not eating the same foods every day. It's not a specific diet per se, such as Paleo, Keto, Mediterranean, etc, but rather a conscious way of eating that reduces your exposure to food proteins. Following this type of a plan requires you to write out what you can eat without repeating a food more than once every four days. By following a rotation diet plan you are able to eat a variety of foods without building up sensitivities to them. This is because with a four-day gap in consumption you are not overconsuming to the proteins in those particular foods on an everyday basis.

Rotation Diet Basics

Here is an example. When it comes to nuts most people eat a lot of almonds. In fact, they may eat them every day, or even multiple times per day. But by eating almonds every day there is a possibility that you will eventually become hypersensitive to the proteins in them. That would then eventually show up on a delayed hypersensitivity test and you would need to avoid them while working on a program to support gut health. By avoiding the foods that you are identified as sensitive to for 3-6 months and doing a supportive nutrition plan, you can potentially restore your insides to the point that you can eat some of those foods again.

Using the category of nuts and seeds for someone with an almond intolerance this might be a potential plan:

Day 1 - flax seeds, pistachio, hazelnuts (also called filberts),
Day 2 - brazil nuts, cashew, pinenuts
Day 3 - chestnuts, pumpkin seeds, walnuts
Day 4 - sesame seeds, sunflower seeds, pecan

At the end of the four day period you begin the rotation again.

It's important to note that peanuts are not really a nut. They are a fatty legume which tend to be one of the top food sensitivities and allergies. Therefore we do not include them in the rotation.

This pattern of rotating foods every four days applies to each category of food:

Dairy (if tolerated)
Herbs and Spices
Fish/Shellfish
Fruit
Poultry
Meat
Nuts and Seeds
Oils
Vegetables

Eggs are included in the poultry category and are consumed with their protein, i.e., chicken eggs with chicken, duck eggs when you are eating duck, turkey, quail, etc.

In the case of severe or a significant number of food intolerances, you may need to follow a rotation diet for an extended period of time while you work on your gut health.