Multiple Food Elimination Diet (By Doris Rapp)

Elimination Diet Part 1

During the first week, most meats, fruits and vegetables can be eaten (the "allowed" and "forbidden" foods are listed in Table 1). Keep detailed records in a food diary of exactly what is eaten. Most individuals who are going to respond favorably to this diet do so about the 6th or 7th day. Others respond as early as the 2nd or, rarely, as late as the 14th day.

If your child or you are better in a week or less, begin Part 2 of the diet on the 8th day. Improvement noted on day 2 may greatly increase by day 7. The object is to see the maximum amount of improvement, which can be noticed during the first 7 days.

If you want to help your entire family, you should urge everyone to try the diet at the same time. Typically, several family members will see improvement in how they feel or act when this is done.

If you or your child are not better within a week, recheck the diet records for the initial week of the diet. Were only the allowed foods eaten? If your child repeatedly forgot and ate the wrong foods or drank the wrong beverages at school or at home, the item which was not deleted or omitted from the diet may be the culprit. Try Part 1 of the diet again, but this time try much harder to adhere strictly to the diet. It's best to do the diet only once, but do it right. This fast, inexpensive method of food allergy detection can sometimes provide rapid, safe relief of many chronic medical and behavioral complaints. (Note: It is not uncommon to undergo some moderate withdrawal and worsening of symptoms and cravings when offending foods are first eliminated. These usually pass after the first 7-8 days on the elimination diet.)

Occasionally, a person is severely worse during Part 1 of the diet. If this happens, immediately stop the diet. A frequent cause is that the dieter has begun to ingest an excessive amount of an unsuspected offending food or beverage. A child who substitutes apple or grape juice for milk, for example, may act or behave much worse if apple or grape juice is the cause of this child's symptoms. Retry Part 1 of the diet, but stop the suspect food or beverage that you think made you or your child worse.

Rarely, someone who was not helped during the first week will dramatically improve with a more prolonged diet. Continue Part 1 for two weeks, not one week. If Part 1 of the diet was tried and did not help by the fourteenth day, this particular diet is probably not the answer for that particular person. The medical problems are not related to foods or are possibly due to other frequently eaten or craved items, such as mushrooms, cinnamon, coffee, tea, tobacco, and others that were not removed from the diet.

If an infection occurs during the diet, stop the diet until you are well. It is too difficult to interpret the results if it is continued.

During Part 1 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)
• eggs
• corn
• sugar
• chocolate (cocoa or cola)
• peas (peanut butter)
• citrus (orange, lemon, lime, grapefruit)
• food colorings
• food additives and preservatives
• luncheon meats (sausage, ham or bacon)

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.

The table below shows a more detailed list of allowed and forbidden foods.

Table 1

Elimination Diet Part 2

• Day 8: Add milk
• Day 9: Add wheat
• Day 10: Add sugar
• Day 11: Add egg
• Day 12: Add cocoa
• Day 13: Add food coloring
• Day 14: Add corn
• Day 15: Add preservatives
• Day 16: Add citrus
• Day 17: Add peanut butter

During Part 2 of the diet, one food is reintroduced into the diet, in excess, each day. Keep detailed records of how you or your child feels at the beginning and the end of each day, and observe carefully for one hour after a food is tried or eaten again. Start with a teaspoon or ½ cup of the test food item and double the amount eaten every few hours so that by the end of the day at least a "normal" amount has been ingested. Do any symptoms suddenly reappear? If there are no symptoms during the day, during the night or the next morning before breakfast, the food tested the day before is probably all right and may be eaten whenever desired. If the food being tested causes symptoms, stop eating it in all forms until you consult the advice of your physician. Do not try another test food until the symptoms from the previous food test have subsided. Usually you will notice that symptoms caused by a food occur within an hour. Symptoms such as canker sores, bed-wetting, tight joints, ear fluid, and bowel problems can be caused by a food and tend to cause delayed reactions several hours later.

If symptoms persist, take Alka-Seltzer Antacid Formula without aspirin (gold foil) or Alka-Aid (you can find these from health food stores). Take 1 tablet to a 6 year-old, and 2 tablets to a 12 year-old. Don't use if liver or kidney disease is present. The usual allergy medications can be taken, so symptoms subside quickly. If concerned, check with your doctor. Remember that if one of the listed foods causes a reaction that is not helped by Alka-Seltzer in gold foil and it lasts over 24 hours, do not try to check the response to another possible problem food until the current reaction has entirely subsided.

Watch closely to see what happens each day. One food might cause a stuffy nose, the next might cause no reaction at all, and the next might be a bellyache. Some reactions occur immediately, others not for several hours. Once again, if a food obviously causes serious symptoms, it should not be tried. NEVER TEST ANY FOOD WITHOUT YOUR DOCTOR'S ADVICE IF IT CAUSED SERIOUS MEDICAL PROBLEMS IN THE PAST. FOR EXAMPLE: IF EGG OR PEANUT CAUSED IMMEDIATE THROAT SWELLING OR FISH CAUSED SEVERE ASTHMA, IT IS UNSAFE TO TRY EVEN A SPECK OF THESE FOODS.

If you are uncertain whether a food causes symptoms or not, discontinue it until the other foods have been checked. Then try the suspect food again at a five-day interval (e.g., Tuesday and Saturday). See if symptoms recur each time.

If you want to learn even more about what each food does when it is eaten again, do the following:

1. For children, have them write and draw. Does either change or deteriorate before and 20 minutes after a food is eaten? If it does, the items ingested could affect your child's school work.
2. Take the pulse. If it increases by 20-40 points after eating a particular food, once again your body could be warning about some food sensitivity.
3. If you have asthma, use a pocket peak flow meter. Use this before and 20 minutes after each food. If the reading on the gauge falls 15, or your writing or drawing is worse, find out what you ate, touched, or smelled that is a problem.

Additional details are available in: Doris Rapp's books Is This Your Child?, The Impossible Child and Allergies and Your Family.