Royal Prince Alfred Hospital Royal Prince Alfred Hospital
Allergy Unit

Order the Elimination Diet Handbook

The Simplified Elimination Diet booklet introduction

Introduction

Before making any major changes to your diet, go and see your doctor. Food intolerances can be very unpleasant, but they don't generally cause permanent damage to the body. If you have persistent symptoms it's wise to first make sure some serious disease hasn't been overlooked.

Sensitive people vary in their reactions to different foods and food chemicals, which means there's no simple diet that suits everybody. If you're having trouble working out which foods are upsetting you, you'll need professional help to look into the problem systematically. This is done in two stages:


  1. Following a strict chemical-free "elimination diet" for a few weeks, until your symptoms disappear.


  2. Taking a series of "challenge tests" by mouth to find out which chemicals in your diet cause reactions.


Once the problem substances have been pinpointed, your dietitian can advise you how to change your diet to avoid a recurrence of symptoms.

If you prove to be sensitive to many foods, don't be discouraged - food intolerance needn't be permanent. You may well be able to build up your tolerance level by gradually increasing the variety of foods you eat and eventually return to a more normal diet. Even if this isn't possible, you'll learn ways of avoiding severe reactions by looking out for the foods that upset you most.


Getting started:

  • Make sure you've got everything you need before starting the diet.
  • Check the "ALLOWED" list when doing your shopping to make sure you have the right foods in the house.
  • Buy a notebook to keep a daily record of everything you eat, what symptoms you get, and the challenge tests.
  • If you haven't already been given one, obtain a copy of the low-chemical recipe book, "Friendly Food" (Murdoch Books).
  • Start whenever you're ready, preferably on a Monday.

Follow the diet carefully:

  • Keep strictly to the "ALLOWED" list.
  • Don't use any foods not listed.
  • Avoid all non-essential medications.
  • Don't take anything containing aspirin.
  • Wash the colour off tablets, or open capsules and take the powder.
  • Use only recommended vitamin preparations.

Beware:

Some people with food intolerance can get a "withdrawal effect" during the first week or so after the diet is suddenly restricted - in other words, symptoms may flare up before they get better. Usually this subsides after a few days, but if it lasts more than a week ring your dietitian or doctor.

You may find that after you've restricted your diet for more than a week or two, certain foods will cause more noticeable reactions when you try to reintroduce them. Make sure you follow the diet strictly until testing is completed.

Your nose may become more sensitive on the elimination diet, and strong odours and fumes may cause you to feel ill. This usually subsides after the diet is liberalized.


When to start challenges:

Follow the diet strictly for at least two weeks. Wait for your symptoms to settle down, and begin taking challenges after you've had five good days in a row.


Social occasions:

If there's a dinner or a party you can't postpone, don't panic! You can break your diet for a day, and treat the occasion as if it were a challenge.

Keep strictly to the elimination diet afterwards, and wait at least five days before continuing where you left off.


When to stop:

If you've had no improvement in symptoms after 4 weeks, check with your doctor or dietitian.

Sometimes it's worth eliminating wheat and dairy products as well for another 2 weeks, if you haven't already done so.

After 6 weeks, chances are food intolerance is not your main problem if you still haven't improved.


Going back to a normal diet:

Even if your symptoms didn't settle down on the elimination diet, some foods may cause reactions when you try them again. By systematically re-introducing foods in groups, according to their chemical content, you'll find out what you can tolerate safely. Use the "Salicylates, Amines & MSG" booklet as a guide.


USING THE DIET CHARTS

Before starting the elimination diet, read "BALANCING YOUR DIET" in this booklet. This will help you meet your nutritional needs whilst on the elimination diet. Children should have no difficulty maintaining their weight, but it's not uncommon for adults to lose two or three kilograms during the first fortnight on the diet, and then to stabilise. If your weight continues to drop, see your dietitian for advice.

Sticking to the diet will be much easier if you're able to prepare attractive and palatable meals. The "MENU SUGGESTIONS" will give you some ideas to start with, but you should also use the low-chemical recipe book "Friendly Food" (Murdoch Books). This has a set of imaginative recipes for all occasions, and helpful hints on shopping and food preparation.

SYMBOLS (used in the charts - not reproduced here):

S   Contains SALICYLATES only

A   Contains AMINES only

SA Contains SALICYLATES and AMINES

G   Contains natural GLUTAMATE (MSG)

Foods in the "AVOID" columns are marked with symbols to show which natural chemicals they contain, and with additive code numbers where relevant. Once you know what substances you're sensitive to, you'll be able to reintroduce some of the foods in this column, using the "Salicylates, Amines & MSG" booklet as a guide.