Food Elimination Diet

[OakLeaf]

Well, the step by step part is the reintroduction. You have to eliminate all allergens to start with, to be able to identify a reaction if you have one.

Keep a diet and symptom diary, and start it about a week BEFORE you start your challenge, eating the way you normally do. Write down everything you eat and every symptom you have, whether or not you think it's allergy-related - include the time you eat each food and the time of onset and duration of symptoms. Be aware that once you start reintroducing allergens, you won't necessarily show a reaction right away - you might wake up the next morning with your face a little more edematous than usual, or your resting heart rate might be a little higher, just as an example. I think if you don't react within a day or two, you're good to reintroduce the next candidate.

Since any time you have a reaction you'll have to take another 4-5 days to clean out, it's best to reintroduce the foods you most strongly suspect last. Start by reintroducing things you don't really suspect (for example, you might reintroduce grains in order of their allergenicity - wild rice, regular rice, and millet early on; wheat, corn and rye late in your challenge).

The hardest part is eliminating trace amounts of things that could throw your challenge off. You'll have to prepare everything you eat during your challenge and really be aware of your ingredients. Vinegars are fermented with yeasts, soy sauce and miso are fermented with molds, so those get eliminated to begin with and probably shouldn't get reintroduced until late. Chili peppers are from the nightshade family, so those get eliminated along with actual nightshade foods like potatoes, tomatoes and eggplant. Lots of thin-skinned fruits like grapes and plums have natural yeasts on their skins, and any prepared fruit product like jam or juice is likely to be contaminated with trace yeasts and molds. Basically, for the initial elimination period you don't get a lot of seasonings (most herbs are probably cool, but be aware what family they're from). Protein-wise you'll need to eliminate soy, seitan (wheat gluten), dairy products, and eggs, as well as shellfish. You'll be getting your carbs from hypoallergenic vegetables and fruits, and the seeds of broadleaf plants like buckwheat, amaranth and quinoa.

It's been a long time since I did this, but the book my allergist recommended way back when was Marjorie Hurt Jones' The Allergy Self-Help Cookbook. It's got a lot of great information on food families. I don't think adults need to worry too much about a rotation diet if you do identify allergens, but it's good information if you choose (like I do) to manage your allergies and try to eat as "normally" as possible, rather than going the whole route to complete elimination.