ELIMINATION DIETS: ELIMINATION PHASE

The aim of any elimination diet is to remove the food components that are causing adverse symptoms or making them grow worse. Elimination diets set the stage for subsequent determination of the culprit food components by allowing the allergic person to become symptom-free in order that when the specific reaction triggers are reintroduced, they cause noticeable, and sometimes measurable, symptoms. There are three types of diets in the elimination phase of the management program:

1. Selective elimination diets 2. Few-foods elimination diets 3. Elemental diets
Each diet has a specific function in the management of food sensitivity .
CHOOSING THE MOST APPROPRIATE ELIMINATION DIET
In order to determine which elimination diet is the most appropriate for you, the following information is required:
◆ A careful medical history. It is especially important to record any anaphylactic reactions suspected to be due to food.
◆ Exclusion of any other cause for the symptoms, determined by diagnostic tests and procedures, carried out by your medical advisors.
◆ Results of any allergy tests previously carried out by qualified practitioners.

◆ A careful record of all foods, beverages, supplements, and medications ingested during a 7-day period, with details of symptoms experienced during this time. This record is called an “exposure diary.”
Exposure Diary

Record each day, for a minimum of 7 days:

◆ All foods, beverages, medications, and supplements ingested
◆ Approximate quantities of each (teaspoons, tablespoons, cups, grams, ounces)
◆ Composition of compound dishes and drinks (ingredient list)
◆ The time at which each was taken
◆ All symptoms experienced, graded on severity: Scale: 1 (mild); 2 (mild-moderate); 3 (moderate); 4 (severe)
◆ Time of onset of the symptoms
◆ How long the symptoms lasted and whether medications were taken to control the symptoms
◆ Status on waking in the morning (symptom-free? type and severity of symptoms?)
◆ If sleep was disturbed during the night, whether this was due to specific symptoms

THE ELIMINATION DIET

The appropriate elimination diet excludes all suspect allergens and intolerance triggers based on the above information, specifically:
◆ The detailed medical history
◆ Analysis of the exposure diary
◆ Results of any previous allergy tests
◆ Foods that you suspect may be a cause of your symptoms
Each type of elimination diet has a place in determining the culprit foods:
◆ Selective elimination diets: one or a small number of specific foods are eliminated for a specified period of time. For example, milk-free diet, egg-free diet, wheat-free diet, or a combination of these .
◆ Few-foods elimination diets (sometimes referred to as oligo-antigenic diets): only a few (usually fewer than ten) foods are allowed for a specified period of time.
◆ Elemental diets: only an amino-acid-based formula is allowed for the duration of the elimination phase. No solid food is consumed. Sometimes an extensively hydrolyzed formula may be used, especially for babies.