Monday, March 18, 2013

Things to consider on an elimination diet

There's a lot of sites out there which discuss how to do an elimination diet, from medical sites to forums to personal blogs. There's lots of different ideas on what to avoid, how to avoid it, and in what order you should try to eliminate foods.

I'm not going to talk about any of that. In my family, we dropped the 8 most common allergens and cooked from scratch for a while, and changed that on subsequent elimination diets, based on what we learned.

And that's what I'm going to talk about right now: what we learned. Because even if you can find a doctor who is willing to help you with an elimination diet, many times they seem to be, to put it bluntly, pretty ignorant about the REALITY of an elimination diet. Most doctors I've met don't seem to have the barest clue about what your every day experience is going to be like, or what the food industry has been adding to your food.

I hope that knowing a bit more about the process, from someone who has been in the trenches, so to speak, might be of use for anyone who is going through the process.

So, things to know when you are going to go on an elimination diet:

  • It's going to be more challenging than your normal diet. I'm sure you know this already, but it's really going to be more challenging, in more ways than one. You're going to have to take more time to think up meals, often a heck of a lot more time. Your body may ned to adjust to new tastes, which can make it even harder to eat the food you should be eating. You have to watch people eating foods that you love that you now can't have. And you have to start planning more for trips and errands so that you have safe, diet-friendly food with you when meal times come. I highly recommend making a weekly meal plan, recipes included, ahead of time, if you can. It will make this MUCH easier, and that makes it much more likely that you'll succeed and not cheat on the diet because you're hungry, tired, too busy, or sick of missing out on foods you want.
  • Knowing that it's going to be crummy to see food all around you that you can't have, it can be important to find at least a couple foods that you really like which you can still eat. Keep these in reserve for moments of weakness when you're looking at a food you shouldn't have, but desperately want. If that means you have a couple days where you're 'yummy' food is in all three meals, so be it. If it helped you stick to your elimination diet, it worked, and that's all that matters at the moment, yeah?
  • On-the-go snacks are really important. Seriously, track these down first. Something you can eat fast, and something that won't spoil so you can cart around in a purse or briefcase, is going to make this that much easier.
  • You need a quick, easy way to write down your reactions and what you eat or this is going to fail spectacularly. It's good to remember that the more processed foods you eat, the more you have to write down. However, nowadays there are apps that can help with this, of varying quality. One I liked fairly well was 'Allergy Detective.' This makes it possible for you to enter in your own foods for a quick list you can simply check off of later. It also helps track reactions up to 24 hours after you eat a food, and start making correlations for you. It's not perfect, but it can be a great starting record in the beginning.
  • Holidays are even more difficult than normal to be on a restrictive diet, so if at all possible, I'd really recommend starting an elimination diet away from a big food holiday like Thanksgiving, Christmas, Duwali, etc.. 
  • Constraints about certain foods belonging to certain meals will make an elimination diet much harder. Life is easier if you eat when you're hungry, whatever the food is. So burgers for breakfast or oatmeal for dinner is fine; whatever works for you. 
  • Making large batches of some of your foods and freezing some for later is a big help. Helps to make it easier to stick to the diet and to make less work for you. Many times, soups and stews are an easy way to get a lot of food with minimal prep time.
  • When you have a limited diet, like you may have if you are eliminating more than one food at a time, a little bit of variety can help to make the monotony bearable. Varying things like dips, sauces, and condiments is a huge help. Even on a 4 food basic diet, like pears, turkey, rice, and sweet potatoes, has the possibility for variety, like cooking and blending up the pear for a sauce with the turkey, or blending pear and sweet potato as a dip for turkey, too.

Sometimes, you luck out in our elimination diets and the answer is easy, like you dropped dairy and suddenly your problems are all gone. That's what we're all hoping for. But sometimes, you go on an elimination diet and while you can tell something is changing, you can't figure out the pattern or can't figure out what exactly you're reacting to. In those cases, this has been my experience:

  1. If you don't have a straightforward reaction, consider that you could be reacting to more than one item, like dairy, soy, and gluten, for example. Or you could be reacting to a component in more than one food group, like fructose for fructose malabsorption, sulfites for sulfite sensitivity, or histamines for those with histamine intolerance. You may also be more sensitive than the norm to your allergy/intolerance (I know some who are very sensitive but don't have intense reactions.). In this case, you may be reacting to lower amounts; the information below will note why that can make things difficult.
  2. It is important to remember the following: our food is not 'pure.' Our food is grown in an open system where practically anything can come into contact with it and contaminate it with something else. Some real life examples for you that I've run into: there can be waxes on fruit that can contain dairy and soy. Meat can be washed at the slaughterhouse with vinegar or acetic acid (citric acid, can be corn contaminated). Maple syrup have fat containing defoaming agents added,which can be numerous products, such as dairy or oils. Cheese can be washed with beer. Beans and wheat can share harvesting equipment.   Anything processed as well as items like whole fruit that seem like they should be pure, can still have contamination. If you react to certain foods and then react to one that doesn't make sense, it doesn't hurt to do some research to make sure that last food wasn't contaminated somewhere.
  3. When you're trying out various foods and you start to think about contamination at the factory, don't forget that if food is from the same factory, it may have the same contamination. So if you find yourself reacting to all products from a particular company, that might be a clue that it's a contaminant that's getting you rather than a huge variety of foods. 
  4. The fact that our food is not 'pure' can even hold true with food we grow ourselves. Many of us who garden use soil amendments, gardening soil, bug and weed sprays, and more. These, too, can contaminate our food. Some examples I've run into have been peanut shells added to garden soil, wheat in slug pellets, and corn in organic weed pre-emergents. If your yard is in an area where there used to be a lot of farming, there can even be pesticide residue still in the soil that can be taken up by your veggies and fruits. I understand that if you garden in land that was once used for farms, getting your soil tested is recommended. 
  5. Even our water can have an affect on our elimination diets. Very corn allergic folks can react to water softeners that contain citric acid, from those I've spoken to. Coconut is a commonly used ingredient for charcoal-based water filters. Some water filters can have other contaminants, as well. And sulfites can be present in amounts high enough to react to in the various water supplies (numerous sulfite-allergic folks report having reactions to Dasani water, for example, although Dasani reports that they do not add sulfites.).
  6. Some reactions to foods are very quantity dependent, so you can eat up to a certain amount before you will react. This can lead to some tricky patterns in a food journal, where you'll eat a food one day and be fine, but the next day you react. Unless you record quantities on your food journal, you may not be able to note that you only react to food X when you've had over a certain amount of it on a particular day.
  7. Sometimes our allergens may be present in things other than our food, in ways we probably don't even think about. Dish soap can have allergens like wheat, for example. Paper plates and paper cups sometimes have corn starch added to keep them from sticking together. Lipstick can contain gluten. Newspaper ink can contain soy. It's good to remember that if we are reacting to things that go into our mouths, whatever touches our food, our mouths, or touches what touches our food and mouths, may have an effect. It may not be a huge effect, but the possibility exists. For highly sensitive folks, even things we inhale can be a problem, like nut products in a scented candle
  8. In a lot of ways, we end up having to think outside the box. Or as I like to think of it: we need to think like someone who is paranoid. If someone was trying to poison you, how could they get it to you? Food, water, air, touching objects around you. Well, these same pathways exist for whatever you are reacting to, and you typically have little knowledge of what has been addd to the foods and products around you. So if you're reactions are strange, don't discount anything at first. Explore it.

I don't know that the above information will be of use, but I hope it will. I'll probably be adding more thoughts on this as time goes on. 

Good luck, to anyone out there going on an elimination diet as they try to find out why their body is freaking out at them. Truly, best of luck to you!

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