Diets & Nutrition

Food elimination diets for treatment of food allergies. Allergies to food, or food intolerance, have become a major area of research in recent years. Many of the researchers involved in this research specialize in environmental medicine (see the "Alternative Systems of Medical Practice" chapter), which is the science of assessing the impact of such environmental factors as chemicals, foods, and inhalants on health. It provides an understanding of the interface between the external environment and the biological function of the individual.

Dietary management of food allergies is based on avoidance of food antigens and the 4-day rotary diversified diet. With the rotary diet and avoidance of repetitive food exposures, it is possible to reduce sensitivity to foods and hasten recovery from food allergies. Nutritional supplements are prescribed as indicated by objective nutritional testing and the symptoms of the patient.

Research base. Miller (1977) studied eight chronically ill food-sensitive patients who were tested with provocation-neutralization techniques. The patients were treated with injections of allergy extracts and compared to those treated with placebos. In a rigidly controlled ~study, King (1988) showed a correlation between oral food challenge and provocation-neutralization testing. Treatment using results from this testing showed significant symptom relief. Using neutralization therapy, Rea and colleagues (1984) found significant improvement in 20 patients with known food sensitivity in signs and symptoms of allergy reactions to certain foods.

Food intolerance is also being studied as a causal or contributing factor in rheumatoid arthritis. In a clinical trial in Norway, Kjeldsen-Kragh and colleagues (1991) found that fasting followed by dietary restriction could relieve the symptoms of rheumatoid arthritis on a long-term basis. They subjected 27 rheumatoid arthritis patients to a 7-to 10-day fast (except for herbal teas, garlic, vegetable broth, a decoction of potatoes and parsley, and extracts from carrots, beets, and celery) followed by 1 year of an individually adjusted vegetarian diet. The diet-restricted patients stayed on a Norwegian health farm the first 4 weeks of the study. A control group of 26 patients stayed in a convalescent home for 4 weeks but ate an ordinary diet throughout the trial.
~After 4 weeks, the diet group showed a decrease in pain score; a significant decrease in pain, morning stiffness, and the number of tender and swollen joints; and improved grip strength and ability to articulate the joints. There was also a significant improvement in a number of biochemical markers associated with inflammation. These improvements were maintained throughout the year. In contrast, the control group showed a decrease in pain score after its stay in the convalescent home, but none of the other indices improved. At the end of the study the conditions of the control patients had deteriorated.

This study suggests that there is a food allergy component to rheumatoid arthritis and that food restriction appears to be a useful supplement to the conventional medical treatment of rheumatoid arthritis. Darlington and colleagues (1986) and Beri and colleagues (1988) obtained similar results, but their studies lasted only 3 months.

There is also evidence that food elimination diets may benefit many children with hyperactivity (Kanofsky, 1986). Several research teams have used double-blind designs to demonstrate this point. The Institute of Child Health and Hospital for Sick Children in ~London undertook a randomized, crossover, placebo-controlled trial to evaluate the effect of diet on the development of hyperactivity (Egger et al., 1985). The first phase of the study consisted of placing 76 hyperactive children on a food elimination diet. The presupposition was that individuals can be sensitive to a food or food additive in their diet and that improvement occurs when the offending foods or food additives are removed from the diet. At the end of the first phase of the study, 62 of the 76 children (82 percent) improved on the diet, and a normal range of behavior was achieved in 21 (29 percent) of them. In addition to overactivity, other symptoms such as headaches, abdominal pain, antisocial behavior, and fits were also often alleviated.