Low-Allergen Diet

Many people experience unpleasant reactions to foods they have eaten and suspect a food allergy is the underlying cause. However, only 2–5% of adults and 2–8% of children are truly allergic to certain foods. The remainder of people may be experiencing food intolerance, or food sensitivity, rather than true food allergy.

“Masked” or “hidden” allergies are a controversial topic; many conventional doctors believe they are rare, whereas practitioners of alternative medicine believe they are extremely common. According to James Breneman, M.D., former chairman of the Food Allergy Division of the American Academy of Allergy, unrecognized food allergies are responsible for 60% of all of the symptoms seen by a family physician that are not adequately diagnosed or treated.

Food allergies and intolerance are best treated by avoidance of the offending food for a prescribed period of time, followed by a “rotation” diet, in which problem foods are only eaten every three to four days, instead of daily. Young children can often re-introduce foods after three months of avoidance, whereas adults may require six to twelve months of avoidance. Most hidden allergies are cyclic (i.e., they settle down after long-term avoidance). Fixed allergies (those that cause a reaction, no matter how long a time the food has been avoided) are less common.

Symptoms of food allergy or intolerance may not be triggered immediately after reintroduction of the foods; therefore, a person can get an erroneous impression their allergy or intolerance is cured. With repeated ingestion of the food, however, symptoms may gradually return. When a problem food is rotated, symptoms are less likely to return. Some healthcare practitioners recommend rotating food groups (such as legumes every other day) in addition to rotating specific foods. The importance of rotating foods varies from person to person and may be related to the severity of the allergies.

Best bets

The following foods are the least likely to provoke allergic reactions:

Beverages:

Almond milk
Herb teas (no lemon or orange)
Pure fruit juices without sugar or additives (dilute 50:50 with water)
Roasted grain beverages may be used as coffee substitutes
Seltzer (salt free)
Soy milk without corn oil
Spring water in glass bottles or clear plastic

Cereals:

Oatmeal
Oat bran
Cream of rye
Puffed rice and millet
Diluted apple juice, apple slices, and nuts go well on cereal.
Use soymilk that has no corn oil added or almond milk.

Grains and flour:

Bean flour
Buckwheat flour
100% buckwheat soba noodles
Cooked whole gains, such as oats, millet, barley, buckwheat groats (kasha), rice macaroni, spelt (flour and pasta), brown rice, amaranth, quinoa, rice, or millet breads (that contain no dairy, eggs, sugar, or wheat)
Potato flour
100% rice cakes
Rice crackers
Rice flour
100% rye or spelt bread with no wheat
Rye crackers
Soy flour

Legumes:

Dried beans should be soaked overnight. Pour off the water and rinse before cooking. Canned beans often contain added sugar or other potential allergens. Some cooked beans packaged in glass jars, and sold at health food stores, contain no sugar.

Nuts and seeds:

Nuts and seeds, either raw or roasted, without salt or sugar
Nut butters from health food stores or from fresh ground nuts (such as almond butter, cashew butter, walnut butter, sesame butter, and sesame tahini)
Peanuts are a common food allergen and should be avoided, along with peanut butter

Oils:

Use cold-pressed or expeller-pressed oils (available from health food stores), as they are safer for the heart and blood vessels. Do not use corn oil or “vegetable oil” from an unspecified source, as this is usually corn oil.
Canola oil
Flaxseed (edible linseed) oil
Olive oil
Peanut oil
Safflower oil
Sesame oil
Soy oil
Sunflower oil

Protein:

Canned tuna, salmon, and other canned fish
Fresh fish
Lamb
Poultry and fowl

Vegetables:

All vegetables except corn are generally acceptable.
Tomatoes sometimes cause problems and should be avoided by susceptible individuals.

Are there any groups or books associated with this diet?

The Food Allergy & Anaphylaxis Network
10400 Eaton Place, Suite 107
Fairfax, VA 22030–5647
800–929–4040
http://www.foodallergy.org

Asthma and Allergy Foundation of America
1233 20th Street, NW, Suite 402
Washington, DC 20036
800–7-ASTHMA
http://www.aafa.org

American College of Allergy, Asthma and Immunology
85 W Algonquin Road, Suite 550
Arlington Heights, IL 60005
800–842–7777
http://allergy.mcg.edu

American Academy of Allergy, Asthma and Immunology
611 East Wells Street
Milwaukee, WI 53202
800–822–2762
http://www.aaaai.org

The Food and Drug Administration. FDA Consumer Magazine
Publication No. 94–2279: Food Allergies, Rare but Risky.
Last revised June 1997
Online: http://www.cfsan.fda.gov/~dms/wh-alrg1.html

The National Institute of Allergy and Infectious Diseases of
The National Institutes of Health. Fact Sheet: Food Allergy and Intolerances. April 1993.
Last revised January 1999
Online: http://www.niaid.nih.gov/factsheets/food.htm

The Allergy Self-Help Cookbook: Over 350 Natural Food Recipes, Free of All Common Food Allergens by Marjorie Jurt Jones. Emmaus, PA: Rodale Press, 2001.

Dr. Braly’s Food Allergy and Nutrition Revolution for Permanent Weight Loss and a Longer, Healthier Life by James Braly, MD, Canaan, CT: Keats Pub., 1992.

Bibliography

Bahna SL. Management of food allergies. Ann Allergy 1984;53:678–82.

Baker HB; David TJ. The dietetic and nutritional management of food allergy. J R Soc Med 1997;90(Suppl 30):45–50.

Crook WG. Tracking Down Hidden Food Allergy. Professional Books, 1980.

David TJ. Adverse reactions and intolerance to foods. Br Med Bull 2000;56:34–50.

The Food and Drug Administration. FDA Consumer Magazine Publication No. 94–2279: Food Allergies, Rare but Risky. Last revised June 1997. http://www.cfsan.fda.gov/~dms/wh-alrg1.html

The Food and Drug Administration. An FDA Consumer Special Report: Focus on Food Labeling. http://www.fda.gov/fdac/special/foodlabel/foodtoc.html

Gaby AR. Food Allergy/Intolerance. Unpublished.

Hill DJ, et al. Clinical spectrum of food allergy in children in Australia and South-East Asia: identification and targets for treatment. Ann Med 1999:31:272–81.

Sampson HA. Food allergy. Part 1: Immunopathogenesis and clinical disorders. J Allergy Clin Immunol 1999;103:717–28.

Sampson HA. Food allergy. Part 2: diagnosis and management. J Allergy Clin Immunol 1999;103:981–9.

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The information presented in Foodnotes is for informational purposes only and was created by a team of U.S. registered dietitians and food experts. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements, making dietary changes, or before making any changes in prescribed medications. Information expires December 2003.