We have now completed week two of our elimination diet. You can read about week one in my previous post on the topic.
In the past week our diet has seemed almost normal. I go to the market, buy lots of good meat, chicken, eggs, and a little fish, plus a lot of pears, leeks, cabbage, green beans, and a few other vegetables. Now that I know what we need, and have the larder stocked, the market shopping is actually easier than it was before the diet. I've also found that following recipes is very easy when you already have all the ingredients, so I've been able to try lots of new foods without the hassle I usually associate with it. And the food, for the most part, has been really good. I'll be sad to relinquish the cookbooks to the library when they're due.
I must admit that I am starting to get a little tired of cabbage and green beans. We have one or the other every night. And my son must miss strawberries; when we read "I Am A Bunny" and "The Very Hungry Catapillar", we can no longer get past the pages with the strawberries on them. He keeps flipping back to them and calling out "straaaaw-be". Nevertheless, my husband continues to be amazed by the meals I am coming up with and is now quite content to be on the diet (especially when he gets to eat anything he wants when he's at work).
On a more positive note, I've been losing weight, despite eating absurd quantities of food, especially goodies like carob fudge, cookies, meringues, and homemade granola bars (now that I know what goes into them I'll never again consider them a healthful snack).
We had two major social challenges of the past week, both of which went very well. The first was a hike followed by a BBQ. I packed rice crackers and green beans to keep my son happy on the hike, and we brought all of our own food to the BBQ, including marinated chicken breasts, pear and bean salad (very tasty), a noodle and cabbage salad that replicated the one provided by the host, and a potato torte to share with everyone (there were two other beautiful desserts, so it's a wonder anyone found space for this one). My husband pigged out, eating some of everything we brought and also tasting everything cooked by the hosts! My son was really good about eating only what we offered him, even skipping the flavored rice crackers that had been left well within his reach before dinner. Only once did he notice the corn sitting on the table (one of his favorite foods) and beg, but fortunately we were able to distract him. Unlike our outing last week, there were actually two things I could eat: steak and potatoes, however the chicken and salad were so nice that I declined.
Our second challenge was last night, when we hosted a dinner for overseas friends. I did a poor job of selecting menu items and found myself juggling four pots at the stove right before dinner. But nothing was burnt or undercooked and everyone enjoyed the meal (lamb noisettes with pear glaze, steamed green beans, steamed red and green cabbage with a creamy leek sauce, and brown rice) and dessert (poached pears with sabayon). Next time I'm cooking a roast.
However, the biggest challenge of the week was Melbourne Cup Day, which closed the market Tuesday, when I would usually do the fresh food shopping. Since the market is only open Tuesday and Thursday through Saturday, I dropped into the local butcher, where I don't normally shop because the selection and convenience aren't as good as the market. I nearly bought three porterhouse steaks, until I noticed the butcher pulling out a big cryovaced piece of meat. When I asked how old the meat was, he said about a week and a half, then paused and said maybe two weeks. It was clear that he wasn't really sure. Amines continue to form as meat ages, regardless of how the meat is packaged or if it is frozen, so eating fresh meat is critical to sticking to the diet. We ate vegetarian for three days.
My son's skin no longer seems to be improving and I'm concerned that we will need to eliminate wheat and dairy. I feel like we should start immediately, but I'm procrastinating until I've had a chance to experiment with the recipes and build up an inventory of wheat and dairy free staples. Of course, I'm also hoping that the current flare is just the withdrawal symptoms taking their time to subside. I think I could happily continue this diet for quite some time the way it is, but to eliminate wheat and dairy would require major changes. Of course, that's how I initially felt about cutting out fruit.
Wednesday, November 15, 2006
Tuesday, November 7, 2006
How much is petrol worth to you?
People like to whinge about the price of gas just as much as they do about the weather. This wouldn't be true if we all used our bikes to get where we were going, but I digress. Virtually every month I read a letter in our local automobile club magazine in which the author argues that the price of gas is fixed by colluding petroleum companies and that there should be a government inquiry into the matter. Some make a pathetic effort to support their annoyance, claiming things like "On my recent trip petrol (that's what they call it here) was $1.23/L in Tamworth and when I was in Brisbane only a few days later it was $1.18/L. Clearly this is a sign of price fixing." Upon reading that line of reasoning I was incredulous; hadn't the author ever noticed that the price of gas at their local station changes daily, if not hourly!
In the most recent issue (October 2006, not on line yet) a reader had very carefully detailed the proportion of a barrel of crude oil turned into the various petroleum products we use. Since the letter is not on line, I will reprint some of the figures he provided. It turns out that only about 27% of the 159 liters of crude oil in a barrel becomes petrol. 10% becomes kerosene, 15% becomes diesel, 22% becomes lubricating oils, 16% becomes cylinder oils, and 10% becomes tar. By his calculations, you get 42 liters of petrol from a barrel of crude. He goes on to argue that the price of petrol should increase by 0.6 cents per liter for ever dollar increase in the price of a barrel of crude and that the daily changes of 5 cents per liter are evidence that the market isn't working freely and government action is required.
Now, I applaud this person's detailed research and math, but he failed to do a reality check. Could it be that the price of petrol changes more when the price of crude changes because people want it more than the other petroleum products?
How much is a liter of petrol worth to you? Are you buying it now, at $1.10-$1.15AU/liter? Were you buying it when it was $1.25/liter? Would you pay $2.00/liter? No, you say? What did you say about $1.00/liter a few years ago? How much you're willing to pay probably depends on what you are using your vehicle for; If your business relies on moving things around, for example, then you have to figure out how to pay for the more expensive fuel or close up shop. But if you're driving to work, maybe you'll find a different way to get there rather than waste valuable fuel on it. What you can see, though, is that the value of fuel is not something you determine, or the petroleum companies determine, but all the people who buy the petrol. If you think that a liter of petrol is only worth $1.00 and everyone else agrees it's worth at least $1.10, then you're just going to have to go without.
The price of petrol is volatile because it the market is so competitive. There is no other good in Australia or the US for which the price is so well advertised, so easily determined without even leaving your car. At some intersections you have the choice of two or even three different petrol stations, all of whom have their prices clearly displayed in front of the shop in writing that even my half blind grandmother can read. And even though most people would willingly part with far more money to fill up their tank, they are always looking for a deal. In an environment like this, of course the price of petrol is going to jump around.
As we saw recently in our discussion about banana prices, there are some goods that people just won't substitute. Petrol is one of them. Vaseline is not. When was the last time you thought, Gee, Vaseline is getting very expensive, but there's nothing else I can use instead. Economists call this elasticity. Bananas and petrol (incidentally, the two items blamed for Australia's high second quarter inflation) have inelastic demand curves, meaning the price can increase a lot before people change their consumption habits. In contrast, Vaseline has an elastic demand curve. Besides, many of the products made out of petroleum, including Vaseline, are really just by-products, an opportunity to reap some financial gain from the left-overs of petrol production. Kind of like trying to sell the tops off your celery stalks. So when the price of crude increases, the change will be borne disproportionately by the purchasers of petrol, because the purchasers of Vaseline will just buy cocoa butter instead.
The volatility of petrol prices is certainly annoying, and makes planning difficult, but it's not in itself a sign of price fixing. Even so, why is a government inquiry the solution? Wouldn't we all be better off if the government used their time and energy to figure out how to promote alternatives to petrol and other petroleum products. By increasing incentives to use alternative fuels and more fuel efficient technology, the government could reduce the demand for petrol, which would cause the real price of petrol to decrease. By supporting investment in alternative energy, the government could reduce the country's dependence on unpredictable foreign suppliers, which is significant for both economic and security reasons. The government could and should provide a boost to the economy by supporting the growth of technology associated with alternative industries. And finally, these actions comprise a few of the many ways the government could be acting to reduce the country's greenhouse gas emissions.
But the price of petrol must still be too low because the government doesn't appear to be doing much at all.
In the most recent issue (October 2006, not on line yet) a reader had very carefully detailed the proportion of a barrel of crude oil turned into the various petroleum products we use. Since the letter is not on line, I will reprint some of the figures he provided. It turns out that only about 27% of the 159 liters of crude oil in a barrel becomes petrol. 10% becomes kerosene, 15% becomes diesel, 22% becomes lubricating oils, 16% becomes cylinder oils, and 10% becomes tar. By his calculations, you get 42 liters of petrol from a barrel of crude. He goes on to argue that the price of petrol should increase by 0.6 cents per liter for ever dollar increase in the price of a barrel of crude and that the daily changes of 5 cents per liter are evidence that the market isn't working freely and government action is required.
Now, I applaud this person's detailed research and math, but he failed to do a reality check. Could it be that the price of petrol changes more when the price of crude changes because people want it more than the other petroleum products?
How much is a liter of petrol worth to you? Are you buying it now, at $1.10-$1.15AU/liter? Were you buying it when it was $1.25/liter? Would you pay $2.00/liter? No, you say? What did you say about $1.00/liter a few years ago? How much you're willing to pay probably depends on what you are using your vehicle for; If your business relies on moving things around, for example, then you have to figure out how to pay for the more expensive fuel or close up shop. But if you're driving to work, maybe you'll find a different way to get there rather than waste valuable fuel on it. What you can see, though, is that the value of fuel is not something you determine, or the petroleum companies determine, but all the people who buy the petrol. If you think that a liter of petrol is only worth $1.00 and everyone else agrees it's worth at least $1.10, then you're just going to have to go without.
The price of petrol is volatile because it the market is so competitive. There is no other good in Australia or the US for which the price is so well advertised, so easily determined without even leaving your car. At some intersections you have the choice of two or even three different petrol stations, all of whom have their prices clearly displayed in front of the shop in writing that even my half blind grandmother can read. And even though most people would willingly part with far more money to fill up their tank, they are always looking for a deal. In an environment like this, of course the price of petrol is going to jump around.As we saw recently in our discussion about banana prices, there are some goods that people just won't substitute. Petrol is one of them. Vaseline is not. When was the last time you thought, Gee, Vaseline is getting very expensive, but there's nothing else I can use instead. Economists call this elasticity. Bananas and petrol (incidentally, the two items blamed for Australia's high second quarter inflation) have inelastic demand curves, meaning the price can increase a lot before people change their consumption habits. In contrast, Vaseline has an elastic demand curve. Besides, many of the products made out of petroleum, including Vaseline, are really just by-products, an opportunity to reap some financial gain from the left-overs of petrol production. Kind of like trying to sell the tops off your celery stalks. So when the price of crude increases, the change will be borne disproportionately by the purchasers of petrol, because the purchasers of Vaseline will just buy cocoa butter instead.
The volatility of petrol prices is certainly annoying, and makes planning difficult, but it's not in itself a sign of price fixing. Even so, why is a government inquiry the solution? Wouldn't we all be better off if the government used their time and energy to figure out how to promote alternatives to petrol and other petroleum products. By increasing incentives to use alternative fuels and more fuel efficient technology, the government could reduce the demand for petrol, which would cause the real price of petrol to decrease. By supporting investment in alternative energy, the government could reduce the country's dependence on unpredictable foreign suppliers, which is significant for both economic and security reasons. The government could and should provide a boost to the economy by supporting the growth of technology associated with alternative industries. And finally, these actions comprise a few of the many ways the government could be acting to reduce the country's greenhouse gas emissions.
But the price of petrol must still be too low because the government doesn't appear to be doing much at all.
Monday, November 6, 2006
Elimination diet, week 1
I've never successfully stayed on an elimination diet, and I suppose this one is no exception. Despite all of my preparation, it turns out soy has been leaking into the diet in the form of bread and crackers. Beware of vegetable oil (it usually contains at least some soybean oil), soy flour, flour improver 472, and lecithin, which sneak into store made food. In a few weeks we may have to eliminate wheat, and then we won't have to worry about having soy in our bread or wheat crackers, but for the time being I'd like to find alternatives that don't involve making my own bread.
Ignoring the soy problem, which I'll deal with when I do the shopping tomorrow, I've been surprised by how easy this has been. The two cookbooks mentioned in my previous post on the elimination diet have a huge number of not only tasty, but surprisingly easy, recipes, and I'm sure this experience is making me a better cook. Here's a sample of some of the dinners we've had over the past week:
For dessert, or sometimes for afternoon tea, we have natural yogurt with pear, which is a combination we enjoyed before we knew about this diet. On Saturday, I made poached pears with sabayon, which didn't come out quite the way I expected, but were still extremely tasty.
I'm finding that recipes are unusually easy to follow because the list
of allowed foods is so small that I have all the
ingredients for many of the recipes in the cookbooks, which makes cooking by recipe easier than usual. I also feel less concerned than usual about how I allocate the vegetables we have, as long as they all get used by the end of the week.
Only once during the past week have I craved something I wasn't allowed to eat, which was chocolate. I resolved this by making a batch of carob fudge that I've been enjoying ever since (though I must admit it is a little too sweet and the recipe will require some fudging to get right). My son has been pretty good too. The first day he was a bit out of character to refuse all of the nice food I gave him, and all he wanted to eat was rice crackers. But since then he has been quite willing to eat everything and has rarely asked for food he isn't allowed to eat (even though he doesn't actually know that there are foods he's not allowed to eat).
We had our first big social challenge when we attended a birthday party this weekend. The father of the birthday girl had prepared an all organic spread that could put any caterer to shame: mini quiches, homemade sausage rolls, skewers of fruit, flap jacks (they looked a lot like granola bars), meringues, chocolate coated cream puffs, and a chocalate mousse roll with strawberries for the birthday cake. I explained that we were doing an elimination diet as soon as they
offered us food, which was pretty much as soon as we arrived, and they were very understanding. Fortunately, I had anticipated there would be a little food and a cake, so I came prepared with pear slices, crackers, and meringues (since I had eggs left over from my poached pears with sabayon of the night before), but it was a little hard looking at all the beautiful and carefully prepared food and not be able to eat any of it (especially since it was probably the highest quality food we will encounter at a birthday or Christmas party this year). The merengues had vinegar in them, the flap jacks had coconut in them, the sausage rolls were made with pork, the quiches had vegetables in them, the birthday cake had chocolate in it. Finally, we worked out that the cream puffs were okay, except for the chocolate on the top, so I ate the bottom and gave the top away, just so I could partake in some way. My son was even better than me. He was happy with two slices of pear and one of my home made meringues.
Now we come to the big question: is all this inconvenience worth it? Is his eczema improving? The short answer is that it is too early to tell. According to Sue Dengate's book "The Failsafe Cookbook," as well as our dietitian, we should expect withdrawal symptoms anywhere from four days to a week after starting the diet. We're still in that range, so we must withhold judgment for the time being.
I don't think either my partner or I would have considered our son, who is nearly two, to be any less agreeable than your average two year old. However, both my partner and I have noticed he has been less negative and more resilient in the past week than usual. Whether it is the diet or coincidence, we don't know. I suppose this may be exposed when we get to the challenge stage. I'll keep you informed.
Ignoring the soy problem, which I'll deal with when I do the shopping tomorrow, I've been surprised by how easy this has been. The two cookbooks mentioned in my previous post on the elimination diet have a huge number of not only tasty, but surprisingly easy, recipes, and I'm sure this experience is making me a better cook. Here's a sample of some of the dinners we've had over the past week:
- Pan fried fish with butter and garlic
- Lamb noisettes with pear glaze
- Yogurt chicken
- Roast rack of lamb
- Golden chicken (marinated in golden syrup and grilled)
For dessert, or sometimes for afternoon tea, we have natural yogurt with pear, which is a combination we enjoyed before we knew about this diet. On Saturday, I made poached pears with sabayon, which didn't come out quite the way I expected, but were still extremely tasty.
I'm finding that recipes are unusually easy to follow because the list
of allowed foods is so small that I have all the
ingredients for many of the recipes in the cookbooks, which makes cooking by recipe easier than usual. I also feel less concerned than usual about how I allocate the vegetables we have, as long as they all get used by the end of the week.
Only once during the past week have I craved something I wasn't allowed to eat, which was chocolate. I resolved this by making a batch of carob fudge that I've been enjoying ever since (though I must admit it is a little too sweet and the recipe will require some fudging to get right). My son has been pretty good too. The first day he was a bit out of character to refuse all of the nice food I gave him, and all he wanted to eat was rice crackers. But since then he has been quite willing to eat everything and has rarely asked for food he isn't allowed to eat (even though he doesn't actually know that there are foods he's not allowed to eat).
We had our first big social challenge when we attended a birthday party this weekend. The father of the birthday girl had prepared an all organic spread that could put any caterer to shame: mini quiches, homemade sausage rolls, skewers of fruit, flap jacks (they looked a lot like granola bars), meringues, chocolate coated cream puffs, and a chocalate mousse roll with strawberries for the birthday cake. I explained that we were doing an elimination diet as soon as they
offered us food, which was pretty much as soon as we arrived, and they were very understanding. Fortunately, I had anticipated there would be a little food and a cake, so I came prepared with pear slices, crackers, and meringues (since I had eggs left over from my poached pears with sabayon of the night before), but it was a little hard looking at all the beautiful and carefully prepared food and not be able to eat any of it (especially since it was probably the highest quality food we will encounter at a birthday or Christmas party this year). The merengues had vinegar in them, the flap jacks had coconut in them, the sausage rolls were made with pork, the quiches had vegetables in them, the birthday cake had chocolate in it. Finally, we worked out that the cream puffs were okay, except for the chocolate on the top, so I ate the bottom and gave the top away, just so I could partake in some way. My son was even better than me. He was happy with two slices of pear and one of my home made meringues.
Now we come to the big question: is all this inconvenience worth it? Is his eczema improving? The short answer is that it is too early to tell. According to Sue Dengate's book "The Failsafe Cookbook," as well as our dietitian, we should expect withdrawal symptoms anywhere from four days to a week after starting the diet. We're still in that range, so we must withhold judgment for the time being.
I don't think either my partner or I would have considered our son, who is nearly two, to be any less agreeable than your average two year old. However, both my partner and I have noticed he has been less negative and more resilient in the past week than usual. Whether it is the diet or coincidence, we don't know. I suppose this may be exposed when we get to the challenge stage. I'll keep you informed.
Wednesday, November 1, 2006
Eating friendly food to challenge eczema
When my son was about a month old, in the middle of a typically hot Melbourne summer, he developed a heat rash on his face. Rather than fading after a few hours, the rash spread to his chest the next day. When it hadn't cleared after a few days I took him to the doctor, who diagnosed eczema and told us to put cream on it. It slowly cleared up off his face, but there continued to be some part of his body covered in rash.
When he was a few months old he got a wicked nappy rash that would not respond to the traditional nappy creams. Once again it was diagnosed as eczema. This time the diagnosis came with a prescription for a low concentration hydro-cortisone ointment. The redness would reduce while he was using the ointment, but flare back up as soon as he stopped. Another trip to the doctor yielded a more powerful cortisone ointment, which would eliminate the redness while it was in use but did nothing for the long term. Finally, a trip to the tropics caused a marked improvement in his skin.
Sadly, within a few months his eczema returned. We continued to "manage" it using greasy ointments after every bath, avoiding the common irritants, and treating it with the cortisone when it got really bad. We've finally come to the conclusion that we need to put in an honest effort to figure out what is causing the eczema, which is easier said than done. The problems could be environmental (like dust mites) or food intolerance or allergy. Or it could be genetic.
So What Are We Going To Do About It?
Only a very low proportion of excema is caused by allergies, so it isn't as easy as doing skin prick tests (which are apparently unreliable anyway). We have decided to try the Royal Prince Alfred Hospital (RPAH) Allergy Unit's simplified elimination diet for natural and artificial food chemicals. The aim of the diet is to remove all possible dietary causes of irritation until a marked improvement in symptoms occurs, then "challenge" the body with individual chemicals to determine which ones cause irritation. Challenges must be done with only one chemical at a time to avoid confusing signals, and must be spaced so that the signs of a reaction are clear. Since reactions to food can happen any time in the 48 hours after the food is consumed, and some challenges require large doses (to reflect the cumulative nature of eating those chemicals in everyday life), challenges must be spaced by several days. The PhD thesis of Anne Swain, head dietician of the RPAH Allergy Unit, explains the development of the diet, and details what chemicals, artificial or natural, are likely to cause problems.
The problem foods can be classified as follows:
This diet appeals to me for several reasons. The first is that I've never been a fan of food additives (this has been especially true since I read Fast Food Nation
). The second is that the RPAH has provided a convincing argument through their research that naturally occurring salicylates, amines, and glutamates, and a series of artificial food additives can cause a host of problems, including eczema. The third, and final one I can think of right now, is that typically doctors recommend eliminating two or three likely triggers, which means you are likely to 1) not see significant improvement during the elimination portion, and 2) get false reactions during the challenges due to other triggers that haven't been eliminated. This diet minimizes both of these.
I decided to be sensible about this, so we visited a dietitian, just to make sure we will have proper nutrition, and also because I'm going to need all the encouragement I can get to stay on this diet, especially since I've never been very good at staying on diets. The good news is that we can eat as much as we like, as long as it's well balanced.
So What Can We Eat?
The food we can eat can best be summarized as follows:
The dietitian gave me a food list so exhaustive that it even dictates what vitamins I can take and what toothpaste we can use (mint is a huge source of salicylates, so most toothpaste isn't allowed).
Where Can I Get More Information?
Sue Dengate, who runs the extensive, but not very well organized Food Intolerance Network website, wrote a cookbook for the diet, "The Failsafe Cookbook" (she calls the elimination diet "Failsafe", which stands for: Free of Additives, Low in Salicilates, Amines, and Flavour Enhancers). Her cookbook provides a food list and a reasonably good explanation for why many foods aren't allowed. This is a good resource full of pedestrian recipes and substitutes for foods you're not allowed to eat. It includes a shopping list. Unfortunately, this book is hard to come by right now since it is between printings.
You can find a complete list of the additives to avoid on the Food Intolerance Network's website. One thing I noted when I first read about these, is that red dye #2, which has been de-listed in the U.S. since I was a kid (remember when the red M&Ms were taken off the market?), is still allowed in Australia.
The RPAH has also put out a cookbook, called "Friendly Food" (now in its second edition). This book also explains the diet, though it virtually ignores the role of food additives despite being clearly implicated by Anne Swain's PhD thesis. It is filled with pretty fancy looking meals. It also contains a shopping list and has the advantage of being readily available in Australian bookstores.
The Diet Begins
Today is day one. The preparation has taken several weeks. In addition to the visit to the dietitian, I have spent the past two weeks testing out recipes and tracking down ingredients. Yesterday I prepared an eating plan for my son's childcare, and tomorrow I will be meeting with them to make sure they know exactly what food they can give him and what to do if he eats something he isn't meant to.
I've been to four grocery stores, and three green grocers, a candy store, a health/vitamin store, and three pharmacies to find suitable foods. One thing that has struck me is how small the "health food" section is in the supermarkets. This should tell you something about the healthfulness of what's general available in supermarkets. Another thing I've noticed is how limited the health food sections are, as if the grocery store defines health food as food that no one would choose to eat unless they were avoiding a more mainstream food (i.e. rice pasta instead of wheat pasta, or carob instead of chocolate, except that I happen to really like carob, and it's so uncommon here that the big supermarkets don't have it even in the health food section). The other thing I've noticed is that all health nuts must be soy addicts, judging by the ubiquity of soy in that aisle (technically, I'm supposed to be avoiding soy in addition to everything else listed above).
In the spirit of my friend Ron, who went on a 10 day juice diet and documented everything he ate on-line, I will periodically post our progress (though not in such exhaustive detail). Incidentally, virtually everything Ron ate during those 10 days would not be allowed on this diet.
Wish us luck, and please, keep your cynical thoughts to yourselves, or at least save them until we're done. As I've already mentioned, I'm going to need a lot of positive encouragement to stick to this.
One Final Note
I have yet to find carob chips without palm oil, nor have I found a recipe for making them from carob powder. If you have one, please post it as a comment.
When he was a few months old he got a wicked nappy rash that would not respond to the traditional nappy creams. Once again it was diagnosed as eczema. This time the diagnosis came with a prescription for a low concentration hydro-cortisone ointment. The redness would reduce while he was using the ointment, but flare back up as soon as he stopped. Another trip to the doctor yielded a more powerful cortisone ointment, which would eliminate the redness while it was in use but did nothing for the long term. Finally, a trip to the tropics caused a marked improvement in his skin.
Sadly, within a few months his eczema returned. We continued to "manage" it using greasy ointments after every bath, avoiding the common irritants, and treating it with the cortisone when it got really bad. We've finally come to the conclusion that we need to put in an honest effort to figure out what is causing the eczema, which is easier said than done. The problems could be environmental (like dust mites) or food intolerance or allergy. Or it could be genetic.
So What Are We Going To Do About It?
Only a very low proportion of excema is caused by allergies, so it isn't as easy as doing skin prick tests (which are apparently unreliable anyway). We have decided to try the Royal Prince Alfred Hospital (RPAH) Allergy Unit's simplified elimination diet for natural and artificial food chemicals. The aim of the diet is to remove all possible dietary causes of irritation until a marked improvement in symptoms occurs, then "challenge" the body with individual chemicals to determine which ones cause irritation. Challenges must be done with only one chemical at a time to avoid confusing signals, and must be spaced so that the signs of a reaction are clear. Since reactions to food can happen any time in the 48 hours after the food is consumed, and some challenges require large doses (to reflect the cumulative nature of eating those chemicals in everyday life), challenges must be spaced by several days. The PhD thesis of Anne Swain, head dietician of the RPAH Allergy Unit, explains the development of the diet, and details what chemicals, artificial or natural, are likely to cause problems.
The problem foods can be classified as follows:
- Salicilates, found in most fruits and vegetables, nuts, and many oils;
- Amines, found in a few fruits, and aged food including cheese, wine,
suction packed meat, frozen meat or fish (the Failsafe Cookbook
recommends buying meat fresh and eating it within two days or freezing
it immediately and eating within four weeks); - Glutamates,including natural, found in a number of really tasty vegetables (like
tomatoes), mushrooms, and a huge variety of foods; - Sulfates, which are found in dried fruit;
- Nitrates and nitrites, which are found in smoked food;
- Artifical flavours;
- A few classes of preservatives, antioxidants, and colours (artificial and annatto 160b); and
- Anything that contains "natural flavours".
This diet appeals to me for several reasons. The first is that I've never been a fan of food additives (this has been especially true since I read Fast Food Nation
). The second is that the RPAH has provided a convincing argument through their research that naturally occurring salicylates, amines, and glutamates, and a series of artificial food additives can cause a host of problems, including eczema. The third, and final one I can think of right now, is that typically doctors recommend eliminating two or three likely triggers, which means you are likely to 1) not see significant improvement during the elimination portion, and 2) get false reactions during the challenges due to other triggers that haven't been eliminated. This diet minimizes both of these.I decided to be sensible about this, so we visited a dietitian, just to make sure we will have proper nutrition, and also because I'm going to need all the encouragement I can get to stay on this diet, especially since I've never been very good at staying on diets. The good news is that we can eat as much as we like, as long as it's well balanced.
So What Can We Eat?
The food we can eat can best be summarized as follows:
- Fruits, vegetables, herbs and spices: Peeled pears, or canned pears in syrup, leeks, chokos, cabbage, brussel sprouts, mung bean sprouts, bamboo shoots, shallots, celery, green beans, garlic, swedes (also known as rutabagas), potatoes, dried beans (except broad beans), iceberg lettuce, parsley (in small quantities), saffron, salt.
- Fresh meat, chicken, and white fish (nothing that is pre-made)
- Wholemeal or white bread with no preservative (no multigrain bread)
- Plain crackers and cookies with no additives
- Cereals without additives or corn
- Milk, rice milk, oat milk, natural yogurt, vanilla yogurt, vanilla ice cream, eggs
- Butter, select margarines, sunflower, safflower, and canola oils
- White sugar, brown sugar, maple syrup, golden syrup, glucose syrup, rice syrup, carob powder
- Decaf coffee (no tea of any type), whisky, gin, vodka
- A variety of baking ingredients including flour, baking powder, etc.
The dietitian gave me a food list so exhaustive that it even dictates what vitamins I can take and what toothpaste we can use (mint is a huge source of salicylates, so most toothpaste isn't allowed).
Where Can I Get More Information?
Sue Dengate, who runs the extensive, but not very well organized Food Intolerance Network website, wrote a cookbook for the diet, "The Failsafe Cookbook" (she calls the elimination diet "Failsafe", which stands for: Free of Additives, Low in Salicilates, Amines, and Flavour Enhancers). Her cookbook provides a food list and a reasonably good explanation for why many foods aren't allowed. This is a good resource full of pedestrian recipes and substitutes for foods you're not allowed to eat. It includes a shopping list. Unfortunately, this book is hard to come by right now since it is between printings.
You can find a complete list of the additives to avoid on the Food Intolerance Network's website. One thing I noted when I first read about these, is that red dye #2, which has been de-listed in the U.S. since I was a kid (remember when the red M&Ms were taken off the market?), is still allowed in Australia.
The RPAH has also put out a cookbook, called "Friendly Food" (now in its second edition). This book also explains the diet, though it virtually ignores the role of food additives despite being clearly implicated by Anne Swain's PhD thesis. It is filled with pretty fancy looking meals. It also contains a shopping list and has the advantage of being readily available in Australian bookstores.
The Diet Begins
Today is day one. The preparation has taken several weeks. In addition to the visit to the dietitian, I have spent the past two weeks testing out recipes and tracking down ingredients. Yesterday I prepared an eating plan for my son's childcare, and tomorrow I will be meeting with them to make sure they know exactly what food they can give him and what to do if he eats something he isn't meant to.
I've been to four grocery stores, and three green grocers, a candy store, a health/vitamin store, and three pharmacies to find suitable foods. One thing that has struck me is how small the "health food" section is in the supermarkets. This should tell you something about the healthfulness of what's general available in supermarkets. Another thing I've noticed is how limited the health food sections are, as if the grocery store defines health food as food that no one would choose to eat unless they were avoiding a more mainstream food (i.e. rice pasta instead of wheat pasta, or carob instead of chocolate, except that I happen to really like carob, and it's so uncommon here that the big supermarkets don't have it even in the health food section). The other thing I've noticed is that all health nuts must be soy addicts, judging by the ubiquity of soy in that aisle (technically, I'm supposed to be avoiding soy in addition to everything else listed above).
In the spirit of my friend Ron, who went on a 10 day juice diet and documented everything he ate on-line, I will periodically post our progress (though not in such exhaustive detail). Incidentally, virtually everything Ron ate during those 10 days would not be allowed on this diet.
Wish us luck, and please, keep your cynical thoughts to yourselves, or at least save them until we're done. As I've already mentioned, I'm going to need a lot of positive encouragement to stick to this.
One Final Note
I have yet to find carob chips without palm oil, nor have I found a recipe for making them from carob powder. If you have one, please post it as a comment.
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