The elimination diet, also known as exclusionary diet is the diagnostic procedure used to identify foods one can not consume without side effects. Adverse effects may be due to food allergies, food intolerance, other physiological mechanisms (such as metabolic or toxic), or a combination of these. The elimination diet usually involves the removal of suspected foods from the diet for a period of from two weeks to two months, and waiting to determine whether the symptoms recover during that time period. In rare cases, a healthcare professional may want to use an oligoantigenic diet to relieve the patient of the symptoms they are experiencing.
Common reasons for the elimination diet include suspected food allergies and suspected food intolerance. The elimination diet may remove one or more common foods, such as eggs or milk, or may remove one or more small or non-nutritive substances, such as artificial food coloring.
The elimination diet relies on trial and error to identify allergies and specific intolerances. Usually, if symptoms improve after removal of food from the diet, then the food is reintroduced to see if symptoms reappear. This challenge-dechallenge-rechallenge approach has been claimed to be very useful in cases with intermittent or vague symptoms.
The exclusion diet may be a diagnostic tool or method used temporarily to determine whether the patient's symptoms are related to food. A long-term elimination diet is also used to describe a "medication diet", which removes certain foods for the patient.
Side effects on food can be caused by several mechanisms. Correct identification of the types of reactions in individuals is important, because different approaches to management may be necessary. The area of ​​allergy and food intolerance has become controversial and is now a widely studied topic. It has been characterized in the past by a lack of universal acceptance of definitions, diagnosis and treatment.
Video Elimination diet
Histori
The concept of elimination diet was first proposed by Dr. Albert Rowe in 1926 and described in his book, Elimination Diets and Patient's Allergies, was published in 1941.
In 1978 Australian researchers published details about the 'exclusion diet' to exclude certain food chemicals from the patient's diet. This provides the basis for the challenge with these additives and natural chemicals. Using this approach, the role played by food chemical factors in the pathogenesis of chronic idiopathic urticaria (CIU) was first established and set the stage for future DBPCT trials of these substances in food intolerance studies.
Maps Elimination diet
Definition
'Food hypersensitivity' is a general term that includes food allergies and food intolerance.
Food allergies are defined as the most common immunological hypersensitivity in food proteins such as eggs, milk, seafood, shellfish, tree nuts, soybeans, wheat and peanuts. The biological response mechanism is characterized by increased production of IgE antibodies (immunoglobulin E).
Food intolerance on the other hand does not activate the individual immune response system. Food intolerance is different from food allergies or chemical sensitivity because it generally requires normal portion size to produce symptoms similar to IgE immunological responses. While food intolerance can be misconstrued as a food allergy, they are thought to be derived from the gastrointestinal system. Food intolerance is usually caused by an individual's inability to digest or absorb food or food components in the intestinal tract. One common example of food intolerance is lactose intolerance.
- The reaction of metabolic foods is due to congenital error or metabolic error metabolism such as diabetes mellitus, lactase deficiency, phenylketonuria and favism. The reaction of toxic foods is caused by the direct action of food or additives without immune involvement.
- Pharmacological reactions are generally low molecular weight chemicals that occur either as natural compounds such as salicylates, amines, or artificially added substances such as preservatives, dyes, emulsifiers and flavor enhancers including glutamate ( MSG). ). These chemicals are capable of causing drug side effects (biochemistry) in susceptible individuals.
- Toxins may exist naturally in foods or released by bacteria or from food product contamination.
- Psychological reactions involve the manifestation of clinical symptoms caused not by food but by food-related emotions. Symptoms do not occur when food is given in an unrecognizable form. Although a person may have a bad reaction to food, this is not considered a food intolerance.
The elimination diet is useful to help diagnose food allergies and food intolerance pharmacologically. Metabolic, toxic and psychological reactions should be diagnosed in other ways.
Diagnosis
Food allergies are principally diagnosed with careful history and examination. When the reaction occurs immediately after a certain food consumption the diagnosis is straight forward and can be documented using carefully administered tests such as skin prick test (SPT) and RAST radioalergosorbent test to detect specific IgE antibodies for specific food proteins and aero allergens. However, false-positive results occur when using SPT when the diagnosis of a particular food allergen is difficult to determine. This can be confirmed with the exception of suspected food or allergens from the patient's diet. Then followed by timely challenges under careful medical supervision. If there is no change in symptoms after 2 to 4 weeks of protein avoidance then food allergies may not be the cause and other causes such as food intolerance should be investigated. The test method of these exceptions is the premise on which the Elimination Diet is built on, as described in the section below.
Vega machine testing, a bioelectric test, is a controversial method that attempts to measure allergies or food or environmental intolerance. Currently this test has not been proven to be an effective measure of allergy or intolerance.
Food intolerance due to pharmacological reactions is more common than food allergies and has been estimated to occur in 10% of the population. Unlike food allergies, food intolerance can occur in non-atopic individuals. Food intolerance is more difficult to diagnose because individual food chemicals are widespread and can occur in many foods. Removal of these foods one by one will not help in diagnosing sensitivity. Natural chemicals such as benzoates and salicylates found in foods are identical to artificial additives in food processing and can provoke the same response. Because specific components are not easily known and reactions are often delayed up to 48 hours after consumption, it may be difficult to identify suspected foods. In addition, chemicals often show a dose-response relationship and food does not trigger the same response each time. There is currently no skin or blood test available to identify the offending chemical (s), and consequently, an elimination diet aimed at identifying food intolerances needs to be carefully designed. All patients with suspected food intolerance should consult a doctor first to eliminate other possible causes.
The elimination diet should be comprehensive and contain only foods that are unlikely to elicit a reaction in the patient. They should also be able to provide complete nutrition and energy during the weeks it will be done. Professional nutrition advice from a nutritionist or nutritionist is highly recommended. Comprehensive education on the elimination diet is essential to ensure patients and parents of children with food intolerance are suspected of understanding the importance of adherence to diet, since the consumption of aberrant chemicals can prevent the resolution of symptoms and make the challenge outcome useless.
While on the elimination diet, the records are stored from all the food eaten, the drugs taken, and the symptoms that the patient may experience. Patients are advised that withdrawal symptoms may occur in the first week on the elimination diet and some patients may experience worse symptoms initially before settling.
While on a diet, some patients become sensitive to smoke and odor, which can also cause symptoms. They are advised to avoid such exposure as this can complicate the procedure of elimination and challenge. Petroleum products, paints, cleaning agents, perfumes, smoke sprays and pressure sprays are certain chemicals to be avoided when participating in the elimination diet. After the procedure is complete, this sensitivity becomes less of a problem.
Clinical improvement usually occurs over a period of 2 to 4 weeks; if there is no change after strict adherence to the elimination diet and the precipitating factor, then food intolerance is unlikely to be the cause. A normal diet can then be continued by gradually introducing suspected and eliminated foods or chemical food groups one at a time. Gradually increase the amount of up to a high dose for 3 to 7 days to see if the aggravated reaction is provoked before permanently reintroducing the food into the diet. A strict elimination diet is usually not recommended during pregnancy, although a suspected food reduction that relieves symptoms may help.
Challenge test
Challenge tests are not performed until all symptoms have disappeared or improved significantly for five days after a minimum period of two weeks on the elimination diet. Limiting the elimination diet is maintained during the challenge period. The open food challenge on wheat and milk can be done first, then followed by a period of challenge with natural food chemicals, then with food additives. Challenges can take the form of refined food chemicals or with foods grouped by food chemicals. Refined food chemicals are used in double-blind placebo controlled trials, and food challenges involve foods containing only one suspected food chemical that is eaten several times daily for 3 to 7 days. If the reaction occurs, the patient should wait until all symptoms disappear completely and then wait 3 more days (to overcome the refractory period) before initiating the challenge. Patients with a history of asthma, laryngeal edema or anaphylaxis may be admitted to hospital as inpatients or attended at specialist clinics where resuscitation facilities are available for testing.
If any doubtful results of the test are repeated, only when all tests are completed is a prescribed care plan for the patient. Diet only limits the compounds that react the patient and liberalization all the time tried. In some patients food allergy and food intolerance can occur together, with symptoms such as asthma, eczema and rhinitis. In such cases, the elimination diet for food intolerance is used for dietary investigations. Any food identified by SPT or RAST as a suspect should not be included in the elimination diet.
References
See also
- Food Intolerance
- Lactose intolerance
- Gluten sensitivity
- Salicylic sensitivity
- Some chemical sensitivity
- Sodium phosphate
- Allergies
- Allergy test
- The Canadian Food Guide
- Food guide pyramid
Source of the article : Wikipedia
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