Integrative Approach to Asthma

Discovering your
food sensitivities:
how to do an elimination diet
Food allergies vs
An allergy involves the immune mediated
reaction between an ‘antigen’ (usually a
protein molecule) and an IgE antibody
Allergic symptoms include: hives, watery
eyes, sneezing, nasal congestion, skin
rashes, swelling of the lips or tongue,
trouble breathing, anaphylaxis (rare)
Mild allergic symptoms can be alleviated
with antihistamines (e.g. Benadryl)
A food sensitivity or intolerance
Does not involve IgE antibodies and is not
able to be tested for with skin prick testing
May involve IgG antibodies but blood
testing is unreliable
Never life threatening
Reactions may include: skin rashes (e.g.
eczema), bloating/gas/diarrhea, nasal
congestion, headaches, burning eyes,
fatigue, joint pain
Common food sensitivities
Dairy products
Citrus fruits/grapes
Tree nuts
“Nightshade vegetables” potatoes, peppers,
tomatoes, eggplant
The ‘gold standard’
An elimination diet is considered the gold
standard for detecting food sensitivities
Planning an elimination diet
Plan to do your elimination diet over a time
when you will be mainly eating your meals
at home.
Avoid doing an elimination diet over a
holiday seasons or while traveling
You will need around 2 months to
complete phase I and II of the diet
Phase 1
Peaches, apricots,
bananas, pears,
cherries, blueberries,
raspberries, kiwi,
pineapple, papaya,
watermelon, etc
Grapes and all citrus
fruits, such as oranges,
grapefruits, limes,
lemons, tangerines
Yellow beans, squash,
carrots, peas, onions,
garlic, broccoli, kale,
cabbage, beets, Swiss
chard, spinach,
lettuce, cucumbers,
sweet potatoes, etc
Corn, mushrooms,
tomatoes, peppers,
eggplant, potatoes
All breads, cereals,
noodles, or whole
grains that do not
contain gluten or corn,
for example, rice,
buckwheat, millet,
tapioca, quinoa, wild
Corn, oats and all gluten
containing grains, such
as, wheat, rye, barley,
spelt, kamut, triticale,
cous cous, egg noodles
All dried beans other
than soybeans
(garbanzo beans,
black beans pinto
beans, kidney beans,
etc). Sunflower,
sesame, flax, chia,
hemp and pumpkin
seeds. Coconut.
Soybeans, tofu, soymilk,
soy nuts and all soy
products. Tree nuts:
walnuts, almonds,
cashews, pecans,
macadamia nuts,
pistachios, peanuts, etc
Alternate list:
Vegetarians only: All
dried beans other than
soybeans (garbanzo
beans, black beans
pinto beans, kidney
beans, etc).
Coconut, pine nuts,
Soybeans, tofu, soymilk,
soy nuts and all soy
products. Sesame,
pumpkin and sunflower
seeds. Tree nuts:
walnuts, almonds,
cashews, pecans,
macadamia nuts,
pistachios, peanuts, etc
All fresh or frozen fish
(plain, unbreaded),
such as salmon, sole,
trout or halibut.
Chicken, turkey and
lamb are also allowed.
Shellfish, eggs, beef,
pork, processed meats
(eg. salami, sausages,
ham, bacon)
Rice milk. (No dairy or
Milk, cheese, ice cream,
yogurt, sour cream,
butter, casein, whey
Olive, canola, sesame
oil. Non-hydrogenated
margarine (with no
soy and no dairy
Butter, most margarines,
oils made from tree nuts
(eg almond oil),
hydrogenated fats
Water, tea, coffee,
herbal teas, fruit or
vegetable juices from
allowed foods
Citrus juices, milk, soy
Salt, black pepper,
cinnamon, cumin, dill,
ginger, garlic,
oregano, parsley,
rosemary, thyme,
turmeric, cardamom
Choose gluten free
condiments. Avoid
cayenne, paprika, chili
powder and other
peppers. Soy sauce.
Honey, maple syrup,
brown rice syrup,
agave, blackstrap
molasses, dried fruit
Corn syrup,
wheat/gluten, soy or
dairy containing
sweeteners, cocoa,
chocolate, white sugar
A few other things to avoid
Food additives/coloring agents
MSG (monosodium glutamate), food
coloring, BHA, BHT, sulfites, artificial
flavoring, nitrites, etc
Before you begin…
Stock up (read labels carefully!)
Gluten free (GF) bread (make sure it is
also free of corn, eggs, dairy, etc.) GF
bread is best toasted.
Gluten free breakfast cereals
Rice pasta
Gluten free flours: rice, tapioca,
buckwheat, quinoa, amaranth, teff,
GF cooked breakfast cereals: cracked
rice, quinoa, millet
More good things to
have around
Pumpkin seed butter and/or sesame tahini
Rice milk
Rice crackers
Sunflower, sesame, flax, hemp seeds
Lots of the allowed fruits and vegetables
Extra virgin olive oil
Fresh herbs and spices: basil, oregano,
garlic, ginger, etc
Phase 1
For 3-4 weeks, completely eliminate all of the
‘avoid’ foods
Keep a diary- write a short note about how you
are feeling each day
In general, avoid restaurant meals, sauces,
canned soups and pre-packaged foods, as
these tend to contain ingredients that may be on
the avoid list.
In order to obtain accurate information, you must
completely, 100%, eliminate all the avoid foods.
Phase 2
After the initial three weeks, you will begin to
reintroduce foods on the avoid list into your diet.
Choose one food at a time to reintroduce. Eat
this food freely for two days, along with all the
allowed foods you have already been eating.
Continue writing a daily entry in your diary
Phase 2
After two days of adding in a new food,
you will either notice no change, or you will
notice new symptoms.
For instance, you may notice that you are
congested, clearing your throat, coughing
or sneezing. You may have abdominal
cramps, bloating, diarrhea or gas. You
may develop a headache or have joint
pains. You may feel just generally unwell
and fatigued.
Phase 2
If the new food does NOT cause
unwelcome symptoms, add it into your diet
and go on to add the next new food the
following day.
If the new food does causes unwelcome
symptoms, remove it again from your diet,
wait two days, and then add the next new
Some foods/food groups can be
added back in together
Dairy products may be introduced all at
Various kinds of peppers may be
introduced together
Different types of potatoes may be
introduced together
Sample meal ideas: breakfast
1. Cooked cracked brown rice
cereal with molasses, mixed
berries, herbal tea
2. Cooked quinoa porridge with
dried cranberries and sliced
banana, pineapple juice, herbal tea
3. 2 slices toasted rice bread with
sesame or pumpkin seed butter
and “fruit only” jam, kiwi and apple
fruit salad, herbal tea
Sample meal ideas: lunch
1. Home made vegetable soup, 2
slices toasted rice bread, salmon
salad (olive oil and rice vinegar
dressing) with sugar snap peas,
green onion, lettuce, cucumber and
2. Lentil soup or carrot ginger soup,
sliced roast chicken sandwich on
toasted rice bread with spinach,
avocado and cucumber, carrot and
celery sticks
Sample meal ideas: supper
1. Lamb chops, brown basmati rice,
steamed broccoli, baked sweet potato,
rooibos tea
2. Roast chicken, rice pilaf with brown
rice, wild rice, sesame and sunflower
seeds; baked winter squash, vegetable
medley of steamed peas, collard
greens, carrots; hot apple cider
3. Grilled halibut, rice noodles tossed
with olive oil, basil and oregano;
asparagus, green beans and baby
carrots, herbal tea
Allowed fruits and vegetables
 ½ avocado
 Apple, banana
 Carrots, celery, snap peas
Rice crackers (read ingredients!)
Cookies/muffins made with allowed
What about supplements?
Keep it simple (e.g.
calcium and vitamin D)
Ensure that the
supplements you are
taking are free of all of the
avoid foods/additives
When you are unsure
If you are not sure about
whether or not you reacted to
a certain food, wait a week or
two and try re-introducing it
Prepare for the fact that some
of your favorite foods may
make you feel unwell
What to do next…
If some of your favorite foods
make you feel unwell, don’t
despair! Sometimes, the food
can be successfully
reintroduced into the diet after
completely avoiding it for 3-6
months. It may then be possible
to eat the food occasionally, in
small quantities, without any
significant symptoms.
Milk sugar vs milk protein
If you discover dairy products bother you,
it is possible that taking Lactaid tablets or
drops along with milk products may help
you. Lactaid will help you to digest milk
sugar (lactose).
If you have a problem with milk protein
(casein), lactaid will not help you.
Gluten intolerance and
celiac disease
If you discover that gluten containing grains
make you feel unwell, you should be screened
for celiac disease (a blood test). This test will
need to be done after you have been eating
gluten containing grains again for several
Or, you could arrange to be screened for celiac
disease prior to doing the diet.
NOTE: Some people feel better on a gluten free
diet even if they do not have celiac disease
You can choose
Doing an elimination diet can give you
some very valuable information
It is up to you how to make use of the
You may decide to continue to eat
certain foods, on some occasions,
knowing that you may ‘pay a price’
Or you may develop some new
favorites that seem to suit your body
Good luck!