Allergy diet - additive low

Aim

To provide a diet that excludes foods containing artificial colours, certain natural colours, flavour enhancers and preservatives.

Characteristics

Avoids the following additives:

Colours

Flavour enhancers

Preservatives

Note: The following colours are permitted: 100 (curcumin or turmeric), 150 (caramel), 160a (carotene).

Indications

Intolerance to additives, established by a medically supervised placebo-controlled challenge.

Nutritional adequacy

Nutritionally adequate.

Precautions

It is not possible to provide a full list of all permitted commercial products; the following are general guidelines only. The ingredient lists of processed foods must be carefully and regularly scrutinised. Potatoes purchased peeled (or in commercial products such as dried mixes) and dried fruits typically have added preservatives to prevent discolouration. If a product lists an ingredient as flavour, without a detailed additive description or code, the product should not be used in this diet. Particular care is needed in food handling and preparation to avoid cross-contamination.

Paediatrics

Suitable for use in paediatrics when combined with an age-appropriate diet.

Specific menu planning guidelines

	Allowed - but check labels	Not allowed - but check labels
Hot main dishes	All plain cooked meat, poultry, fish, eggs Note: Some plain meat and poultry for roasting may have added flavour enhancers - check labels	Casserole dishes made with commercial stocks and flavour enhancers, or wine Processed meats (eg ham, silverside, bacon, sausages); meat pies Items containing cheese, potato, breadcrumbs or dried fruit (eg macaroni cheese, quiche, crumbed fish)
Sauces, gravies	Plain white sauce (made from flour, butter and milk only)	Gravies, tomato sauce
Starchy vegetables / pasta / rice	All plain fresh potato, pasta and plain rice, cooked without margarine	Any potato purchased pre-peeled (eg frozen french fries) Commercial savoury rice
Vegetables	All others	Vegetables in white sauce or with cheese (eg cauliflower au gratin)
Soups	Most commercial soups have flavour enhancers – check label	Pumpkin, tomato, vegetable, chicken noodle – check label
Sandwiches	None	All
Salads, dressings	Most salad ingredients Plain salad dressing (oil and vinegar) and mayonnaise – check labels (many vinegars have preservatives)	Processed meats (eg ham, silverside, chicken roll) Commercial salad dressings Chutneys and relish
Breads, cereals	Breads labelled preservative free. Confirm vinegar as an ingredient is sulphite free. Rice cakes Most plain breakfast cereals without added fruit or nuts (eg Weet-Bix™, rolled oats, Corn Flakes®, Rice Bubbles®) Bread crumbs	Most commercial breads have added preservatives Cereals with added fruit – check label
Spreads	Butter Honey, marmalade, peanut butter Most jams – check label	Most margarines Vegemite™ Jams with added colours
Hot breakfast choices	All others	Sausages, bacon, ham
Fruit	All fresh fruit and most canned fruits	Some canned fruit salads – check label Dried fruit, prunes and commercial fresh fruit salads – check label
Yoghurt	Plain yoghurt Note: Some fruit yoghurts may not have added colours – check label	Flavoured and fruit yoghurt
Desserts	Custard made without added colours Ice-cream, puddings, cheesecake, creamy rice – check label	Jelly Most commercial soft custards, toppings, mousses Fruit cake Chocolate
Milk and cheese	All plain milk Plain cheddar-style cheeses	Flavoured milk, milkshakes Parmesan, camembert, blue vein, cottage and ricotta cheeses
Beverages	Tea, coffee Only tetra-pack juices and those without additives	Juice with non-permitted colours or preservatives added Cordial and soft drink
Biscuits	Plain biscuits only if preservative free (eg Milk Coffee™)	Most commercial biscuits
Miscellaneous	Milo® 100% white vinegar created from molassess via microbial fermentation	Bonox® Coconut All other vinegar

References

1. Australasian Society of Clinical Immunology and Allergy. Food intolerance.
2. Royal Prince Alfred Hospital Allergy Unit. RPAH elimination diet handbook. Sydney: RPAH; 2010.
3. Royal Prince Alfred Hospital Allergy Unit. Allergy information sheets.
4. Food Standards Australia New Zealand. Choosing the right stuff: the official shoppers’ guide to food additives and labels, kilojoules and fat content. Sydney: Murdoch Books; 2007.
5. Food Standards Australia New Zealand. Benzoates, sulphites and sorbates in the food supply: report of the 21st Australian total diet study. 2005.
6. Swain AR, Soutter VL, Loblay RH. Friendly food: the complete guide to avoiding allergies, additives and problem chemicals. Sydney: Murdoch Books; 2004.
7. Swain, Anne; Soutter, Velencia; Loblay, Robert (2013). RPAH Elimination Diet Handbook with Food & Shopping Guide (PDF). ISBN 9780980616408.

Change log

August 2020

Section updated	Change
Specific menu planning guidelines - Breads/cereals	In Allowed, added after Breads labelled preservative free. Confirm vinegar, as an ingredient, is sulphite free
	In Allowed, added Bread crumbs
Specific menu planning guidelines - Miscellaneous	In Allowed, added 100% white vinegar created from molassess via microbial fermentation
	In Not Allowed, added All other vinegar
References	Added Swain, Anne; Soutter, Valencia; Loblay Robert (2013). "RPAH Elimination Diet Handbook with Food & Shopping Guide" (PDF). ISBN 9780980616408