Allergy diet - elimination strict

Aim

To provide a diet that excludes foods and chemicals that lead to severe food sensitivity and allergy reactions.

Characteristics

Avoids or reduces salicylates, amines and the following additives:

• Antioxidants: Gallates (310-312), TBHQ (319), BHA (320), BHT (321)
• Colours: Yellows (102, 104, 110), reds (122-129), blues (132, 133), greens (142, 143), black (151), brown (155), Annatto (160b)
• Flavour enhancers: Monosodium glutamate (MSG, 621) and related flavour compounds (620, 622, 623, 624, 625 627, 631, 635, 636, 637, 640, 641), Hydrolysed Vegetable Protein (HVP), Textured Vegetable Protein (TVP)
• Preservatives: Sorbates (200-203), Benzoates (210-218 and PABA: Para-aminobenzoic acid), Sulphites (220-228), Nitrates and Nitrites (249-252), Propionates (280-283).

Indications

• patients admitted with severe allergic / food sensitivity reactions
• as a diagnostic test of food sensitivity.

Nutritional adequacy

This diet is not nutritionally adequate – supplemental vitamins and minerals are normally required.

Precautions

Requires supervision by a dietitian. Any allergens specific to individuals should be avoided.

Paediatrics

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

Specific menu planning guidelines

	Allowed	Not allowed
Hot main dishes	Plain cooked beef, lamb, poultry Plain cooked chicken without skin or stuffing Whole eggs Fresh white fish (bream, flathead, ling, perch, snapper, whiting) Soft tofu Some dried and canned legumes without sauce (e.g. 3 bean mix, chick peas, butter beans, lentils, red kidney beans, canellini beans)	Ham, bacon, corned beef, salami Frozen and canned fish Pork, sausages Egg-based dishes (e.g. quiche, frittata, omelette) Crumbed meats, fish and poultry
Sauces, gravies	None	-
Starchy vegetables / pasta / rice	Plain fresh cooked potato (peeled) Steamed rice, rice noodles, plain pasta Quinoa	All others Pre-peeled potatoes, e.g. whole or potato chips
Vegetables	Green beans, brussel sprouts, cabbage, celery, choko, garlic, leek, shallot, swede, iceberg lettuce, chives	All others
Soups	None	-
Sandwiches	None.	-
Salads, dressings	Salads using allowed ingredients	-
Breads, cereals	Rice cakes Plain wheat or rice cereals, rolled oats	All others
Spreads	Butter Margarine - no antioxidant or sorbate, made from sunflower, safflower, canola or soy oils	Margarine, jam, honey, peanut butter, yeast spread Hummus, tahini
Hot breakfast choices	Whole eggs Semolina Pancakes, croissants (without preservatives and antioxidants)	All others
Fruit	Fresh peeled pears, drained canned pears	All other fruits
Yoghurt	Soy yoghurt (plain or vanilla)	All others
Desserts	Special desserts using pear, rice and soy beverage only Plain or vanilla soy custard	All others
Milk and cheese	Plain milk Soy beverage or rice drink fortified with calcium Fresh ricotta and cottage cheese Cream cheese without preservatives	Flavoured milk All aged and tasty cheeses Fetta and processed cheese
Beverages	Water, plain milk, soy beverage, rice drink, decaffeinated coffee	Tea, coffee, soft drinks, cordial, flavoured milk and juice
Biscuits	Rice cakes, some plain biscuits and crackers	All others
Miscellaneous	Cream Salt, sugar Oils without antioxidants (e.g. canola, sunflower, rice bran, safflower) Cashews (raw or lightly roasted, <10 per day) Cornflour	Pepper Chocolate Herbs and spices (including cinnamon) Artificial sweetener Mustard (all types) Coconut – desiccated, milk or cream All other nuts and nut products (e.g. almond meal and hazelnut meal) Sesame seeds and snacks

References

1. Royal Prince Alfred Hospital Allergy Unit. RPAH Food Intolerance Handbook, Volume I: Diagnostic elimination diet. Sydney: RPAH 2016.
2. Royal Prince Alfred Hospital Allergy Unit. RPAH Food Intolerance Handbook, Volume II: Challenges, liberalizing and maintenance. Sydney: RPAH 2016
3. Swain AR, Soutter VL, Loblay RH. Friendly food: the complete guide to avoiding allergies, additives and problem chemicals. Sydney: Murdoch Books; 2004.