Food allergy

About the elimination diet

The gold standard of food allergy treatment is the elimination diet, which consists of eliminating trigger foods. Care must be taken, however, not to eliminate foods that can actually be tolerated, especially in children who need nutrients to grow. Excessive elimination can diminish a person’s quality of life. “Minimal elimination,” in which the patient eats what he or she can tolerate, is the key.

Approach to minimal elimination

Eliminating only the foods which cause symptoms

Foods which need to be eliminated are only those which cause allergic symptoms when they are eaten. Just because you tested positive to a certain food may not necessarily mean you need to eliminate it (foods which give you no symptoms may show up positive on a blood or skin test).

Eating trigger foods “within tolerable range”

Even trigger foods, which cause symptoms, may be tolerated when cooked or processed, or in small quantities. The “tolerable range” increases with age. However, it is dangerous to determine that range by yourself. Be sure you consult your doctor. Testing a potential food trigger can help make an accurate determination.

Key points for the elimination diet

1. Try to keep elimination to a bare minimum.
2. Understand the characteristics of the foods you are eliminating,and make sure you balance your diet by eating other foods to make up for nutrients you are lacking.
3. Never under any circumstances try to determine what to eliminate, how much you can eat, etc, on your own. Be sure to consult your doctor for these matters.
4. Any foods you eat should be fresh and thoroughly cooked.
5. Be careful to avoid accidental ingestion.
6. Read the allergy labels on processed foods.
7. Exercise special care when eating out or when eating processed foods.
8. If you have problems, do not hesitate to consult a specialist (doctor, registered dietitian, public health nurse, etc.).

Next: Allergy food labeling

Allergy food labeling

Processed foods and food additives may contain ingredients which are possible triggers. That is why food labeling laws require that packaged processed foods and food additives meet certain labeling requirements, such as showing a list of ingredients (“specified ingredients”) which trigger food allergies in people or are associated with serious symptoms.

Labeling requirements and recommendations for ingredients

<Required> Ingredients which must be indicated on the label (7 ingredients)	Egg, milk, wheat, soba buckwheat, peanuts, shrimp/prawn, crab
<Recommended> Ingredients recommended for labeling (20 ingredients)	Abalone, squid, salmon roe, orange, cashew nuts, kiwi fruit, beef, walnuts, sesame seeds, salmon, mackerel, soy, chicken, bananas, pork, matsutake mushroom, peach, yamaimo (Japanese yam), apple, gelatin