Tuesday, February 21, 2012

It's All In The Family: Why A Rotation Diet
Might Help Prevent Food Allergies!

The Potato Family (Nightshades)
Did you know that it is possible to develop more and more food allergies over time?

I had no clue.

I learned about this in September 2010 when my allergy doctor (an internationally famous MD and chair of the department of Allergy and Immunology at our leading local hospital) ran a skin test on my back and cheerfully announced that I had developed a true allergy to soy along with milder IgE mediated reactions to rice, almonds and sesame seeds.


This news came as a real shock to me because I'd based much of my gluten-free diet for two years on rice and almond flour.

"But, I've never had a problem with rice before! Really! I've eaten it for nearly 34 years!  And almonds?  I *love* almonds!  I eat almond butter every day!"

"Well," he responded pleasantly, "We often crave the foods that we're allergic to. Why don't you try strictly avoiding these foods for a while and we can re-test you in the future to see if your body has resolved the issue. It's possible that in the future you'll be able to enjoy rice again."

Dumbfounded, I consulted a nutritionist friend.

"How is this possible?" I asked her.

"Most people today eat the same foods day after day," she said. "They get very little variety in their diet. Over time this can cause allergic reactions to foods that they once tolerated just fine. Even though eating the same foods repeatedly is just one cause of allergy, it is real. You should take his advice seriously."

This is how I first came to learn about rotation diets and food families.

* * *

If you've never heard of botanical food families before, you are not alone.

Foods are classified into different botanical food families. If you have an allergy to one member of a food family, it is quite possible that you may be reacting to other members of that food family too.

A common example would be someone with a cashew or pistachio allergy. They may also have problems with mangoes, which (surprisingly enough) turn out to be members of the cashew family as well.

Wisdom about which ingredients hail from the same families may have been common knowledge back in the days when the average family grew its own food, saved seeds and harvested their crops with pride. Families then knew much more about what appeared on their dinner tables.

These days, most of us in developed countries go to the grocery store to purchase our prepackaged, sanitized foods and produce that is flown in from all over the world. Unless you're buying organic, most vegetables are grown with pesticide and even genetically modified to create (for example) carrots or tomatoes that are all the exact same length, width and color. (They generally share the same lack of flavor too!)

Because we no longer need to rely on the growing seasons to provide us with certain staple foods, it is possible to purchase the same variety of apples to eat year-round. Folks aren't forced to vary their diets... they can just purchase apples or rice grown in some other part of the planet where the climate is just right for a harvest.

I've always been a creature of habit.

As a kid I ate the same lunch every day for a year and never got tired of it:

Ham and bean (canned) soup
Bread and butter
Celery with peanut butter
An apple
...and when I was really lucky, a cookie.

Knowing what I know now about food sensitivities and rotation, it's not particularly surprising that - especially given my intense love of cheese danishes and pasta with cheese over the course of three decades - I ended up with significant intolerances to wheat and most dairy.

* * *

So now that you understand food families and the need for variety, it's time to talk about rotation diets.

Foods in the same families may cause similar reactions in the gut.

For normal folks it takes FOUR days to completely "clear" a food they've eaten from their digestive tract. During those four days, the person's immune system may continue to react to foods they've eaten by generating antibodies or cell-based immune responses. This means their immune system is working overtime long after they've completely forgotten about eating the meal.

If you (or people you love) suffer from food sensitivities, you can go a long way toward managing sensitivities and intolerances by rotating your diet regularly. This means switching up the foods you eat so that you don't repeat them until you've completely cleared them from your digestive tract.

There are many benefits to a rotation diet.

First, by eliminating an entire food family for four days and then re-adding it, you may notice - perhaps for the first time - which foods or food families are truly causing symptoms.

"Wow, every time I eat potatoes or eggplant, I feel tired for the next two days!"

Next, when you become aware of your reactions to different foods, you can eliminate them for a few months and then re-add them after your immune system has had a chance to settle down. This significantly reduces your chance of becoming allergic to foods that you can currently eat without trouble.

The "settling" of the immune system (when a person becomes less sensitive over time to foods to which they were allergic) is commonly referred to by doctors as tolerance

Scientists are working hard to understand how tolerance develops with the goal of learning how to induce this state in patients.  Says John J. Oppenheimer, MD, of the UMD-NJ New Jersey Medical School in New Brunswick, "Why tolerance occurs is the million-dollar question in food allergy.  We are working on it."*

* * *

So how does this all look, in action?

Well... today's a "Pheasant Family" day in our kitchen.

I started out bright and early with a lovely farm fresh egg, sauteed in extra virgin olive oil.

Since I've already embarked on the pheasant path for the day, this means I can now also freely cook with chicken, peafowl, pheasant or quail. Maybe a lovely roasted chicken for dinner?

Tomorrow though, and actually for the next three days, I'll need to be mindful in the kitchen about these foods... and try hard to avoid them in the meals I prepare.

Of course, we won't just be eating eggs and chicken all day long today! I'll be selecting many diverse ingredients from other food families too.

Right now I'm hankering for a taste of the fresh, fragrant avocados sitting in the glass bowl on our counter. If I decide to go for it, to dive into one of those luscious ripe avocados... this opens my way today for the Laurel Family. Laurel Family members make wonderful spicing for tasty recipes. They include bay leaves, cinnamon and sassafras. From the bones of our roasted chicken, I could make a lovely chicken broth flavored with bay leaves!

Or perhaps, I'll dive into the Mustard Family. The options are virtually endless there: Brussels Sprouts, Collards, Kale, and Turnips to name a few. We could have roasted Brussels sprouts drizzled in olive oil and serve our roasted chicken on a bed of kale.

The main thing is awareness. If I KNOW that I'm going to want to make a special lasagna dinner with tomatoes and cheese tomorrow evening for my husband, I need to plan tomorrow's menu around the Potato and Bovine families.

This inspires me to think of appropriate breakfasts... potato hash with sauteed bison? Steak and potatoes? A protein-style hamburger and French fries for lunch? It's not that I'm eating less, or limiting my calories. I'm just keeping my meals "all in the family" for that day.

* * *

If you find yourself experiencing increasing food sensitivities and are considering a rotation diet, I highly recommend that you buy the book that helped me very much in the beginning of my experiments with rotating foods and understanding food families... "The Adaptation Diet". Its author, Dr. Charles Moss, is a practicing physician in La Jolla, California who treats patients with chronic, stress-induced problems using nutritional therapy and acupuncture. I met Dr. Moss in person once and he seemed like a very wise man.

I know it can seem overwhelming at first, but the benefits are real - and worthwhile.

After carefully avoiding soy, rice, nuts and sesame seeds for a full year, I was skin-tested again my my MD this past Fall.

"All of your skin reactions were less severe this time," he reported, "...and I'm glad to say you are now non-reactive to rice. It looks like that strict avoidance really helped you. Feel free to re-add rice to your diet in small amounts. I think you'll be fine."

* Oppenheimer quote was originally published in this WebMd article.


Ali said...

The concept of a rotation diet is very interesting and different than much of what I've learned about IgE mediated food allergies. The rotation concept seems more consistent with non-IgE mediated allergies and conditions like eosinophilic esophagitis. I am familiar with cross reactions due to food families - for example soy & peanuts are both legumes and many people with a reaction to one may also react to the other. This goes for non-edible allergens as well. People who react to certain pollens or grasses may react to foods from the same plant family. I want to point out that skin prick testing (and CAP-RAST testing, for that matter), have a relatively high rate of error (false positives and very infrequently, false negatives). If a person tests positive to a food, but does not react when eating the food, it is common practice to assume the test is negative and continue to include that food in a person's diet. The one exception is very young children who may not be able to communicate a reaction.
Has your allergist discussed systematic desensitization? Recently there has been a lot of research supporting the use of systematic desensitization as a treatment for severe IgE food allergies, rather than avoidance. The process must be undertaken with a Dr's supervision and is not appropriate for all allergens or all people with food allergies.
Thanks for sharing this! I'm so glad you are back!

strivingChef said...

Thanks Ali, I know you have probably learned more than you ever wanted to know about IgE mediated allergies in the last few years! I appreciate your insights and so have changed some of my terms to try to differentiate more clearly between a sensitivity or intolerance and a serious allergy.

In my case, there were actually painful clinical symptoms associated with the eating of rice and almonds... which is why he'd tested me in the first place. I'll tell you more about this in person sometime ;-) as it was pretty personal.

Dr. Moss' book is very interesting, I think you might like it!

Ali said...

Thanks! I'd really love to learn more.