By Joan Breakey
B Sc. DNFS. Cert Diet. TTTC. M AppSc.
Dietitian Specialising in Food Sensitivity
Guidelines for prevention of allergy in children with no symptoms are useful, but dietary management of babies with symptoms is complex. Baby Suzie had allergies diagnosed at 3 month for frothy, bloody, mucousy stools and was given help to manage a diet with no dairy, soy or gluten. But Suzie still had reflux. At 10 months she was still waking often through the night, had tummy pain, constipation, was irritable, and was not gaining weight. When the Low Chemical diet was added to her diet all of these symptoms reduced and she looked like a different girl with more colour in her now-happy face.
Food chemical intolerance aggravates the underlying disorder in susceptible people. The important idea here is that one of the underlying disorders it aggravates is allergy. One indicator of chemical susceptibility is an atopic family history. Another is sensitivity to aspirin. Another is sensitivity to environmental factors such as perfumes. Chemicals excluded during investigation of food sensitivity include medicinal and natural salicylates, additive colour, flavour and benzoates [which have a similar chemical structure to salicylates], other preservatives, additive and natural MSG, amines and strong smells.
Why has food chemical intolerance not been recognised as relevant in the treatment of allergy? The first reason is because sensitivity to food chemicals is susceptibility dependant not diagnosis dependant. It is recognised that different allergic people are allergic to different whole foods because many can be shown with skin prick testing [SPT]. It is also recognised that there is delayed onset reactions which are usually SPT negative. Yet somehow the idea of chemical sensitivity with individual variation in chemicals is not recognised. Like delayed onset allergic reactions there is no clarifying test. Similarly the only way chemical intolerance can be clarified is by dietary elimination and challenge.
Another reason that food chemical sensitivity is not recognised is that it has an immunological component [antihistamines are some help] and a pharmacological component. Reactions occur when the sum of several suspect chemicals reaches a threshold, so the patient is rarely able to pinpoint all the suspect foods. Many also have positive results with SPT and delayed-onset reactions to whole foods.
While food sensitive patients do sometimes report feeling faint when having a reaction they rarely have anaphylaxis reactions. Another interesting finding is that the susceptible group also have a family history of another group of symptoms which are not allergy. These include headaches, migraine, irritable bowel syndrome, mouth ulcers and car sickness. It is possible to see a family where one member is seeing a neurologist re migraine, another an allergist re hay fever or eczema, another a gastroenterologist re IBS, an infant with diarrhoea seeing a paediatrician with diarrhoea and the child presenting for dietary investigation of diet related ADHD.
The role of food sensitivity in allergy has gradually evolved when the diet investigation for symptoms not usually seen as allergy has been practiced.
- Children whose behaviour and ADHD symptoms improved with diet also reported reduction in physical allergic symptoms, especially eczema, or family members using the same diet for migraine or IBS had improvement.
- The issue is complex and researchers do not like work that is difficult because all of the suspect chemicals and allergens mentioned above have to be minimised at the same time. Then they can challenged with any one suspect substance [such as tartrazine] or the effect size will not be relevant. Also artificial flavour is used in ten times the dose of colour so it can be a confounding factor.
Food chemical intolerance exists and occurs more often in atopic families. It should be considered wherever attention to allergies do not solve all symptoms. It should also be used in infants where symptoms such as eczema have not completely resolved, the baby is not thriving, is still irritable, demanding or has sleep problems.
See FIP [Articles ] section for more information on all the symptoms that the low Chemical Diet can help with and the book Fussy Baby for all the issues to consider when helping parents with a distressed baby.