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to Menu Page~Food elimination diets for treatment of food allergies. Allergies to food, or food intolerance, have become a major area of research in recent years. Many of the researchers involved in this research specialize in environmental medicine (see the "Alternative Systems of Medical Practice" chapter), which is the science of assessing the impact of such environmental factors as chemicals, foods, and inhalants on health. It provides an understanding of the interface between the external environment and the biological function of the individual.
Dietary management of food allergies is based on avoidance of food antigens and the 4-day rotary diversified diet. With the rotary diet and avoidance of repetitive food exposures, it is possible to reduce sensitivity to foods and hasten recovery from food allergies. Nutritional supplements are prescribed as indicated by objective nutritional testing and the symptoms of the patient.
Research base. Miller (1977) studied eight chronically ill food-sensitive patients who were tested with provocation-neutralization techniques. The patients were treated with injections of allergy extracts and compared to those treated with placebos. In a rigidly controlled ~study, King (1988) showed a correlation between oral food challenge and provocation-neutralization testing. Treatment using results from this testing showed significant symptom relief. Using neutralization therapy, Rea and colleagues (1984) found significant improvement in 20 patients with known food sensitivity in signs and symptoms of allergy reactions to certain foods.
Food intolerance is also being studied as a causal or contributing factor in rheumatoid arthritis. In a clinical trial in Norway, Kjeldsen-Kragh and colleagues (1991) found that fasting followed by dietary restriction could relieve the symptoms of rheumatoid arthritis on a long-term basis. They subjected 27 rheumatoid arthritis patients to a 7-to 10-day fast (except for herbal teas, garlic, vegetable broth, a decoction of potatoes and parsley, and extracts from carrots, beets, and celery) followed by 1 year of an individually adjusted vegetarian diet. The diet-restricted patients stayed on a Norwegian health farm the first 4 weeks of the study. A control group of 26 patients stayed in a convalescent home for 4 weeks but ate an ordinary diet throughout the trial.
~After 4 weeks, the diet group showed a decrease in pain score; a significant decrease in pain, morning stiffness, and the number of tender and swollen joints; and improved grip strength and ability to articulate the joints. There was also a significant improvement in a number of biochemical markers associated with inflammation. These improvements were maintained throughout the year. In contrast, the control group showed a decrease in pain score after its stay in the convalescent home, but none of the other indices improved. At the end of the study the conditions of the control patients had deteriorated.
This study suggests that there is a food allergy component to rheumatoid arthritis and that food restriction appears to be a useful supplement to the conventional medical treatment of rheumatoid arthritis. Darlington and colleagues (1986) and Beri and colleagues (1988) obtained similar results, but their studies lasted only 3 months.
There is also evidence that food elimination diets may benefit many children with hyperactivity (Kanofsky, 1986). Several research teams have used double-blind designs to demonstrate this point. The Institute of Child Health and Hospital for Sick Children in ~London undertook a randomized, crossover, placebo-controlled trial to evaluate the effect of diet on the development of hyperactivity (Egger et al., 1985). The first phase of the study consisted of placing 76 hyperactive children on a food elimination diet. The presupposition was that individuals can be sensitive to a food or food additive in their diet and that improvement occurs when the offending foods or food additives are removed from the diet. At the end of the first phase of the study, 62 of the 76 children (82 percent) improved on the diet, and a normal range of behavior was achieved in 21 (29 percent) of them. In addition to overactivity, other symptoms such as headaches, abdominal pain, antisocial behavior, and fits were also often alleviated.
In all, 48 foods were implicated as contributing to hyperactivity in the young patients. However, 34 of the 50 children for whom full data are available reacted to fewer than 7 foods. Two reacted to 30 foods. Five patients were also noted with symptoms from such inhalants as pollen, perfume, and house dust. Foods that frequently caused problems included cow's milk (64 percent of subjects tested), chocolate (59 percent), wheat (49 percent), and oranges (45 percent).~The second phase of the study included 28 children from the original group, who entered into a double-blind, crossover, placebo-controlled trial that reintroduced one incriminated food. Symptoms returned or were exacerbated much more often when patients were on active material than on placebo. One of the most interesting findings of the study is that the artificial food coloring tartrazine and the preservative benzoic acid were the commonest food items causing a reaction. The behavior of 79 percent of the 34 children tested deteriorated when tartrazine or benzoic acid was reintroduced into their diet. These findings are compatible with the work of Dr. Benjamin Feingold, the San Francisco allergist who implicated tartrazine and other artificial food additives in children's diets as contributors to hyperactivity. It is worth noting that the same London group also published a study stating that 93 percent of 88 children with severe, frequent migraines recovered on a diet that eliminated foods and food additives that had been shown to cause symptoms (Egger et al., 1983).
Some confirmation for the food elimination treatment for hyperkinesis was provided by Kaplan and colleagues (1989). In their study, 10 of 24 hyperactive children exhibited ~approximately a 50-percent improvement in behavior when placed on an elimination diet that was not as restrictive as the London diet.
Macrobiotic diet for cancer. The philosophy and general components of the "standard macrobiotic diet" are described below in the "Alternative Dietary Lifestyles and Cultural Diets" section of this chapter. In the area of cancer management and treatment, the macrobiotic philosophy holds that the development of cancer is determined by dietary, environmental, social, and personal factors; by extension, existing cancers may be influenced by the same factors. The development of cancer is described as a long-term, multistep process that begins well in advance of actual tumor formation (Kushi and Jack, 1983).
According to macrobiotic teachings, accumulated toxins result from overconsumption of milk, cheese, meat, eggs, and other fatty, oily, or greasy foods. Also included in this list are foods with a cooling or freezing effect, such as ice cream, soft drinks, and orange juice (Kushi and Jack, 1983). Macrobiotics uses the traditional oriental concepts of yin (expansive) and yang (contractive) to devise a framework for explaining and formulating a ~set of dietary recommendations to treat each type of cancer.
A macrobiotic approach to treating cancer would first classify each patient's illness as predominantly yin or yang, or sometimes a combination of both, partly on the basis of the location of the primary tumor in the body and the location of the tumor in the particular organ. In general, tumors in peripheral or upper parts of the body or in hollow, expanded organs are considered yin; examples include lymphoma, leukemia, Hodgkin's disease, and tumors of the mouth (except tongue), esophagus, upper stomach, breast, skin, and outer regions of the brain. Tumors in lower or deeper parts of the body or in more compact organs are considered yang; examples include cancers of the colon, rectum, prostate, ovaries, bone, pancreas, and inner regions of the brain. Cancers thought to result from a combination of yin and yang forces include melanoma (skin cancer) and cancers of the lung, bladder, kidney, lower stomach, uterus, spleen, liver, and tongue (Kushi and Jack, 1983).
For cancers classified as predominantly yang, the standard macrobiotic diet is recommended, with slight emphasis on yin foods. The same diet is recommended for ~yin-classified cancers, with a slight emphasis on yang foods. Patients with cancers resulting from both yin and yang imbalances are advised to follow "a central way of eating," as suggested in the standard macrobiotic diet. Different cooking styles also are recommended on the basis of this disease classification (Kushi and Jack, 1983).
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