Procedure to identify foods that produce adverse effects
An elimination diet, also known as exclusion diet, is a diagnostic procedure used to identify foods that an individual cannot consume without adverse effects.[1] Adverse effects may be due to food allergy, food intolerance, other physiological mechanisms (such as metabolic or toxins),[2] or a combination of these. Elimination diets typically involve entirely removing a suspected food from the diet for a period of time from two weeks to two months, and waiting to determine whether symptoms resolve during that time period. In rare cases, a health professional may wish to use an elimination diet, also referred to as an oligoantigenic diet, to relieve a patient of symptoms they are experiencing.[3]
Common reasons for undertaking an elimination diet include suspected food allergies and suspected food intolerances. An elimination diet might remove one or more common foods, such as eggs or milk, or it might remove one or more minor or non-nutritive substances, such as artificial food colorings.
An elimination diet relies on trial and error to identify specific allergies and intolerances. Typically, if symptoms resolve after the removal of a food from the diet, then the food is reintroduced to see whether the symptoms reappear. This challenge–dechallenge–rechallenge approach has been claimed to be particularly useful in cases[clarification needed] with intermittent or vague symptoms.[4]
The exclusion diet can be a diagnostic tool or method used temporarily to determine whether a patient's symptoms are food-related. The term elimination diet is also used to describe a "treatment diet", which eliminates certain foods for a patient.[2][5][6]
Adverse reactions to food can be due to several mechanisms. Correct identification of the type of reaction in an individual is important, as different approaches to management may be required. The area of food allergies and intolerances has been controversial and is currently a topic that is heavily researched. It has been characterised in the past by lack of universal acceptance of definitions, diagnosis and treatment.[2][7]
^"Allergies: Elimination Diet and Food Challenge Test". WebMD. Retrieved 2009-04-01.
^ abcClarke L, McQueen J, Samild A, Swain AR (1996). "Dietitians Association of Australia review paper. The dietary management of food allergy and food intolerance in children and adults" (PDF). Aust J Nutr Dietetics. 53 (3): 89–98. ISSN 1032-1322. OCLC 20142084.
^Egger J, Carter CM, Wilson J, Turner MW, Soothill JF (October 1983). "Is migraine food allergy? A double-blind controlled trial of oligoantigenic diet treatment". Lancet. 2 (8355): 865–9. doi:10.1016/S0140-6736(83)90866-8. PMID 6137694. S2CID 33813933.
^Minford, A M; MacDonald, A; Littlewood, J M (October 1982). "Food intolerance and food allergy in children: a review of 68 cases". Arch Dis Child. 57 (10): 742–7. doi:10.1136/adc.57.10.742. PMC 1627921. PMID 7138062.
^Laitinen K, Isolauri E (2007). "Allergic infants: growth and implications while on exclusion diets". Nestle Nutr Workshop Ser Pediatr Program. Nestlé Nutrition Workshop Series: Pediatric Program. 60: 157–67, discussion 167–9. doi:10.1159/000106367. ISBN 978-3-8055-8283-4. PMID 17664903.
^Barbi E, Berti I, Longo G (2008). "Food allergy: from the loss of tolerance induced by exclusion diets to specific oral tolerance induction". Recent Pat Inflamm Allergy Drug Discov. 2 (3): 212–4. doi:10.2174/187221308786241875. PMID 19076011. Archived from the original on 2013-04-14.
^Allen DH, Van Nunen S, Loblay R, Clarke L, Swain A (1984). "Adverse reactions to foods". Med J Aust. 141 (5 Suppl): S37–42. doi:10.5694/j.1326-5377.1984.tb133035.x. PMID 6482784. S2CID 222050621.
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