Archive for March 30th, 2009

The way that most people start an exclusion diet is by leaving a single food out of their diet totally. If you have an obvious suspect in mind -one that you think makes you ill, or one with which you have an addictive relationship, or which you particularly crave – start with that one.

The benefits of the single-food approach are that you are not excluding many foods at once, so that if there is absolutely no change, or if you feel substantially better straightaway, you know that you have a clear result from this food. If you go the single-food-exclusion route, choose your food and leave it out of your diet totally for a minimum of four days, and preferably for a week. This gives your system time to clear the food. If you are sensitive to that particular food, you may feel worse at first and get withdrawal symptoms, including cravings for that food. As your system clears the food, you should start to feel better and, by the fourth day, you should feel significantly improved if that food is the source of your problems.

If you feel a lot better, you may decide to leave the food out permanently, provided you can find ready substitutes in your diet. If the first food you exclude and test gets no result, then proceed on to another candidate and test that systematically, using the same total exclusion and reintroduction procedures.

There are drawbacks to the single-food approach, however. The first is that it is very difficult totally to exclude the common allergens, such as cow’s milk, eggs, wheat, yeast and corn, from your diet, unless you leave out virtually all processed foods. Cow’s milk products, for instance, are found not just in milk, yogurt, cheese and butter, but also in all sorts of processed foods like biscuits, pies, white sauces, even in pills, home medicines and margarine. You have to leave the food out totally to get results. If you get inconclusive results after testing one of the most common foods, look at the relevant box and check that you have excluded it totally. Retest a food, if necessary, before turning to another food. If you are in fact sensitive to more than one food, you may get only partial improvement in your symptoms on single-food exclusion and it can take a long time for you then to work through other suspects individually. If you suspect multiple sensitivity, you may be better starting off on a more stringent diet.

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Allergy can be caused by any kind of substance, but inhaled particles, such as dust mites, pollens and moulds, are the most common. Foods and chemicals can also cause allergy. The symptoms are caused by the release of chemical messengers in the body which bring about (either immediately, or after some delay):

• dilating of small blood vessels

• spasm or contraction of smooth muscle

• an increase in secretions, such as mucus

The classic allergic diseases are:

• angio-oedema • hay fever

• asthma • rhinitis

• eczema • urticaria

• dermatitis

Other allergic symptoms are headache or migraine; itchy eyes or conjunctivitis; gut spasm, nausea, vomiting and diarrhoea. Infant colic can sometimes be caused by allergy. Joint pains sometimes accompany other allergic symptoms. Allergy is also among the possible causes of persistent coughs, sinusitis, and of glue ear and chronic infections of the middle ear – resulting from inflammation and swelling of tissues and the collection of mucus.

Anaphylaxsis, sometimes called anaphylactic shock, is the most severe type of allergic reaction, and extremely rare. It is most unlikely ever to happen to you. It is a violent, massive reaction to an allergen -often immediate, and usually in response to something swallowed or injected – a food, a drug or an insect sting. Its symptoms can include urticaria; swelling of the tongue, mouth, throat and breathing passages; nausea, vomiting, gut pain and diarrhoea; a sudden drop in blood pressure. Unconsciousness and even death can follow. Urgent medical attention is required.

The symptoms of allergy overlap to some degree with those of food intolerance and chemical sensitivity. Skin and blood tests can go some way to identifying allergy, but understanding the pattern of your symptoms, and knowing where allergens and other substances causing reactions are found, can often help you better to identify the cause of trouble. The conditions are not mutually exclusive; you can have an allergy as well as having intolerance or sensitivity.

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The active ingredients in fly and wasp killers are often powerful toxic agents such as dichlorvos, fenitrothion or lindane. Some use pyrethroids, which are natural toxic agents derived from plants. All of these can cause unpleasant reactions and should be avoided.

If you have a troublesome wasp nest which has to be removed, get professional help from your local authority and see if they can use means such as smoke or water to remove the nest before using chemicals. If you have to kill ants, you can do so by pouring boiling water on the nest.

To repel and deter insects, keep all dustbins and wastebins sealed. Empty and clean regularly. Wipe up food spills. Keep food covered and cupboards closed. To remove insects, use a fly-swat or a fish-slice. Open the windows and chase them out.

Lavender and citronella are natural insect repellents, as are many herbs. If you tolerate plant oils, hang dried lavender and herbs around. You can also dab lavender oil or citronella (available from pharmacies) on cloths and hang them in the kitchen.

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Some babies and toddlers develop sudden passions or aversions to particular foods and they can also develop temporary intolerances -due to viruses, gastric upsets or sometimes coinciding with teething. Allow for these temporary preferences and intolerances – foods and preferences will come and go in and out of a child’s diet. Stay flexible and ready to try new things.

Appetite also can go up and down day by day. Temporary loss or surge of appetite is a normal feature in toddlers.

If you can keep up breastfeeding for 12 months or longer, then stick to it. If you have to wean from the breast from nine months onwards, you may be better to wean the baby on to a soya milk formula milk rather than a cow’s milk formula.

If you wean from the breast after 12 months, you may still find that a soya milk formula suits your baby better. You do not have to give it in a bottle – you can give it in a cup or as an ordinary drink.

If your baby has been on a cow’s milk formula without problems, continue giving this for as long as you wish – many young children tolerate an infant formula much better than they tolerate ordinary cow’s milk.

When you first try cow’s milk on a breastfed child who has never eaten it before, try heat-treated milks as follows. Either use a cow’s milk infant formula, or bring cow’s milk to the boil, simmer for five minutes, and then cool, or you can use diluted evaporated milk. Heat treatment modifies the proteins and can make cow’s milk less likely to cause allergic reactions.

If your child is lactose intolerant. If your child is very severely sensitive to any form of cow’s milk, goat’s milk or soya, one other option is nut milks. Sheep’s milk is less prone to cause reactions than cow’s or goat’s milk (>FOOD AND DRINK for more advice). Always get a doctor’s and dietitian’s advice if your child has a very restricted diet.

If your baby has multiple food sensitivities, he or she may be advised to go on a rotation diet.

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Keeping a constant warmth helps to prevent sudden surges of mould growth. A steady average, but lower temperature, is probably better than having cold and hot spots around the home, or than having a few hours a day only when the place is well heated. If you are exceptionally sensitive to moulds, and obliged to take extreme care, there are many things you can do to eliminate moulds from your environment. Even if this applies to you, no-one would expect you to do all of the things suggested below all of the time. They are things you might try that can be helpful. Pick and choose what seems relevant to you and do what you feel you can. These more intensive measures cover:

• Damp control

• Kitchens, bathrooms, laundry and clothes

• Plants and gardens

• Paper and books

• Foods and diet

• Antibiotics

Damp control

Keep your home as warm and dry as you can afford. The threshold for most mould growth on the organic materials on which they feed is a relative humidity (RH) of 65 per cent. As a guide, keeping the temperature indoors a steady 5°C (10°F) above the outdoor temperature should achieve this.

If you are seriously affected by moulds, your target should be to keep your environment, or at least one or two rooms where you spend most of your time at home, at between 50 per cent and 65 per cent RH. In most summers in the UK, the heat of the sun should be sufficient; heating will be required in the winter. If your house has penetrating damp, however, or is in a damp location, you will need to keep a temperature difference of more than 5°C (10°F) between indoors and outdoors, to achieve the maximum 65 per cent RH level, and may need to heat more. Use a humidity meter (from garden centres, DIY shops or jewellers) and a thermometer to guide you.

Use insulation, such as roof lining, double glazing and lined curtains, as far as you can to conserve energy and warmth. Do not cut out draughts altogether; keeping your home ventilated and aired also helps to keep down damp.

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