For many years, the rotation diet has been a core approach in managing and treating food allergies. There are multiple benefits to the rotation diet, not the least of which is unmasking the symptoms caused by food allergy. The original idea of a four-day rotation comes from studying gut-transit times, or how long a food takes to completely leave the body. While food remnants remain in the gut, it is possible that the immune system continues to react to the food through production of antibodies or cell-based immune responses. It appears that, for most people with a typical fiber intake, four days is the time it takes to clear a food completely from the digestive tract.
Symptoms of food allergies
Studies estimate that as many as one in every two Americans might have some level of food allergy or food intolerance. Symptoms triggered by food allergy promote inflammation and changes in the hormonal system, which can lead to an elevated cortisol burden. Most physicians never take into account the possibility that food intolerance can be contributing to a host of these symptoms, including:
Asthma and recurrent respiratory infections
Nasal congestion and discharge
Skin rash, eczema, hives
Recurrent ear infections, fluid in ear, dizziness
Recurrent yeast vaginitis
All chronic digestive disorders—bloating, gas, heartburn, reflux, diarrhea, constipation, irritable bowel syndrome, and colitis
Frequent urination, recurrent bladder infections, burning when urinating, bed-wetting in children
Fatigue and lethargy
Depression, moodiness, and anxiety
Headaches and migraine
Joint pains, arthritis, unexplained muscle pain
Hyperactivity and ADD, ADHD
Cognitive dysfunction—poor concentration
Eczema and hives
Obesity and food cravings
Treating food allergies with … food?
Based on the results of standard gut-transit times, the four-day rotation diet has become the standard for treating food allergies. Additionally, because foods of the same family might cause similar allergic responses, rotating through food families is also recommended to discover sensitivities. Using chicken as an example, if this was part of Monday’s food intake, it should not be eaten again until Friday. In addition, eggs, turkey and other foods from the same family (outlined in The Adaptation Diet) should also be rotated on those days. The benefit beyond unmasking reactions to foods is to reduce the likelihood of creating additional allergic reactions to tolerated foods. The rotation diet supports the process of desensitization and tolerance, which lowers cortisol and reduces allostatic load.
For most people, rotation of the whole diet is not needed unless food allergy is a major problem. Foods that are symptom triggers discovered through the challenge part of the Adaptation Diet require avoidance for three to four months. This usually brings back tolerance, but if symptoms still occur when reintroducing the food, then a four-day rotation diet makes sense. The bottom line is that the more variety in one’s diet, the less likely one is to develop a food allergy.
Food allergies: Then and now
For tens of thousands of generations, humans were hunter-gatherers – picking berries and other fruits, fishing, and hunting game for food. There was no repetitive exposure to foods, since you ate what was available and then moved on to the next food source. Until the cultivation of grains and the rise of cities, this was the diet of Homo sapiens. Compare that to how we eat now – most people eat the same limited number of foods every day. Seasonal availability is often overcome by transporting foods from other continents, so the same meals can be consumed regardless of season or time of year.
The repetitive nature of today’s diets is one of the causes of the epidemic of food allergy. The rotation diet, which encourages the maximum variety of food, can modulate this problem and prevent additional food allergies and food intolerance. Even incorporating just some of these concepts improves adaptation. For many people, a strict four-day rotation diet is not necessary – however, knowing the different food families and understanding the need for variety will encourage greater adaptation, lower allostatic load, and improve cortisol control.
Variety: The key to managing food allergies
The key to managing food allergies with the rotation diet is variety. There are multiple food families, recipes, and suggested rotations (outlined in The Adaptation Diet) that can be incorporated with the diet – below is an example of what a four-day rotation diet could look like:
Cereal: Pearl barley, kamut, or milo; walnuts, pecans, or macadamias; pineapple, banana, or papaya; and goat yogurt
Green blender drink: Pineapple or banana with romaine lettuce
Sautéed mahi-mahi or ahi with walnuts and shiitake mushrooms
Asparagus or okra with walnut oil
Baked sweet potato
Salad of romaine or other lettuce; jicama; diced pineapple, apple, or pear; pecans or walnuts
Tuna salad with pineapple, diced apple, pear, or kiwi; diced jicama; and walnuts
Cereal: Teff or buckwheat; mango, grapes, or blueberries; yogurt; pistachios, cashews, or Brazil nuts
Green blender drink: Kale with mango or grapes
Baked turkey dogs with sauerkraut, mustard, and cashew cheese or mozzarella on rye bread
Steamed broccoli and cauliflower garnished with cashews or pistachios
Steamed spicy cabbage with sea salt, cinnamon, and vinegar
Arugula, mango, and cashew salad
Turkey and cheese wraps with arugula, mango or grapes, and cashews; or buffalo patty melts with provolone and mustard on rye bread
Cereal: Quinoa; berries, diced apple, or diced pear; pine nuts, sesame seeds, or peanuts; and sheep yogurt
Green blender drink: Chard with apple, strawberries, or raspberries
Sautéed filet of sole with parsley and sesame seeds; or lamb patties with dill sauce made with sheep yogurt
Snow pea pods or boiled beets
Salad of beet greens with sesame seeds; or strawberry and spinach salad with pine nuts
Apple wedges with tahini
Bean soup with leftover or frozen vegetables
Cereal: Whole-grain or steel-cut oatmeal with peaches, apricots, nectarines, cherries, or plums; and almonds, sunflower seeds, or pumpkin seeds
Green blender drink: Cantaloupe or watermelon smoothie with fennel, celery, and carrots
Sautéed salmon with capers and stone-ground mustard
Slaw made from grated zucchini, crookneck squash, carrots, coconut, and almonds
Steamed parsnips, zucchini, crookneck squash, and baby carrots
Celery sticks with almond butter
Learn more about food-based treatment of allergies
If you’d like to learn more about the use of food-based treatments for allergies, there are a number of options provided in The Adaptation Diet. If your health shows evidence of multiple food allergies and symptoms that point to other food allergies, the four-day rotation of the Adaptation Diet could be the best solution for you. As with any chronic medical condition, the rotation diet should be supervised by a physician with training in environmental medicine. For those people who do not have any evidence of food allergy, simply trying to get the greatest variety possible in the diet will suffice.
Some people need additional treatment to reduce the symptoms from food allergy and food intolerance. At the Moss Center for Integrative Medicine, we have 30 years of experience in testing and treating food allergies. The technique used for testing includes provocative neutralization, the gold standard for skin testing per the American Academy of Environmental Medicine. The testing involves introducing a minute amount of a food antigen extract under the skin, and measuring the amount of wheal (swelling) growth. Each food is tested separately at differing dilutions until the skin response becomes negative – this is known as the “neutralization dose,” which is then used to determine treatments. We typically test between 10 and 20 foods, including those that are most commonly symptom triggers – wheat, dairy, yeast, corn, soy, beef, chicken, and others.
Additional treatments for food allergies
Additional treatments for food allergy (beyond dietary restrictions) can be very effective in reducing a variety of symptoms, including headaches, joint pain, fatigue, asthma, rhinitis, irritable bowel symptoms, gastritis, and even depression. There are two distinct treatments we typically use for food allergy and food intolerance, which are individualized based on the needs of each person. One is the use of sublingual (under the tongue) drops, which are used to build tolerance to the foods tested by the skin testing technique – the specific formulation of the drops is based on the results of the skin tests and are used twice daily for 6-12 months.
The other technique is called Low Dose Antigen Therapy, which involves an injection under the skin every 2 months. In this approach, over 190 foods are treated along with airborne allergies in people with more widespread allergy problems. Both techniques target the T-tolerance lymphocytes to retrain the immune system to not react to foods. (More information on LDA is found on the website.)