By the time Phase Two of the elimination diet has been reached (after avoidance of a food allergen for three weeks), symptoms and allostatic load associated with that food have often been reduced, and Phase One of the diet has eliminated all the common food allergy triggers. By avoiding these foods, most people will have “unmasked,” meaning that the next time they eat the food, if they are allergic to it, symptoms will be more noticeable and quicker to occur. This makes Phase Two of the diet (also known as the “food challenge”) so instructive in realizing the connection between foods and specific symptoms.   

How to identify common food allergies

The most common and significant food allergies are to wheat, corn, soy, dairy, beef, tomatoes, and yeast – by slowly introducing these foods back into the diet, the food challenge can be an effective method for identifying specific allergies.  Starting with wheat on day one, add each food to be challenged in sizable portions to two consecutive meals. Observe symptoms over the subsequent twenty-four hours and keep a diary of foods introduced and symptoms. If there are no symptoms by the following day, a new food can be tested. As mentioned in The Adaptation Diet, if symptoms occur, no new food should be introduced until the symptoms have cleared. If it is unclear whether there were significant symptoms, challenge the food again after waiting at least four days to retest. To hasten clearing of food allergy symptoms, drink at least sixty-four ounces of purified water every day, increase vitamin C intake to 2,000 milligrams for a few days, and use Alka-Seltzer Gold (only Gold has the right bicarbonate mix) as directed. Wait to challenge the next food until symptoms have cleared. Below are the specifics on food challenge for testing the major food allergens: 

• Wheat: Use shredded wheat, matzo, wheat crackers without yeast, wheat pasta, or pure wheat cereals. Do not use bread, because it contains multiple ingredients. If there is no reaction to wheat, it can be kept in the diet but only in whole wheat or sprouted wheat forms. 

• Dairy: Cow’s milk (whole), plain unsweetened yogurt, and cottage cheese are recommended for challenging. Ice cream and aged cheeses (such as Swiss, cheddar, and blue) are not to be used. Butter has little or no milk protein, so it is not used as a challenge food. If lactose intolerance is an issue, this challenge should be avoided. Digestive symptoms are common with dairy products in people who have not eaten them in a while. If dairy is tolerated in the food challenge, I recommend using only low-fat yogurts and kefirs to reduce the inflammatory response to the fats in dairy. Organic dairy products are strongly recommended to reduce the inflammatory fatty acids and chemical contaminants. 

• Corn: Fresh corn on the cob, canned corn (not creamed), popcorn (plain without flavorings), or polenta (corn flour) can be used. Corn—including corn syrup, cornstarch, high- fructose sweeteners, cornmeal, and other ingredients—is one of the most common adulterants in prepared foods. If symptoms from corn are identified in the food challenge, then reading labels is essential. Even if there is no allergy, avoidance of foods sweetened with high-fructose corn syrup products leads to better blood-sugar control and less cortisol production.

• Beef: Eating six to eat ounces of beef (preferably organically raised) is the best way to test for beef allergy. If there are no symptoms, most people should use only small portions of beef at most once a week because of the inflammatory fatty acids and saturated fats in beef. Organically raised beef is much better in terms of these fats and toxic chemicals. 

• Eggs: Two or three eggs at a serving (preferably boiled or poached) is the best challenge. Eggs that come from organically fed and free-range chickens have enormous differences in fatty acid composition from industrially produced eggs. Only eggs from free-range and organically fed chickens should be consumed. If eggs trigger symptoms in the food challenge, it is possible that chicken itself is an allergen and should be tested separately. If eggs are tolerated, they are best prepared by boiling or poaching, not breaking the yolk during cooking. Depending on a person’s cholesterol levels, eggs can be eaten twice weekly. 

• Soy: Challenge with plain soymilk, roasted soybeans, tofu, or tempeh. Do not use sweetened soymilk. With the tremendous increase in soy use during the past several decades, I have seen many more soy allergies. If the test for soy is positive, read labels diligently to avoid the many products with soy as a filler or stabilizer. 

• Yeast: Baker’s yeast is a common allergen and can be tested by eating bread if wheat and dairy are not problematic. The other option is adding a package of nutritional yeast to water or juice. Yeast allergy is often seen with chronic digestive symptoms or recurrent respiratory infections.

• Other foods that can be tested include tomatoes, pork, sugar, coffee, black tea, potatoes, oranges, chocolate, peanuts (if no history of severe allergic reactions), and food colorings.

When Phase Two is completed, whether it takes two weeks or longer, the maintenance Phase Three of the Adaptation Diet has begun. All foods that tested positive need to be avoided for the next three months. At that point, these foods can be reintroduced one at a time. If no symptoms are noted, they can be used as often as twice a week for the subsequent three months.

Conclusions about the food challenge

There is one caveat to the food challenge – anyone with asthma or a history of severe reactions to foods should not undertake the food challenge without medical supervision. Severe food reactions are typically limited to foods that trigger IgE antibodies (involved with immediate hypersensitivity and anaphylaxis) and include peanuts, Brazil and other nuts, shellfish, and strawberries. 

The food challenge part of the diet requires good record keeping while carefully following the rules. Use only the forms of the food listed above to do the challenge. For example, wheat can only be tested using shredded wheat or matzo, not bread, because there are many other ingredients in a slice of bread. Symptoms generally occur within the first few hours – however, they might be delayed as much as twenty-four hours. Reactions to these foods are generally mild and consist of headaches, fatigue, digestive upset, mood changes, poor concentration, or muscle and joint pain. 

Use at least two portions of the challenge food with two consecutive meals in addition to the foods from the elimination diet. If symptoms occur, do not challenge another food until the symptoms resolve, usually within twenty-four hours. Record all symptoms in a diary so you can review these at a later date if symptoms reoccur. Think of this exercise as empowering, not restricting. Many of my patients are upset to discover food allergies because it restricts their gustatory freedom. However, knowledge of food allergies provides control over symptoms and premature aging. 

If you’d like more information about identifying and treating food allergies, please contact our office at (858) 457-1314.