CHAPTER 7

THE RE-ENTRY FOOD CHALLENGE

Jennie, a college field hockey player, suffered from chronic sinusitis that would flare up during hockey season in the fall. The sinusitis made her miserable and interfered with her game. She had seen an allergist, who found allergies to mold and dust. Jennie had been prescribed antihistamines, but even the “non-drowsy” type made her feel drowsy. Nasal steroids gave her nosebleeds. A prescription anti-allergy medication caused profound mood swings. Clearly Jennie needed a different approach.

Jennie was a cheese-aholic. Sharp cheddar was her daily fix. This was an important clue. So when she came to my office I applied two principles: First, if there’s a food you crave, you are probably both addicted to, and sensitive to, that food. A Re-entry trial may be worthwhile. Second, people who are allergic to airborne mold often have issues with molds found in food. Aged cheese is a mold-based food, and fall is a time for environmental mold, especially in Connecticut, where Jennie lives. I suspected mold might have an additive effect in creating her nasal congestion.

I recommended that Jennie stop eating cheese and milk-derived foods. The look on her face told me that I was right: Jennie was seriously addicted to cheese. I asked her to avoid it for five days and to call me after she had reintroduced her favorite cheeses on Days Six and Seven.

The call came early on Day Six. Fifteen minutes after eating two ounces of her beloved cheddar cheese, Jennie felt very bloated and congested. She felt gas and had to relieve the pressure by passing gas numerous times. Bloating, burping, gas, diarrhea, and other digestive symptoms are one of the not-so-subtle ways the body tells us that it is not happy with a food or beverage. For Jennie, the digestive disturbances were probably her body’s response to avoiding her favorite food for five days and then eating it again. The bloating, gas, and congestion were enough to convince Jennie that healing her allergies had to start with the elimination of cheese. I assured her that this was not forever. There were ways to eventually overcome her problem with dairy, but they wouldn’t work if she kept taking her daily dose of cheddar.

Learning What Foods Make Your Body Happy

After the Three-Day Power Wash, the next step is the Re-entry Food Challenge. Re-entry follows a standard medical procedure of structured food challenges, used in medical centers and universities around the world, to uncover hidden food sensitivities. Jennie’s story is one example of how reintroducing foods may produce unexpectedly strong responses, which is why you should always consult your doctor before and during Re-entry. If you have a known food allergy, you should not consume that food. People with asthma must not follow the Re-entry Food Challenge: asthmatics must avoid foods to which they may be allergic.

If you want to continue the Power Wash for another few days, you’re free to do so. Just remember that the Power Wash is not designed to be an ongoing maintenance diet, so don’t continue for more than seven days total.

During Re-entry you continue drinking the Immune Balance Smoothie and Organic Oolong Tea and continue eating Immune Balance Soup. You also begin expanding your diet step by step. Continue keeping your journal of symptoms, and keep a record of every food and beverage you add each day. If you experience symptoms, you’ll need this record to bring with you to your doctor for evaluation in order to understand which foods, if any, may contribute to symptoms.

Re-entry is based on science. Its purpose is to help you connect with the wisdom of your body. Once you’ve completed the Power Wash, your body can tell you which foods you need to avoid for healing to occur.

During Re-entry, you will expand your diet in three stages. You are likely to notice changes in your body during each of them. Sometimes the changes will be immediate responses to a specific food you’ve just added. It may be a food you consumed regularly and had no idea you had an issue with, like Jennie and cheese. Other Re-entry responses may be delayed: a response may require more than one exposure to the food or may not occur for a day or two after eating the food. A delayed response is fairly common.

If you experience an adverse response after starting a new Re-entry stage, stop and proceed to the section called “Zeroing In.” If you experience no symptoms, continue to follow the Re-entry schedule until you’ve gone through all three stages.

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Re-entry at a Leading Medical Center

In the 1980s, a famous British immunologist, Professor J. F. Soothill, teamed up with German neurologist Josef Egger—whose research on food allergy and ADHD you read about in Chapter 1—to investigate the role of food allergy in epilepsy and migraine among children. They conducted their research at the leading pediatric hospital in Britain, the Hospital for Sick Children in London, among patients who had epilepsy that was not responding to medication.¹ Since this was a research study with very sick children, they used an extended and rigorous protocol that should not be attempted outside a medical center, but their findings prove the importance of delayed food reactions.

They gave the children an elimination diet with a very limited range of foods for two weeks. This diet consisted of one or two starchy foods like rice or yams, chicken or lamb for protein, one vegetable, and one fruit. They found that 80 percent of the children who had epilepsy combined with headache, abdominal pain, or hyperactivity responded to the elimination diet with fewer seizures or complete cessation of seizures, along with improvement in their other symptoms. Children who only had epilepsy did not get better with the diet. They then had the children undergo a food challenge phase, in which each child received one new food a week, to see if specific foods would provoke symptoms. Symptoms were provoked by 31 different foods, with most of the children being reactive to several foods.

When the researchers confirmed these results with a double-blind, placebo-controlled food challenge, they observed that the reactions could take several days to occur. Using this technique, Soothill, Egger, and their colleagues enabled 60 percent of these children to remain completely free of epilepsy without drugs.

 

Important Notes

ALWAYS consult your doctor before attempting the Re-entry Food Challenge.

If you suffer from anaphylaxis or asthma, you should NOT attempt the Re-entry Food Challenge.

If you have ever experienced an adverse reaction from eating one of the foods mentioned in this chapter, do not eat it during Re-entry. Reintroduce only those foods that you believe are safe for you to eat.

Re-entry Stage One

This stage will last for a minimum of two days. After completing the Power Wash, you can add brown rice and poultry (chicken or turkey) to your diet. You can mix these into the Immune Balance Soup or eat them together as a separate dish. The poultry should be oven roasted and flavored with salt and pepper but no other spices except turmeric, if desired. Eat as much food as you need to prevent hunger.

• If you prefer to not eat poultry because you are a vegetarian, you may skip the poultry and have green peas in addition to rice. If you would rather have lamb than poultry, you can eat lamb as a substitute. Poultry and lamb are the meats included in the classic elimination and challenge programs.
• Rice allergy is rare in Europe and the Americas but common in Asia. If you suspect you have a rice allergy, choose oats or oatmeal instead of rice. Oatmeal can be eaten with blueberries for flavor, but with no milk added.
• If you prefer to avoid starches or grains, skip the rice and eat cauliflower or green peas in addition to chicken or turkey.
• Continue the Immune Balance Smoothie, the Immune Balance Soup, and the Organic Oolong Tea. When you include all the components, Stage One can be followed for up to a week, and you can enter Stage Two on your own timing.

If you experience any type of symptoms during Stage One, stop and follow the instructions under “Zeroing In”. If you’ve had no symptoms after two days of Stage One, you can proceed to Stage Two.

Re-entry Stage Two

This stage usually lasts for five days. It’s designed to allow you to expand your diet, so that you’re eating a variety of nutritious and flavorful foods. You can continue the Immune Balance Smoothie and Organic Oolong Tea for the unique nutrients they supply. The Immune Balance Soup is optional. Foods you may add are:

• Any vegetables you like, except those in the nightshade family, such as tomatoes, peppers, and eggplant. Use fresh or frozen vegetables, but not canned. Also avoid corn, which is a grain. You may enjoy your vegetables cooked or raw. I recommend trying squash, sweet potatoes, cabbage, and cauliflower. Do not eat any type of hot pepper.
• Beans, peas, lentils, and other legumes. But no nuts or peanuts, and no cocoa beans or chocolate.
• Beef, pork, and lamb. These are optional and should not be consumed more often than twice a week. Beef should be free-range and grass-fed.
• Organically grown coffee, if desired, but it must not be sweetened and should be taken black or with rice milk or coconut milk. At this point you do not yet know whether you can tolerate soy, almond, or cow’s milk well. Why organic? Because coffee is one of the plants most heavily sprayed with pesticides on the planet.
• Fruit (with the exception of citrus fruit), fresh or frozen, but not canned. No dried fruit, no juices, and no syrup. Limit fruit to no more than three servings a day. If there are fruits to which you’ve previously had an allergic reaction, such as an itchy mouth or throat, continue to avoid them.
• Your choice of herbs and spices, fresh or dried, with the exception of cayenne, habañeros, jalapeños, and paprika. These spices are members of the troublesome nightshade family.

If you experience any type of symptoms during Stage Two, stop and follow the instructions under “Zeroing In”. The foods in Stage Two are diverse and nutritious enough that you can remain in Stage Two for as long as you like, although five days is the minimum. If you’ve had no adverse reaction after five days of Stage Two, you can proceed to Stage Three.

Re-entry Stage Three

This is where you test more foods and expand your menu further so that you have many delicious choices on your menu. I recommend that you test each food or food group separately for two days. During the two-day test, you may eat the food twice a day. Remember that a response may not occur on your first exposure to the food and that it may be delayed. If at any point you experience symptoms, stop adding new foods and move to Zeroing In. If at any time you want to stop testing new foods and maintain the diet you’ve been following, go ahead and do so. By now you’ve reached the point where there are enough foods available to you that you should be able to sustain the diet for as long as you like.

This is the order in which you may add foods in Stage Three. You do not have to eat any of these foods if you don’t want them. Just skip what you dislike and move on to the next choice.

• Eggs: boiled, poached, fried, or as omelets. If you use oil in preparing eggs, use a little extra-virgin olive oil. Extra-virgin olive oil contains anti-inflammatory and antioxidant flavonoids that play an important role in the Allergy Solution.
• Fish. Choose low-mercury organic or wild fish: salmon, sardines, sole, flounder, and tilapia. Shellfish and high-mercury seafood such as tuna, sea bass, or swordfish should not be among your staple foods and are not included in the Immune Balance Diet.
• Nuts and seeds: dry roasted or fresh and raw, unsalted. Walnuts and almonds have the greatest nutritional benefit. Brazil nuts are rich in selenium but should be limited to no more than two per day, for a total of fourteen in a week. Peanuts are not really nuts; they are legumes. They are naturally contaminated with mold, which grows inside the peanut shell. Some of the healthiest seeds to chew on are pumpkin seeds, which are an excellent source of zinc, and sunflower seeds. Flaxseed should be freshly ground to convey its health benefits. Careful with sesame, though. It’s a major allergen.
• Nightshade vegetables. The most nutritious members of this family are tomatoes and bell peppers, especially the orange and red varieties. All peppers except black pepper (peppercorns) are members of the nightshade family. Skip jalapeños, habañeros, cayenne, and paprika because they can mimic allergy and aggravate pain, inflammation, and asthma through a nonallergic biochemical reaction. Spicy peppers cause nerve endings to release a chemical called Substance P, which can increase inflammation in your tissues. That is why I recommend that you not consume hot peppers during Re-entry.

• Some berries come from plants in the nightshade family. The most common of these are goji berries, also known as wolfberries. They are native to Asia and are now popular as health foods in North America and Europe. They can be eaten raw or dried or made into a juice. You can test unsweetened goji berries as part of the nightshade family.
• Other common nightshade foods are potatoes and eggplant. They do not play an important role in the Immune Balance Diet because they lack the anti-inflammatory benefits of tomatoes, peppers, and goji berries.

• Citrus fruit: lemon, lime, grapefruit, tangerine, and all varieties of oranges. They can be eaten fresh or taken as juice, but limit the quantity of juice to no more than eight ounces a day. Organic fruit is recommended, because citrus can be heavily treated with pesticides.

The Final Four: Milk, Wheat, Corn, and Soy

These four foods are staples of the Western industrial diet, which makes them part of the problem. There are many reasons why they should not be staple foods, including genetic modification and contamination. They are not mainstays of the Immune Balance Diet, and you can easily live without them.

If you are happy avoiding milk, wheat, corn, and soy, go ahead and keep them off the menu. However, if you decide to try these, to know if any of them may be an issue, test each group separately, following the same protocol I’ve just described for other foods in Stage Three:

• Soy can be eaten as tofu or as whole soybeans (edamame) or drunk as unsweetened soy milk.
• Corn can be eaten as corn tortillas or grits or as whole kernels or corn on the cob.
• Wheat can be eaten as pasta, matzo, or wheat cereal. Bread, crackers, and baked goods contain too many other ingredients to allow a “wheat only” challenge.
• Milk can come from cows, sheep, or goats. Milk products include milk, yogurt, and cheese.

• Casein, an allergenic milk protein, is concentrated in milk curd, so it’s at its highest in cheeses. It is also a common food additive, listed on labels as sodium caseinate or calcium caseinate. When testing cow’s milk, you can include foods with added caseinate.
• Whey protein is also isolated from milk. You may remember the nursery rhyme about Little Miss Muffet eating her curds and whey. Whey is more soluble than casein. It comes as a powder, and at this point you can mix it into your Immune Balance Smoothie.

Re-Entry will only work if you’ve already cleared the tracks with the Power Wash and brought down the level of allergic inflammation in your body. Otherwise there will be too much noise for you to be able to listen to your body.

Zeroing In

If you experience symptoms during Re-entry, you might want to determine which food may have been a problem and whether the effect was just a chance association. Take the following steps:

• Stop testing new foods.
• Avoid any foods you’ve added to your diet in the past three or four days. Remember that Re-entry responses may be delayed, so how you feel can be due to a food you started eating two or three days ago rather than a food you ate today. Rolling your diet back a few days will help eliminate any foods that may have been part of delayed responses and leave you with a better diet.
• Maintain your improved diet until the reaction clears, which may take one to four days.
• Begin testing individual foods, starting with what you ate most recently before the symptoms occurred. The journal you’ve been keeping will really come in handy now. Let’s say that on Saturday you added green peas and lentils, on Sunday you added beef, and on Monday you had scrambled eggs for the first time. Then Monday afternoon you broke out in a rash. Eggs would be the most likely culprit, so you’ll retest them first, but only after cutting out beef, peas, and lentils and allowing the rash to subside. If eating eggs once more does not provoke a rash, then challenge yourself with beef, peas, and lentils, one food at a time. If the second round of challenges does not provoke a rash, the symptom may have been a coincidence, the result of an environmental exposure or stress or some factor other than food allergy. If you do experience a rash, you’ll have a better theory about which food may be an issue.

Conclusion

Here I introduced the concept of Re-entry, which is based on the standard medical procedure of structured food challenges, used in medical centers and universities all over the world. For Jennie, the field hockey player with sinusitis, the issue was with milk-derived foods such as cheese. After cutting out all dairy for five days, she experienced bloating and gas after reintroducing her favorite cheese into her diet. Eliminating cheese from her diet was the next step.

Food allergy carries the risk of a dangerous allergic reaction. Re-entry must be supervised by a doctor. If you suffer from anaphylaxis or asthma, you must not attempt Re-entry.

Once you’ve used Re-entry to identify and remove the foods that may be an issue, you are ready to create long-lasting immune balance by learning about the research on nutrition science in the next chapter.