Flavour enhancers, E620-E635. The most important of these is monosodium glutamate, or MSG, and its relatives, E620-623. Eating large amounts of MSG is said to produce a set of symptoms known as ‘Chinese restaurant syndrome’

- the symptoms described for this condition vary considerably: ‘tightness, pain and tingling in the front of the chest, radiating to the arms, often associated with palpitations and faintness’ according to one authority, but ‘flushing, sweating, loss of coordination, headache and hypotension [low blood pressure]‘

according to another. Some studies have failed to confirm the existence of a reaction, but it has been suggested that the source from which the MSG is manufactured is important. There are reports of MSG triggering attacks in some asthmatics.

Flavourings. These do not have to be listed on food labels, unlike the other additives. There are over 3,000 of these, they do not have E-numbers, and most have never been properly tested for safety. However, they are used in extremely small quantities, and are assumed to be non-harmful for this reason. Although this may be true for the majority, there are doubts over some flavourings, particularly a group known as the ally! alcohols which are potent toxins. The average person only receives small amounts of these, but anyone eating large amounts of sweets, crisps and soft drinks would get a much higher dose.

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Feeling much better, but with one or two lingering symptoms It looks as if you have cut out your main offending foods, but are still eating something that is a problem. If the lingering symptoms are fairly minor, then you can proceed to the reintroduction phase. Test the major foods: milk, eggs, wheat, rice etc, and continue eating those diat cause no problems. This will help to broaden your diet. Having done this, look through the food diary you kept before the diet and try to identify possible causes for your lingering symptoms – is there anything you used to eat quite frequently and have continued eating throughout the diet? Potatoes, onions, tomatoes, shellfish and fish are likely suspects. Cut all these out and then test them.

If your lingering symptoms are fairly troublesome, or very variable from day to day, then it will not be possible to get clear results from the reintroduction phase. In this case, look back through the food diary you kept before the diet for potential culprits. Cut these out immediately. Should your symptoms clear, then go on to the reintroduction phase immediately. If they don’t, then go on to the Stage 3 diet, preferably a rare-food diet.

Before deciding which course of action to take, consider the possibility that

it might be something other than food causing the residual symptoms. If you have candidiasis, for example, the sugar-free, yeast-free diet could have helped considerably but not removed all your symptoms. Or it could be that food was your main problem, but something else is causing the residual symptoms – an airborne allergen or environmental chemical perhaps. If you have not checked out these possibilities, then think about them now.

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These measures can help to prevent allergies developing in babies born into atopic (allergic) families.

Plan the timing of birth for September-February; avoid March or April. Don’t eat too much of any one food while pregnant. It may also be worthwhile avoiding foods that are potent allergens (listed below), but there is no firm evidence that this is of benefit during pregnancy. Give up smoking before becoming pregnant. Once the child is born, make

sure that no-one smokes in the house. Breast-feed for the first year if possible. Give nothing but breast milk for

the first 4-6 months. If breast-feeding is not possible, discuss with your doctor the possible

alternatives, such as hydrolysate formulas. While breast-feeding, avoid eating foods that are likely to cause allergic reactions: milk, eggs, peanuts, fish, citrus fruits (oranges, lemons etc), wheat, beef and chicken. To this list, add any food to which a previous child is allergic.

After 4-6 months, introduce some solid foods, but withhold those listed

above until 9-12 months. Introduce these foods gradually, one at a time, so that reactions can be

noted. Do not give new foods when the child is ill. For the first year, have no furred pets, keep dust to a minimum and keep the house free of moulds (see p67 for details). If the child has an infection, take special care to keep allergens to a minimum. Where possible, avoid exposing the baby to air pollution. Avoid unnecessary surgery, during the first year of life. As far as possible, avoid exposure to people with throat and chest infections during the first three years of life.

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Claire’s eight-week-old baby, Jamie, was apparently healthy but cried a lot of the time, and seemed to be in pain. As Claire was breastfeeding, her doctor asked about her diet and found that she was a vegetarian. She explained that she had been eating more cheese and drinking an extra pint of milk a day to make sure she got enough protein during pregnancy and breastfeeding. The doctor suggested that she might avoid milk, cheese and butter for a while, to see if this had any effect, and prescribed some tablets to give her extra calcium. He persuaded her to eat a little fish to make up for the missing protein. A couple of days after starting this diet, Jamie’s crying was noticeably less and it became easier to get him to sleep each evening. Claire was delighted at the improvement. She tried drinking a glass of milk, to see what would happen, and 24 hours later Jamie, following a feed, suffered, a severe attack of colic. After that, Claire stayed on a milk-free diet for six weeks. She then introduced a little milk and butter into her diet and found that Jamie could now tolerate this.

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Jane could fairly be described as a ‘typical’ case of food allergy. But Susan is not a typical case of food intolerance because there is no such thing. Food intolerance cannot lay claim to any single set of symptoms. Every patient is different, both in the cluster of symptoms they show and in the foods that affect them. Nor is there a single, clear-cut mechanism underlying the symptoms, as there is with food allergy. The available evidence indicates that there may be half-a-dozen or more different factors that contribute to the illness. In other words, food intolerance is a complex subject, and few generalizations can be made.

Nevertheless there are certain features that characterize this type of food sensitivity, and distinguish it from food allergy. Whereas food allergy reactions are usually immediate, food intolerance reactions tend to be much slower. The culprits in food intolerance are foods that are eaten very regularly, especially items such as wheat and milk that are consumed at almost every meal. The slowness of the reaction, combined with the fact that the foods are eaten so often, contributes to the ‘masking’ effect observed by the first doctors to study these reactions – the link between food and symptoms is unlikely to be made when the body is subjected to a constant bombardment with the food.

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