Failsafe Diet Food List: Identifying Food Intolerances and Sensitivities

Food intolerances and sensitivities are common, affecting up to 20% of the global population. An elimination diet is a short-term method to identify foods your body can’t tolerate well by removing them from your diet. This approach can benefit individuals with conditions like Irritable Bowel Syndrome (IBS), Attention Deficit Hyperactivity Disorder (ADHD), migraines, eosinophilic esophagitis (EE), and skin conditions such as eczema.

What is an Elimination Diet?

An elimination diet identifies food intolerances, sensitivities, and allergies through a carefully structured dietary process. It involves removing foods known to cause uncomfortable symptoms and reintroducing them later while closely monitoring for any adverse reactions. Allergists and registered dietitians have utilized elimination diets for decades to help individuals determine which foods are not well-tolerated.

The core principle of an elimination diet involves removing foods from your diet that you suspect your body cannot tolerate. These foods are then reintroduced one at a time, as you observe for any symptoms that indicate a reaction. Typically lasting only 5-6 weeks, this diet helps individuals with sensitive guts, food intolerances, or food allergies identify which foods contribute to their symptoms.

By identifying and eliminating trigger foods, an elimination diet may alleviate symptoms such as bloating, gas, diarrhea, constipation, and nausea. Once a food is identified as problematic, removing it from the diet can prevent these uncomfortable symptoms.

There are various types of elimination diets, each involving the removal or consumption of specific foods. However, it is crucial to undertake an elimination diet under the supervision of a medical professional, especially if you have a known or suspected food allergy. Reintroducing a food allergen can trigger a dangerous condition known as anaphylaxis. If you suspect a food allergy, consult a doctor before starting any elimination diet, and be aware of allergy symptoms like rashes, hives, swelling, and difficulty breathing.

Read also: The Hoxsey Diet

How an Elimination Diet Works

An elimination diet is divided into two primary phases: elimination and reintroduction.

The Elimination Phase

This phase, lasting about 2-3 weeks, involves removing foods that are suspected to trigger symptoms. Common culprits include nuts, corn, soy, dairy, citrus fruits, nightshade vegetables, wheat, gluten, pork, eggs, and seafood.

The goal of this phase is to determine whether your symptoms are indeed caused by food or by something else. If symptoms persist after removing these foods for 2-3 weeks, it is important to consult a doctor to explore other potential causes.

The Reintroduction Phase

During this phase, eliminated foods are slowly reintroduced back into the diet. Each food group should be introduced individually over 2-3 days, while carefully monitoring for symptoms. Symptoms to watch for include:

• Rashes and skin changes
• Joint pain
• Headaches or migraines
• Fatigue
• Difficulty sleeping
• Changes in breathing
• Bloating
• Stomach pain or cramps
• Changes in bowel habits

If no symptoms occur during the reintroduction of a food group, it can be assumed that the food is acceptable, and you can move on to the next group. However, if adverse symptoms arise, the food is identified as a trigger and should be removed from the diet. The entire process, including elimination and reintroduction, typically takes about 5-6 weeks.

Read also: Walnut Keto Guide

It's important to seek advice from a doctor or dietitian if you plan to eliminate many food groups, as eliminating too many may lead to nutritional deficiencies.

Foods to Avoid on an Elimination Diet

The most effective elimination diets are often the most restrictive. Removing more foods during the elimination phase increases the likelihood of discovering which foods trigger symptoms. Commonly removed foods include:

• Citrus fruits: Oranges and grapefruits.
• Nightshade vegetables: Tomatoes, peppers, eggplant, white potatoes, cayenne pepper, and paprika.
• Nuts and seeds: All nuts and seeds.
• Legumes: Beans, lentils, peas, and soy-based products.
• Starchy foods: Wheat, barley, corn, spelt, rye, oats, and bread, as well as other gluten-containing foods.
• Meat and fish: Processed meats, cold cuts, beef, chicken, pork, eggs, and shellfish.
• Dairy products: Milk, cheese, yogurt, and ice cream.
• Fats: Butter, margarine, hydrogenated oils, mayonnaise, and spreads.
• Beverages: Alcohol, coffee, black tea, soda, and other sources of caffeine.
• Spices and condiments: Sauces, relish, and mustard.
• Sugar and sweets: White and brown sugar, honey, maple syrup, corn syrup, high-fructose corn syrup, agave nectar, desserts, and chocolate.

According to a 2023 study, nightshade vegetables may potentially cause gastrointestinal reactions in those with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), triggering uncomfortable symptoms.

It's important to note that restrictive diets can be harmful, potentially leading to nutritional deficiencies and adverse psychological effects, which may result in disordered eating and eating disorders.

Other Types of Elimination Diets

Besides the traditional elimination diet, several other specialized elimination diets cater to specific needs:

Read also: Weight Loss with Low-FODMAP

• Low-FODMAPs diet: This diet removes FODMAPs, which are short-chain carbohydrates that some individuals have difficulty digesting.
• Few foods elimination diet: This involves consuming a limited combination of foods that are not regularly eaten. An example is the lamb and pears diet, where lamb and pears are not commonly consumed.
• Rare foods elimination diet: Similar to the few foods diet, this involves eating only foods that are rarely consumed, as they are less likely to trigger symptoms. Typical foods include yams, buckwheat, and starfruit.
• Fasting elimination diet: This involves strictly drinking water for up to 5 days, followed by the reintroduction of food groups. This diet should only be undertaken with medical supervision due to potential risks.
• Other elimination diets: These include lactose-free, sugar-free, gluten-free, and wheat-free diets, among others.

Benefits of an Elimination Diet

Elimination diets help identify foods that cause uncomfortable symptoms, allowing for their removal from the diet. Additional benefits include:

1. Reducing Symptoms of Irritable Bowel Syndrome (IBS)

   IBS, a common gut disorder affecting approximately 11.2% of people worldwide, can be improved through elimination diets. Many individuals experience relief from IBS symptoms like bloating, stomach cramps, and gas. A 2004 study involving 150 people with IBS found that those who followed an elimination diet excluding trigger foods reduced their symptoms by 10%, with those adhering most closely to the diet experiencing up to a 26% reduction in symptoms.

2. Helping People with Eosinophilic Esophagitis (EE)

   EE is a chronic condition where allergies trigger inflammation of the esophagus, leading to difficulty swallowing dry and dense foods and increasing the risk of choking. Studies have shown that elimination diets can effectively improve symptoms of EE. A 2005 study of 146 patients with EE found that over 75% experienced significantly fewer symptoms and reduced inflammation through an elimination diet.

3. Reducing Symptoms of ADHD

   Attention deficit hyperactivity disorder (ADHD) affects 3-5% of children and adults. Studies suggest that elimination diets may reduce ADHD symptoms in children sensitive to certain foods. However, children should only follow an elimination diet under medical supervision due to the risk of restricting essential nutrients necessary for growth.

4. Improving Skin Conditions Like Eczema

   Eczema, characterized by discolored, itchy, cracked, and inflamed skin, can be aggravated by certain foods. Several studies have indicated that elimination diets may reduce eczema symptoms.

5. Reducing Chronic Migraines

   Chronic migraines affect approximately 39 million people in the United States alone. Emerging evidence suggests that inflammation may be a contributing factor. A 2016 study of 50 patients with frequent migraine attacks found that following an elimination diet for 2 months helped reduce the number of headache attacks.

Risks of an Elimination Diet

While elimination diets can help identify problematic foods, they also pose certain risks. These diets should be followed for only 4 to 8 weeks, as longer durations can lead to nutrient deficiencies due to the elimination of entire food groups. Children and individuals with known or suspected allergies should only undertake an elimination diet under the supervision of a doctor. Children are also more prone to severe reactions like anaphylaxis when reintroducing food groups, as their bodies can become more sensitive to foods after a period of avoidance.

Understanding Salicylate Intolerance and Low Salicylate Diets

Salicylate intolerance occurs when the body reacts to salicylates, natural chemicals found in plants that protect them from threats like disease and insects. Common symptoms include airway inflammation, asthma, GI inflammation, diarrhea, and hives. Salicylate levels vary in foods but are commonly found in vegetables, fruits, nuts, spices, alcohol, coffee, and tea. While salicylates can cause issues for some, particularly those with mast cell activation syndrome (MCAS), recent research suggests they may also have anti-inflammatory effects.

A low salicylate diet involves consuming foods with no or very low levels of salicylates to reduce symptoms of intolerance. This typically starts with eliminating foods high in salicylates, then slowly reintroducing them to identify if salicylate intolerance is an issue. This process should be guided by a healthcare provider.

Foods High and Low in Salicylates

Numerous studies have reported salicylate levels in foods, but results can vary due to differences in testing methods, food processing, and source. The following list serves as a general guide in consultation with a healthcare provider:

Fruits

• Negligible: Banana, Canned Pear (in sugar syrup)
• Low: Apple - golden delicious, Nashi Pear
• Moderate: Apple - red delicious, Canned or dried Fig, Canned Morello Cherries, Avocado, Lime, Papaya, Canned Pear (in natural juices/syrups), Cantaloupe, Blackberry, Pear (ripe and peeled), Paw Paw, Custard Apple, Grapefruit, Blackcurrant, Tamarillo, Lemon
• High: Kiwi fruit, Blueberry, Loquat, Lychee, Boysenberry, Mango, Mandarin, Cherries - all other kinds, Passion fruit, Melons, Cranberry, Pear (w/peel), Mulberry, Currant, Persimmon, Nectarine, Date, Pomegranate, Peach, Grape, Rhubarb, Sugar banana, Guava, Fresh Tomato, Watermelon, Loganberry, Orange, Pineapple, Plum, Raisin
• Very High: All dried Fruits, Raspberry, Redcurrant, Strawberry, Sultana, Tangelo, Tangerine, Tomato, Youngberry

Vegetables

• Negligible: Bamboo Shoots, Bean Sprouts, Asparagus - trimmed, Alfalfa Sprouts, Canned Green Olives
• Low: Beans (dried - not borlotti), Borlotti beans, Aubergine - peeled, Artichoke, Capsicum, Cabbage (green or white), Brussels Sprouts, Beetroot, Aubergine - w/peel, Champignon, Celery, Cabbage - red
• Moderate: Black Olives, Broad Bean, Chicory, Green Split peas, Chickpeas, Canned Asparagus, Broccoli, Chili peppers, Lentils (brown), Chives, Carrot, Canned black olive, Courgette, Lentils (red), Choko, Fresh Tomato, Cucumber, Endive, Lettuce (iceberg, Fresh Asparagus, Frozen Spinach, Eggplant, Gherkin, Peas (dried), Green Beans, Lettuce (other than iceberg)
• High: Fresh Spinach, Hot pepper, Potato (old/white and peeled), Green Peas, Marrow, Okra, Peppers, Swede, Leek, Mushrooms, Radish, Radish, Mung bean sprouts, Parsnips, Sweet Potato, Tomato, Onion, Potato (new and red Pontiac), Water chestnut
• Very High: Tomato Products, Potato (white w/peel), Pumpkin, Watercress, Water Chestnut, Shallots, Snow Peas, Zucchini, Yellow split peas, Sprout, Sweet corn, Turnip

Nuts & Seeds

• Negligible: Poppy seed
• Low: Cashews, Desiccated coconut
• Moderate: Brazil nuts, Almond, Hazelnuts, Peanut Butter, Macadamia nuts
• High: Peanuts w/skins on, Pecan, Pumpkin seeds, Pine nuts, Water chestnut
• Very High: Sunflower seeds, Sesame seeds, Pistachio, Walnuts

Sweets

• Negligible: Carob, Caramel (Homemade)
• Low: Molasses, Chewing gum
• Moderate: Cocoa, Golden Syrup, Raw Sugar, Fruit Flavors, Homemade Caramel, Malt Extract, Honey, Maple Syrup
• High: Honey Flavors, White Sugar, Jam (except pear, preferably homemade), Liquorices, Mint flavored sweets, Peppermints
• Very High: Caramel (Store bought)

Seasonings, Condiments, Sauces & Toppings

• Negligible: Golden Syrup, Apple Butter (only if homemade from acceptable varieties of apples), Fresh Coriander Leaves (also known as Chinese parsley)
• Low: All Spice, Aniseed, Malt Vinegar, Chives, Horseradish, Bay leaf, Basil, Maple Syrup (pure), Mayonnaise
• Moderate: Caraway, Black pepper, Salt, Garlic, Cardamom, Cayenne, Parsley (except Chinese parsley also known as coriander), Cinnamon, Celery powder, Saffron, Cloves, Chili flakes, Shallots, Coriander, Chili powder, Soy Sauce (if free of spices)
• High: Ginger, Cider vinegar, Mixed herbs, Commercial gravies and sauces, Mustard, Cumin, Pimiento, Curry, Dill, Fenugreek, Fish, meat, and tomato pastes, Garam masala, Ginger, Honey, Jam/Jelly (all commercial varieties), Mace, Marmite
• Very High: Mint, Mustard, Nutmeg, Oregano, Paprika, Peppermint, Rosemary, Sage, Tabasco, Tarragon, Thyme, Turmeric, Vegemite and other Yeast Extracts, White pepper, White Vinegar, Wine Vinegar, Worcestershire Sauce

Fats & Oils

• Negligible: Butter, Ghee, Almond Oil, Copha, Coconut Oil
• Low: Canola Oil, Corn Oil, Sesame Oil, Olive Oil
• Moderate: Margarine (only if it’s made from vegetable oil or canola oil), Peanut Oil
• High: Walnut Oil
• Very High: Safflower Oil, Soy Oil, Sunflower Oil

Grains

• Negligible: Barley
• Low: Breakfast cereals that include fruit, nuts, honey or coconut, Buckwheat
• Moderate: Corn/maize cereals, Millet, Cornmeal, Oats (plain), Flavored breakfast cereals
• High: Rice, Maize, Rice cereals (plain), Polenta
• Very High: Rye, Wheat

Meat

• Negligible: Beef, Liver, Fish canned in an unacceptable oil and/or with seasonings added
• Low: Processed luncheon meats, Chicken
• Moderate: Prawns, Gravy made from prepared mixes, Seasoned meats (e.g. salami, sausages, frankfurters, and hotdogs)
• High: Eggs, Shellfish
• Very High: Fish, Lamb, Organ meats, Rabbit, Sausage casing, Scallops, Tripe, Veal

Dairy & Soy Products

• Negligible: Butter, Blue vein cheese, Cream
• Low: Cheese (not blue vein), Milk
• Moderate: Yogurt (natural only), Ice Cream, Rice Milk
• High: Goat Milk
• Very High: Soy Milk, Tofu

Baking Supplies

• Negligible: Arrowroot, Sesame seeds, Corn Syrup, Corn starch (also known as corn flour), Golden Syrup
• Low: Malt, Malt extract, Poppy seeds
• Moderate: Rice Flour, Rye Flour, Sago
• High: Soy Flour
• Very High: Sugar (brown, castor, granulated, icing, powdered), Tapioca, Wheat Flour

Commercial Snacks

• Negligible: Plain potato chips (read the ingredient list), Apple chips (only if homemade from acceptable varieties of apples)
• Low: Popcorn
• Moderate: Chewing gum (all flavors)
• High: Popping corn, Fruit flavored candy, gelato, ices, popsicles, sherbet, sorbet, and sweets
• Very High: Licorice (all flavors), Mint/peppermint/wintergreen flavored candy/sweets, Pickles (and anything pickled)

Beverages

• Negligible: Decaffeinated coffee, Dandelion coffee, Coco cola
• Low: Regular coffee, Milk (goat and cow)
• Moderate: Store bough pear juice, Rose hip tea
• High: All teas, Ovaltine, Rose hip syrup, Cordials and fruit flavored drinks, Homemade Pear Juice
• Very High: Fruit and vegetable juices, Soy Milk, Rice Milk, Water

Alcohol

• Negligible: Gin
• Low: Cider, Liquor, Whiskey
• Moderate: Beer
• High: Port, Vodka, Sherry
• Very High: Wine, Brandy, Rum

Products That Often Contain Salicylates

Many products contain salicylates, making it difficult to determine if a product is salicylate-free. Common items include:

• Acne products
• Air fresheners
• Alka Seltzer
• Breath savers
• Bubble baths
• Cleaning products
• Cosmetics
• Detergents
• Essential oils
• Fabric conditioners
• Fragrances and perfumes
• Gums
• Hair sprays, gels and mouses
• Herbal remedies
• Lipsticks and Lip glosses
• Lotions
• Lozenges
• Medications
• Mouthwash
• Muscle pain creams
• Pain relievers
• Pepto-Bismol
• Razors with aloe strips adjacent to the cutting edge
• Shampoos and Conditioners
• Shaving cream
• Skin cleansers or exfoliants
• Soaps
• Sunscreens and tanning lotions
• Supplements derived from rose hips or bioflavonoids
• Toothpaste
• Topical creams
• Wart or callus removers

Terms/Ingredients to Avoid

When following a low-salicylate diet, it is important to avoid products containing the following:

• Acetylsalicylic acid
• Aloe Vera
• Any coal tar derived dye
• Artificial flavorings
• Artificial food colorings
• Aspirin
• Azo dyes
• Benzoates (preservatives)
• Benzyl salicylate
• Beta-hydroxy acid
• BHABHT
• Choline salicylate
• Disalcid
• Ethyl salicylate
• Eucalyptus Oils
• Isoamyl salicylate
• Magnesium salicylate
• Menthol
• Methyl Salicylate
• Mint
• Nitrates/Nitrites
• Octylsalicylate
• Oil of Wintergreen
• Peppermint
• Phenylethyl salicylate
• Red Dye (#40)
• Salicylaldehyde
• Salicylamide
• Salicylate
• Salicylic acid
• Salsalate
• Sodium Salicylate
• Spearmint
• Yellow Dyes (#5 & #6)

Brand Names of Common Drugs Containing Salicylates

This is not a complete list, but it provides a starting point for avoiding drugs containing salicylates. Always check with a pharmacist or doctor if unsure about a medication's salicylate content. Never start an elimination diet without checking all medications first and consulting a professional. Avoid starting a medication with salicylate immediately after an elimination diet to prevent shock from reintroducing too much salicylate after a period of avoidance.

The FAILSAFE Diet: An Alternative Approach

The FAILSAFE diet, also known as the RPAH diet, tests for food chemical intolerances, focusing on naturally occurring or added food chemicals rather than FODMAPs or gluten.

Understanding Food Chemical Intolerance

Food chemicals can be tolerated in small amounts, known as a threshold. These chemicals are different from FODMAPs or gluten and can be naturally occurring or added during processing.

Types of Food Chemicals

1. Salicylates: Found in many plants.
2. Amines: Including histamine, which some people may be intolerant to due to insufficient diamine oxidase, the enzyme that breaks down histamine.
3. Glutamates: The role of glutamate in adverse reactions is debated.
4. Additives: Preservatives can produce sulphur dioxide and hydrogen sulphide in the gut, potentially causing hypersensitive reactions.

Food chemical intolerances are believed to irritate nerve endings, causing broad symptoms. While some studies suggest low-chemical diets can be effective, particularly for chronic hives, evidence for their efficacy in treating IBS is lacking. If a low FODMAP diet does not yield results, a low-chemical diet could be considered.

FAILSAFE vs. Low FODMAP

A low FODMAP diet identifies sensitivities to certain carbohydrates, while a FAILSAFE diet checks for food chemical intolerances. The FAILSAFE diet is more restrictive and typically lasts 2-6 weeks, potentially requiring the exclusion of dairy, gluten, and certain FODMAP carbohydrates based on symptom history.

Implementing the FAILSAFE Diet

Consult with a dietitian or refer to the RPAH Elimination Diet Handbook to determine whether to follow the strict, moderate, or simple version of the diet based on symptoms. Rechallenge dairy and wheat first (if previously eliminated), then move on to salicylates and amines, which are present in the most foods. For severe reactions, challenges can be done with a doctor or dietitian using capsules containing concentrated amounts of each food chemical.

Considerations for the FAILSAFE Diet

Much of the research on this diet is outdated, and side effects from food chemical sensitivities are numerous and broad.

The Feingold Diet

The Feingold Diet is an elimination diet that removes artificial food additives and foods high in salicylates. Food additives removed include artificial colors, flavorings, fragrances, and preservatives like BHA, BHT, and TBHQ. This diet was developed by Dr. Ben Feingold, who observed that salicylates and food additives caused hyperactivity in some children.

Low SAG Diet™

Julie Matthews, founder of Nourishing Hope and the BioIndividual Nutrition Institute, has created a hybrid version of the Low Salicylate, Amine and Glutamate diet called the Low SAG Diet™ for clients with Autism and ADHD.

Identifying Food Sensitivities

Food sensitivities can occur when the digestive system has trouble breaking down certain foods, causing reactions like itching, tingling, upset stomach, bloating, and headaches. These sensitivities can range from mild to severe.

Steps to Identify Food Culprits

1. Eliminate foods: Remove suspected trigger foods from your eating plan and observe any changes in symptoms.
2. Keep track of symptoms: Use a food journal, app, or voice memos to record symptoms.
3. Maintenance phase: If symptoms improve after removing foods, continue to avoid them.
4. Reintroduce trigger foods: Establish the threshold (or portion size) you can tolerate without discomfort.

What to Eat for Food Sensitivities

Factors influencing food sensitivity intensity include medical history, severity of sensitivity, and amount of food consumed. Focus on eliminating suspected foods, with common culprits including dairy, nuts, seeds, high FODMAP foods, histamine, and food additives.

Elimination Diet Meal Plan

The following is an example of an elimination diet meal plan.

Day 1

• Breakfast: Hot oatmeal with cinnamon and mixed berries.
• Lunch: Quinoa salad with cucumbers, tomato, feta cheese, and shredded carrot. Serve with a poached egg on top.
• Dinner: Roast chicken with basil and lemon slices, served with rice with green and yellow long beans.
• Snacks: Trail mix with your favorite nuts; fresh fruit with cheese.

Day 2

• Breakfast: Egg omelet with spinach, chives, and shredded sweet potato.
• Lunch: Leafy green salad with chicken, berries, walnuts, and goat cheese.
• Dinner: Sheet pan salmon with broccoli, served over herbed quinoa.
• Snacks: Rice-based crackers with nut butter; fresh-cut vegetables with dip.

Day 3

• Breakfast: Cold cereal (choose puffed rice for great crunch) served with milk and diced apple. Add a mix of nuts.
• Lunch: Buckwheat soup with carrots, cauliflower, green beans, and chicken breast.
• Dinner: Grilled chicken thighs with apples, served over brown rice and a side salad with fresh cucumber salad.
• Snacks: Fresh fruits with cheese; fresh-cut vegetables with hummus.

Day 4

• Breakfast: Hot oatmeal with berries and nut butter.
• Lunch: Brown rice bowl with scrambled eggs, bok choy, carrots, and bean sprouts. Dress with olive oil and grated ginger.
• Dinner: Grilled tilapia tacos served in corn-based shells. Decorate with shredded red cabbage, carrots, avocado, and lime juice. Add your favorite vegetables on the side.
• Snacks: Rice-based crackers with hummus; trail mix which includes some of your favorite nuts.

Day 5

• Breakfast: Banana and egg pancakes spiced with ground clove and cinnamon.
• Lunch: Spiraled vegetables served with turkey meatballs and dressed with olive oil, fresh herbs, and garlic powder.
• Dinner: Seared tuna steaks served with brown rice, pan-fried bok choy, and carrots. Garnish with oil and freshly squeezed lemon juice.
• Snacks: Fresh fruits with cheese; fresh-cut vegetables with avocado dip.

Day 6

• Breakfast: Cold cereal with milk, nuts, and berries.
• Lunch: Shrimp lettuce wraps served with peanuts, cubed parsnips, and fresh herbs.
• Dinner: Black bean bowl with cooked millet, avocado, orange salsa, cucumber, and turnips.
• Snacks: Rice-based crackers with nut butter; fresh fruits with cheese.

Day 7

• Breakfast: Hot oatmeal served with cinnamon and a side of cubed melon.
• Lunch: Spinach salad with cucumber, fennel, apple, and baked trout. Dress with olive oil and white wine vinegar.
• Dinner: Grilled chicken with vegetables (zucchini, kohlrabi, and carrots) served over polenta. Dress with olive oil, fresh herbs, and freshly squeezed lime juice.
• Snacks: Fresh fruits with cheese; fresh-cut vegetables with avocado dip.

Tips for Meal Preparation

• Batch cooking: Prepare multiple servings of a recipe to eat leftovers throughout the week.
• Pack meals: Pack lunches and dinners into individual containers for convenience.
• Buy precut vegetables and fruits: Save time by purchasing precut produce.
• Use frozen vegetables: Convenient and nutritious, frozen vegetables are ready to eat.
• Seek recipe recommendations: Ask a dietitian for recipe recommendations or cooking tips.

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