ARI Publication 40 – 2013 Version

reactivity to food proteins. However, validity of skin patch testing to food allergens is unclear, so it
is best used as a possible guide of foods to consider removing.

Again, commercially available laboratory testing is limited, especially for delayed-type food allergies.
For delayed-type food allergies, the current gold standard for diagnosis is removal of the suspect
food, followed by reintroduction, as discussed above.

In severe cases of food allergy, the diagnosis procedure can involve an elimination diet of the most
common reactive foods. For non-IgE-mediated food allergies, soy and milk products are the most
common. For IgE-mediated food allergies, egg, milk, and peanuts are the most common. Grains
such as wheat, rye, barley, oats, and corn can sometimes be allergens also. If there is
improvement after removing several foods, then try challenging with one suspect food every 4
days, to see if any can be added back in. Some children may also be sensitive to artificial colors,
flavors, and preservatives, and sensitivity to those can be assessed in the same way.

Explanation of treatment:

• Avoid foods that cause allergic reactions or symptoms
• Consider other methods to heal the gut – many food allergies will disappear when gut
  inflammation is healed.
• May consider using a 4-day diet rotation, in which a given food is only eaten 1 day every four
  days, so that there is less likelihood of developing an allergy to it (this is a method typically used
  for patients with eosinophilic esophagitis and some patients with severe reactions to food
  proteins, but there is not a good scientific rationale and this method is still controversial).

Benefits:

Removing allergic foods can result in a wide range of improvements in some children, including
gastrointestinal and improvements in behavior and attention.

ARI Survey of Parent Ratings of Treatment Efficacy:

Duration: Some food allergies (like peanuts) seem to be lifelong, whereas others can disappear
when gut inflammation is healed and/or the gut immune system develops tolerance to the
offending food.

Research:

A study by Vojdani et al. found that many children with autism have food allergies.

Vojdani A,. et al.,. Immune response to dietary proteins,. gliadin and cerebellar peptides in children with
autism. Nutr Neurosci. 2004 Jun;7(3):151-61.

There are also 3 studies by Jyonouchi et al, which found that children with autism had more
hypersensitivities to food allergens than did typical children, which seemed to contribute to gut
problems.

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