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The fact of being allergic or intolerant is not a defect or a misfortune as was believed in the past. It is simply a loss of the active control that every human being puts into action since birth (and partly in fetal life as well) to adapt to the substances that surround him whether they be food, respiratory or environmental. Thus we are all allergic and intolerant to everything at birth. It is only the active control that makes the difference between who maintains tolerance (a healthy person) and who loses it (and becomes allergic and intolerant).
A person living today is surrounded by the result of one of the most extensive statistical samples that has ever existed. Nearly 7,5 billion living persons (some well, some not) that have gone through the weaning process to overcome their initial condition of hypersensitivity to everything. By way of gradual contact with the outside world made of mites, fungi, molds, foods, bacteria, toxic substances and an infinite amount of other elements, they have been able to go from a condition of violent reactivity to tolerance. The ability to pass from the protection of fetal life to the encounter with a world full of foreign and potentially dangerous substances without being harmed, and learning to tolerate them, is physiologically crucial in dealing with the current allergies of a single individual and of the worldwide population.
If contact with the outside world occurs in the correct way, if it develops according to the individual's ways and times, with respect for the physiological rhythms that have been maintained for thousands of years, then tolerance takes the upper hand and the external world is no longer to be feared. However, if the balance is upset after tolerance has been achieved, the signs of an allergic condition appear thus signaling a loss of control.
In some cases the initial tolerance is only partially achieved and some children seem to be allergic or intolerant from birth, but even in these cases it's possible that the interruption of evolution was due to external traumatic factors (interruption in nursing, when the mother or child must take drugs, vaccines, etc) that halted the normal processes leading to tolerance.
The dietary outline for recreating tolerance follows one of the most tried and true physiological processes in the history of mankind which is, of course, weaning. Through the gradual and progressive introduction of non-tolerated foods, a human being reaches the point of being able to tolerate all edible food substances within a period of months (12-18).
The re-introduction begins with minimal quantities which are gradually increased at least twice a week. This pattern gradually comes to resemble a diet that is almost free of restrictions every day of the week or with just one day of "abstinence" or controlled diet per week.
Diet for regaining tolerance
The objectives of a correct dietary therapy are to:
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encourage recovery of tolerance for non-tolerated foods;
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avoid dangerous elimination diets, useful solely in the case of a classic allergy, that is, one that is high value IgE mediated;
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make allowances for socializing and the pleasures involved in eating by way of a rotational diet that provides for days of unrestricted diet.
In today's social and environmental situation it seems indispensable to eat a varied diet, especially due to the fact that the systematic repetition in the consumption of some foods (even if they are used to substitute non-tolerated foods) can easily give rise to new hypersensitivities.
One of the positive effects of the rotational diet compared to the elimination diet is the control of inflammatory reactions without the loss of tolerance for the food in question, a risk that is well-illustrated by the following story.
During their work with a group of nine youths who had diffused allergic symptoms (atopic dermatitis, asthma) and positive RAST test for fish, the two notable immuno-allergists Pascual and Larramendi tried to completely eliminate fish products from their diet.
Before this diet, the youths had never experienced any sort of anaphylactic display linked to eating fish. After a period of total elimination all nine reacted with immediate allergy-like symptoms (urticaria, angioedema, vomit, rhinitis, asthma) even at the slightest contact with fish. Two developed symptoms upon merely perceiving its scent.
A rotational diet is a diet that allows for unrestricted consumption - for one day that must then be followed by three days of complete elimination - of the non-tolerated food.
For example, a person who is intolerant of milk can consume milk, dairy products, sweets that contain them, cheeses and all other "forbidden" foods on Sunday and during one meal on Wednesday. After a person has followed this diet for a certain period, which usually varies from 3 weeks to 2 months, the food can be re-introduced more frequently if the diagnostic tests for it give a negative result.
Here is an example of a possible diet outline: unrestricted eating during the weekend (Saturday and Sunday) and possibly one day in midweek (usually Wednesday).
In many cases in which the symptoms solely arise from an overload, a dietary outline that allows a person to eat in an unrestricted way on Saturday evening, all Sunday and all Wednesday, could be adopted in many cases from the start of the dietary therapy.
If at this point the clinical response is satisfactory, the diet can be further expanded within a period of another 2-3 months, until reaching a point at which the diet includes at least one day of restricted eating per week (a sort of "day of abstinence") in order to avoid a systematic food reloading.
The nutritionist must follow this re-introduction in a responsible way and guide the patient towards the complete recovery of tolerance for the food in question, thus becoming a guide for this new "weaning" process.
An important innovation in this area is the possibility to receive online assistance that allows for a targeted, personalized and reserved form of assistance, especially at the beginning of the diet.
Regardless of the type of test that is performed, once any possible intolerances are identified, one may proceed in accordance with the most recent guidelines applied by the DRIA Centers that are scientifically affiliated with the SMA in Milan. The diets never require a total elimination of the offending foods, but are based on the recovery of tolerance by way of a rotational diet, with a procedure that resembles that of an infant's weaning process.
The use of low dosage hyposensitizing substances, or "vaccines", can be carried out with the DRIA Test even when the previous tests that were conducted were different.
Doctor Attilio Speciani
Clinical Allergist and Immunologist
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