Though elimination diets are often an effective tool for diagnosing food allergies and intolerances, they are not foolproof. Some foods have to be tested several times before a cause-and-effect relationship is established. Factors that can skew the results of an elimination diet include:
Some people do not react every time they consume a certain food, and others react only after consuming large amounts of the food.
Some patients appear to react to one food, but are actually suffering a delayed reaction to something eaten much earlier.
Viral infections and other illnesses can lower a patient’s tolerance to a specific food allergen, falsely indicating a higher level of sensitivity than is normally present.
Some patients can tolerate a little bit of a food, but react after consuming additional amounts of the food.
The way a food is prepared and cooked can change its chemistry.
A process called cross-reactivity can result in a person having an allergic reaction to certain foods or ingredients that contain similar proteins to another allergen. Foods that come from related families may cause similar allergic reactions, such as potatoes and tomatoes. In addition, when pollen counts are high, people with certain pollen allergies may experience a cross-reaction when they eat certain fruits with proteins similar to the pollen. This is referred to as oral allergy syndrome. The food reaction is therefore secondary and not a true food allergy.
Many common food allergens are “hidden ingredients” in a variety of foods. To ensure a successful elimination diet, patients have to carefully read the labels on all foods eaten during the period when foods are restricted.
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