8 Food Elimination Diet

To improve your symptoms, your doctor wants you to avoid

the top 8 allergens: milk, eggs, peanut, tree nuts, soy,
wheat, fish and shellfish. In order for you to follow this 8
food elimination diet, theres a few things you need to
know.

How to Read a Food Label

The FDA requires processed food companies legally have to declare on the food
label if they intentionally include any of the top 8 allergens in their food in one of
two ways: either in a Contains: statement or within the ingredients in
parentheses. For example:
o Contains: Milk, soy and egg
o Ingredients: Whey (milk), sugar, nougat (almonds, pistachios)
Manufacturers are also required to list the specific type of nut, fish or shellfish
included in their food.
Molluscan shellfish like scallops, clams, mussels and oysters are not considered
by the FDA to be a major allergen. Therefore, it is not required for food
companies to label their products as containing this type of shellfish.
Allergy advisory statements about potential cross-contact such as May contain
or Was produced in a facility that also processes are not required and may
be used voluntarily. If you are unsure about ingredients or potential crosscontact, call the company and discuss their processing procedures. If still unsure
or skeptical, it is best to err on the side of caution and avoid the food.
o Studies have found some of these foods do contain enough of the
allergen to cause a reaction.
Foods such as bakery items or sandwiches purchased for individual order that
come in a container or wrapper are not required to label allergens.
Fresh meats, fresh fruits and fresh vegetables do not apply to the FDAs labeling
laws, however, safety measures are followed by the USDA to avoid allergens
contaminating foods.
Read every label, every time
o Companies can and will change ingredients. Just because something was
safe previously, does not mean it will be safe again.
Note: Coconut is classified as a nut, but it is botanically a fruit, and therefore,
can be eaten on this diet.
How to Find Allergy Free Foods

Search for a particular product you are interested in finding using Google. This
can be a lot easier than looking for allergy-free foods in general.
o For example if you wanted to make brownies try Google searching
Allergen free brownie mix

Avoid Cross-contact

Look for companies who take strict quality control measures to avoid crosscontact and also test their products for allergies Ex. SO Delicious
o Check company websites for this information, generally found under
Nutrition Information or FAQ
Cross-contact occurs when a safe food is exposed to an allergen. This can
happen in two ways.
o Direct cross contact Ex. Cheese peeled off of a sandwich after touching
bread
o Indirect cross contact ex. using the same knife to cut wheat bread right
before cutting a allergy-free bread without cleaning it in between.
Avoid open bins of food with scoops, especially flours
To avoid cross-contact, carefully wash counter tops, tables, cutting board, pots,
pans, utensils.
It may be helpful to have separate safe utensils that are only used for allergy
free cooking.
Use squeeze bottles for condiments.
Use separate jellies, jams and other spreads.
Use separate toaster and colander.
Cook allergy free foods first and keep them away from potential splattering from
other dishes.
Wash your hands with soap and water before touching any allergy free food and
after touching any allergens
Do not share food or utensils
Dining Out Safely

Eating out can be very overwhelming if you do not prepare and plan ahead.
Avoid restaurants where cross-contact is very likely such as buffets, bakeries,
restaurants serving only premade food or those that use allergens in a majority
of their dishes like seafood restaurants.
Avoid salad bars.
Call ahead and talk to the manager or chef about your allergies and immediately
alert your waiter or waitress.
Ask about the ingredients and how a dish is prepared. Emphasize to your waiter
or waitress and the chef that cross-contact must be avoided.
Keep it simple. A safe option would be a plain meat like chicken, pork, or beef
with a steamed vegetable and plain brown rice or a plain baked potato.
Be wary of fried foods and desserts that often contain allergens or are at greater
risk for cross-contact.
Chain restaurants are becoming much more aware of allergies and may be a
good option to try. Look at website before going to restaurant.

If going to a family event, bring your own dish free of allergens and keep safe
snacks on hand.

Nutritional Deficiencies caused by avoiding multiple allergens

Milk allergy can often lead to deficiencies in calcium, vitamin D and protein.
o Choose milk/yogurt substitutes (rice, coconut or hemp) or orange juice
fortified with calcium & Vitamin D and other foods naturally high in
calcium (green leafy vegetables, beans, especially white beans).
o Take a vitamin D supplement and if necessary, a calcium supplement also.
o Be sure your protein intake is adequate through other means such as
meats or legumes.
Elimination of seafood in particular can cause deficiency of essential fatty acids
like omega 3s.
o Flax seeds are a good allergy free option for omega-3s.
Other deficiencies like that of iron and B-vitamins due to wheat restriction are
also possible.
o Look for fortified grains
o A multivitamin is recommended. Extra iron may also be needed if not
eating enough meat.
A restrictive diet may also restrict calories. Especially in children, it is important
to make sure enough calories are being consumed.
Despite the limitations of an 8 food elimination diet, it is important to still
consume a balanced diet of food or supplements from all 5 food groups. For
more info visit: www.myplate.gov
Menu Ideas

Breakfast:
o Plain oatmeal with brown sugar and raisins + Milk Substitute + Crisp
bacon
o Gluten Free Rice Chex Cereal + Milk Substitute + Sliced banana
o Hash of potatoes or sweet potatoes with peppers, onions and diced
ham, chicken or Welshire Farms allergy free sausage + glass of
calcium enriched OJ
Lunch
o Sandwich with allergy free bread + No Nuts Peabutter + Jelly
o Chicken salad made with soy-free vegan mayo, celery and grapes on
allergy free bread or in lettuce cups
o Allergen free pizza crust topped with tomato sauce, Daiya mozzarella
cheese and diced veggies.
Dinner
o Baked chicken with rice and carrots (or other vegetable)
o Roast turkey with steamed broccoli and homemade mashed potatoes
(made with milk substitute and Earth balance buttery spread)
o Rice or quinoa based pasta with homemade meatballs (use gluten free
oats as binder)
o Hamburger on allergy free bun with lettuce, tomato, onions and side of
corn on the cob

Snacks
o Potato or corn chips and dip (guacamole, hummus or bean)
o Plain popcorn with Earth balance buttery spread (optional)
o Fresh fruit or vegetables
o Homemade trail mix with puffed rice cereal or other allowed cereal,
dried fruits like raisins, sunflower or pumpkin seeds, and gluten free
pretzels.
o Enjoy Life chewy bars

Baking Substitutions*
Milk:
Replace 1 cup cow's milk with one of
the following:
1 cup rice milk
1 cup fruit juice
1 cup water
1 cup coconut milk
1 cup hemp milk
Buttermilk:
Replace 1 cup buttermilk with one of
the following:
1 cup coconut milk
7/8 cup rice milk
7/8 cup fruit juice
7/8 cup water
Yogurt:
Replace 1 cup yogurt with one of the
following:
1 cup coconut yogurt
1 cup unsweetened applesauce
1 cup fruit puree
Butter:
Replace 1 stick butter with one of the
following:
8 tablespoons Earth Balance (NonDairy, soy Free) Buttery Spread
8 tablespoons vegetable or olive oil
For reduced fat: 6 tablespoons

unsweetened applesauce + 2
tablespoons fat of choice
Eggs:
Replace 1 large egg with one of the
following:
3 tablespoons unsweetened
applesauce (or other fruit puree) + 1
teaspoon baking powder
1 tablespoon flax meal, chia seed or
salba seed + 3 tablespoons hot water.
(Let stand, stirring occasionally, about
10 minutes or until thick. Use without
straining.)
Egg Replacer, according to package
directions
Replacing more than two eggs will
change the integrity of a recipe.
Because egg substitutions add
moisture, you may have to increase
baking times slightly.
Note: To replace one egg white,
dissolve 1 tablespoon plain agar
powder into 1 tablespoon water. Beat,
chill for 15 minutes and beat again.
Nuts:
Replace tree nuts or peanuts with an
equal amount of the following:
Toasted coconut
Sunflower seeds

Toasted sesame seeds

(use only 2 to 3 tablespoons)
Crushed cornflakes

Crushed crispy rice cereal

Crushed potato chips
Pumpkin seeds

*From Living Without Magazine www.livingwithout.com

Gluten-Free Flour Substitutions

To make a flour blend, thoroughly combine all ingredients. Store in a covered
container in the refrigerator until used. You can double or triple these recipes to
make as much flour mix as you need.
Note: If you purchase a commercial flour blend, read the ingredient list carefully.
Some blends contain salt and xanthan or guar gum. If so, there is no need to add
more.
Nutritional analyses of recipes are based on data supplied by the U.S. Department
of Agriculture and certain food companies. Nutrient amounts are approximate due
to variances in product brands, manufacturing and actual preparation
All-Purpose Flour Blend

High-Protein Flour Blend

Use this blend for all your gluten-free

baking.
1/2 cup rice flour
1/4 cup tapioca starch/flour
1/4 cup cornstarch or potato starch

This nutritious blend works best in

baked
goods that require elasticity, such as
wraps
and pie crusts.
1 1/4 cups bean flour (your choice),
chickpea flour or soy flour
1 cup arrowroot starch, cornstarch
or potato starch
1 cup tapioca starch/flour
1 cup white or brown rice flour

Each cup contains 436 calories, 1g total fat,

0g saturated fat, 0g trans fat, 0mg
cholesterol,
99g carbohydrate, 3mg sodium, 2g fiber, 5g
protein

High-Fiber Flour Blend

This high-fiber blend works for
breads,

Each cup contains 588 calories, 3g total fat, 0g

saturated fat, 0g trans fat, 0mg cholesterol,
128g

pancakes, snack bars and cookies

that
contain chocolate, warm spices,
raisins or
other fruits. It is not suited to
delicately
flavored recipes, such as sugar
cookies,
crepes, cream puffs, birthday cakes
or
cupcakes.
1 cup brown rice flour or sorghum
flour
1/2 cup teff flour (preferably light)
1/2 cup millet flour or Montina flour
2/3 cup tapioca starch/flour
1/3 cup cornstarch or potato starch
Each cup contains 428 calories, 2g total fat,
0g
saturated fat, 0g trans fat, 0mg cholesterol,
92g
carbohydrate, 19mg sodium, 5g fiber, 8g
protein.

carbohydrate, 24mg sodium, 6g fiber, 11g

protein.

Self-Rising Flour Blend

Use this blend for muffins, scones,
cakes,
cupcakes or any recipe that uses
baking
powder for leavening.
1 1/4 cups white sorghum flour
1 1/4 cups white rice flour
1/2 cup tapioca starch/flour
2 teaspoons xanthan or guar gum
4 teaspoons baking powder
1/2 teaspoon salt
Each cup contains 514 calories, 3g total fat, 0g
saturated fat, 0g trans fat, 0mg cholesterol,
113g
carbohydrate, 1163mg sodium, 8g fiber, 10g
protein.

*From Living Without Magazine www.livingwithout.com

Recipes you can make!
Mock Ranch Dressing
by Melanie Carver
1 cup unsweetened plain yogurt alternative (cultured coconut milk) -OR1 cup safe mayo (egg-free, milk-free, soy-free)
1/4 cup or less plain milk alternative
1 Tbsp fresh chopped chives (optional)
1 tsp Garlic & Herb Mrs. Dash
Directions
The base of the recipe uses a yogurt OR mayonnaise substitute. Use an
unsweetened/plain milk-free yogurt alternative like cultured coconut milk; or use an eggfree soy-free mayo such as soy-free Vegenaise.
Pour the liquid in slowly while whisking all of the ingredients together. If making a dip,
you will use less liquid (if any at all) than you would use to make dressing. If you add too

much liquid, just add more of the base until you get the right consistency.

Pumpkin Seed Butter

By Melanie Carver
4 oz roasted pepitas (pumpkin seeds)
3 Tbsp oil
2 Tbsp organic agave nectar

Directions:
Pour your pepitas into a bowl and check them for debris (little pebbles, etc.). Then put
them into a food processor and pulse the seeds until they are ground like thick sand. Let
them sit for a few minutes to allow the seeds to release their oils and then pulse them
some more until they begin to stick together.
Slowly allow oil to drizzle in while you continue to "chop". I like to use the small air holes on
my food processor lid to drip the oil in. I prefer canola or grapeseed oil.
I like to use liquid sweetener like agave nectar so that I don't have to use as much oil in my
recipe. You can skip the sweetener if you are using this pepita butter to make pesto or
cookies. Add in the sweetener after the oil and pulse again.
Test the consistency and texture of the pepita butter to determine if you want to add more
liquid (oil/sweetener). Be careful not to add too much oil as it will separate from the pepitas
over time. Roasted pepita butter will be a little grainy. If you use raw pepitas, the butter will
be smoother and lighter in color.
Refrigerate in a sealed container. You may need to stir it before use.

Turkey Meatballs
By Heidi Bayer
1 lb ground turkey
1/4 cup gluten free oats or safe crushed cereal
1 tsp salt
1 tsp pepper
Directions:
Mix all ingredients together.
Roll into balls.
Place on cookie sheet lined with parchment paper.
Bake at 400 F for 25-30 minutes.

1 Tbsp
oregano
1 Tbsp canola

oil
dash apple cider vinegar
Blackberry and Raspberry Crisp
By: Elyse Hahne
24 oz fresh or frozen blackberries
24 oz fresh or frozen raspberries
1 1/4 cups sweet rice flour
1 1/4 cups brown sugar
1 1/4 cups + 2 Tbs butter substitute (Ex. Earth balance buttery spread), divided
use
1 1/2 tsp cinnamon
1 tsp salt
Directions:
Preheat oven to 375 F.
Grease 8x11 pan well. Place blackberries and raspberries in the pan. Cut up 1/4 cup
butter sub and place over the blackberries and raspberries.
In a small bowl, combine the sweet rice flour, brown sugar, cinnamon, and salt. Stir.
Then add softened, almost melted, 1 cup butter sub into mixture. Mix well and be
sure that butter sub is combined with dry ingredients. Pour or scoop mixture over
berries. Cut up the 2 remaining tablespoons of margarine and place on top of crisp
mixture. Bake in preheated oven for 40-45 minutes or until crisp is browned.

Recipes above from http://www.Kidswithfoodallergies.org. For other recipes like

these go to:

Living Withouts http://www.glutenfreeandmore.com/

http://enjoylifefoods.com/recipes/
http://allergicliving.com/ and filter by allergy
http://gfbakingfree.com/blog/
http://allrecipes.com Good recipe for chocolate avocado pudding!

List of Helpful Websites and Resources

Allergyeats.com Find allergy friendly restaurants in your area
Befreeforme.com Recipes, articles, blog
Food Allergies and Research Education (FARE) (foodallergy.org)
FoodAllergyAwareness.org
Glutenfreepassport.com Find gluten-free and allergy free restaurants when
traveling; Blog
Godairyfree.org
GlutenFreeandMore.com Magazine for people with allergies and food sensitivities
Helpful Apps

MyFoodFacts.com - Can personalize your food allergens, scan barcode w/ your

camera to get list of ingredients, provides immediate food recalls and undeclared
allergen alerts from FDA.
iCanEat Fast Food Gluten Free and Allergy Free AND iEatOut Gluten Free and Allergy
Free by Allergy Free Passport
ContentCheckedLite USA Shopping aide for people with food allergies and
intolerances

References
http://www.fsis.usda.gov/OPPDE/rdad/FSISNotices/29-13.pdf
http://www.cureceliacdisease.org/archives/faq/what-common-nutrient-deficienciesmight-an-adult-experience-prior-to-diagnosis
http://www.hsph.harvard.edu/nutritionsource/omega-3-fats/
http://www.ncbi.nlm.nih.gov/pubmed/18671692
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280668/
http://www.foodallergy.org/document.doc?id=263
http://www.foodallergy.org/emotional-and-social-issues
http://www.sciencedirect.com/science/article/pii/S0002822302903512
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2222.2010.03586.x/full
http://www.sciencedirect.com/science/article/pii/S0091674902912534
http://onlinelibrary.wiley.com/doi/10.1111/j.1399-3038.2007.00700.x/full
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3071637/
http://www.kidswithfoodallergies.org
http://www.eosaware.com/

Created by Taylor Palm, Volunteer and Rutgers Student for RDs at RWJMS