As mentioned above, the treatment of food allergy begins with eliminating the culprit from the diet. At the same time, it is essential to provide a balanced diet which contains enough proteins, calories, trace elements and vitamins. Close cooperation between the patient, the doctor and a qualified dietitian is just as important; patients and their families should be aware that even small amounts of the offending food are sufficient to produce symptoms. A knowledge of food families (see below) is also important. For example, someone who is allergic to peanuts may react adversely to any member of the legume family.
Food Families
Very restricted diets should not be used for long periods and foods of the various groups should gradually be reintroduced, so as to build up a permanent diet which excludes only the allergens.
When recommended diets do not appear to work, this may be due to one of two reasons: either the patient is not following the diet strictly enough, or he or she is reacting to additives, colouring agents, salicylate or histamine-rich foods or to other naturally occurring chemical agents.
Foods that contain salicylates
* Citrus and most other fruits (except banana, mango, pawpaw and peeled pears
* Most herbs and spices and many vegetables (except potatoes, peas, beans, cauliflower, cabbage, brussels sprouts, lettuce, celery, onion, asparagus and garlic)
* Tea, some coffees, fruit juices, most alcoholic beverages (except whisky, gin and vodka)
Recent years have seen the development of a very safe drug called sodium cromoglycate (sold under the trade name of Nalcrom), which prevents mast cells from releasing their chemical substances. It is thought that it may act in the wall of the intestines by decreasing the digestive tract's permeability to large food molecules. Another anti-allergic drug, ketotifen (Zaditen), may work in the same way and also has the benefit of some antihistamine effects. These drugs may, therefore, interfere with the processes which produce symptoms in food allergic people. Both drugs must be taken before meals. They both show great promise but research is still continuing in this area.
In conclusion, it should be mentioned that there seems to be a general belief (whether true or false) that our entire environment is being progressively poisoned and that our health is suffering as a result. This is especially prevalent in the conviction that we are falling victims to the food we eat, in one way or another. As yet, there is no direct evidence of a general increase in obviously toxic reactions to our diet, but what is undoubtedly necessary is a great deal of research in the field of food allergy and food intolerance, as well as better diagnostic methods and better treatment. The future promises some exciting developments in a field that doctors have known about for centuries but largely ignored, and where they now have much ground to make up.