Joan Breakey’s Blog

“This is Jason.  Just thought I’d let you know that the diet has been a big game changer. I have started to have way more control over my impulses and I don’t feel the need to eat any excess food, it has been a real life saver. I find it is a lot easier to identify and stop my cravings and I am able to distinguish them from normal hunger much easier. Thank you for your help. It has really worked.”

A very dedicated mother recontacted me about her son in his late teens. His restlessness, excitability, impulsivity, and tantrums had improved with diet as a 5 year old. His bedwetting had also resolved. Salicylates were the biggest contributor to his problems [mint was particularly bad].

As he grew his tolerance improved so diet was able to be relaxed somewhat.

But in his late teens he did not notice any direct diet effect, but he really just wanted to eat sugary foods and found this craving hard to control. He also had eczema to deal with in his teens. At home his mother was providing healthy foods with minimal processed foods.

They got my new book Tolerating Troublesome Foods as a revision and update and returned to a ‘good results’ level of the Family Elimination Diet. His mum reported very obvious changes in Jason’s behaviour, attitude and cravings for food.  He no longer craves food unnaturally and his mum can have allowed sweet foods in the house which do not disappear!

It was interesting that the other changes were not the same as the ’small boy behaviour’ that changed years earlier. They were having a less demanding attitude, not being ‘as loud’, more aware of himself , improved concentration and not as itchy.

Overall the baseline diet has been a great success and the family are managing well.  The food Jason seems to miss the most is sauce to have with his meal, so they decided to make gravy in the pan with meats, and the low salicylate chutney in the book.

Jason is happy for me to tell his story so other teenagers can benefit from going back to using diet to help with whatever symptoms are bothering them at that stage in their lives.

Joan Breakey - Dietitian specialising in food sensitivity

Tessie had bad eczema. Her mother Sophie fed her only breast milk, but the eczema continued. When Tessie was 4 months old Sophie attended an allergy clinic and had testing done. Since Tessie’s big sister, Andrea, aged 5, had asthma and less severe eczema she has testing also. Sophie was surprised at the severity of the reactions as she had not seen any clear changes with particular foods. Tessie’s results were 6+’s to peanut and eggwhite, and three to egg yolk, wheat and milk. She was interested that Andrea had a severe reaction to peanuts even though this had not caused any worsening of symptoms during her 5 years.

When Sophie cut out all the egg, dairy, wheat and milk from her diet there was a great improvement in Tessie’s skin. She home cooked all her food.

However Tessie’s eczema flared Sophie she had orange juice which she had not had for some time. She found some information about additives and salicylates and excluded these from her diet as well. When the eczema decreased but did not clear and Sophie wanted to make longer term decisions about diet she made an appointment to see me for diet therapy.

She was also worried as Tessie was progressing but was small and did not have a great appetite. Before attending diet therapy Sophie filled out the Family Sensitivity History. The one reaction that Sophie had seen in Andrea was that she vomited severely after a paediatric syrup [not penicillin] high in additive colour and flavour. Sophie herself is allergic to penicillin and to bees. She has a very sensitive nose, noticing all smells. Her sister suspects yeast, beer, and rich foods. Her mother just can’t stand the smell of beer brewing. Tessie’s dad, Bryan, has hayfever with pollen and dust, his brother cannot eat lemons, fish or onion, and their mother, Tessie’s grandmother, also reacts to dust, pollen and many flowers.

To make sure we had a good baseline diet for Sophie to test various foods from we attended to all the detail for the low chemical diet, discussing suspect additives, using information on reported reactions to foods containing salicylates, amines, added flavours, and natural monosodium glutamate, as well as emphasising the role of smells. Since the allergy tests did not show positive for soy or fish they were still included.

A month later Sophie attended for her second diet investigation appointment. She was so pleased. Tessie’s skin had completely cleared. And importantly her appetite had improved. She had gained more weight and was much happier, playing more, and attending to whatever was going on around her. Sophie said that the main exclusions that had made the final difference were the peppermint toothpaste, the almonds in the nuts she had after carefully excluding all peanuts, and olive oil, which she had not thought about when attending to all the other foods high in salicylate.

She had a list of foods she wanted to gradually trial and we chose some low and high risk ones which she could use to clarify just what were necessary exclusions. First we introduced solids to Tessie as the foods tolerated in food sensitive babies and so Tessie was getting solids as well as breastfeeds using all the foods Sophie was eating.

They tested foods by Sophie eating them for three days to see if they had an effect via breast milk and then feeding them to Tessie as well for the next 4 days. Nashi fruit and banana were tolerated, and while capsicum seemed OK for the first three days Sophie had it but Tessie’s eczema got worse on the fourth day, so they stopped it. What was annoying then was the Tessie’s appetite went off as well and took 5 days to recover.

Sophie tested peanut in Andrea first, beginning with one speck of peanut paste increasing to one half of a peanut over a month, and maintaining the ½ peanut/day to maintain tolerance. She was happy with that and waited until Tessie was nine months to do the same for her. Meanwhile she tested dairy and wheat first gradually increasing one in her own diet and then testing it in Tessie. She used the information I had from other families as a dietitian on how to maximum tolerance in foods.

Tessie gradually tolerated wheat as home-made rusks, toasted preservative-free well cooked bread. By 12 months she had increased intake of dairy to include mild cheese and home-made ice cream, using just evaporated milk, pure cream sweetened with sugar. She still used soy as her main milk. Sophie decreased Andrea’s dairy intake by gradually incorporating more soy milk into her milk and she liked Tessie’s ice cream. Sophie says that she needs less asthma medication for Andrea now. Egg yolk is still being trialled beginning with eating only ¼ of a home-made biscuit of 24 made from a recipe with 2 cups of flour in it and the biscuits well cooked. Tessie’s eczema has remained well controlled apart from the flare-up after capsicum, and one drink of beer Sophie had on a very hot day.

Joan Breakey Dietitian www.FoodIntolerancePro.com

Yes, ear infections are among the many symptoms that may respond to dietary investigation.
Cows milk is often suspect. However just like other symptoms each child has their own cluster of sensitivities. They can include any of the suspect chemicals, and foods to which any family member is allergic, as well as infections, or inhalant allergens.
One problem that makes this sad is that often the children are food intolerant and therefore are reacting to the strong artificial flavour in the paediatric syrup that is needed once the child has an infection. [For every one part of colour in a lolly there are 10 parts of artificial
flavour, in a paediatric syrup the ratio is 1: 15!!] So we have a vicious cycle whereby the mother gives the child high salicylate or additives in food, and the child gets an ear ache which becomes infected. Then it needs antibiotics which come with a load of artificial flavours four times a day and the cycle goes on.
So if you have a baby who has symptoms that respond to diet in the first year and their tolerance seems to improve [i.e. the diarrhoea or eczema seem to be tolerant to introduced foods, but the child begins to get ear ache [ Those researching food intolerance at Royal Prince Alfred Hospital in Sydney would remind us that the target organ can and does change], then the diet that was necessary for the earlier symptoms needs to be used while ear aches are present. Each child has his or her own cluster of symptoms and own cluster of sensitivities. And they each have their own level of response to diet. Some respond usefully, some very usefully and some have symptoms clear completely.
Parents need to be assertive and ask for medicines without colour or flavour, and to reassure the doctor and pharmacist that you can manage to divide a white tablet or contents of a capsule so the baby does get the right dose of antibiotic and takes the full course of treatment. This is important I have met many mothers who often do not finish the course of coloured and flavoured antibiotics as the baby gets other symptoms such as greater irritability, and even more sleep problems, looseness or rashes.
I have included a page ‘Diet and chronic ear infections’ http://www.foodintolerancepro.com/chronic-ear-infections-diet-role/ on the web site, and you can read how to manage diet investigation in my book Are You Food Sensitive?
Joan Breakey Dietitian specialising in food intolerance 2013

When I remind food sensitive patients to reduce all toiletries containing perfumes as part of their diet investigation many mothers say “That is a problem as we need deodorants for our strong body odour!” So I found perfume-free deodorants. As well, some mothers comment on their children’s smelly poos or the strong urine odour.

What is happening?

It seems that food sensitive people are poor metabolisers of strong smelling compounds in their diet. This means that their body excretes them through the skin, in bad breath, and smelly poo or urine. The other problem that those with IBS comment on is foul smelling wind. Everybody passes lots of wind but where it smells bad it can be very distressing. What was amazing for me was the finding that once on their low chemical diet [minimising artificial flavours, high salicylates in any herbs, spices, tomato and acidic fruit, chocolate, sauces, and of course MSG],  they reported much lower body odours of any kind. People with IBS are very pleased when they have this particular improvement with diet investigation.

The other interesting idea is that food sensitive people are supersmellers so they notice all smells more. That means they are often more conscious of body smells than the general population is, so they may worry more about their body odour than they need to. Others near them may not even notice their body odour at all!

Where people have body odour of any kind that bothers them, or it occurs in their children they can use this as an additional reason for diet investigation using a diet low in additives and natural chemicals. It is wise to have the support of an accredited practising dietitian. You can see Are You Food Sensitive? for detail to help you can understand that you can solve this problem. See http://www.foodintolerancepro.com/food-sensitivity-advice/

Many people who have tyramine sensitivity are also sensitive to other amines, and many are also sensitive to other chemicals in food that are often reported as causing reactions [additives,and chemicals in highly flavoured foods]. In addition they are often sensitive to factors in the environment, particularly strong smells, and to factors changing in themselves. I call this the “Total Body Load” to emphasize that the greater the total body load the closer you are to your threshold, the more likely you are to react to any of the factors that you are sensitive to. Many women report that they are more sensitive in the week before their monthly so much so that foods they can eat just after their monthly they react badly to in the last week of the cycle. Each will still get their own particular physical symptoms, and they may have sleep disturbances, mood changes, like much worse pre-menstural tension [PMT], or fuzzy thinking.

There is an important part of this to think about. That is that if you change or use a different hormone treatment you may decrease your amount of reactivity. Another point to remember is that particular times when hormones change, such as pregnancy or during breastfeeding your liklihood of more symptoms may be much less or more. What can we learn from this? We can remember that when symptoms are less then the diet can be more liberal, and when symptoms are distressing then diet can be given more attention. These ideas are explained more fully with information on what to expect when you are reacting, and how to manage food so you improve your tolerance in Tolerating Troublesome Foods. See http://www.foodintolerancepro.com/tolerating-troublesome-foods/

You can see comments and free download of Chapter 1 as well as how to obtain the ebook for immediate download. Joan

Bad breath can be very distressing

I discovered bad breath, and how to reduce it, in a particular group of people, by accident.

As a dietitian I helped people who suspected they were having adverse reactions to food investigate their diet. They often suspected they, or their children, reacted to foods high in additives, rich food, chocolate, herbs and spices, acidic fruit, or monosodium glutamate [MSG]. Over time I realized that suspect foods were usually high in flavour. The symptoms they often had included eczema and other allergic conditions, migraine and headaches, irritable bowel syndrome [IBS], and attention deficit hyperactivity disorder [ADHD].

A symptom many commented on was bad breath. As I collected information about their reactions I often heard about their supersentivity to various smells. These included petrol products, cigarettes, strong perfumes, and foods they thought are “going off”.  Since they are more sensitive to smell it is no surprise that they notice smells and comment on them in their family members. What was surprising was that I, and other researchers, found that on the elimination diet used to investigate possible food intolerance, bad breath was a symptom reported as reduced along with the main presenting symptom.

After 20 years of learning about food sensitive people I read with interest an article The science of bad breath in the Scientific American April 2002 issue.  It considered research into what dentists and other scientists were finding. It discussed how sensitive some people with bad breath are to how others view them. It mentions that two compounds found in bad breath are putrescine and cadaverine. Fish odour syndrome was mentioned. It is due to the body’s inability to break down a chemical called an amine. One researcher reports that it is a lack of a sulphotransferase enzyme in the gut that allows amines to get into the bloodstream. Another reports that it is lack of a sulphotransferase in the kidney that prevents additive colours, flavours and natural salicylates [other suspect chemical groups] being broken down.

How did this apply to my patients?

They are the group who are likely to smell and be conscious of their breath smell as they are supersmellers. Because some people, usually only a few, often including relations, comment on their smell they think that everyone can smell their bad breath to the same degree. However it is likely that the supersmellers are only a small proportion of the community and so most people do not notice anything out of the ordinary.

Puterescine and cadaverine were of special interest to me. They are among the amines that are produced in food as it ages and goes “off”. The names say it all! Food sensitive people often want to throw out food in the refrigerator as they are sure it smells “off”, when their friends or relations say there is no bad smell. But, as supersmellers they can detect these smells much better than others can. What is more, while they are on their low chemical elimination diet, if they avoid smells that smell stale to them they can reduce production of adverse reactions.

How does this connect to the sulphotransferase enzyme problem? This was very interesting to me. I had been researching why food sensitive people react to additive colours, flavours, some preservatives, as well as another group similar shaped natural chemicals: salicylates, many more amines, and MSG. This work was frustrating! Those who worked in the area knew by gradual food testing just which foods were implicated in reactions. But why people reacted was not known.  I noted that one sulphotransferase enzyme was used to metabolise, or “detoxify” amines. This includes the offensive smelling ones, as well as the usually attractive smelling ones in chocolate, red wine, aged meats, cheeses, and dark sauces. What tied it together was the finding that another sulphotransferase was used to metabolise the suspect additives and salicylates. Just who is food sensitive and what other possible mechanisms are involved is still complex and controversial.

How does bad breath and diet connect?

A group of people with bad breath are among those who appear to be slow metabolisers of all the aromatic compounds that are suspect in food sensitive people. Sulphotransferase enzymes are reported to lower in those with bad breath. Food sensitive people who investigate diet report that where bad breath was among the initial symptoms, it resolved when they responded to dietary investigation. In food sensitive individuals there can be a connection between what goes into the gut and bad breath because excretion of some compounds via breath is one way the body can rid itself of aromatic compounds from the blood, after they have been absorbed from the gut.

The big picture is even more interesting. It would take a whole book to cover all the other connected issues, such as bad breath not being the only body odour reported a problem, individuals differing in what they react to, and foods differing in their likelihood of causing reactions. See my book Tolerating Troublesome Foods, for the detail.

Overall what can we say?

Those with bad breath should have medical and dental investigation to exclude any problems that can be solved there. As well consider that bad breath often occurs in people who are food sensitive. This group of people are often supersmellers so they are more sensitive about the smell of their breath. Where they also have any of the usual food sensitivity symptoms they can investigate their diet, preferably with the help of a dietitian experienced in the area, and using my books. Where the diet produces reduction in other symptoms they often very pleased to also report a reduction in their bad breath.

Joan Breakey  Dietitian/nutritionist specialising in food sensitivity.

www.foodintolerancepro.com

A tasty pudding without spices or sultanas; may be gluten-free to use at Christmas.

Ingredients

1 ½ cups of sago

2 1/4 cups milk – dairy, soy or rice milks

1 1/4 cups breadcrumbs (2 slices)

Soak these for at least 12 hours in fridge.

Add

2 eggs

3/4 cup sugar

1 1/4 cups finely diced tolerated dried fruit - dates, sundried pears, dried figs

1 tablesp melted butter

1 ½ teasp bicarbonate of soda

Mix all ingredients and put into two deep cooking bowls [ pyrex, stainless steel, or enamel ]

Cover each with greaseproof paper. One can be stored in refrigerator for a day or freeze.

Place covered bowl of mixture in a deep saucepan in 6 cm boiling water. Place a small plate over the paper to prevent steam entering under the paper.

Reduce heat and keep water simmering.

Steam for 3 hours. Remove from heat, stand for 5 minutes. Carefully remove plate and lift paper. Use a fork to lift centre of pudding to check if all sago is glassy.

If not, stir mixture carefully, cover and continue cooking another ½ hour.

Serve hot with white cornflour custard, cream or tolerated icecream.

Note - This recipe may be made wheat free by using wheat free breadcrumbs.

                                                                        Joan Breakey