Frequently Asked Questions

Diet questions

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Thanks to Sonia for these lovely and useful graphics that answer many common questions. Sonia runs a facebook page that is additive-free

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       MORE FAQS

 

What information do you have about yeast protocols along with Failsafe? My doctor has recommended a low to moderate salicylate diet and also a yeast protocol (where I would take many supplements).

Can you help me understand amines a bit better please?

Intimate question: can your partner *load * you with sals while making love (like from kisses or sperm?) when he is eating normal diet?

My friend has been telling me that nightshade vegetables such as potato can lead to leaky gut which might result in eczema..is this true?

How do salicylates work at the biochemical level?

I have seen posts about histamines and oxalates but have never read of these in regards to food. Are these linked to salicylates, are they in particular foods?

I have been told I have 'leaky gut syndrome' and that this supplement (containing seeds, green tea and dried fruit) will benefit me? Or is this term just bs?

We’ve been meaning to do a dairy challenge but there always seems to be a reason not to.

What about GAPS gut healing and other alternatives?

What is the mechanism behind food intolerance?

Why does my naturopath take me off wheat and dairy without any test and why does it work sometimes?

What about claims about fish oil and zinc supplements increasing tolerance for salicylates?

Do you have a position on things like the GAPS diet or biomed treatments? I have seen them discussed as options for 'healing' or 'fixing' intolerances.

Is it possible to combine a FODMAP diet with the RPAH Elimination Diet?

I tried a FODMAP elimination diet for a month but reacted to high salicylates: Should I do the full elimination diet?

I would like to do the challenges but would like more information.

We’ve been meaning to do a dairy challenge but there always seems to be a reason not to.

How do I reintroduce foods that cause intolerance reactions?

How do I make sense of confusing food intolerance symptoms?

How can I find an experienced dietitian?

What if my dietitian is not supportive?

What if there is no local experienced dietitian?

What if my doctor is ignorant?

What if my doctor is not supportive?

What if my adult son wants to restart failsafe?

How can I get the most current info on the salicylate and amine content in foods?

Is vinegar in bread failsafe?

Have you found that eliminating problem foods makes you more sensitive when you DO have them?

Do you think that eating a food a child/adult is intolerant to weakens their immune system, leaving them more prone to colds and the like?

How long does it generally take to notice improvements?

How long does it take to see positive effects?

Why no improvement after 3 weeks?

Do you have any suggestions for a fussy eater?

How will we know if we are reacting to amines or the milk solids in the chocolate?

Should we eliminate dairy foods?

Should I avoid gluten?

How can food affect the voice, make you deaf, fearless, and completely oppositional?

I’m worn out with saying “NO” to my kids.

Should I not eat Japanese food?

My husband’s boss has invited us to an Indian restaurant and we can’t refuse – any suggestions?

Could you please tell me what others do for Easter celebrations?

How does the Glycemic Index (GI) apply to failsafe foods?

I am worried that the failsafe diet contains too much sugar.

When my ADHD son eats kiwi fruit, his behaviour doesn’t change. Since kiwi fruit is very high in salicylates, does this mean he isn’t affected by salicylates?

I’d like to do the diet for my asthma but I’m not prepared to give up wine.

How does the bicarb antidote work?

How are parents supposed to know about allergies before it is too late?

I tried the Feingold diet and had not much luck with it.

Isn't the RPAH diet too hard for ordinary families?

My son has ADHD but we've never seen him react to any foods. Does this mean he's not affected?

How can I tell if my child might be affected by food?

The doctor says we will be wasting our time using diet for ADHD. Is this true?

Do amine/salicylate intolerances ever develop in adults?

Has any work been done on problems common in adults and how they are different to those of children?

Is it possible to test for salicylate intolerance by taking aspirin?

Where can I get a book containing the amount of salicylates in food?

Is this plan for going failsafe OK?

Can you suggest what foods I should be giving my 4 ½ baby?

Are we making a mistake?

How much vanilla is too much?

I am wondering if there is a list of what preservatives are the best to avoid?

I would like to lose a bit of weight.

My son refuses to have any vegetables.

We'd like to break the diet occasionally but not too much. Can you recommend some not-too-bad treats?

Help. Where do I start?

We have just done the amine challenge with our children. My three-year-old daughter reacted but my son actually improved. How can this be?

How am I going to do the amine challenge? I'm sure my kids won't eat dark chocolate.

My 5 yo son has been invited to a birthday party at Macdonalds. What do you recommend?

I am curious as to what kind of behaviour a 2 1/2-year-old child might exhibit due to an intolerance to some foods?

I find it difficult when we are out somewhere and the kids start the "I'm hungry, Mum" whine! What can they have if we are at the movies or out shopping for instance?

I have observed that small amounts of salicylates seem to disrupt my child's ability to regulate his blood sugar. Is this possible?

Can this diet not work?

Do you think that everyone should try this diet?

I have been wondering since reading your book if my son may have always been intolerant to foods, even my breastmilk?

Perhaps you avoid even the smallest traces of pineapple?

My problem now is to try and cook meals which are rice & wheat free.

 

Q: What information do you have about yeast protocols along with Failsafe? My doctor has recommended a low to moderate salicylate diet and also a yeast protocol (where I would take many supplements).

A: The diet we support is the RPAH Elimination Diet from the Royal Prince Alfred Hospital Allergy Unit in Sydney (we call it failsafe for short).  Yeast - other than the naturally occurring free glutamates (MSG) in brewers’ yeast, nutritional yeast and yeast extracts - is not considered to be a problem by people on the RPAH diet, see the following reader success stories:

Three years ago, my son had such terrible candida you could smell the yeast on his breath and his skin. We learned to avoid yeast, almost as a reflex. It's a habit that's hard to unlearn. But unlearn it we must, because yeast free breads are dangerous if you react to amines, and my son reacts to amines ... My son is happy to be back on wheat and dairy again, as you might imagine. There's even a commercial pizza he can have, Hungry Howies (may not be available in Australia), original crust, cheese, ground beef. The cheese is pure 100% mozzarella, and he can have that once in a while. And now, probably because he is failsafe, yeast doesn't bother my son at all. No sign of candida. So we are back on yeast. - Karl from story [154]

After ten years of trying different diets - candida, vegetarian, allergy testing, you name it - I tried your diet after buying your book and the results were amazing. Convinced I was a chronic fatigue sufferer, I used to take more and more vitamins and health foods, only to find I was sicker and sicker. But now, for the first time in 31 years, I feel normal. I have energy and have lost my coated tongue, mouth ulcers, acne and negative attitude. I am actually a nice person! I can't believe how even tempered and smiley I am when I stick to this diet ...  from story [148]

See more in factsheet on candida, yeast, sugar and hypoglycemia

     Q: Can you help me understand amines a bit better please?

A: "Amines" is a general term to cover a very wide range of chemicals, all of which have the NH2 amine group. In the food intolerance context, we focus on them because they cause a pharmacological response. We call them ‘biogenic amines’ because they are produced or brought about by living organisms.

Some well-known hormones are amines, like adrenaline and brain chemicals serotonin and dopamine, so it is no wonder amines in foods can cause reactions.

Amines are found naturally in some fruits (eg in avocado, berries, citrus, grapes) and vegetables (eg eggplant, olives, mushrooms, spinach) and many more including low-salicylate fruits  bananas and papaya. But most of the ones we react to in food are bacterial fermentation breakdown products of longer proteins. They can be any length from one amino acid to many amino acids. For instance in fish that is starting to be not fresh, you can measure the steady increase of about a dozen amines, the main ones being trimethylamine and dimethylamine. There are many others, including tyramine and tryptamine (eg in cheeses), histamine (eg in cheeses and wine) and phenylethylamine (eg in chocolate).

Very few foods have been tested systematically for amine content because the way they are produced means that the amine content of foods is highly variable and very hard to quantify. One batch of yoghurt might be low in amines, the next high. If you react to amines you need to be careful.

There are no home remedies for an amine reaction – the only way is to learn your limits and avoid or limit foods to which you react. Amines, like other food chemicals, are cumulative. That is, if you eat some yoghurt for breakfast, a banana for lunch and then have some chocolate for dessert, you may develop a nasty headache and blame the chocolate, but it was the total load of amines that tipped you over the edge.

      Q: Intimate question: can your partner *load * you with sals while making love (like from kisses or sperm?) when he is eating normal diet?

Answers from facebook group:

A similar question was asked re: gluten in Coeliac group... Most coeliacs insist their nearest and dearest wash their mouth out and/or clean their teeth before kissing due to potential cross contamination from food eaten BUT apparently NO gluten in sperm!???.. Anne

I would think so with sloppy kisses. Make sure partners wipe their mouths first because I have heard of a reaction this way!  - Tom

Significant Others of persons with anaphylaxis have to avoid the same foods due to risk of transferring it when kissing. With household it can be a cross contamination issue, thus why some families will all go (on the whole) gluten free. But the main worry is with the severe food allergies - Betty

Someone commented before they had noticed problems 'down there' depending on what her husband had been eating.  Given that it's also commonly stated that taste of semen is affected by diet, it makes sense that it could be possible.... - Charlotte
I definitely think it's possible. My husband does not restrict his intake and I'm very food sensitive. It's not pleasant - Denise

Research with aspirin (measures concentration of salicylates etc in semen at time intervals...) http://www.ncbi.nlm.nih.gov/m/pubmed/3680588/ - Jessie

       Q: My friend has been telling me that nightshade vegetables such as potato can lead to leaky gut which might result in eczema..is this true?

A: Of the Nightshade (Solanaceae) family, only white potatoes well peeled are regarded as failsafe. All the other members (eg tomatoes, eggplant, Goji berries, tobacco and peppers of various kinds (bell peppers, chili peppers, paprika, tamales, tomatillos, pimentos, cayenne)) are not failsafe because they are high in salicylates or other food chemicals - note that salicylates are used as markers for a range of chemicals to which people react.

Everyone is different. Generalisations like "nightshades cause eczema" are not useful. There really is no substitute for doing a thorough and systematic Royal Prince Alfred Hospital Elimination Diet and challenges, preferably with an experienced and supportive (both!) dietitian.

Do it once and do it properly and then you will know for sure what affects you is my motto and then you can eat failsafe or explore other avenues from then on with confidence.

       Q: How do salicylates work at the biochemical level?

A: We are often asked this question. This reference talks about it, including why fatigue and hypoglycemia are typical symptoms. The paper is about overdose and emergencies, but also shows why taking an alkali like soda bicarb works. Intriguing for those interested: http://www.crispedia.com/case-study-in-pediatric-emergency-medicine-two-and-one-half-year-old-male-with-vomiting-and-lethargy/

See more references in the Salicylates factsheet

       Q: I have seen posts about histamines and oxalates but have never read of these in regards to food. Are these linked to salicylates, are they in particular foods?

A:
Foods containing histamine are included in the list of amine foods which are avoided by sensitive failsafers. Histamine is one of many different types of amine.  Histamine liberators, however, are different group of chemicals entirely, with lists often causing concern to failsafers because they sound like amine foods to be avoided but aren't.

Oxalates are ‘natural pesticides’ like salicylates and found in many plants, including root vegetables, stems, leaves, nuts and fruit. A search of Pubmed does not return any science on oxalate sensitivity or intolerance. People who report improvement on adopting a low-oxalate diet are also reducing salicylates and in fact eat many of the foods that failsafers eat.

Foods contain a lot of natural chemicals, but RPAH has identified salicylates, biogenic amines and glutamates as the most likely to cause problems. These are therefore the focus of failsafe. If you decide to pursue alternatives we would prefer not to hear from you through the failsafe groups where our focus is on encouraging failsafers. However, we would be interested to receive an email about your experiences after six months and 12 months so that we can add to our bank of knowledge.

       Q: I have been told I have 'leaky gut syndrome' and that this supplement (containing seeds, green tea and dried fruit) will benefit me? Or is this term just bs?

A:
The supplement offered would NOT be failsafe due to the high salicylate ingredients you have identified.  The diagnosis of 'leaky gut' is conceptually appealing and there are now 100 references in PubMed. However most references are speculative (check them out http://www.ncbi.nlm.nih.gov/pubmed/?term=%22leaky+gut%22 ) and there is limited evidence that such a diagnosis leads directly to a cure. There are, in my view, a lot of people enthused with this concept without evidence. Here is my test: if the person who diagnosed it wants to sell you something, a supplement or more tests, be suspicious and ask for scientific evidence.

Probiotics can be useful but can also have high levels of amines - http://fedup.com.au/factsheets/additive-and-natural-chemical-factsheets/probiotics. See also http://fedup.com.au/information/frequently-asked-questions/diet-questions#GAPS

Failsafe is based on science, not profiteering (thanks Stephanie)

       Q. We’ve been meaning to do a dairy challenge but there always seems to be a reason not to.

A.
From the beginning of January right through to March can be a good time because the Christmas and pre Christmas party season is over. Challenges can be more difficult than most people expect. It is important to get them right or you can end up with an inconclusive result. You need to stick to the RPAH recommendations (e.g. 1-3 glasses of milk per day for at least 7 days for the dairy food challenge). Your dietitian can give you a list of challenges; also see the Challenges hints factsheet and the amine and salicylate challenge recipes in the Failsafe Cookbook. Email This email address is being protected from spambots. You need JavaScript enabled to view it. for recent updates to challenges.

       Q: What about GAPS gut healing and other alternatives?

A: While some people have reported success and even cures with the GAPS diet or various biomed approaches, there is often limited scientific evidence, unlike Sydney's Royal Prince Alfred Hospital Allergy Unit, whose work we recommend.

Many alternative approaches appear to work because they exclude so many foods. The trouble is that you may also be excluding some foods that you can in fact tolerate (false negatives), and still taking some foods that you can't tolerate (false positives). People who try this approach often say they can tolerate more than they expect initially, but it is very difficult for an individual to measure symptoms that change by small amounts on a daily basis - this can be because symptoms are changing - eg going from restlessness to loud and annoying - or because the changes build up slowly.

We often see that when people say "failsafe isn't working" and send details of what they are doing, we can generally find at least five mistakes - enough to alter to outcome of the diet.

In our experience, people are typically enthusiastic about any new regime at first, then after six months they may be less certain or realise that they are back where they started, perhaps with a different set of symptoms but certainly not performing as well as they are able. They then either abandon diet completely, accepting the limitations but claiming that the treatment worked, or revert to lower levels of the chemicals that affect them and resume a science-based diet. The second course is more difficult because it means admitting that all the cost and effort of testing was wasted.

The scientific way to determine food intolerances is to use an elimination diet. In our experience, the RPAH elimination diet is the most effective. It is best when the diet, challenges and reintroduction are done under the supervision of an experienced dietitian and this is what we recommend.

If you decide to pursue alternatives we would prefer not to hear from you through the failsafe groups where our focus is on encouraging failsafers. However, we would be interested to receive an email about your experiences after six months and 12 months so that we can add to our bank of knowledge.

       Q: What is the mechanism behind food intolerance? (question from the Adelaide presentation at the 2013 Roadshow)

A:
Food intolerance is thought to be due to enzyme deficiencies or reduced enzyme activity (not the same as digestive enzymes you can buy in pharmacies). These can be inherited or acquired, either temporarily through taking drugs, or possibly long term through in utero exposure to environmental chemicals.

It is well known that people who are sensitive to amines have a deficiency of the monoamine oxidase (MAO) enzymes, especially MAO-A.  In people who are taking drugs known as MAOIs (monoamine oxidase inhibitors), this enzyme is inhibited and a build up of tyramine can occur, leading to life-threatening high blood pressure as well as the usual range of food intolerance symptoms including headaches, itchy skin rashes, heart palpitations and diarrhoea.  There is a rare condition in which people who are born without the MAOA gene lack the MAO enzyme altogether and researchers have long known that this condition is associated with aggression in men. Much more common is a low activity variant that seems to occur in about one third of the population.

Similarly, there is an inherited life-threating condition called propionic acidemia in which babies lack or have a low activity of the enzyme propionyl-CoA carboxylase. These people are unable to metabolise propionic acid (the same as the bread preservative) which builds up in the bloodstream and can cause damage the brain, heart, and liver, cause seizures, and delays to normal development like walking and talking. It seems that children and adults who react badly to a build up of the bread preservative calcium propionate (E282) may have a lower activity of this enzyme. http://en.wikipedia.org/wiki/Propionic_acidemia

Salicylate intolerance is due to a deficiency of the two cyclooxgenase enzymes called COX-1 and COX-2 for short. The effects of salicylates in food from plants or in salicylate-based painkillers such as aspirin and ibuprofen (called COX inhibitors) are essentially the same. They can both cause intolerance symptoms such as gastrointestinal, respiratory or behavioural symptoms by blocking the enzyme function. For more details see Baenker H, Salicylate Intolerance, 2008 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2696737/

There is growing concern about pesticides that work by targeting enzymes in pests that may be identical or very similar to enzymes in human beings. Experts now think these may be contributing the Western epidemic of behavioural and learning disorders, because children are particularly vulnerable while in utero or very young. WHO, Pesticides http://www.who.int/ceh/capacity/Pesticides.pdf

More information in factsheets about amines, propionates and salicylates and about managing salicylates

       Q: Why does my naturopath take me off wheat and dairy without any test and why does it work sometimes?

A: Most naturopaths automatically take people off wheat and dairy, even though the science says that these are the food items least likely to be causing the problems (although if they really are a problem they need to be taken seriously).This change does remove many additives, so people may see an effect even though it was neither the wheat nor the dairy that was the problem.

There really is no substitute for doing a thorough and systematic Royal Prince Alfred Hospital Elimination Diet and challenges, preferably with an experienced and supportive (both!) dietitian. Do it once and do it properly and then you will know for sure what affects you is my motto and then you can eat failsafe or explore other avenues from then on with confidence.

       Q. What about claims about fish oil and zinc supplements increasing tolerance for salicylates?

A. Zinc supplements are NOT part of the RPAH elimination diet, but a few failsafers say they may help with acne and some dietitians recommend them as long as you can find a zinc supplement that contains ONLY failsafe ingredients, see http://fedup.com.au/factsheets/support-factsheets/supplements-a-vitamins#zinc. Be careful because megadoses of zinc to treat acne have been associated with anaemia and neutropenia (low white blood cells).

Fish oils are NOT part of the strict RPAH elimination diet. The RPAH approved omega supplement is flax oil in limited quantities due to small amounts of salicylates and amines. We have not received any reports about fish oil increasing tolerance for salicylates. In the medical literature, there is one small report of 3 people with asthma/hives improving on fish oil supplements (not increasing tolerance – their symptoms returned as soon as they stopped taking the supplements http://www.ncbi.nlm.nih.gov/pubmed/18795922). It is also true that some parents report fish oil-related improvements in children with behaviour or learning problems – but in our experience, when they do the diet (which means dropping the supplements), they do even better. People who pass their amine challenge can try fish oils as long as they don't contain non-failsafe ingredients such as lemon flavouring. Regarding any label claims about no salicylates or amines, you may want to read more about fish oils in Dr Ben Goldacre's book "Bad Science" especially about marketing techniques and law suits by fish oil manufacturers. See failsafer reports about adverse reactions to fish oils, and more info about how to eat a good omega ratio through food http://fedup.com.au/factsheets/support-factsheets/supplements-a-vitamins#fishoil

 

       Q. Do you have a position on things like the GAPS diet or biomed treatments? I have seen them discussed as options for 'healing' or 'fixing' intolerances. What is your opinion on them?

A. Our website and groups are dedicated to supporting the RPAH elimination diet because we have found it to be the most effective elimination diet in the world. However, for best results, the diet has to be nearly 100% perfect – and that means ignoring other diets and non-failsafe supplements. We do prefer committed failsafers or newbies not to be distracted by frequent discussion of other diets. We have not yet heard from readers about anything that actually 'heals' or 'fixes' intolerances in the long term other than treatment of longstanding infections – in one case a hysterectomy and in another case removal of wisdom teeth. If people want to try GAPS or other diets and treatments, please do it and discuss it elsewhere and get back to us with some feedback after 12 months. In our experience, people are enthusiastic about something new but a year later it is often a different story, e.g. this report from one failsafer: "... was a total waste of time and money. Unbelievable that it is funded by health funds. Wish I could get my money back."

Biomed treatments – based on what readers have told us, these can be expensive, time-consuming and in the long term not effective for curing intolerances, except possibly for trying a range of probiotics especially S boulardii: http://fedup.com.au/factsheets/additive-and-natural-chemical-factsheets/probiotics

Q. Is it possible to combine a FODMAP diet with the RPAH Elimination Diet?

 

A. It is much easier to get best results by sticking strictly to the RPAH Elimination Diet. Breath hydrogen testing is of no value for food intolerances and not very useful anyway because about 50% of people test positive. If your only symptoms are IBS (bloating, reflux, abdominal discomfort, wind and diarrhea) your dietitian may recommend a trial of the FODMAPS diet but if there are any other food intolerance symptoms – e.g. behaviour, rashes, migraines, sleep disturbance, asthma, then it is best to do the 3 week strict RPAH Elimination diet, perhaps with gluten and dairy free options - and no mistakes. If clues indicate possible problems with both, some people do a combined low chemical and low FODMAP diet, however a dietitian who specializes in IBS tells us that she has most frequently found food chemicals to be the main issue, and the RPAH diet is the one she uses most frequently. See story [993] and Fructose malabsorption factsheet.Note that FODMAP is an acronym for Fermentable Oligo-, Di- and Mono-saccharides and Polyols—was coined to describe a previously-unrelated group of short-chain carbohydrates and sugar alcohols (polyols). The list of sugars includes fructose, lactose, fructo- and galacto-oligosaccharides (fructans, and galactans), and polyols (such as sorbitol, mannitol, xylitol and maltitol).

       Q: I have been suffering from various IBS-like symptoms for several years and have finally decided to do something about it. A couple of months ago I went to see a dietitian and following her advice tried a FODMAP elimination diet for a month. Although there was improvement in some areas there was a decline in others. I became VERY forgetful and suffered stomach cramps when eating what turned out to be foods high in salicylates. Should I do the full salicylates elimination diet and get myself better? - Sharon

A: Yes. See a previous answer http://fedup.com.au/information/frequently-asked-questions/diet-questions#fodmap

 

Challenges

       Q. I would like to do the challenges but would like more information.

A. Challenges can be more difficult than most people expect. It is important to get them right or you can end up with an inconclusive result. You need to stick to the RPAH recommendations (e.g. 1-3 glasses of milk per day for at least 7 days for the dairy food challenge). Your dietitian can give you a list of challenges; also see the Challenges hints factsheet on our website and the amine and salicylate challenge recipes in the cookbook. However, there have been some recent updates to the salicylates challenge. You can ask for our challenge update information (This email address is being protected from spambots. You need JavaScript enabled to view it.).

       Q. We’ve been meaning to do a dairy challenge but there always seems to be a reason not to.

A. From the beginning of January right through to March can be a good time because the Christmas and pre Christmas party season is over.

Mistakes, introducing foods

       Q. How do I reintroduce foods that cause intolerance reactions? I went through the RPAH elimination diet about 3 years ago. The dietician confirmed I was intolerant to dairy, wheat, salicylates, amines and glutamates. Despite following a strict regime I have not been able to reintroduce any of the foods that caused an intolerance reaction.

A. Most people who write that they are “following a strict regime” are in fact making mistakes and the writer of this enquiry was no exception. After receiving our salicylate and amine mistake information sheets, she cleaned up her diet, suffered from withdrawal symptoms – which indicates that there had been a problem – and is now feeling much better, see story [1005] You can request information sheets from This email address is being protected from spambots. You need JavaScript enabled to view it..

Suitable foods

       Q. What can I eat for a quick supermarket snack? I’m failsafe, gluten free and dairy free – when I get stuck without food, what can I buy as a quick healthy snack?

A. Thanks to Leah who says: ‘as I’m very sensitive to sals and amines, and intolerant to soy, my favourite (and only) supermarket snack is Sunrice ricecake thins. Make sure you buy a bottle of water too coz they are a bit dry. I would have gone hungry many times without these’. There are 39 calories in a thick Sunrice ricecake (ingredients: wholegrain rice, and that’s all). If you haven’t tasted them dry, they are surprisingly good. Some other suggestions: a popper of So Good Soymilk Lite contains about 100 calories, similar to 10 raw cashews, 1 container Heinz babyfoods Pureed Fruity Pear, 15 Red Rock Deli Sea Salt potato chips or a medium size pear if you can find one that’s ripe.

       Q. How do I make sense of confusing food intolerance symptoms? I have a 13-month-old who appears to be intolerant to dairy, soy and legumes for certain, and I am questioning eggs and fish. I am also not sure if my drinking wine or coffee affects him. His symptoms were prolific vomiting (which has resolved now) and inconsolable night times where he can cry for over an hour at a time several times a night. He has been known to sleep through the night with one wake for a feed, but then he and I can eat the identical food the next day and have a shocking night ...

A. This email shows just how confusing food intolerance symptoms can be and why the RPAH elimination diet is the easiest approach. This mother was reluctant but when she finally tried the elimination diet, her son was sleeping through the night (4 nights in a row) by the end of the third week.

Dietitians and doctors

       Q. How can I find an experienced dietitian? I tried phoning a dietitian but she told me she didn't really like to do elimination diets. I was wondering what to do next?

A. Email for our list of experienced, supportive dietitians who have been recommended by other failsafers (email This email address is being protected from spambots. You need JavaScript enabled to view it.)

       Q. What if my dietitian is not supportive? Yesterday I went to a new dietitian ... I became frustrated yet again as these professionals just don't seem to be passionate about what they do. It is as if I have to justify my son’s behaviour. The first thing she said was ‘do you know what to expect for a 4 year old boy?’ I am sick of having to justify myself, being on the elimination diet has changed our whole family life for the better. Why is it that even the professionals come across as not being fully aware of how food affects behaviour? I usually end up feeling let down, confused and disappointed (AND similarly: ‘I saw a dietician but she seemed quite vague about it and I got a lot more information from your site than she gave me anyway’)

A. There are some extremely supportive dietitians who have many experience supervising the RPAH elimination diet, and then there are the others. You can ask for our list of dietitians who have been recommended by other failsafers (email This email address is being protected from spambots. You need JavaScript enabled to view it.) - it is probably worth travelling to see a good one. We welcome feedback about dietitians, both supportive and non-supportive, as this can help others.

       Q. What if there is no local experienced dietitian? My 5yr-old daughter has been diagnosed with severe food intolerances and a moderate allergy to soy. I do not have the finances to use a private dietician. I went to the public hospital yesterday with no positive outcomes – they can’t offer the service of their dietician as they are understaffed and are not taking outpatient appointments – and I was told to go home and try the elimination diet again. This is hard work on your own. I need some support. – by email

A. I recommended the Failsafe booklet and our email support groups to this mother. A week later, she replied “Thank God for the Failsafe booklet. I am now managing to keep the whole family on the elimination diet due to the extra recipes”. She had also joined an email support group.

       Q. What if my doctor is ignorant? My nearly two-year-old is the most boisterous boy I have met, and to be honest I am feeling beaten down. I cannot remember the last time he slept all night. He is a handful from the moment he wakes up, and that never stops. We don't eat a lot of junk food, but after looking at your website I am identifying a lot of my family’s behaviour with intolerances. I feel I need to start cutting out certain things from his diet but after talking to my doctor I came away deflated. She told me that it is very rare that people have allergies to salicylates and that it would be an expensive, long and hard path to go down when it probably wasn't the answer. *sigh* Instead she recommended some sort of controlled crying.

A. Some doctors may not understand dietary salicylates because the information is quite new. The elimination diet is:

  • not expensive - one mother wrote: ‘my shopping bill has gone down by about $100 per week with no junk or frozen convenience food anymore’
  • not long – you only have to try it for three weeks
  • not hard – most mothers say it is easier than living with a difficult child
  • is probably the answer. Your doctor is partly right – it is very rare that people have “allergies” to salicylates – however intolerances to salicylates are very common. Royal Prince Alfred Hospital allergy clinic research shows that about 75 per cent of boisterous children are salicylate-sensitive.

Follow up: One week later – after cutting down on fruit and high salicylate vegetables - this mother wrote to say her son had slept through the night: ‘could this be a glimmer of hope?’

       Q. What if my doctor is not supportive? My 4.5 year old son has been eating failsafe for 5 months with amazing results. I have read all your books, belong to your discussion groups and have done the PPP program. Thanks to you and only you, when failsafe he is a loving and compliant angel with a dry nose and no physical problems. When he is not failsafe he is aggressive, defiant, never satisfied, loses his temper, discipline is ineffective and he has difficulty falling asleep, along with continual runny nose, recurrent ear infections, bright red ears, sore tummy etc. Our doctor said that so long as I kept my son failsafe, I would keep his behaviour at bay but suggested I would not be able to do this forever (tiring, time consuming, school canteen etc), and because of that, he would probably be diagnosed with ADHD in the long run, where other strategies would be looked at - I'm presuming medication. I would love to hear your opinion.

A. I am now receiving emails from a whole new generation – failsafe students in their late teens or twenties who choose to stick to their diets because they are healthier, happier or can concentrate on their studies (see stories [023] and [1019], so it can be done. Only a few years ago most doctors said diet didn't work, so it is a big step forward to find a doctor admitting that diet is effective. The next step is for doctors and schools to actually support mothers by minimising the use of nasty food additives and supporting failsafe food for those who need it. The more we spread the word, the sooner it will happen.

       Q. What if my adult son wants to restart failsafe? My son (now 22) ate very limited salicylates for much of his younger childhood. It made a dramatic difference to his personality and behaviour. He now wants to eliminate them again to see if it helps him to focus, become more organised, and gain a bit of self-control to assist him in his uni studies.

A. We have heard from many failsafe parents that their grown up children have good motivation and do well on the diet at university. One 18 year old student wrote ‘...the diet has been immeasurably useful. I can now think better, clearer, and I can reason logically where before an idea would just revolve around in my head … Thanks to the diet, I am going to try again to pass Year 12 next year, so I can go to university. It's quite interesting to trace the time in my life when I started doing badly in school. It was the exact time that I moved to the city, started eating more junk food like meat pies, ham etc. I continued to do worse and worse in school until I dropped out of Year 13 last semester. Now, I can be confident of having my old powerhouse brain back again’ - from story [1019].

Information

       Q. How can I get the most current info on the salicylate and amine content in foods?

A. The RPAH Elimination Diet Handbook with food and shopping guide (2009) is available from your dietitian or from www.allergy.net.au If using the older lists, you can request our updated Salicylate and Amine Mistakes information sheets (This email address is being protected from spambots. You need JavaScript enabled to view it.)

       Q. Is vinegar in bread failsafe? My 2 yo son is highly sensitive to salicylates. We find that he is having a very strong salicylate type reaction whenever he eats bread. He can only have 2 slices a day or he goes ballistic. Would this be due to yeast or vinegar?? The bread is 282 free. He has also reacted to pitta bread.

A. Vinegar is definitely NOT OK for salicylate responders - all white vinegars are very high in salicylates and that is what they use in bread (I've checked). I am surprised he can manage 2 slices per day. That’s why we recommend certain breads, see Shopping List

       Q. Have you found that eliminating problem foods makes you more sensitive when you DO have them?

A. It is true that failsafers sometimes notice a big reaction when they break the diet but you have to remember that previously there was less of a contrast between good and bad. You can choose to go back to the old diet but you will have to put up with the old symptoms again. The best time to break the diet is on holidays when there is less stress. If concerned about reintroduction of foods, see an experienced dietitian (ask for our list of supportive dietitians: This email address is being protected from spambots. You need JavaScript enabled to view it.) and ask for our Reintroduction information sheet (This email address is being protected from spambots. You need JavaScript enabled to view it.).

Immune system – benefits of diet

       Q. Do you think that eating a food a child/adult is intolerant to weakens their immune system, leaving them more prone to colds and the like? I've noticed this pattern in my kids and myself, but when I ask Paediatricians and GPs they dismiss it, saying it could have been coincidental and that there's no evidence to prove this.

A. It is common for failsafers to report that they no longer suffer frequent colds, flu and other recurrent infections once they are established on failsafe eating (e.g. see stories [874] and [848]) - and yes, there is scientific evidence. Studies have shown that certain artificial colours and preservatives act as immunosuppressants, that is, they can actually suppress the immune system, making us more likely to suffer from recurrent infections. This has been shown in the laboratory by Greek researchers with artificial colours tartrazine (102) and amaranth (123) using small doses normally considered to be nontoxic, and by Brazilian researchers with propionic acid which is part of the group that includes bread preservative 282. As well, a US study with beagle dogs showed they were more susceptible to fatal viruses when fed indigotine (132). Failsafers who are salicylate-sensitive know that although we are constantly told to eat fruit to build up our immunity, for us, it works the opposite way. We are better off eating failsafe vegetables such as cabbage as described in the Myths of Fruit: http://www.guardian.co.uk/lifeandstyle/2008/jan/23/foodanddrink.healthandwellbeing.

  • Koutsogeorgopoulou L and others Immunological aspects of the common food colorants, amaranth and tartrazine.Vet Hum Toxicol. 1998;40(1):1-4.
  • Wajner M and others Inhibition of mitogen-activated proliferation of human peripheral lymphocytes in vitro by propionic acid.Clin Sci (Lond). 1999;96(1):99-103.
  • Hansen WH and others Chronic toxicity of two food colors, brilliant blue FCF and indigotine, Toxicol Appl Pharmacol. 1966;8(1):29-36.

Withdrawal symptoms and how long does it take to notice improvements?

       Q. How long does it generally take to notice improvements? I have a 9-year-old son with autism who has been on a gluten- and casein-free diet for 7 years, which has helped his behaviour and digestive problems immensely. We have noticed/wondered over the years whether certain foods, including eggs, citrus, tomatoes, and others cause him problems. We have not done a systematic removal of any other category of foods from his diet besides gluten and casein, mostly because he was doing fairly well and we couldn't bear to limit his diet any further--he enjoys foods and is not a picky eater. Lately, however, he has had problems with wetting his pants and more difficulty keeping up in school. I would like to try reducing his intake of salicylates to see if this helps him. If we reduce but not completely eliminate these foods, should we see an improvement, or is a complete elimination necessary?

A. Regarding reduced salicylates, one mother wrote: 'I cut back my five year old daughter's intake of fruit to about a quarter of what she normally had. Within days we saw dramatic changes. Her behaviour evened out - she was more sensible and obliging, less aggressive and defiant - and altogether much more pleasant to live with.' As a result of seeing such positive changes she then went ahead and did the full elimination diet and was very pleased she did. It is a difficult decision: while socially the diet is awkward, children are then able to be themselves and reach their full potential rather than be held back by something they are eating. For more information, ask for our Salicylate Mistakes information sheet (This email address is being protected from spambots. You need JavaScript enabled to view it.)

       Q. How long does it take to see positive effects? We're on day seven of our elimination diet for my six-year-old daughter, and every day since we've been on this new diet she's gotten a little worse - more insolent, less able to keep still than normal, much MORE day-dreamy and going off on tangent-ish, slightly 'violent' - absolutely driving me crazy!

A. These turned out to be withdrawal symptoms, and the answer was, it took 8 days to see positive effects.

       Q. Why no improvement after 3 weeks? I have just started my son on the elimination diet, he is in the 3rd week and we have slowly seen some improvement.

A. Although some people see improvements by the end of the second week, most families go through the second week blahs, think they may be seeing a few small improvements at the beginning of the third week and by the end of the 3rd week have often seen spectacular improvement if they have the diet right. Have you read the Checklist of Common Mistakes on the website? You are welcome to send me a list of everything your son eats in a typical day so I can look for possible mistakes. I can usually find about five mistakes - some serious enough to prevent improvement - in food lists from people who swear they are sticking strictly to the diet.

Limited foods, fussy eaters

       Q. Do you have any suggestions for a fussy eater? I am finding it hard to come up with enough variety of foods for my son as he is very fussy and this seems to limit what sort of foods he can eat.

A. Fussy eaters usually improve when you get the diet right. One mother whose two young daughters had previously been picky described how they turned into 'clean plate' eaters after three weeks on the diet. For suggestions regarding a variety of foods I recommend the Failsafe Cookbook. One mother whose son was lunch swapping wrote: 'I bought your cookbook, so now he is getting enough interesting things and variety that he feels he is not missing out!'

Dairy free

       Q. How will we know if we are reacting to amines or the milk solids in the chocolate? We are off dairy I thought we would have to do an amine challenge without chocolate.

A. You can buy dairy-free chocolate (read labels, e.g. Sweet William www.sweetwilliam.com.au, contains soy flour and soy lecithin).

Dairy and gluten free

       Q. Should we eliminate dairy foods? We are at the end of week 2 of the elimination diet and my 7 year old daughter’s tantrums, defiance, hyperactivity and anxiety are as bad as ever.

A. The rule of thumb from RPAH is that if symptoms are severe, avoid dairy foods and gluten on your elimination diet. In an ideal world everyone would do that right from the start because it is quicker, but I know many parents find it too daunting at first. About 25% of children with behaviour problems react to dairy, so at this stage it is probably worth taking out (warning: reactions to dairy can be the slowest of all to improve and to build up during challenge - one boy took 4 clear weeks to recover completely from dairy although that is unusual). See two reader stories below about behavioural effects of dairy foods.

• There is no doubt at all in my mind about the great effect that foods have on my children although it has taken me about 3 years to accept it. But I still can not get my head around why dairy foods cause such a behavioural response with my daughter. When eating dairy foods, she gets dark rings around her eyes, and is not just bad, she is impossible to live with. I just can not understand how a food can affect her in this way. Her oppositional defiance is incredible. It is also as if she is completely deaf. Her voice becomes so loud it makes me cringe and it also becomes a lot higher in pitch. She is not affectionate at all and is very serious as well. It is as if she has complete focus, driven, locked in, intense, not able to snap out of her bad behaviour. It is only now (she is 5 1/2 years of age) that I am starting to bond with my daughter in a calm and loving way, before this it has been a desperate, lost love. Since she has been dairy-free she listens, talks more quietly and without intensity, she lets me cuddle her, she does not get locked into bad behaviour and we can negotiate together. She has always been strong willed and very smart but now I can enjoy it. I am so happy now. I guess if there was a logical explanation for this huge behavioural response I would stop questioning my judgement so much. Because it is just behavioural, you can tell our peer group think it is our parenting and they also question the failsafe food idea as a bit odd. I find it hard to believe how much a food can affect the voice, make you deaf, fearless, and completely oppositional.

• When I started the diet (for severe ADHD) I was looking for foods to replace the many I had taken out and as a result ate plenty of failsafe ice cream, and failsafe cream cheese, though I didn’t touch milk. Many behaviours improved, but many did not and it wasn't long before we suspected the dairy. I stopped the dairy and the results were clear that I was intolerant to it. I was now on total elimination diet plus dairy. I discovered my reaction to dairy had been very strong. Without dairy I didn't seem to react to other foods as strongly, and I could tolerate a little of this and a little of that.

 

       Q. Should I avoid gluten? I find that the scariest of all because I don't really understand what gluten is or how to avoid it.

 

A Gluten is commonly associated with gut reactions (about 20% of people with irritable bowel are affected) but fewer than 1% of children are affected behaviourally by gluten. However, because gluten is eaten so frequently, if people are affected by gluten, it is very serious. It is best for people with severe symptoms to avoid gluten during their elimination diet, if not from the start of week 1 - which can be too daunting - from the start of week 3 is good. It is particularly important to consider a trial of gluten free - but best to get a blood test for coeliac disease first - if there are any diagnosed or suspected coeliacs in the extended family; anyone who chooses to avoid wheat or gluten because they feel better, anyone with short stature or very skinny, or any of the following: diabetes, Down syndrome, immune-mediated skin diseases (dermatitis herpetiformis, psoriasis, aphthosis and alopecia), unexplained infertility, unexplained nutritional deficiencies such as iron, calcium; coeliac-type permanent tooth enamel defects; bowel cancer or behavioural symptoms that do not respond sufficiently to a low chemical diet and medication. People with coeliac disease do not necessarily have any gastrointestinal symptoms, or they may have only mild abdominal discomfort; classically they are short or skinny but they can also be tall and/or overweight. It is also possible to have gluten intolerance without coeliac disease. See reader story below.

 

[892] Wild and extremely violent behaviour due to undiagnosed coeliac disease (February 2010)

 

Three years ago I stood in the bookshop with 'Fed Up' in my hand debating whether to part with $20. Your book has repaid itself a thousandfold. I send my heartfelt thanks.

 

My youngest son's problems are a long saga, suffice to say that eliminating additives and low amines as suggested by your book provided the answer for some time. Then at nearly nine, out of the blue, he had some sort of breakdown. The teacher suggested Asperger's but he soon became worse - quite autistic, wild and extremely violent. He was off school for three months.

 

The doctors I approached turned their backs on me. I couldn't believe it. I can only think they thought that as he already had a disability (Central Auditory Processing Disorder) it was part of the condition and didn't realise how extreme his behaviour was. I insisted that he be screened for a variety of degenerative diseases, but they came back negative.

 

Finally realising that no one else "gave a stuff", I turned back to your book. If it was diet before, then maybe, it's diet again, I thought. I tried eliminating salicylates, he got worse; I tried wheat, no change; I tried dairy no change. Eventually I tried eliminating both dairy and wheat and he improved.

 

He spent two years on a wheat free, dairy free, no additive, careful about amine diet and he could manage if he had a small dose of Ritalin 5mg breakfast, 5mg at lunch as well. Our lives were back on track, he was progressing at school, having a go at different sports, and excelling in his favourite sport. But it was all because of the ritalin - and diet.

 

Without the medication it was still like living with a drunk - he could be fun sometimes, but more often silly and tiresome, and aggressive too often. I always felt that the child that he had been was still there deep down, intact and undamaged, although why I believed it, I don't know. In November when he turned 11, I contemplated the thought that maybe he did have irreversible minor brain damage, but I couldn't accept the notion.

 

Then, by chance ("Mum, I don't want Rye bread this morning, I want Rice cereal") we realised it was the GLUTEN. I never suspected it, because I'd known a baby who nearly died of coeliac disease and the symptoms were quite different from my son's. I followed up your footnote in Fed Up and read Professor Duggan's article in the Aust. Med.Journal. My son was diagnosed with Coeliac disease a month ago and I am absolutely delighted by his response to the gluten free diet.

 

As you can see I am much indebted to you. It was only fine reading of your book that has helped me tease out my son's difficulties. I shudder to think where he'd be now (at a special school, I'm sure) if it hadn't been for your persistence in acquiring all this knowledge and for passing it on - Anne, Qld

 

 

       Q. How can food affect the voice, make you deaf, fearless, and completely oppositional? I cannot get my head around why dairy foods cause such a behavioural response with my 5 ½ yo daughter. When eating dairy foods, she gets dark rings around her eyes, and is not just bad, she is impossible to live with. I just cannot understand how a food can affect her in this way. Her oppositional defiance is incredible. It is also as if she is completely deaf. Her voice becomes so loud it makes me cringe and it also becomes a lot higher in pitch. She is not affectionate at all and is very serious as well. It is as if she has complete focus, driven, locked in, intense, not able to snap out of her bad behaviour. Since she has been dairy-free she listens, talks more quietly and without intensity, she lets me cuddle her, she does not get locked into bad behaviour and we can negotiate together. - reader, Qld

A A 1985 study by CSIRO researchers at CSIRO found that hyperactive children excrete five times more of a chemical called para-cresol than non-hyperactives. Para-cresol is a breakdown product of the amino acid tyrosine which occurs in large amounts in dairy foods. Para-cresol is known to be neurotoxic to rodents (neurotoxic means in affects then brain). There are many different symptoms that can occur due to neurotoxicity. Toxicologist Professor Bernard Weiss thinks that behavioural symptoms such as hyperactivity are the first sign of toxicity. Behavioural symptoms due to food can include temper outbursts, seeming not to listen, loud voice, seems not to listen and during my bread preservative study, I noticed that loud voice was the symptom most often reported as improving by mothers, yet I have never seen it mentioned in the medical literature.

Diet too hard - support

       Q. I’m worn out with saying “NO” to my kids. We just returned from a 4-day camping trip. Before we left, I made lots of bread, rolls and failsafe muffins, and I packed lots of pretzels, Kettles chips, milk shake lollies, pears and red delicious apples. I would have packed some Peters vanilla ice cream if I could have figured out a way to keep it frozen! In spite of all this preparation, I still found myself frequently saying, "No, you can't have that." When we stopped at petrol stations or mini-marts, or in supermarkets or the one restaurant we ate in, my son always seemed to find something he really wanted and couldn't have. I'm just so tired of having to tell him "No", but I know I pay in the end anyway if I say "Yes". I feel I'm caught between a rock and a hard place. I'm tired of always baking, baking, baking. Sometimes, I just want to pitch this failsafe food out the window, and buy all our food at the supermarket. But I know life would not be any easier if I did. It's just hard to always have to say, "NO".

A. I agree. I, too, sometimes feel like shouting that everyone can eat what they like because I'm not going to all this trouble any more. But of course, it doesn't happen because we all know what the results would be. We have found that life is easy if you can buy just one treat in a roadhouses or supermarkets (such as Peters Dixie Cup icecreams, or for non-amine responders, Nestle Peters Billabong choc NOT vanilla choc which contains annatto). But when there is absolutely nothing your kids can buy, then life is very difficult indeed. This is why we need to tell food manufacturers. We have found that they do listen to consumer concerns and products do change over the years though they won’t thank you for your complaint at the time. If we say nothing, the situation will get worse. Unfortunately we live in a society where it is acceptable to drug children and even babies for food reactions such as restlessness, irritability and sleep disturbance, but not acceptable to remove from our foods the additives which cause these reactions. It is time for a change. We can make a difference!

Eating out and special occasions (Easter etc, Japanese, Indian)

       Q. Should I not eat Japanese food? I am intolerant to salicylates, natural MSG and have restricted all types of colourings, additives, wheat and milk. With such intolerances, do you think it would be wise to refrain from eating Japanese food?

A. It depends what you choose. Wasabi sauces and flavours, e.g. wasabi flavoured peas, generally contain artificial colours 110 and 133. MSG is commonly used in Japanese food for flavour. Soy sauce is high in natural glutamates even when all natural. Miso soup is high in amines and natural glutamates. Japanese foods such as soba – traditionally buckwheat noodles – and tempura batter – traditionally rice flour – now often contain wheat. Sushi rolls are made with rice vinegar which would contain amines and nori seaweed is listed as very high (salicylates, amines, glutamates). .

Follow up: The questioner replied: ‘this confirmed why I was getting headaches every day (MSG). Back to my strict diet!’ (updated May 2011)

       Q. My husband’s boss has invited us to an Indian restaurant and we can’t refuse – any suggestions?

A. It won’t be failsafe. It is best to enjoy yourselves rather than worry about breaking your diet on this occasion because stress can make food reactions worse. When I have to eat out, I take a dose of ENO regular antacid powder (see shopping list) as soon as I get home because it works as an antidote.

       Q. Could you please tell me what others do for Easter celebrations? We live in country NSW and I don't have a clue. My son has asked me if the Easter Bunny still comes. He can eat carob without any adverse reactions.

A. Most people commercial carob Easter eggs from their local health food store, or by mailorder, see the Failsafe Shopping List.

Nutrition

       Q. How does the Glycemic Index (GI) apply to failsafe foods?

A. The GI measures the rate at which carbohydrate foods are digested and absorbed in the body. Low GI carbohydrate foods are considered to be healthiest because they provide a gradual energy release – keeping your blood sugar level - throughout the day. High GI foods provide a quick energy boost. Overall it is best to have a combination. See a list of the GI per serve for failsafe foods below. You can turn a high GI food (over 70) into a low or moderate GI food by mixing it with a low GI food (under 50).

However you need to apply some commonsense. Since fats and oils have low GI, in some commercial products the low GI rating comes from high fat, which is not desirable. The moral of the GI story is that it is good to limit your intake of dietary fats, to include low GI carbohydrate foods such as nuts, lentils, beans, oats, pasta and cereal fibre such as bran (from wheat, oats, rice or psyllium) in your diet and to eat balanced meals and snacks rather than to consume sweets or sugary drinks alone. See http://www.glycemicindex.com/

HIGH

100 Glucose

90 Bread, gluten free (added fillings will reduce the GI)

83 Rice bubbles (served with milk or soymilk will reduce GI, also see porridge at 42)

 

MODERATE

70 Bread, white or wholemeal (average)

70 Mashed potato

69 Milk arrowroot biscuits

66 Magic cordial (and other sweet drinks)

65 Sugar (sucrose)

65 Rye bread

61 Icecream (average)

59 Rice, Doongara compared to 87 for Calrose

55 Oatmeal biscuits

55 Banana (FS for non amine responders)

54 Pound cake

54 Potato crisps

 

LOW

48 Peas, green, fresh or frozen half cup (FS if moderate glutamates tolerated)

42 Porridge made with water, same as All-Bran

41 Spaghetti, white, cooked

38 Pear, fresh compared to about 50 canned in syrup

31 Soy milk (So Good)

28 Sausages, fried

28 Lentils, boiled

27 Milk, full fat

27 Kidney beans

25 Barley, pearled

19 Rice bran (psyllium is also low, failsafe and can be added to cereals)

14 Cashews (assuming same as peanuts)

       Q. I am worried that the failsafe diet contains too much sugar.

A. There are many types of failsafe eating. You can choose whatever suits you – you don’t have to eat sugar, although many failsafers find they need extra treats at first to help them get through withdrawals and the food chemical cravings stage. After your family is settled on the diet, you can reduce sugar and increase vegetables. (“I just gave up baking, and it’s much easier now” said one failsafer 12 months after starting failsafe). However, you can choose failsafe foods without sugar from the beginning if that’s what you want. See Ethan’s menu in Newsletter 43 for an example of a child’s glutenfree, dairyfree failsafe day with little sugar. One mother was pleased to hear that you can feed children dinner recipes such as pasta, mince and vegies for lunch and snacks - “I never thought of that,” she said. See also the Failsafe Weightloss factsheet.

Remember that sugar in home-made foods is obvious because you can see it, whereas sugar is more hidden in processed foods. See tips on sugar reduction (‘Sugar in itself is not bad for you, in moderation it’s unlikely to cause harm and may even help make some healthy foods taste better, for example having a little jam on your wholegrain toast in the morning may help to make it more palatable …’) http://www.foodnut.com.au/latest-nutrition-news-winter-2011/w1/i1009007/

       Q. When my ADHD son eats kiwi fruit, his behaviour doesn’t change. Since kiwi fruit is very high in salicylates, does this mean he isn’t affected by salicylates?

A. No. Very few parents ever notice a reaction to salicylates in foods because salicylates are eaten many times a day, every day. Most children don’t react to a few serves of fruit, but the effects build up slowly. You will only see the difference when you avoid salicylates then do a challenge - note that failing to eat six good serves of high salicylates per day during the challenge can cause confusing results. If in doubt, it’s a good idea to repeat the challenge.

       Q. I’d like to do the diet for my asthma but I’m not prepared to give up wine.

A. The majority of asthmatics only have to avoid additives such as preservatives (especially sulphites and benzoates). It is now very easy to avoid sulphites in wine - you can add some SO2GO or Pure Wine, or buy preservative-free wines, see the Failsafe Shopping List. If you are a salicylate-sensitive asthmatic, that is more difficult. You would need to switch to e.g. Gin & Tonic.

       Q. How does the bicarb antidote work? We gave our son some soda bicarb in a glass of magic cordial when he was having one of his hissy fits and he calmed down immediately.

A. Sodium bicarbonate which is alkaline increases the pH of the urine, thus increasing excretion and getting rid of salicylates faster. It is used in hospitals for acute or chronic salicylate poisoning and has traditionally been used for as a home remedy for indigestion, however, symptoms of overdose have become obvious due to the practice of soda loading - or soda bicarb overdose - by athletes (http://en.wikipedia.org/wiki/Sodium_bicarbonate)

Antidote for food intolerance reactions

ENO regular antacid powder (ingredients: sodium bicarbonate,sodium carbonate, citric acid) temporary relief for stomach upsets, has also been found to worked for food intolerance reactions including hyperactivity, difficulty falling asleep, itchy rashes, headaches and stomach aches. Use according to directions on bottle. Do not exceed recommended doses. Not recommended for children. Failsafers say that baking soda baths (bi-carb soda) baths can help (adult dose is half a cup of soda bicarb or 1 tsp per 4 litres of soda bicarb for babies)

True allergies

       Q. How are parents supposed to know about allergies before it is too late? I wish someone told me that the best way of preventing future allergies may be not to feed the usual allergenic foods to young babies (wheat, eggs, fish, milk etc) when my son was weaned from breastfeeding. He is now allergic (not just intolerant) to all these food groups.

A. True food allergies are increasing and allergy specialists are not sure why. Opinions on how to prevent allergy vary. See the RPAH Food Allergy Prevention factsheet http://www.sswahs.nsw.gov.au/rpa/allergy/resources/allergy/prevention.pdf

Feingold

       Q. I tried the Feingold diet and had not much luck with it. I am wondering if your book would help my girl. I live in the US.

A. First, please understand that I greatly admire Dr Ben Feingold's heroic work. Nearly 40 years on, Dr Feingold’s book "Why your child is hyperactive".is still a thrilling story by an observant pediatric allergist who noticed - and was prepared to speak up about - the effects of food chemicals on children’s behaviour and learning!

The diet that we recommend is a revised version of the Feingold diet developed over 30 years by researchers at the Royal Prince Alfred Hospital (RPAH) in Sydney over 30 years. It was developed for patients with symptoms such as urticaria and other itchy skin rashes, migraine and irritable bowel. Along the way, researchers noticed that it helped children with hyperactivity although that was not their main interest. The RPAH diet excludes many more foods than the Feingold diet: more additives, especially calcium propionate in bread, annatto natural yellow colour and more salicylate-containing foods, as well as natural amines, natural glutamates and wheat, gluten, dairy products and soy if required. It involves a 3-6 week period of elimination of all provoking substances, followed by careful challenges of specific food chemicals (Ref: Swain AR and others, 'Salicylates, oligoantigenic diets and behaviour',Lancet, 1985;6;2(8445):41-2). At the end of three months, you should know exactly which food chemicals cause problems, what kind of problems, how long each reaction takes to start, how long each reaction lasts, and how much tolerance your child has for each food chemical.

       Q. Isn't the RPAH diet too hard for ordinary families?

A. Here is a comment from a mother in New Hampshire who has done the RPAH diet: "My family would not have done well on the Feingold diet because we would have eaten an increased amount of the allowed fruits ... Some people talk about how your diet is too hard and how could a single mom with an ADHD child possibly cope with this kind of diet ... I think the mom would be better able to cope if she had a healthy, pleasant child to raise!!!!

ADHD

       Q. My son has ADHD but we've never seen him react to any foods. Does this mean he's not affected?

A. Most people whose children are affected by foods have never noticed a reaction. This is for two reasons. Firstly, most reactions are delayed yet research shows that unless a reaction occurs within 30 minutes, consumes won’t make the connection. If a child drinks a can of coloured soda on Monday and reacts with temper outbursts on Wednesday, no-one will connect those two events. Secondly, children who constantly eat foods that affect them will develop recurring symptoms with no obvious cause.

       Q. How can I tell if my child might be affected by food?

A. If you have ever seen your child react to any foods like colours, chocolate or party foods - even once - this is an indication that your child might be affected in less obvious ways by other foods. A family history of migraine, eczema or irritable bowel is also a good indication of a food sensitive family. However, most families have no idea that their children are affected by foods until they try an additive free or full elimination diet for a few weeks.

       Q. The doctor says we will be wasting our time using diet for ADHD. Is this true? I have an eight year old son who is, according to the specialist, suffering from ADHD. The specialist wants us to put him on Ritalin and various other medications. We are afraid to pump our son full of drugs ... there must be another way! My wife and I are considering changes to his diet.

A. You can easily search all of the Success Stories on our website for hundreds of parent reports showing that your doctor is wrong - children with ADHD, ADD, hyperactivity, oppositional defiance, autism and other behavioural conditions can improve on diet, for example, story [039] ‘They said we would be wasting our time doing diet for ADHD and ODD’ :

My eight year old son was recently diagnosed ADHD and ODD by three different doctors. All three doctors said we would be wasting our time altering his diet and that the only thing to do was to prescribe drugs.

We didn't want to put him on drugs but my wife and I were at our wits end, our son was becoming more and more of a handful, I must admit I was about to give up and take the doctors' advice.

We bought your book "Fed Up" and started the diet. My God, the improvement was almost instant. He changed from an aggressive and argumentative little creep to a loving and caring little boy almost immediately. My wife, myself, our other two children and most of all, our son's teacher are amazed …’ from Story [039].

Dietary management of ADD can be extremely successful but it is difficult to do properly. One mistake a day can mean the diet will not work at all. So you have to be well-informed and committed. My book Fed Up will give you a good idea of what is involved. Eight is an excellent age to try dietary management - old enough to reason with, young enough to still have control over food.

Adults

       Q. Do amine/salicylate intolerances ever develop in adults?

A. Yes. Unlike food allergies, food intolerance is common in both children and adults. Women are twice as likely to be affected as men due to the effect of female hormones, and commonly develop symptoms after the birth of a baby. Common triggers of food intolerance include illness (anything from a gastrointestinal infection such as giardia to infected wisdom teeth); exposure to chemicals such as agricultural, industrial, solvents or medications, and stress.

       Q. Has any work been done on problems common in adults and how they are different to those of children? It seems from your book and web site that children are the main sufferers from food intolerance. However, I know a couple of adults who have intolerance problems, and while many of the symptoms are the same as for children, there appear to be some differences. For example, adults appear to have more digestive problems ("irritable bowel syndrome"), and less like hyperactivity (although some aspects are still apparent...).

A. Symptoms can change throughout life. Everyone is different. Both children and adults can suffer from irritable bowel, itchy skin rashes and respiratory problems. Adults are more likely to be irritable and restless than hyperactive. Some children who are hyperactive when young may become lethargic or depressed as adults. People who have lethargy and impairment of memory and concentration are usually the most sensitive of all and are likely to react to even small quantities of a large number of food chemicals for a long time. Further reading: Loblay RH and Swain AR. Food intolerance. In: Wahliqvist ML, Truswell AS, editors. Recent Advances in Clinical Nutrition. London: John Libbey 1986. p.169-77.

       Q. Is it possible to test for salicylate intolerance by taking aspirin?

A. According to researchers ( Swain et al, Salicylates in Foods, 1985), an average Australian diet may contain up to 100 mg of natural salicylate per day. This quantity can easy trigger food intolerance symptoms when eaten daily by sensitive people. Failure to react to aspirin while on a normal diet does not exclude salicylate intolerance, because many people may already eat the equivalent of an aspirin tablet in dietary salicylates every day. Many people will only react to a challenge when dietary salicylates have first been completely eliminated for several weeks. A 300 mg aspirin tablet can be used for the salicylate challenge, but is only recommended at teaching hospitals. Because this kind of challenge introduces a much bigger dose at one time than food challenges, asthmatics with severe bronchial hyper-reactivity are routinely hospitalised for this challenge, as well as capsule challenges with metabisulphite, MSG and tartrazine. Aspirin is no longer used for children due to a suggested risk of Reye’s Syndrome.

       Q. Where can I get a book containing the amount of salicylates in food? (e.g. 0.08 mg/kg in Golden Delicious apples)

A. It's not a book, it's in a scientific paper published in the Journal of the American Dietetics Association (Swain et al, Salicylates in Foods, 1985). You can order it from your state reference library or a medical library. Although it is interesting, it will not help you much because you cannot go strictly by salicylate contents since people who react to salicylates usually react to other natural chemicals, such as benzoates that can be present in the same foods. The categories of low, moderate, high and very high as defined in the RPAH Elimination Diet Handbook available from www.allergy.net.au are the best you can do.

       Q: Is this plan for going failsafe OK? We live on a farm in WA and I am planning for the whole family to do the Elimination Diet. I am determined to persevere this time, nearly 5 years after our first attempt. I think the best way for me to ensure we stick at it is to do a thorough menu plan, including lunch boxes and snacks; to do a big shop in Perth for food and non food items; discuss incentives and rewards before commencing; clear my diary of all unnecessary time-consuming, stress-inducing appointments, meetings etc; advise the school and other relevant people; keep a food and behaviour diary; communicate frequently with the dietitian. Have I missed anything? Is Amway still OK for washing clothes?I see toothpaste is available by mail order). We buy our meat in bulk (about every 3 months). Our butcher cooks a chook for me on the rotisserie without anything added. I use the white meat only (no skin) for the children's lunches.

A: It all sounds good except the meat. Meat should be cooked the day you buy it or frozen and used within 4 weeks. If you pass your amine challenge you can go back to buying in bulk every three months.

       Q: Can you suggest what foods I should be giving my 4 ½ baby? My baby is 4 1/2 months old. He's never been a great sleeper and since I started him on solids three weeks ago at least one breastfeed a day is a nightmare - he will drink for a minute or two then pull off and scream and arch his back. People told us he would be more settled on solids! I've given him potato, sweet potato, pumpkin, apple and avocado and I can't say I've noticed any of these really affecting him.

A: Some babies are more sensitive than others. You won't always see an immediate reaction but effects build up. All the foods you are giving your baby except potato contain natural chemicals called salicylates that can contribute to restlessness and sleep disturbance in babies. Preservative free baby rice cereal, potatoes and baby pear are some of the safest wearning foods for babies, see shopping list. If you are breastfeeding you may have to change your own diet too. There are more details in The Failsafe Cookbook and you can ask for our list of supportive dietitians (This email address is being protected from spambots. You need JavaScript enabled to view it.)

       Q. Are we making a mistake? We have been doing to the diet now for 2.5 weeks and we are really struggling. My daughter's behaviour seems to a be a little worse than before, crying, pains in tummy, tantrums, irritable, and my son is very grumpy. I have read stories/frequently asked questions I have just discovered that the bread (which we have been living on) contains vinegar …

A. The diet will not work if you make mistakes. Read the Checklist of Common Mistakes. It is also essential to get your bread right. If things don’t improve on a different bread you may need to consider gluten intolerance.

       Q. How much vanilla is too much? We have definitely seen an improvement overall in my son at school since going failsafe, but not a total elimination of all behavior issues, just more tolerable - so it may mean we haven't gotten it all yet. My children have vanilla in cookies, vanilla flavoured soy milk and icecream.

A. Vanilla is supposed to be limited to 2 drops per day, but if the diet isn't working 100 per cent for you, you could try cutting it all out for a few weeks – but read the Checklist of Common Mistakes and you are welcome to send me a list of foods eaten in a typical day for checking.

       Q. I am wondering if there is a list of what preservatives are the best to avoid? My son is 4 years old and he has been diagnosed with borderline ADHD and the children's doctor has recommended I take him off all preservatives and colours.

A. It is good to hear that doctors are now recommending avoidance of food additives. However, children with ADHD are equally likely to be affected by natural food chemicals called salicylates. It would have been more helpful for your doctor to refer you to an experienced dietitian for a 3-week trial of the elimination diet (ask for our list of supportive dietitians: This email address is being protected from spambots. You need JavaScript enabled to view it. ).

       Q. I would like to lose a bit of the weight that I have put on in the last 12 months and altogether I need to lose about 8 kgs. How can I eat well and stay sane at the same time?

A. See the Failsafe Weight Loss factsheet.

       Q. My son refuses to have any vegetables.

A. There are heaps of suggestions in the Failsafe Cookbook about how to get disliked vegetables into children, see Mum’s Mash, or vegetable soup. I started mine with just potato, cabbage and salt blended well so you couldn't tell what was in it, no lumps. My kids only had to lick the tiniest amount off one teaspoon (just touch it with their tongue) the first night to get a reward - a small reward. The next night they had to have more (lick a small amount off the teaspoon) to get another reward. The next night it was twice as much and so on. By the end of two weeks they would eat a mug of vegetable soup. Then we cut out the rewards and established the most important rule of the house - no dinner until soup is eaten. Since then they have eaten vegetable soup nearly every night of their lives. I could put any failsafe vegetable in the soup including Brussels sprouts, lentils and dried beans and they would eat it without complaint.

       Q. We'd like to break the diet occasionally but not too much. Can you recommend some not-too-bad treats?

A. Everyone is different. It depends what affects you the least and the worst. You have to work it out for yourself. We always avoid additives. Dairy foods are the least of my problems but amines (and salicylates) are bad, so quark cheese or dairy based desserts like ice cream are a treat for me. When breaking the diet, it is best to stick to moderate fruit and vegetables or a small amount of high (e.g. a salad sandwich with a few slices of cucumber or even fresh ripe peeled tomato) – rather than citrus, tomato based sauces or anything else from the very high column. You don’t have to eat huge amounts for it to feel like a treat e.g. just a little rhubarb or a few blueberries added to fresh chopped pears with a tiny amount of yoghurt or ice cream can make a difference, see shopping list for more suggestions.

       Q. Help. Where do I start?

A. Preferably, ask for our list of supportive dietitians (email This email address is being protected from spambots. You need JavaScript enabled to view it.) and your dietitian should help you. If not, write down everything your child normally eats in a day. Now check whether they are failsafe by reading the Failsafe Shopping List. If not, write down a substitute for each food. (For example, breakfast: Nutrigrain. Not failsafe. Switch to rolled oats or pancakes instead) and so on. Read How we did our elimination diet in my books. Any questions, join the discussion group and email your local contact or me for support. See reader story below.

"I think the biggest hurdle is that first shopping trip. I picked out several recipes I wanted to try, and carefully reviewed the list of acceptable foods. I made sure I put all the ingredients I needed for the recipes on my shopping list, along with acceptable foods, including goodies like chips, pretzels and ice cream. At the supermarket it did take a long time to find all the new things I was buying, but when I got home, I had a kitchen full of failsafe products and all the ingredients I needed for some failsafe recipes. Having all those things in the house made following the diet a lot easier. I'm such an organizational freak that I have my shopping list on the computer. I print out copies and post them on the refrigerator; then I check off the things I need as they run out. On the back, I print out the additives to avoid, so I always have it with my shopping list when I'm shopping."

       Q. We have just done the amine challenge with our children. My three-year-old daughter reacted but my son actually improved. How can this be?

A. It is common for non-responders to improve during challenges. There are several possible reasons for this: 1) normal improvement over time - improvements on this diet will sometimes continue for months if the diet isn't broken 2) People tend to stick to the diet during challenges thus avoiding deliberate mistakes in the form of treats 3) Challenge foods may have replaced another food to which you have an intolerance. The commonest is dairy foods, fo example, the boy who improved dramatically during the dairy challenge because he had been reacting to soymilk. But it could just as easily be a reduction in e.g. yoghurt intake due to filling up on chocolate and bananas

       Q. How am I going to do the amine challenge? I'm sure my kids won't eat dark chocolate.

A. Have you tried Nestle dark chocolate Choc Bits? - in your supermarket baking section. I would be surprised if your kids don't eat those. They need to eat about 60 grams a day. You can make the lunchbox choc chip muffins, Fed Up page 230, as a loaf (put in extra choc chips and bake for one hour) and slather it with a thick layer of chocolate icing, using pure cocoa powder (not flavoured) and pure icing sugar. With challenges it is terribly important to eat enough, right from the start. If you don't use chocolate the results are likely to be confusing. As well as chocolate, eat at least 2 ripe bananas a day. Bananas go well in milk or soyshakes or frozen on a stick and dipped in homemade chocolate sauce, or in banana cake. See Challenge recipes in my books. Don't forget you can also eat tinned fish like tuna in springwater, lots of gravy with roasts and pawpaw, which also goes well in milkshakes. Reactions are often delayed, day 3 or later. Stop as soon as you see a reaction. If you are not totally sure because of other factors like bullying, wait for three good days and start again.

       Q. My 5 yo son has been invited to a birthday party at Macdonalds. What do you recommend?

A. You might like to try this reader's approach: "My son is in kindergarten and has been invited to three Macdonalds parties this year. At the first one he ate everything and it resulted in hyperactive behaviour and tantrums. For the next two he ate only the chicken nuggets, chips and drank water. I supply the lollybag, and tell him not to eat the icecream cake - which seems fine with him. We haven't had a problem with this." Some children will react the next day to the antioxidants in the oil. Minimise the amount he eats by feeding him just before he arrives. Then what he will eat most of is your approved lollybag, and he will be happy about going to parties.

       Q. I am curious as to what kind of behaviour a 2 1/2-year-old child might exhibit due to an intolerance to some foods?

A. The most common behavioural effects of food chemicals are, in this order, irritability (touchy, easily annoyed, short fuse), restlessness, inattention and sleep disturbance (difficulty settling to sleep or frequent night waking). Quoting from the 1994 study by Rowe and Rowe (see Scientific References): "The younger children (aged 2 to 6) had constant crying, tantrums, irritability, restlessness and severe sleep disturbance, and were described as "disruptive", "high as a kite", and "out of control", “Their parents were exhausted through lack of sleep and the demands of their children who were unable to be comforted or controlled."

Children are not necessarily hyperactive, as you can see this story from a reader in Victoria: "I was referred to your book by a friend who had great success with her overactive son. I too have had success, however my 4-year-old boy has always been the opposite. He was always tired and grizzly. He would get upset easily if he couldn't do something and would rarely amuse himself. I also had to put him to bed at the right time or he wouldn't settle and would wake between 5 and 6 o'clock. He would also wake up very cranky and require his breakfast straight away but wouldn't eat much. It was very difficult to persuade him to do what we would like. It caused a lot of friction in the family and I would often hate him … Now he is a changed boy. He sleeps in until nearly 7 o'clock, wakes up in a good mood and doesn't demand his meals straight away. He is very happy and co-operative and his appetite has increased immensely. He originally scored a 50 on the Fed Up scale and now only rates a 5.''

       Q. I find it difficult when we are out somewhere and the kids start the "I'm hungry, Mum" whine! What can they have if we are at the movies or out shopping for instance?

A. Plan ahead. Some suggestions for movies: buy spring water and take your own food, preferably not sweets – I always have fresh dry plain rice cakes with me - but if you have to Pascall's white marshmallows or some kids can manage Maltesers if they do not react to amines. Handbags or the pockets of cargo pants are good for smuggling food or you can write for permission to bring your own food. Suggestions for shopping: preferably, don't take the kids. Or feed everyone before you go. Or take a packed lunch. Or you can buy spring water, fresh rolls with no filling from a Brumby's or Baker's Delight, celery juice from a juice bar (with half a carrot as a treat). This all gets easier as you go, but there are some excellent tips about how to deal with whining in the 1,2,3-Magic DVD

       Q. I have observed that small amounts of salicylates seem to disrupt my child's ability to regulate his blood sugar. Is this possible?

A. Yes, there is a condition called salicylate-induced or ketonic hypoglycemia which was relatively common in children 40-50 years ago, when children were often given aspirin (salicylates) and became rare when aspirin was no longer recommended for children. One of the children in our network was diagnosed with it - the recommended treatment of a caloric supplement such as Poly Joule powder (which is failsafe) throughout the day as well as failsafe foods made a huge difference to him.

       Q. Can this diet not work?

A. The diet won’t work if there is some other reason other than food intolerance for symptoms, such as skin cancer causing a rash. There are many mistakes which will stop the diet from working, see Checklist of common mistakes. Too much stress can cause the diet to fail. A child or adult who is angry or forgetful cannot be expected to become a cheerful high achiever in an authoritarian, punitive, hostile atmosphere at home, school or at work. Often when families take a break and try again later they do much better the second time.

       Q. Do you think that everyone should try this diet?

A. I think everyone should try at least a two week additive free diet because our school trials have shown that about 60% of children are affected by additives and most families have no idea they are affected.

Avoiding salicylates, amines and glutamates is different – dietitians recommend that you should only try the full elimination diet if you have a problem, but I have seen plenty of people who didn't realise they had a problem until they did the diet to support another family member - and found that they felt much better. If there is a family history of migraine, itchy skin rashes, asthma or irritable bowel symptoms it is worth doing at least additive free. The elimination diet is pretty much like a three week course in how to avoid additives. If you don’t think you have any problems at all, a good compromise would be to do the elimination diet but to include unlimited fresh fruit and vegetables.

       Q. I have been wondering since reading your book if my son may have always been intolerant to foods, even my breastmilk? He had skin rashes/eczema in the first weeks of his life and was a very difficult baby (reflux, colic) until I stopped breastfeeding him. At the time it was felt that this was because I had enough milk for two babies and very heavy let down that this little baby was trying to guzzle! I wonder now if he was so unsettled because I was eating foods he reacted to.

A. Food chemicals including additives and salicylates can pass through breastmilk to affect a food sensitive baby with any reactions from the range of food intolerance symptoms including breastfeeding difficulties, itchy skin rashes, irritable bowel (colic, reflux), irritability, restlessness, difficulty falling asleep and frequent night waking. I wish I'd known about this when my kids were babies.

       Q. Perhaps you avoid even the smallest traces of pineapple? I notice you mark, as salicylate, many items that feingold.org does not, such as pineapple. Feingold does this too, in their special SAS diet, but I've never looked at that one.

A. Pineapple is definitely not a small trace of salicylates. It is the salicylate equivalent of dynamite, but yes, we do avoid even small traces. I believe the SAS diet is the same as ours regarding salicylates. Most people have no idea how sensitive their children are to salicylates until they avoid them all. Some children react even to pears. I have seen desperate families exclude dairy, gluten and soy when the only problem was salicylate sensitivity, plus additives of course.

       Q. My problem now is to try and cook meals which are rice & wheat free. My daughter has been diagnosed with numerous allergies including rice, my son is sensitive to soy and my husband needs to avoid wheat.

A. Some suggestions: millet porridge (from millet flour or millet meal) or puffed millet, buckwheat pancakes, sago and tapioca puddings as snacks, and other options include amaranth or quinoa puffed or flours, arrowroot flour, cornflour made from corn not wheat, chickpea (besan) flour and Gluten Grain Free pasta (Ingredients: potato, quinoa, amaranth, bi carb and guar gum). And don’t forget mashed potato, homemade potato chips, rotmos and other vegetables as tummy fillers. See the gluten free sections of the Failsafe Cookbook and the Failsafe shopping list.