Most bananas, for instance, are artificially ripened by exposure to ethylene gas immediately before they are distributed to the markets. The more time that elapses after this gassing, the more readily the bananas are tolerated by those who are highly susceptible to chemical exposures. This is apparently why chemically susceptible people are sometimes able to eat bananas and sometimes are not. There is a fairly certain way, however, to detect gassed bananas. The naturally ripened bananas have black seeds and tend to have small, specked spots on their skins, in contrast to the gassed bananas, which have immature white seeds and large blackened areas of the skin at points where they were bruised in handling or shipping.

One of the most common forms of food allergy is suceptibility to coffee. Many people are made chronically ill from the steady and habitual drinking of this, our national “grown-up” drink. But when patients with alleged coffee allergies were given electrically roasted coffee in an office test, some of them had no reaction at all. They only reacted to coffee which had been roasted over a gas flame. Almost all commercial coffee is gas-roasted, however. How much this fact contributes to the high incidence of susceptibility to coffee has not been investigated adequately.

The difficulty of separating the effects of chemicals and foods is illustrated by the following episode. In 1950, I co-authored an article on apparent susceptibility to sugarcane in a medical journal.4

Six patients were each given a glass of spring water with two heaping teaspoons of cane sugar dissolved in it. Each of them showed some adverse reactions to the drink, ranging from dizziness to sudden, uncontrollable fatigue.

We published these findings, feeling quite certain that these patients were sensitive to cane sugar per se. As I learned more about the effects of chemical contaminants in food, however, I realized that these patients may have been reacting to something other than sugar itself.

I visited a large sugar refinery and observed the process by which sugar is converted from rough cane to fine, white crystals for the table. Suspicions of chemical contamination centered on one particular stage in this process, clarification, when the cane syrup is filtered through roasted animal bones (called “bone char”). From time to time, these filters are washed, dried, and then reactivated at 1,000°F. over a gas-fired flame. It is highly likely that the char absorbs some of the combustion products of the gas. The sugar then picks up microscopic particles of this gas: not enough to taste or see, but enough to trigger a reaction by chemically susceptible patients.

In order to check this idea, several patients with other aspects of the chemical problem, who appeared to be also susceptible to cane, were tested with a special lot of cane sugar. This lot had been manufactured by means of a process which bypassed the bone-char filter. The test was “blind,” in that the patients did not know whether they were receiving the special or the normal commercial sugar. Several of the patients became sick from the uncontaminated sugar; they were truly susceptible to cane. But a surprising number of those who had believed themselves unable to eat sugar discovered, to their surprise, that they could eat the unfiltered sugar with impunity. (Beet and corn sugar are also manufactured by similar processes.)

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Indomethacin ((Artracin, Flexin Continus, Imbrilon, Indocid, Indolar, Indomod) is powerful anti-inflammatory drug that has been in use for many years. It is useful for morning stiffness because it goes on acting for a long time, and a dose taken the night before will make getting up easier. This drug can cause stomach upsets, headaches or dizziness, in which case another drug will usually be tried. When taken for a long period of time it can also affect the eyes, and it is important to have regular check-ups. Anyone who is allergic to aspirin may react to this drug too.

Sulindac (Clinoril) is a similar drug, with less anti-inflammatory effect than indomethacin but fewer side-effects. It sometimes causes stomach upsets, rashes, dizziness or ringing in the ears. Occasionally more serious side-effects occur which should be reported to the doctor. Other NSAIDs that are similar to indomethacin are etodolsc (Lodine), diclofenac (Rhumalgan, Voltarol), fenclofenac and Tolectin

Piroxicam (Feldene, Larapam) and tenoxicam (Mobiflex) are NSAIDs with strong anti-inflammatory effect. They have the advantage of only needing to be taken once a day. These drugs can sometimes cause stomach upsets, water retention, ringing in the ears, headaches or other side-effects.

Azapropazone (Rheurnox) is another powerful anti-inflammatory. It can sometimes cause side-effects in the form of stomach upsets, headache, water retention and rashes (the skin may become more sensitive to sunlight). As with other drugs of this type, anyone taking them on a long-term basis should have regular check-ups.

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The following synonyms may be used on food labels:

Casein, caseinate Cereal binder Cereal filler Cereal protein Cereal starch

Corn meal Corn starch Corn syrup Dextrose

Edible starch

Flour Fructose Glucose syrup

Hydrolysed protein Hydrolysed vegetable protein Lactalbumin Lactose Leavening Lecithin Maltose Modified starch

Ovalbumin Starch

Sucrose Vegetable oil

Vegetable protein Whey

Milk

Usually wheat Usually wheat Usually wheat Usually wheat or maize (com) Maize Maize Maize

A type of sugar, derived

from maize Usually wheat or maize

(corn)

Usually wheat flour A type ot sugar A type of sugar, usually derived from maize (corn) Usually yeast

Usually yeast Milk

Milk sugar Yeast

Usually egg or soya A type of sugar Usually wheat or maize (corn)

Egg

Usually wheat or maize (corn) Sugar

Usually a mixture of oils, often including corn (maize) oil

Usually soya

Milk

In some foods labelled ‘no added sugar’, apple juice could be considered as a synonym for sugar, because highly concentrated apple juice has been used to sweeten the product.

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Bran can cause serious mineral deficiencies because iron and zinc are often lacking in Western diets. Vegetarians and vegans are particularly liable to iron deficiency (anaemia) since vegetarian food is low in iron anyway. Children under the age of two are also at risk, as are many women, because they lose blood while menstruating and have to make good the lost iron. Drinking tea with meals further reduces the absorption of iron, and is something that all vegetarians should avoid.

Zinc deficiency is more controversial than iron deficienq7, and has become something of a fad, but there is fairly good evidence that it may be quite widespread. Vegetarians, pregnant women, elderly people, diabetics, and those on restricted diets are at greatest risk, but almost anyone can be short of zinc. The processing of food may be to blame, since this appears to reduce the zinc content. In addition, virus infections seem to ‘use up’ some of our stores of zinc.

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We hope that parents using this book will read it carefully, try to understand it fully, and use the information responsibly. Above all, they should consult their doctor and make every effort to work with him or her. The human body is very complex, and the human mind even more so – a book such as this can only provide a glimpse of the factors that may be involved in your child’s illness. If you feel that the doctor regards you as an overanxious or ‘difficult’ parent, then try to stay calm and state your case clearly. Remember what Kipling said: ‘If you can trust yourself when all men doubt you, but make allowances for their doubting too…’ It is ‘making allowances’ that is difficult, but bear in mind that the doctor does see parents who are genuinely harming their children, either mentally or physically, and it is part of his or her job to consider all the possibilities in every case.

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Current research suggests that atopy is not due to a simple defect affecting just one gene: many different genes are probably involved, each one producing a small effect that adds to the total. This explains why the severity of atopic disease varies from one person to another – the more ‘allergic’ genes a person has, the worse are their symptoms.

It is also possible for parents with no obvious atopic symptoms to produce an atopic child. Both are probably carrying genes that can contribute to atopy, but have not produced any effect in the parents themselves. These ‘silent’ genes may by masked by other, more beneficial genes in the parents. Or each parent may lack certain crucial ‘bad’ genes, that are needed for atopy to develop. Whichever is the case, the ‘silent’ genes can become more vociferous if their circumstances change. When all the parental genes are reshuffled to produce eggs and sperm, and then combined with genes from the other parent, a different genetic setting is produced. In this setting, the formerly ‘silent’ genes may have a much stronger effect, producing symptoms in the child.

Genes are not the whole story, however. The fact is that identical twins -who are genetically exactly the same – can differ in terms of allergy. One maybe afflicted and not the other, suggesting that something they have been exposed to in their environment (such as a viral infection) is also important. What seems likely is that the tendency to allergy is inherited and that environmental factors, especially early in life, may push the individual over into an allergic reaction. It is interesting that babies born in the spring are more likely to develop hay-fever later in life. Certainly, in the case of food, early exposure to potential allergens is risky for the children of atopic parents.

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Choose an item made of the fibre you want to test:

COTTON: a T-shirt, pillowcase, cotton towel or cotton blanket.

LINEN: a pure linen tea-towel.

SILK: a silk scarf.

SYNTHETICS AND BLENDS: a garment of your choice.

VISCOSE AND RAYON: a garment.

WOOL: a rug, scarf or sweater.

Wash the item several times, placing 1 dessertspoonful of sodium bicarbonate in the washing machine or bowl. Dry thoroughly and make sure it is bone dry.

Remove the pillow from your bed. Fold the item into a pillow and sleep on it. If you have obvious symptoms, then you can be reasonably confident that you react to the fibre tested.

If you have strong symptoms early on in the Pillow Test, then stop. Do not persist if you get an early result.

Take great care if you have a history of anaphylactic shock, or of life-threatening asthma attack.

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Only some people with allergies and related disorders are prone to cross-reaction, and people who do cross-react do not always do so; they are most susceptible when they are run down, reacting badly to another allergen, or under physical or mental stress. So you should not assume that, because you react to one thing, you will automatically react to closely-related substances. Cross-reaction is not inevitable.

An understanding of cross-reaction is only really useful in three situations, namely where:

• you know already that you cross-react to specific things;

• you have problems in working out a pattern to your reactions and suspect cross-reaction as a cause;

• you have multiple sensitivities and need to know substances are related in order to manage your condition.

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There is no easy answer on how to manage a child on an elimination diet when foods are being tested, or on a special permanent diet which excludes problem foods. It can also be very hard to have to get rid of a much-loved pet, or for a child to give up a loved activity, such as swimming.

Perhaps the best advice is to start as you mean to go on; to be as firm, clear and consistent as you can, and not to go back on your word or appear to waver. Explain, as far as the child is able to comprehend and in practical terms, why you are doing things – ‘because you get spots’, ‘to stop your tummy hurting’. Even very young children can be sensible if they see practical consequences.

Do not bully, plead, cajole, manipulate or over-compensate – most children can spot when you are feeling vulnerable and will exploit it. Just be matter-of-fact and do your best.

Do not be provoked, either, by other siblings playing off the situation – deal with them as fairly as you can, quash any taunting or teasing, and make sure they get enough attention – they may act badly if they feel neglected. Do not over-compensate, either – they too have to learn that life sometimes can be unfair and does not deliver exactly what they want.

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If the baby does not have evening colic, or if the above measures do not work, then the next step is to select a food or drink to leave out of the mother’s diet. The most common causes of babies’ reactions to breastmilk are the foods that most frequently cause food allergy and intolerance, namely cow’s milk (including cheese, butter and yogurt), wheat, eggs, yeast, com, nuts, pulses, fish and citrus fruit.

Cut down on a chosen food

As a first step, it is sometimes sufficient simply to cut down on the amount of a particular food that you eat rather than to eliminate it totally from your diet. Try this first: reduce the amount you eat of your chosen food for two days. See if the baby improves at all.

(If you are reducing the amount of cow’s milk you take, the first step is to stop taking cow’s milk as a drink, in cooking, or in tea or coffee. Avoid using it in sauces, baked dishes or puddings. Continue taking a little, but not too much, in yogurt, butter or cheese, if you like, as these are sometimes tolerated better. Continue, if you want, to take any processed foods such as margarine or biscuits, which usually contain small traces of milk products.)

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