Checklist of common mistakes
All of the following mistakes have been made by readers. Each one was enough the stop the diet from working, but difficult to identify because effects build up slowly. If the diet isn't working, read the list below. You can also ask your dietitian or email support group to check every item for you.
(Mistakes introduction: 0:33)
Are you doing the diet supervised by a dietitian?
Are red or golden delicious apples included in your diet?
Have you started your elimination diet within the last 2 weeks?
Are you allowing occasional 'treats'?
Is your child sneaking food at school?
Have you failed your salicylate challenge?
Are you consuming pears, pear jam, pear ketchup and/or pear juice?
Do you consume coconut products?
Do you eat commercial products with vanilla flavours?
Do you consume a lot of citric acid, lemon flavours or G&Ts?
Are you eating cold pressed oils?
Are you using carob powder or products?
Do you or your child appear to be reacting to sugar?
Are you eating corn or maize in any products?
If eating 'all natural' yoghurt or icecream, have you checked the label for annatto?
Are you eating bread with chia seeds?
Are you eating wholemeal bread or wholegrain cereals such as Weetbix or Vitabrits?
Are you eating soy products or drinking soymilk?
Are you suffering from increased bloating, stomach aches or diarrhoea?
Have you checked the label on every product you use?
Have you checked for sulphites in your mince?
Have you considered other possible unlisted additives?
Do you know about antioxidants in vegetable oils?
Are you sensitive to sulphites and/or do you eat prawns?
Do you seem to have problems with shallots, garlic, leeks, chives, cabbage or Brussels sprouts?
Do you seem to be extra sensitive?
Are you doing the diet for a young child with a strong family history of allergy?
Are you using medications, supplements, herbal or other remedies?
Are you using recommended toothpaste?
Do you or your children swim in chlorinated pools?
Are you limiting exposure to environmental chemicals?
Are you (or your child) feeling stressed out?
Do you think that you are reacting to some food that is listed as failsafe?
Do you feel as if you still need help?
Are you doing the diet supervised by a dietitian?
NO
I would prefer that every family who wants to try diet have access to an experienced and supportive dietitian but a mother wrote:
I have tried to get help from a dietician and a specialist about seeing what foods exactly cause my son's behaviour to deteriorate and they were not much help and suggested I just do it myself, as my son is fit and healthy and eats a very wide variety of foods.
You can see our list of supportive dietitians recommended by failsafers.
YES
Some dietitians get better results than others. We have noticed that dietitians who get best results are those who use the strict version of the RPAH elimination diet. While the moderate approach or simple approaches may work for some families, if they are not working for you, you can switch to the strict approach ('for those with distressing symptoms that interfere with day-to-day life or work' - p22 of the RPAH Elimination Diet Handbook, available from www.allergy.net.au). This means you should be sticking to foods in the LOW column, e.g. the only fruit in the low column is peeled ripe pears, and you can't have moderate vegetables such as carrots or sweet potatoes until you finish your strict 3-4 week elimination phase.
We are concerned that some dietitians are not sticking strictly to RPAH guidelines. The most successful dietitians we know all agree that the devil is in the details with this diet. It only works if you stick to the diet strictly! ONE small error per week can be enough to stop the diet working. Beware of dietitians who recommend off-list foods. For example, a dietitian who says “it’s okay to have one apple/banana/something else per day/per week “. Or worse: “it’s okay to eat ladyfinger bananas” – these are definitely NOT okay during the elimination diet, rated as high due to both salicylates and amines. If your dietitian recommends off-list foods then concludes your symptoms are not due to food intolerance, this is not right. What they are meant to do is “nit-pick” – try to find out which tiny errors have caused the lack of response. You may want to try the strict version of the elimination diet with a different dietitian. Beware of probiotics (NOT okay during the strict diet and challenges due to amines) and any supplements other than those listed in the RPAH Elimination diet handbook. Beware of any dietitian who wants to combine your RPAH elimination diet with any other (except FODMAPs). And please tell us at This email address is being protected from spambots. You need JavaScript enabled to view it. so that we can help others.
Are red or golden delicious apples included in your diet?
NO
Go to next question
YES
We often receive emails like the following:
We are going into the fourth week of our elimination diet. My 10 year old son's behavior is quite 'angry' at the moment and he is finding a lot of simple tasks quite hard, like getting dressed in the mornings. Is there anything in particular we should be avoiding?
The problem for this family was daily red delicious apples recommended by their dietitian. We are aware that some dietitians include delicious apples and some families benefit from an easy version of the elimination diet. However, if the diet isn't working for you, make sure you are doing the strict version of the RPAH elimination diet as set down in the RPAH Handbook . This means you should be sticking to foods in the LOW column, e.g. the only fruit in the low column is peeled ripe pears.
NO
Go to next question
YES
Sakata plain rice crackers used to be listed as failsafe but we received many complaints (below) which we assumed were due to flavour or MSG contamination on the line. However, the label has changed and it now says "Ingredients: Rice, vegetable oil, salt" PLUS "Contains sesame seeds". So presumably sesame seeds are the contamination in this case. Good that we can trust our readers to report reactions. The only failsafe rice crackers now appear to be Peckish brown rice crackers NO SALT from Coles (ingredients: brown rice flour, rice bran oil 10%). The Peckish tagline is "no funny business!" BUT **WARNING** even the 'lightly salted' variety contains soy sauce powder which is funny business MSG 621!! Approach all rice crackers with caution e.g. Aldi Damora plain rice crackers contain 319. Anyone who hasn't improved could consider avoiding all rice crackers, see reader reports below.
I just wanted to alert you to the Sakata Plain Rice Cracker - my daughter reacts to them even though the ingredients listed are safe! - Jill, by email
Regarding the sakata plain rice crackers, we have had multiple reactions from them and it took a while to put the finger on the problem, because we have always used them as an okay food. My son has had reactions with behaviour, getting very angry and turning into a"transformer" as I call it (one minute he is a car or motorbike and the next he is a monkey or a tiger). Also a rash on the faces of all three of the kids but my son's has been the worst lasting for a week or more after having them. Also my sister's little girl has had really bad nappy rash and rash on the face from them. A friend's little boy also had the rash on his face and whingeing etc after just a few sakatas. All the problems have settled since we stopped having the sakatas. - Tina, by email
I have been doing an elimination diet for 6 weeks now and not getting the results I wanted. I did do the diet last November with my son and it was brilliant but this time there seemed to be something wrong. I checked all the mistakes, I saw a dietician and still he is having terrible outbursts and I am beating myself up about it, thinking maybe it is just him. Last Tuesday I left my son with his grandparents with a bag full of food. The next day he was absolutely out of control and I questioned my daughter who was also there if nanny and pa gave him something he wasn't supposed to have. She said they both ate what I supplied. It was doing my head in all day wondering what had set him off. Then I realised that the only addition I gave him that he doesn't normally have is the Sakata plain rice crackers. He would have had about 10 of them with dip. I read on your website that some people react to these. - Belinda, by email
My three year old is extremely sensitive to amines - defiant, disruptive and hyperactive. More than 5 plain Sakatas send her off the planet. - from story [530]
We've been failsafe for over a year now, though we are tolerant of sals so we eat those. We are also GF, being allergic to wheat. My children haven't eaten sakata rice crackers (plain) for at least 10 months. On Monday, I let my 3 yo have a few at a meeting. She hasn't had a rash of any sort at all since having thrush as a baby but the next day she had a redness across her mons veneris. It wasn't obvious, wasn't nasty looking at all. It just resembled a slight reaction to her wee from her night nappy. The next day, I wiped the area clean with a face washer and her skin peeled off. There was still no obviously bad (visual) problem. She also said it really hurt. The following day you could see the peeling off skin - it resembled our skin after we've been badly sunburnt. Yesterday the skin was hanging off her.- Bronnie, by email
Have you started your elimination diet within the last 2 weeks?
YES
If you have just started your diet or recently dropped more items from your diet, your problems could be due to withdrawal symptoms as in the following example:
I have been on the diet successfully for months but have been experiencing troubles of late, so I went over my diet with a finetooth comb and found the probable causes, including canola oil with anti-oxidants. It has been about 5 days since I have been completely failsafe, and I am now feeling depressed, unmotivated, teary, irritable, etc, would this be the side effect of eliminating the last of the food chemicals from my diet?
Withdrawals can occur any time within the first two weeks. For behavioural symptoms, withdrawals most often occur on days 4 & 5 but in some cases can last up to the end of the second week. For temporary relief, adults can take ENO regular antacid powder, children can take soda bicarb baths, see Shopping List. If frequent colds, flu or infections such as tonsillitis are part of your symptoms, they can occur now as part of withdrawal symptoms. If you have to use pain relief or take antibiotics, see the Shopping List.
NO
Your problems could be due to withdrawal symptoms if you have dropped even one item or food group from your diet within the last two weeks, see example above.
Are you allowing occasional 'treats'?
NO
Well done. The whole aim of an elimination diet is to get it right – it's only for 3 weeks. After challenges you can choose what you want to eat, knowing how it can affect you.
YES
Deliberate mistakes such as one or two serves of hot chips, takeaways, Vegemite or any other mistakes per week can be enough to prevent improvement. One mother wrote:
My three boys have been avoiding a number of additives for many years now because of obvious effects on their behaviour and health. Last year my 8 yo was diagnosed with Chronic Tic Disorder which is one step before Tourettes Syndrome. He could not sit still, having tics in his face, neck, shoulders and arms. After a period of time, I realised that this behaviour coincided with an increase in eating hot chips. I stopped my son eating hot chips and the tics went away. – from Story [471]
Accidental mistakes can prevent the diet from working. One mother wrote:
I am about to embark on the strict elimination diet for the 3rd time, but I am trying to pinpoint what went wrong the 2nd time round - was consistently bloating but not as severely as normal - versus the 1st time round when I felt fantastic. Using your salicylate and amine mistakes information sheets and the shopping list on the fed up website, I have so far picked up the following errors: Coles Pears in Syrup snackpacks (contained pear juice), Simply Wize Crusty Bread (maize flour), Dovedale Rice & Chia Bread (Chia seeds), and the wrong Cenovis multivitamin (Once Daily Women's Multi, contains evening primrose oil). Thanks for all of your help and detailed knowledge, I think I would have been doing many more things wrong in the diet without having the fed up site to look at.
Read the rest of this factsheet and ask for our Salicylate & Amine Mistakes information sheets - email This email address is being protected from spambots. You need JavaScript enabled to view it.
Is your child sneaking food at school?
NO
Are you sure? One mother said:
We tried the diet unsuccessfully three times. It turned out our daughter had been eating coloured sweets at school nearly every day. We only found out when we saw how much she improved over the long weekend – because it was the longest she had stuck to her diet.
YES
• See hints in Chapter 10 of Fed Up "How do you get difficult children to eat failsafe?"
• You can start the diet during school holidays
• Some supportive schools will ban lunch swapping
• One mother of a teenager took 2 weeks annual leave to stay at home with her son and cook for him
• Some children do better on home detention for three weeks while doing the diet, which is how Superintendent Peter Bennett achieved success with juvenile offenders in the UK
(1:30)
We did the elimination diet for our son's migraines. He managed his diet and reduced symptoms but didn't ever completely eliminate salicylates. Years later when he developed depression and hives we thought he had multiple health issues rather than multiple symptoms. It wasn't until a week or so ago I read the Wikipedia list of salicylate intolerance symptoms that I thought "My God this has been staring us in the face for all of this time" – Ann by email.
NO
Salicylates affect more food intolerant people than any other food chemical - approximately 75% of children with behaviour problems, 70% of people with irritable bowel symptoms, 60% of people with migraines, headaches or urticaria and 50% of people with eczema - so it is important to take them seriously. If the diet isn't working, it is worth rethinking salicylates. I know many families who thought they had passed the salicylate challenge, but hadn't given high enough dose, as this mother wrote:
We did not do the elimination diet correctly the first time. We made the usual mistakes - not enough commitment, cheating, coming off it too quickly – and were misdirected in our conclusions - thought salicylates were fine and amines were the baddies. We decided to put our daughter back on the elimination diet after she failed to improve when we removed amines. This time we are 100% committed and the results are clear. Our daughter was fine the first day of the salicylate challenge, a bit iffy the second, and by day 3 she was back to pre-diet days, even resorting to deliberately (in front of me) urinating on the lounge room floor. Add to this a constant headache, tummy pains and a small rash on both legs. I promptly cleaned out the fridge, and removed all salicylates from the house. Two days on and we are gradually improving, but what a shock! An even bigger shock was my son's reaction. - From Story 714
SOME
The problem with salicylates is that everyone expects a quick reaction like artificial colours but instead there is usually a slow build up. It doesn't mean the effect is any milder, it's just that the reaction takes longer.
Many people write I think we can manage moderate to high salicylates. If the diet isn't working, it is usually worth cutting right back on salicylates. Expect a slow build up of effects, not an immediate big reaction.
YES
When the diet isn't working, it is vital to check for too many salicylates. Beware the advice 'an apple a day can't hurt you' – it can! People rarely notice an immediate reaction to salicylates in foods but you won't get the improvement you want - or you will see an improvement but after a while the effects will build up and you'll be back where you started. Stick to low salicylates during your strict elimination diet. There are many dodgy salicylate lists on the internet – ignore them. The only salicylate tables we recommend are the revised figures in the 2009 RPAH handbook.
Some extra sensitive people have problems with low salicylate items such as pears, shallots, leeks, golden syrup or brown sugar. According to RPAH, an intolerance to pears suggests an intolerance to sorbitol (avoid or reduce your intake of pears). Problems with shallots, garlic, leeks, chives, cabbage or Brussels sprouts suggests an intolerance to sulphur compounds which can double after 5 minutes of cooking. (To avoid this problem, you can eat these vegetables raw, or quickly steam or stir fry). For sweeteners, white sugar and maple syrup are much safer than golden syrup and brown sugar, which are at the high end of the low scale.
Reader report: Every time I use golden syrup (CSR) both kids react (itchy & rashy) yet they both tolerate maple. I just read on the Salicylate mistake list about the golden syrup. Wow! I don't use it often & not in large amounts. Usually just in the Big Anzacs but have seen a pattern of both of them reacting after eating the anzacs. Thanks!
You can request our Salicylate Mistakes Information Sheet - email This email address is being protected from spambots. You need JavaScript enabled to view it.
Have you failed your salicylate challenge?
NO or haven't done it yet
Go to next question
YES
If you have failed your salicylate challenge, RPA trained dietitians usually recommend reintroducing salicylates gradually to find your level of tolerance (e.g. using foods that are moderate in salicylates such as carrots, butternut pumpkin or other moderate vegetables, start with half a cup every second day for two weeks, the day for two weeks). Some people add in a lot of salicylate-containing foods in a hurry and say "my child is only sensitive to high salicylates". Lots of moderate salicylates can equal the same dose as high salicylates. Six months later, they say 'the diet isn't working any more'. Effects can sneak up on you, see reader comment below.
Thought I would let you know I am a lot better. Seeing RPAH Allergy Clinic directly made the difference and now I am having symptom free days. The key was the chart they gave me that showed how to add foods back in. That has made the difference. Every time my symptoms increased I had been going back to elimination and I was becoming more and more reactive. I started with 1/2 serve of amines (salmon or banana) every second day. Then introduced half a serve of sals once a week ... then I stuffed up and had to go back BUT NOT to the beginning (one step back) so you build up the base no matter how small it seems to be. I am now on 1/2 serve of moderate sals or amines each second day ... and I am so much better The problem is with rushing ... you can't help it ... you end up further back but not at the beginning.
If the diet isn't working as well as you'd like, you can try systematic reintroduction and keep the rest for holidays when your tolerance is higher due to lack of stress.
You can request our Reintroduction information sheet - email This email address is being protected from spambots. You need JavaScript enabled to view it.
Are you eating potatoes?
White potatoes are ZERO in salicylates but coloured potatoes, even cream and yellow, contain some salicylates and are therefore may not be suitable for your strict elimination diet.
In the 1985 Salicylates in Foods study, potatoes were tested as :
*potato, white (with peel) fresh 0.12
*potato, white (no peel) fresh 0
More recently, potatoes are described in the RPAH Elimination Diet Handbook (p 36):
*LOW Potato brushed white, peeled
*MODERATE Potato blue, new, pink, purple, yellow
It has become extremely difficult to buy truly white potatoes in Australian supermarkets now. If the diet isn't working for you, this may be your problem.
Do your best to find WHITE potatoes. It is very frustrating, because sometimes they will be labelled "white potatoes" and when you get them home and peeled they turn out to be cream. WARNING: Even the cream coloured potatoes are moderate in salicylates. They have to be regarded like carrots or butternut pumpkin, therefore not suitable for your strict elimination diet. We tried growing Kipfler potatoes in our vegie garden one year. If we ever needed a demonstration that too many salicylates make you irritable, that was it. After a lot of arguments that season we agreed to go back to 100% white potatoes.
We are hearing from salicylate-sensitive adults and children that they cannot tolerate a steady diet of cream potatoes or worse still, that the diet didn't work for them - and then it turns out that they included cream coloured potatoes in their 3-week trial of the strict RPAH Eliminination diet. If you fail your salicylate challenge, the next step is try systematic diet liberalisation. You may want to test cream potatoes to see how much you can tolerate. Ask your dietitian (see our list of recommended dietitians) OR request our Diet Liberalisation sheet if your dietitian hasn't given you one: This email address is being protected from spambots. You need JavaScript enabled to view it. See more in our potato blog post
Are you consuming pears, pear jam, pear ketchup and/or pear juice?
NO
Most people can tolerate 2 pears per day. According to RPAH, a reaction to pears is likely to be due to sorbitol intolerance.
YES
• Pears are limited to 2 pears per day or equivalent
• Pear juice is not failsafe because commercial pear juice contains the peel and is therefore moderate in salicylates
• Pears canned in juice instead of syrup are not permitted (including snackpacks with syrup AND juice, see Shopping List)
• Pears must be ripe, soft and peeled
• Pears must be soft and pear shaped, not crisp an apple shaped like Nashi and Ya (moderate in salicylates)
Do you consume coconut products?
Coconut information (from the RPAH Elimination diet Handbook 2011)
• fresh coconut is MODERATE in salicylates and amines (page 46, nuts & seeds)
• coconut milk and cream are HIGH in salicylates and amines (page 48, baking aids, herbs, spices, condiments)
• coconut oil and coconut fat (copha) are HIGH in salicylates and amines (page 50, fats & oils - copha is usually listed as “vegetable fat” in e.g. pastry and dairy free ice creams)
• desiccated or shredded coconut is VERY HIGH in salicylates and amines (page 46, nuts & seeds)
• coconut water is not listed but is likely to be at least MODERATE in salicylates and amines (page 46, nuts & seeds) For foods that haven't been tested, always assume that ANY fruit, nut or seed will contain some salicylates. Try the taste test: if it has a pleasant, acidic, sharp, tangy, zesty flavour (does it taste better than spring water sweetened with cane sugar?) it contains salicylates. If it is bland, sweet and mild, it might be moderate in salicylates - but probably not. Most fruits, nuts and seeds are at least high in salicylates.
Do you eat commercial products with vanilla flavours?
NO
If the diet is working, it is okay to have a little bit sometimes.
YES
(1:50)
Artificial and natural flavours, fruit flavours and even vanilla can cause problems. Vanilla essence is limited to 2 drops per day (due to salicylates) but even that can be too much for some children. If your child is not improving, reduce or avoid 'flavours', 'vanillin' or 'vanilla' in commercial products such vanilla flavoured yoghurt, custard, ice cream, soymilk, caramels, biscuits, carob and sweets. Home cooking is safer but avoid vanilla in that too.
My son is going well, although it was a bit rocky for a while until the vanilla ran out. He had been helping himself to lashings of vanilla essence in his cereal, drinks etc. Once the vanilla ran out he was back to being wonderful - such a little thing and such a big impact - a very big difference between the two allowable drops, and his great sloshes!! - reader story [269]
Unfortunately, over the last 14 days we have noticed a gradual reversion to [my 6 yo son's] old ways although there is still improvement from before starting the diet ... The most obvious major change in his diet has been moving to So Good Vanilla flavoured drink. I noticed on one of your reports that So Good lite with corn syrup can have a slow build up reaction ..... I don't suppose there are any reports of the vanilla flavoured one having a similar effect ??? [Yes!! - many children react to vanilla, even natural vanilla. If in doubt, take it out.] - from reader story [010]
Do you consume a lot of citric acid, lemon flavours or G&Ts?
YES
Citric acid is permitted on the elimination diet but some people react to it especially to large amounts. If the diet isn't working, limit or avoid magic cordial and other citric acid containing failsafe foods. You also need to avoid commercial flavourings in moderate products such as preservative free lemonade and tonic water (in gin & tonic) – previously listed as low.
NO
Even if eating small amounts, you may need to drop it until you get the improvement you want, then try again later.
NO
Go to next question
YES
(0:56)
Eat meat as fresh as possible - fresh meat that has been hung by your butcher for a week or two is acceptable but supermarket meats are usually now vacuum packed for up to three months, avoid if possible.
Fermented products contain amines - wine, beer, soy sauce, tempeh, miso, chocolate, cheese, sauerkraut, and even sourdough bread, so are not not suitable for your strict elimination diet. Plain yoghurt - which is listed as low in amines in the latest RPAH elimination diet handbook - may be a problem if not fresh (very sour and sharp tasting) and eaten in large quantities. As well, despite seemingly failsafe ingredients (eg flour, water, salt), yeast free bread can be made by a long rising process which encourages fermentation and can be a problem for the extra sensitive - bakers' yeast is failsafe and yeasted bread can be safer than yeast-free bread for this reason
Fetta cheese is not failsafe.- bland fresh white cheeses such as preservative free cottage, ricotta, quark, mascarpone and cream cheeses are failsafe, sharp fermented white cheeses are not.
Cashew paste must be made from raw cashews. Commercial cashew paste from lightly roasted cashews is not okay, make your own (see recipe, the option with maple syrup is particularly good).
Ask for our Amine Mistakes Information Sheet - email This email address is being protected from spambots. You need JavaScript enabled to view it.
Are you eating cold pressed oils?
NO
Go to next question
YES
Cold pressed canola, sunflower and safflower oils can contain small amounts of salicylates – otherwise removed by refining - that can build up slowly to cause symptoms.
• Cold pressed soy oil is failsafe.
• Cold pressed ricebran oil is failsafe but there has been been a report of a slow build up of symptoms from a family who are known to react to wholegrains (see wholegrains below).
Are you using carob powder or products?
NO
Go to next question
YES
Technically, carob powder is failsafe. Beware of added flavours in carob products, and milk powder if you are sensitive to dairy foods. Every so often, a batch of carob powder appears to cause problems, not linked to any particular supplier, if the carob has a bitter taste, or is a particularly dark colour, or has dark flecks in it. Howard feels there could be a problem with the processing (e.g. over-roasting, that could perhaps lead to the development of amines) or possibly contamination (e.g. with leaves, that may contain salicylates). If you suspect a problem – as with the report below – try a different brand as they do vary. Look for a pale rather than dark colour with a mild, sweet flavour.
We started the elimination diet on a Monday and saw results pretty much straight away. Our 3 & 4 yo sons had their withdrawal symptoms on the Friday (I remember this day because I thought that the diet was no longer working & I didn't think I had the strength to stick with the diet). By Sunday morning both of them were back to normal & from then on they have been like perfect lil angels until I made a carob birthday cake on day 12. Within 1 hour of eating a piece of the cake alone without icing, they turned absolutely wild and it was exactly like pre-diet days!!! It lasted until lunchtime the next day. I went back through all the things that they had eaten that day and the only thing that kept coming up was the carob. The carob powder (it was organic) had a bit of a bitter after-taste, definitely not sweet.- thanks to Clare
Do you or your child appear to be reacting to sugar?
(0:53)
NO
Go to next question
YES
White sugar, icing and caster sugars and light brown sugar are failsafe; dark brown sugar if very dark can be moderate in salicylates; raw sugar is now rated as high in salicylates; honey is very high in salicylates.
Even white sugar appears to affect children and adults sometimes. If this is happening, are you sure you have eliminated all salicylates? Salicylate-induced hypoglycaemia can cause sugar reactions, see reader story below.
We're just trying to start an elimination diet but over the last few weeks my 8 year old's behaviour just seems to have gotten worse! I've looked back on his food diary and nothing really sticks out. I made some home-made marshmallows from the failsafe book and he reacted badly to them (two small pieces and licking the whisk!) (crying, sad followed by hyper then on to the humming and repetitive singing, ending after three days as usual) …. My husband is convinced it's the sugar. The only possible thing I can think of that is new is that we have had the chia bread from bakers delight … thanks to Kate
In this case, the salicylates in the chia seeds probably caused the sugar reaction. People who are failsafe 'but not 100%' and swear they react to sugar have almost certainly failed to reduce their salicylate level enough. For more information, see Salicylate-induced hypoglycaemia in the index of my books such as Fed Up.
Are you eating corn or maize in any products?
NO
Go to next question
YES
Corn and maize can be terribly confusing.
• cornflour or cornstarch is okay because it is highly processed but corn or corn flour (i.e. ground corn in bread and tortillas, see reader report below) is not okay. Similarly, refined maize flour called maize starch is okay but maize flour is not.
• corn oil (no added antioxidants) is moderate in salicylates therefore not failsafe
• all other corn – fresh cobs or kernels, creamed corn, canned sweetcorn, cornmeal, polenta, corn chips, taco shells, cornflakes and other corn cereals such as Nutrigrain - are now classified as high because corn contains some glutamates as well as salicylates, definitely not suitable for your elimination diet
• popcorn was not tested but I would assume it is high
• corn syrup was not tested but could be low because it is highly processed
• small amounts of corn in gluten free pasta are technically not failsafe
• if you are gluten free, check that the corn starch is not made from wheat, see our Shopping List
• cornflour may contain residual sulphites (about 30 ppm) that can affect the extra sensitive
Readers report: My son is a salicylate sufferer. He has had major reactions the last 4 weeks to something and I finally phoned Naturally Gluten Free to confirm the ingredients in their Classic Naturally Gluten free bread and they told me it is ground corn. However, the Oriental loaf is failsafe because it uses rice flour instead of corn. - thanks to Melissa
If eating 'all natural' yoghurt or icecream, have you checked the label for annatto?
YES
Go to next question
NO
Annatto 160b natural yellow colour is used in many dairy foods such as yoghurt and icecream, as well as biscuits, breakfast cereals, cheese slices, frozen or crumbed products, croissants and a wide variety of other processed foods. It is often in products labelled 'all natural, no artificial colour, flavours and preservatives'. Since annatto usually causes a next day reaction, people don't realise when it affects them, they just see a slow build up of problems, as in the following report:
My 2 yo son has been an angel since starting the elimination diet however took a backwards step at about 2.5 weeks. We discovered we had been giving him soy yoghurt with 160b in it. We took him off it and his symptoms (irritability, huge tantrums) cleared again. – thanks to Greg
NO
Go to next question
YES
Bread is one of the major causes of diet failure because it is a seemingly healthy food eaten many times a day every day and there are so many ingredients to avoid (e.g. vinegar, seeds except poppy seeds, wholegrains, preservatives such as 282, sorbates 200-203 or sulphites 223, honey, fruit, synthetic antioxidants such as 319 or 320, possibly unlisted, cultured whey powder and the newer incarnations of 282 such as cultured wheat and cultured dextrose). See blog post
Remember that wraps often contain more preservatives than loaves of bread.
See the Shopping List for more about bread – what to look for, what to eat and what to avoid. If in doubt, plain unflavoured rice cakes such as Sunrice or Pureharvest (no corn, no sesame, no flavours) are one of the safest foods on the market.
Are you eating bread with chia seeds?
NO
Skip the next question
YES
A mother wrote:
We've lived failsafe since Christmas which up until recently has made our house a calm, lovely environment (thank you for that!) but over the last few weeks it just seems to have gotten worse! I've looked back on his food diary and nothing really sticks out. The only possible thing I can think of that is new is that we have had the chia bread from bakers delight . .. LATER … I called my husband after I got your email and he said he'd bought two loafs on saturday and they were all gone by monday morning. As bread is the one thing we thought of as safe, we let our son make himself toast or bread and nuttelex as a snack without really monitoring how much! He must've had about one loaf over the two days - thanks to Kate
Chia seeds are not permitted on the RPA elimination diet. Chia is a member of the mint family. Mint is very high is salicylates and there have been numerous reports of gastrointestinal symptoms due to chia seeds from salicylate sensitive people overseas http://nutritionalconcepts.blogspot.com/2008/03/caution-regarding-chia-seeds.html and several reports from failsafers in Australia. Some people with food intolerance are also affected by wholegrains, see next paragraph.
Are you eating wholemeal bread or wholegrain cereals such as Weetbix or Vitabrits?
NO
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YES
People with food intolerance, including many children with behaviour problems, can be affected by wholegrains in wholemeal bread and wholegrain cereals such as Weetbix or Vitabrits.
You can switch to white bread and limit cereals (eg 2 Weetbix every second day) or if no improvement, avoid. White bread is not as nutritionally unsound as parents have been led to believe. I agree with the quote below from dietitian Sharon Natoli:
"Many parents feel guilty about feeding their children white bread - yet often it's the only thing kids will eat. Ordinary white bread provides a range of B vitamins, is a source of fibre and a good source of carbohydrate - vital for growing, active bodies. It is better nutritionally than many of the other foods commonly found in kids' lunchboxes." http://www.femail.com.au/white-bread-bakers-delight.htm
But if you don't like the idea of white bread you can switch to gluten free, e.g. Naturally Gluten Free Oriental loaf with quinoa.
According to RPAH, some people don't do well with wholegrains: "Refined rice products and wheaten/maize cornflour are the lowest in natural chemicals, though some people prefer wholegrain and wholemeal products. Try them both to see which suits you best". From page 7 Salicylates, Amines & Glutamates booklet by RPAH. In any case, when introducing any food that contains a fair amount of fibre, you may want to start with a small dose and build up slowly to get used to them. For example, see below for what RPAH say about legumes. The same presumably applies to wholegrains:
"If you have an irritable bowel or are not in the habit of eating legumes, don't eat too much to begin with or you will get symptoms from gas-producing bacteria which use the undigested fibre as their food source. The prebiotic effect of legumes may have some health benefits but the gas and other by-products of fibre fermentation can cause bloating, wind and loose bowel motions. Start with a small amount (e.g. a few beans, 3-4 chick peas) and increase slowly over a few weeks until you find the amount that suits you best without causing wind or discomfort." From page 45 RPAH Elimination Diet Handbook.
(1:22)
NO
Perhaps you need to reconsider. In my experience families are often extremely reluctant to avoid dairy but research shows about 25% of children with behavioural problems are affected by dairy foods and the figures are similar for most other symptoms - about 25% of people with irritable bowel symptoms and about 20% of people with eczema are affected by dairy products.
One mother wrote:
When eating dairy foods, my daughter 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 …. 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 … from Story [1020]
If the diet doesn't seem to be working, it is probably worth cutting out all dairy foods as part of the elimination diet, and doing the dairy challenge (1-3 glasses of milk per day for at least a week, I prefer ten days as reactions can build up very slowly). If you don't want to cut out dairy from day 1, you can cut it out from the beginning of the 3rd week.
Parents often say 'but I can't ask my kids to stop drinking milk'. Failsafers say an easy way to do it is to switch to A2 milk first for two weeks – in some cases that is enough - then switch to oat milk (not for gluten free diets), rice milk, soy milk or Dari-free, see Shopping List.
YES
When avoiding dairy foods you need to avoid not only milk but also yoghurt, ice cream, cream cheese, butter and milk powder in bread, biscuits and other foods. You can switch to a milk substitute such as oat milk, Nuttelex margarine (not with olive oil) and ice cream substitute such as Sanitarium So Good Vanilla Bliss or Icey Ricey, see Shopping List for more information.
While people with physical problems such as rashes, rhinitis, irritable bowel or migraines may do well on A2 milk (www.A2milk.com.au) but it is often not helpful for children with behaviour problems, except as a stepping stone to milk substitutes such as soy, rice or oat milk.
Are you eating soy products or drinking soymilk?
NO
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YES
Some people are affected by soy not only in soymilk but in numerous common products including most breads, and also in some otherwise harmless additives. The effects can be extremely difficult to recognise, see story below:
[702] Diet not working 100 per cent - another soy intolerance story (November 2008)
We have had a major breakthrough with my nine-year-old daughter. Over a year ago we did the elimination diet for her and worked out what her intolerances were - severe for dairy, moderate to severe for salicylates, mild for amines and reacted to all the additives. I wrote to you some time back noting that my daughter who had finally started drinking soy milk (in fact she was guzzling it down), was bed wetting again and old behaviours were returning. You asked if she was OK with soy. So we removed soy (or so we thought) and the bedwetting stopped, unless she consumed anything with soy flour in it. For the next year we lived with a much improved daughter but it niggled at me that she still didn't seem 100 per cent and I thought she could be better ... See the full story in Success Stories
NO
Go to next question
YES
Ricemilks are probably the safest of all milk substitutes but children or adults with nut or soy allergies may be affected by brands which add chickpea flour for extra protein. Ricemilks alone are not suitable for infant feeding. For babies with milk problems you need to consider a prescription only formula such as Elecare or Neocate - ask your dietitian or doctor.
CONTINUE TO THE REMAINDER OF THE CHECKLIST OF COMMON MISTAKES
Thanks to failsafer Sonia Gulwadi for the great graphic https://www.facebook.com/easytoavoid
update December 2016
