Transcript LEAP Elimination & Rotation Diet Protocol Training

LEAP Elimination & Rotation
Diet Protocol Training
Jan Patenaude, R.D.
Director of Medical Nutrition
Signet Diagnostic Corp.
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Getting Started
For this LEAP dietary training you need:
A LEAP Immunocalm Diet Report (i.e.
Sample patient LEAP report)
 Pen for note-taking
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Getting Started
Let’s do a “tour” of the LEAP Immunocalm
Diet Program Booklet.
 The LEAP ImmunoCalm Diet is an
elimination diet based on the individual’s
MRT results.
 Each patient receives his or her own LEAP
ImmunoCalm Diet Plan
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Understanding MRT
Test Results
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MRT is a food “sensitivity” test, not a food
“allergy” test.
“I know I’m allergic to strawberries. Why didn’t
it show up in my test results?”
Regardless of MRT results, patient should avoid
“known” problem foods.
The goal of LEAP is to help establish a healthy
eating plan for all patients, while eliminating all
reactive foods from their diet.
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Turn to your LEAP
ImmunoCalm Diet Program Test
Results page
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LEAP ImmunoCalm Diet –Phase 1
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Limited to 20 - 25 items or less
Consume freely.
Whole foods, cooked from scratch, ideally
Organic recommended
Better to eat 4-5 smaller meals
Drink plenty of water (64 oz/day)
Salt may be added in moderation.
Withdrawal: May feel worse before you feel better
Should see significant improvement in 7-10 days.
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“Why can’t I just avoid my
yellow and red foods?”
Answer: Assume reactive to ALL
untested foods until “proven otherwise.”
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“THERE’S NOTHING TO EAT!
I’LL STARVE!”
Answer: My phase 1 diet was a
feast/banquet compared to what millions
of people in 3rd world countries have to
eat. Just that realization made it easier.
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If you think it will make the
difference between adherence and
non-adherence, consider making
small diet changes, trading some
preferred foods from phase 2
(or even phase 3 if necessary)
to phase one.
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Food Chemical Reactions
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Dose related
May not be enough in a food antigen to trigger,
but may trigger if enough of food is eaten that
contains a food chemical
Modify diet to move foods from early phases to
later phases that contain highly reactive chemicals
(this tends to be a clinical judgment on the part of
the counselor)
And, if no improvement in 7-10 days, suspect
other hidden chemicals
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Food Chemicals Tested
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Acetaminophen, Ibuprophen (Meds only)
Aspartame/Nutrasweet (may contain
maltodextrin-corn)
Benzoic Acid (If highly reactive, may want to
limit raspberries, cinnamon)
Caffeine Wean off gradually. Common
migraine/IBS/insomnia trigger
Candida Albicans (Naturally present, not found in
food)
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Food Colorings (Not a big concern diet-wise as
most foods are in their natural state during early
phases. May want to review mouthwash,
toothpaste and medications, however.)
Fructose (Mostly dose related issue)
Lecithin (Corn, eggs, soy-often dose related)
MSG
Phenylethylamine and Tyramine (Common
migraine triggers)
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Polysorbate 80 (Sorbitol)
Nitrates and Nitrites (natural and added- may want
to test water.)
Saccharin-the pink stuff (mouthwash, toothpaste)
Salicylic Acid (Aspirin, personal care products
and Food-dose related)
Sodium Metabisulfite -Sodium Sulfite (Assume
reactive to all sulfites)
Solanine (Nightshade family)
www.noarthritis.com
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Other Concerns
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Yeast (Brewers and Bakers)
Lactose – May cause symptoms even if diary is
“non-reactive”
Sugar (Cane vs. Beet)
Coconut (May be very healing to the gut. Soapssodium laurel sulfate.)
Mint (Mouthwash, toothpaste, gum)
Cottage Cheese (dry curd)
Yogurt (plain, not flavored)
Meds-PDR, inserts, www.rxlist.com
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“SO I STILL DON’T
KNOW WHAT TO EAT!”
Food Idea List (Review with patient)
Hopefully, you can be creative with combinations
Orange juice concentrate, ginger and some leek
with duck, chicken, fish
Oven roasted vegetables, brushed with oil and
seasoning
Use your slow-cooker
Roast some meat, cook some grains, steam some
veggies, add oil/nuts
Pureed or mashed fruit and/or juice for sauces
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Menu, Shopping & Cooking Ideas
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Local Large Health food stores (Trader Joes,
Whole Foods, Wild Oats, naturalgrocers.com, etc)
Farmer’s markets
References in LEAP Booklet: Cookbook, Catalog
listings, websites
Two more: How to Cook Everything: The Basics
by Bittman and Food Allergy Survival Guide by
Melina, Stephaniak and Aronson
LEAP Website –www.nowleap.com (LEAP
Patient Section) and www.nutritionresults.com
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Building a Menu
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Review patient’s Phase 1 Foods
Get creative. Can you come up with protein,
starch, veggie and fruit dessert for a meal?
Are there “breakfast” items available? If not, is
client willing to eat “non-breakfast” foods for
breakfast? Leftovers from last nights’ dinner?
If not, some rearrangement may be in order.
Let’s look at your client’s leap results-brainstorm
ideas.
Picky Clients –Share “Learning to eat new foods.”
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Consult 1: Approx 45-60 min
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See LEAP Affiliate Physician Guide
Eliminate all vitamins/minerals/herbs and OTC
meds if possible, add back when stabilized.
Summarize what you’re about to covered
Obtain patient verbalization that they are willing
to follow phase 1 and keep food/symptom records.
Set a “start date” with patient. Schedule F/U appt
7-10 days after patient plans to start diet.
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Consult 2: 8-10 days
after starting diet
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Symptom survey
If No Significant Improvement in 7-10 days,
review Food/Symptom records for:
Adherence
Pattern of symptoms with 1-2 items?
Dose related issues
IgE allergies
Chemical issues
Lectin issues
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Consult 2: Continued
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Fiber issues
Lactose Intolerance (Should have been anticipated
in Consult 1)
Patient often knows/suspects what food is still a
problem
Eliminate “suspect” foods, and continue with
phase 1 for a few more days, until symptoms
subside.
If nothing else, may suspect meds
Continue to “build menu” with more meal ideas 20
Consult 3: Rotation Diet
4-5 weeks after patient begins diet. (Start
Phase 6/rotation diet)
 Helps prevent new sensitivities from
emerging.
 Have patient do another Symptom Survey,
compare to earlier surveys
 45 min – 1 hour.
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Teaching Tips for Rotation Diet
Arranged according to Food Families
 If you move a food to another day, move
the entire family
 If you eat a food in its own family, and only
eat it every 10 days, it doesn’t really matter
what day it falls in.
 Caution: Foods that are very similar in a
food family should be consumed more
cautiously, and need to be rotated (ex. Dairy
or Gluten grains)
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Teaching Tips for Rotation Diet
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Try to find a “milk,” an oil, a sweetener and a
“vinegar/sour” for each day.
Cow’s milk, goat’s milk, soy milk, rice milk,
almond milk, etc.
Sweeteners: Honey, cane sugar, apple juice
concentrate, saccharine, aspartame, brown rice
syrup, corn syrup. Try stevia and maple syrup.
Vinegar and/or “sour” (for dressings, vinaigrettes,
flavoring): Distilled vinegar, apple cider, rice, and
raspberry vinegars; red wine or balsamic vinegar
(amine & sulfite alert); lemon juice or yogurt,
buttermilk.
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Teaching Tips for Rotation Diet
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Keep a Kitchen/Personal Rotation Calendar
Consider starting a new rotation day before the
Dinner (main) meal instead of at breakfast.
Label items with a black marker: 1, 2 or 3
Continue to add one new food a day.
When all “test” foods have been added, start
adding untested foods-Use Food Family Guide.
If reactive to 2 or more foods in a food family, add
other foods in that family with caution.
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Teaching Tips for Rotation
Diet -more
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If a food is in a family by itself, and not
commonly consumed, add it, monitor response. If
“safe” add it into the rotation diet food list.
In time, the rotation diet should contain MANY
more foods.
Consider homemade “TV dinners.” Prepare a full
meal, place in divided freezer container or Ziploc
freezer plate with cover. Label with masking tape
and permanent marker. Freeze and have available
when “that day” rolls around again.
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Food/Symptom Diary
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Essential tool for sleuthing out problems
Recommend them to ALL patients.
They are a hassle, but a tool to getting well.
Think of it as playing “diet detective.”
Forces patient to pay attention to diet and
symptoms.
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FOLLOW-UP
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One month and two months after starting rotation
diet.
Repeat Symptom Surveys (SF-36 forms?)
Monitor for adherence
Review Food/Symptom Diary if desired
[email protected]
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MOST DIFFICULT PATIENTS
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65 year old, refuses to cook, only eats in local
restaurant (Probably not a great LEAP candidate.)
Client who’s never cooked a meal in 45 years of
life, eats all meals out.
Assess willingness to make major lifestyle
changes before testing.
Patient unwilling to do full elimination or rotation
diet, but still is thrilled with his results doing just
an avoidance diet.
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The best part of LEAP:
Healthier, happier patients
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