This new approach is based primarily on diet. But it must be emphasized from the start that the kind of dieting advocated by clinical ecologists has nothing to do with any of the standardized, mass-applicable dietary programs

you may have heard about. It does not advocate the use of any particular nutrient, vitamin, or mineral in the fight against illness. Nor does it summarily ban any food.

Rather, it explains how you or your physician can detect and eliminate those commonly encountered foods and environmental chemicals which may be responsible for your ill health. The emphasis here is on the word you: this is an individualized approach. It concerns the interaction between you and your own particular environment, which is different from anyone else’s. You must discover the foods and chemicals which may be making you feel sick without your being aware of their effect. You must eliminate them from your diet and environment, or learn to control their intake, in order to get well.

For many people, of course, “allergy” primarily means reactions to such inhalants as dusts, pollens, danders, and molds. Patients with these afflictions can also be helped by the methods of clinical ecology, especially when such allergies are made worse by hidden food and chemical reactions. In this book, however, reactions to common foods and chemicals shall be emphasized, and the more serious cases at that. This is because the allergic basis of such problems as hay fever is already well known, while serious reactions to foods and chemicals are still a largely unknown territory to most people. I have practiced this approach to illness throughout my forty-five years as an allergist in the Midwest. I have treated about 20,000 people for food allergies and related problems and have dealt with virtually every kind of chronic illness on an allergic basis. About 7,000 of these patients were primarily suffering from so-called mental problems. The majority of these patients have been helped significantly, often after conventional methods of treatment had failed. Sometimes patients have come to me with a single well-defined ailment. Typically, however, patients have been polysymptomatic, that is, they have had a long history of many problems, physical and mental, which had left them in a general state of misery. The more symptoms they accumulated, the less their doctors have believed their complaints.

Usually, neither patients nor their physicians have suspected food allergy as the root of their problem. This is because most food allergy, by its very nature, is masked and hidden. It is hidden from the patient, hidden from his or her family, and hidden from the medical profession in general. It is said that often the solution to a difficult problem is right in front of your nose, but you cannot see it. In the case of food allergy, the source of the problem is literally in front of you, in the form of some commonly eaten substance which is bringing on and perpetuating chronic symptoms.

Of course, some people do know that they are allergic to certain foods, but generally these are foods that are rarely eaten. A person who is allergic to cashews, for instance, may break out in a rash on the rare occasions when he consumes these nuts. He overcomes this problem by simply avoiding cashews, and that is generally the end of the matter.

Allergies to commonly eaten foods are not so readily detected or avoided, however. Let us say, for instance, that you developed an allergy to milk early in life. At first, this may have resulted in acute reactions, such as a rash or a cough. In time, if the allergy was not recognized and controlled, the symptoms may have become more generalized and less easily detected. Since you probably went on drinking milk or eating milk products almost every day, one day’s symptoms blurred into the next day’s. You developed a chronic disease, such as arthritis, migraine, or depression. It never occurred to you that your daily dose of milk was the source of the problem.

In fact, you were probably “abusing” milk. You had become a milk junkie, a milk-o-holic. It is in the nature of this problem that a sudden loss of the craved substance can cause withdrawal symptoms. Since removal of milk brought on a particularly bad attack of the symptoms, you unconsciously learned to keep yourself on a maintenance dose. Milk in the morning with cereal, milk in your coffee, yogurt for lunch, a glass of milk with your dinner, and, of course, a platter of cheese tidbits before retiring.

Milk is just mentioned as an example. In fact, any food can be abused by overeating it. If a food is eaten in any form once in three days, or more frequently, it is being abused and may become a big problem for the consumer. Since it ordinarily takes between two and three days for a meal to make its way through the digestive tract, the person in question is not free of that food before another dose is added to the stomach. Intolerance to this food may sneak up on the person who eats it after months, years, or even decades of day-in and day-out ingestion. The chief reason these reactions to commonly eaten foods are not readily recognized is that they are part of a pattern of constant reactions in which periods of heightened stimulation may give way to periods of letdown, or “withdrawal” effects. In the beginning of the problem, eating the food has a marked, immediate stimulatory effect lasting up to several hours. Simply by eating a particular food, such as coffee, wheat, or corn, as often as necessary, this “up” effect may be maintained for a relatively long period of time. It is only when such foods are not eaten regularly that a kind of “hangover,” or withdrawal reaction, occurs. Some people find, for instance, that if they sleep late on Sunday morning they wake up with a headache, which usually goes away when they eat. The reason for this is a physical need for some food, such as coffee, which is normally taken early in the morning.

Since the delayed withdrawal effects can usually be controlled by eating some form of the same food, the whole cumulative process of reaction can be called a food addiction. A food addiction differs only in degree of severity from a drug addiction. In all other respects, the two phenomena are remarkably similar. In fact, I have arranged both food and drug addictions in an “addiction pyramid” (Fig. 1). At the peak of this addiction pyramid are heroin and other opiates and natural drugs. These are the most highly addicting substances known. Lesser degrees of addiction can develop, however, to synthetic drugs and to combinations of foods and drugs. Coffee, which is consumed in over 100 billion doses (cups) a year in the United States is a good example of such a mixture.1 In fact, according to experts on addiction, “Any man and any mammal will develop an addiction if certain substances are introduced into the body in sufficiently large doses for a sufficient length of time.”2

The relationship between allergy and addiction may seem a bit complicated at first. Actually, neither of these terms perfectly fits the disease state we are talking about.

Allergy, in this book, is used in its original meaning of any individualized reaction to an environmental substance occurring in time. This would include all those symptoms, such as rashes, hives, coughs, or sniffles, which are identified in the public mind with allergies.

When a person is exposed on an infrequent basis to some substance, and has an immediate reaction to that substance, then the cause and effect of the allergy is apparent to all. Hay fever sufferers, for instance, have little trouble in identifying the source of their problem as pollen.

When the exposure to an allergy-causing substance is constant, however, eventually the acute symptoms will give way to either a period of no symptoms, or to chronic symptoms such as headaches, depression, or arthritis. In other words, the acute symptoms have been suppressed because of the constant nature of the exposure, and the body has reacted by attempting to adapt itself to the problem.

It is this phase which we call addiction, and this most often occurs in response to commonly eaten foods. Unlike the drug addict, however, the food addict does not usually know the object of his desire. In fact, the food addict may not consciously crave any particular food, but may simply arrange his eating schedule so that it always includes the unknown addicting substance. A milk addict, for instance, may always make himself a melted cheese sandwich before retiring, never realizing that he has a physical need for the milk product in that snack.

The food addict resembles the drug addict in one particular, however. Like the drug addict, he tends to alternate between “highs,” or what we call stimulatory reactions, and “lows,” which we call withdrawal reactions. Because of this alternation of “up” and “down” reactions to the addicting substance, the average person can come to understand quite well the essentially addictive nature of common food allergies.

Unfortunately, there is no single word which connotes the longing for an unknown substance, or a craving for something which is hidden not only from the world but usually from the victim himself, but the word “addiction” comes closest to that meaning.

If such food allergies are hidden, the reader may wonder how they were ever discovered. The story of their discovery by Herbert J. Rinkel, M.D., is a fascinating example of medical detective work by one of the pioneers of modern medicine.

Herb Rinkel was a technological genius, an innovator and an inventor with a passion for making cause-and-effect observations of patients and, especially, for measuring them. Under these circumstances, it is not surprising that he should come up with unusual and unique clinical observations. In my opinion, he was the outstanding clinical investigator of his day, as far as the field of allergy is concerned.3

Rinkel was married and had a small child when he entered Northwestern University Medical School in the 1920s. Since they had little money, he and his family subsisted mainly on eggs as their principal source of protein while he was attending medical school. His father, a Kansas farmer, sent the family a gross (144) of eggs a week. From what was later learned about food allergy, it is not surprising that under these circumstances he became highly sensitive to eggs. About this time, he developed a severe nasal allergy. Although he consulted several different physicians, the cause of his profuse rhinorrhea (running nose) was not determined, and treatment was ineffective.

Finding that the medical profession could do nothing for his nasal problem and being familiar with the early investigations of food allergy, he wondered if he might have such an allergy. However, when he tested himself with eggs by drinking down six raw eggs prepared in a blender, he failed to develop any evidence of a reaction. Several years later, however, he happened to avoid eggs along with several other foods, while testing the assumption that a combination of foods might be involved. After eliminating eggs in all forms from his diet for about five days, he ate a piece of angel food cake at a birthday party. Within a few minutes he lapsed into a state of profound physical collapse. Other physicians present were at a complete loss to explain it. Pulse, blood pressure, respiratory rate, neurological and other findings were within normal limits; unconsciousness was his only symptom. The other physicians, as well as Rinkel, after he had regained consciousness within a few minutes, were astounded by this sequence of events.

In thinking about his experience, Rinkel wondered if it might indicate something of importance about the basic nature of food allergy. Perhaps if one had been eating a given food every day, or frequently and regularly, and then omitted it for a period of several days, reexposure might induce an acute, violent type of reaction. To put this concept to the test, he began eating eggs again as formerly. He then omitted eggs again for five days, repeated the egg ingestion, and experienced another bout of unconsciousness. Rinkel next began experimenting with several unsatisfactorily treated, chronically ill patients from the clinic where he worked. By 1936, he had confirmed and extended his observations of masked food allergy. Although these findings were reported in several local allergy journals, his major article op. masked food allergy was not accepted for publication by the editor of the prestigious Journal of Allergy. Rinkel was very upset by this rejection and made no further attempt to publish on this subject for the following eight years. During this time he worked out the basic nature of masked and unmasked food allergy.

What foods did Rinkel and others find caused such hidden allergies? The most common culprits, quite logically, were the most commonly eaten foods. In North America at this time these include coffee, corn, wheat, milk, eggs, yeast, beef, and pork. In fact, any food, eaten repeatedly, could cause allergic reactions. If a person did not eat one of these foods, the chances are he would not become allergic to it. On the other hand, if a food were taken more than once every three or four days (and most of those on the above list are), then they may possibly cause trouble.

Americans have become largely unaware of what goes into their stomachs. The increased consumption of prepared food, including restaurant food, often leads us to eat blindly. Many people still do not read labels, and labels are often incomplete or inaccurate. Some labels, for example, list “sugar” as an ingredient, but rarely say whether this means cane, beet, or corn sugar.

The result of this situation is that many people think they are not consuming a particular food, when they are in fact having it every day. A good example is corn: you may not eat corn as a vegetable very often, yet eat it at practically every meal in the form of corn sugar (dextrose or glucose), corn syrup, cornstarch, corn oil, or as a hidden ingredient in other foods, such as beer or whisky. Both Rinkel and I showed that allergy to corn was, in fact, a dominant form of food allergy in North America.

In this book, therefore, when I speak of “eating” a food, I am referring to consumption of that food in any form in which it enters the body, not just in its most obvious shape. Part of the difficulty in unmasking food allergy stems from the hidden way in which various foods enter the diet.

As I have indicated, the continuous intake of such a food may eventually result in a response which resembles addiction: one has an unconscious need to consume a particular substance in order to feel relatively well. Being deprived of that substance brings on a feeling of illness, whose nature depends on the individual in question. The American humorist Don Marquis once said that “ours is a world where people don’t know what they want and are willing to go through hell to get it.” This is a good description of the food addict, who doesn’t know the exact nature of the food he craves, but is willing to eat compulsively, to the point of addiction, in order to get it.

The addictive response is broadly composed of two phases: 1) an immediate improvement of chronic symptoms of illness, such as tiredness, headache, fatigue, or aches and pains, when the food is eaten and then 2) a delayed hangover unless the addicting food or drink is taken on schedule. Each individual establishes his own addiction routine, his own pattern of ever-decreasing periods between food “fixes.” By taking his addicting food, the addict keeps himself in a relatively “high” state and postpones feelings of letdown, hangover, or pain which follow withdrawal of the addicting food.

Since the craved food results in pleasure or at least the absence of pain when it is eaten, the confirmed “food-a-holic” may indignantly reject the suggestion that his “favorite” food or drink is bad for him. Why, that’s the very food that makes him feel good! This is part of the paradoxical nature of food allergy—that one’s best friend, foodwise, often turns out to be one’s worst enemy.

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Activated carbon filters

Activated carbon is a highly reactive surface which attracts substances such as chlorine, chloroform, carbon tetrachloride, trichloroethyiene, phenols, DDT, other pesticides, PCBs and dioxins. These and other organic molecules found in tap water stick to the carbon leaving the water much less contaminated.

There are various forms of activated carbon, granular activated carbon or GAC being one of the most effective. The amount and quality of activated carbon in a filter determines how efficient it is at removing pollutants. Plumbed-in filters contain far more activated carbon than jug filters.

A major problem with these filters is that they are en ideal breeding ground for bacteria, including harmful forms. To combat bacterial growth, most such filters are now impregnated with silver. There have been alarming reports of silver leaching out into the water, and this can happen with some filters. But new production methods, such as bonding the silver to the carbon at high temperatues, can overcome this problem.

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Spinach and chickpeas should not be included if you have bowel symptoms. Parsnips should be eaten in limited quantities only, and not too often, as they contain small amounts of a carcinogen.

Plantains are closely related to bananas and should not be included if you regularly eat bananas.

You should only eat sunflower oil if you have not previously eaten much margarine, nor used much sunflower oil (or ‘vegetable oil’) in cooking. There is some evidence, that polyunsaturated oils, such as sunflower oil and safflower oil, are harmful if eaten in large quantities. Since the diet is rather low in calories, it is tempting to make up for this by using a lot of oil in cooking, but this is inadvisable. Olive oil is a monounsaturated rather than a polyunsaturate and is thought to be safer in large quantities – it is probably better for you than other plant oils. Unfortunately, it has a mild laxative effect on some people, so use it in moderation if you have bowel symptoms. If you have not eaten it before, it is worth testing it out before you start Stage 3 to see if it has any effect.

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In the light of this discovery, some doctors believe that women whose children are likely to be atopic should restrict their diet during pregnancy. However, the few studies that have attempted to test this idea have produced largely negative results. Given the difficulty of eating a restricted diet during pregnancy it is probably not worth doing so for such uncertain gains. But anyone who is concerned about allergies in their children – having had one severely allergic child already, perhaps – could omit certain foods that are highly allergenic. The list should include cow’s milk, eggs, peanuts, fish and wheat, plus any foods to which the earlier child is allergic. It is, of course, essential that you consult your doctor to ensure that you are getting enough nutrients. A calcium supplement will probably be required.

The more of a food that is eaten, the more passes into the bloodstream. So eating huge quantities of one type of food during pregnancy is probably bad for the unborn child who may be predisposed to allergy. There have been no scientific tests to prove this, but not ‘bingeing’ during pregnancy, or while breast-feeding, would seem to be a sensible preventive measure.

Smoking during pregnancy has been shown to increase the risk of allergy, quite apart from its other damaging effects on the foetus. It is advisable to give up well before conception, and to maintain a smoke-free house once the baby is born – see next section. Putting on excess weight during pregnancy is also a risk factor for allergy in the child.

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Given that the doctor has ruled out infection and other likely causes for the diarrhoea, then food sensitivity should be considered.

As new foods are introduced into a child’s diet, there may be temporary’ bouts of diarrhoea in response to them, although these do not necessarily develop as soon as the new food is eaten. Such transient diarrhoea is sometimes given the name toddler diarrhoea and is characterized by loose stools that contain some undigested food. Toddler diarrhoea usually clears up by about two years of age, and the usual medical advice is to leave it untreated. Given what we now know about food sensitivity, this is not necessarily the best advice. There seems to be a general pattern in some children, particularly with illnesses such as colic and eczema, of symptoms disappearing but other symptoms appearing later in their wake. If this is also true of toddler diarrhoea then it might be better, in the long run, to identify the offending foods and avoid them for a while. In one study, six out of 21 children with toddler diarrhoea proved to be food-sensitive.

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It looks very much as if coeliacs are unfortunate casualties of the slow adaptation process between the human race and wheat. Wheat, after all, is a relatively new food – we have only had 10,000 years to get used to it, which is the blinking of an eye in evolutionary terms. Although natural selection should gradually eliminate any genes that make human beings susceptible to wheat (at least among wheat-eating populations) it seems to be a process that has not had time to run to completion.

If this theory is correct, then it is possible that some non-coeliacs are adversely affected (though not as seriously) by lectins orother defensive chemicals found in wheat. Not just affected by very large amounts, as in the experiment described above, but affected by a normal, everyday intake of wheat. Natural selection works more slowly on a gene that has mild ill-effects than on one with serious ill-effects, such as coeliac disease. So it is even more likely that minor problems with a new food would persist for thousands of years.

This could explain why wheat sensitivity is so common, although there are other equally plausible explanations. Wheat, along with milk, is the most commonly eaten food in Western countries, and may appear in every meal and snack of the day. There is little doubt that a food which is consumed frequently is far more likely to cause food intolerance (although no-one knows precisely why) and this alone could account for wheat’s bad record.

Other foods, besides cereals, are a possible source of toxic or damaging chemicals. Some are known to cause false food allergy in susceptible individuals and a few can cause cancer. Others, such as coffee, have a drug-like (pharmacological) action on the body, which means that they produce marked physiological effects even though they are eaten in very small amounts.

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