Thursday, January 14, 2016

FAILSAFE: A brief explanation

After 5 months it really is time to get to write about our FAILSAFE journey. A few friends have been interested in having more information - so I want to try and explain it all a bit. This post will just be a brief explanation of what it's all about.

FAILSAFE stands for Free of Additives and Low In Salicylates, Amines and Flavour Enhances.
It's also known as the RPAH elimination diet because it was designed by the Royal Prince Alfred Hospital in Australia, who dealt with children with severe allergies. Over the years, the diet has shown to be very successful with a wide range of issues.

Here are some of them:
  • headaches, migraines, head banging
  • rashes, itching, swelling
  • asthma, stuffy/runny nose
  • short fuse, temper outbursts, rages
  • foggy brain, forgetfulness, difficulty concentrating
  • oppositional defiance, symptoms of ADHD, silly noises
  • diarrhoea and/or constipation, reflux, sneaky poos
  • insomnia, night terrors, anxiety, depression
  • atrial fibrillation, arthritis, alopecia
  • eating disorders

If you want to do some reading yourself, check out the Fedup website. There are many testimonies to read too. I will try and summarise what I have learnt, but if you would like more information, check out the website.

As a family we didn't really have many additives in our diet, so I have focused more on the natural food chemicals. These are salicylates, amines and glutamates (flavour enhancers). What you need to understand about these is that they occur naturally in food. Especially salicylates and amines. So even if you buy organic food, these food chemicals are still present as they are a natural occurring substance in the food (and not a chemical that has been sprayed onto them).

Most fruit and vegetables have got either salicylates or amines. So on the strict elimination diet, the range of fruit and vegetables is VERY limited. Fruit is the worse and is limited to only pealed pears. Pealed, because there are salicylates in the skin, but the flesh is fine. Every other fruit has some level of salicylates. The vegetables that we have been limited to are: white potatoes (must be pealed), green beans, leek, cabbage, celery, Brussels sprouts and garlic. There are a couple others, but they aren't ones that we normally eat (like chokos).

Amines are also found in protein foods like cheese, fish (unless you eat it within 1 day of it being caught), processed meat and any meat that is frozen for more than a month, or not frozen soon after been slaughtered. If you cook meat for more than a couple of hours (like in a slow cooker) the amine level gets very high. Chocolate is also very high in amines.

Herbs, spices and fragrances are very high in salicylates, so the only thing we can use for flavouring meals is salt or vanilla. Other "healthy" foods are also not FAILSAFE, like honey. Thankfully Pure Maple Syrup is ok - so we are able to use that for sweetening. Even though white sugar is FAILSAFE, I don't like the effect it has on the immune system, so we still stay away from cane sugar (we haven't used cane sugar in our home for well over a year).

On that note, wheat is also acceptable on a FAILSAFE diet. As our family has been off wheat for over a year due to other medical issues, we choose to continue to exclude wheat.

Most nuts are not FAILSAFE, so the only ones we can have are raw cashew nuts. This also means that coconut is out, so no coconut oil for a while. This leaves us with butter and cream as the only healthy fats left (with olive oil also out). There are some vegetable oils that are FAILSAFE, but again, I choose not to use them as I don't like the other health issues associated with them.

As a quick glance summary, this is what we can eat:
Meat: Beef and chicken
Fruit: Pealed pears (or tinned in syrup not juice as they use the skins to make the juice)
Vegetables: Green beans, cabbage, Brussels sprouts, leek, pealed white potato, celery.
Grain: Oats (we do sometimes use a little bit of buckwheat and psyllium husks.)
Dairy: Butter, Cream, Milk, plain homemade yogurt (from milk, not a packet so there are no preservatives or colour), fresh homemade cottage/ cream cheese.
Other: egg, pure maple syrup, pure vanilla essence, salt, baking powder, baking soda.
Snacks: Cashew nuts, carob buttons, Bluebird ready salted chips – original cut, hardboiled egg, Hummus (made with chickpeas, butter and salt only).
Mayonnaise: We make our own white sauce out of cashew nuts and leek. We use this as a white sauce or mayo.
Other dried beans (red beans, black beans ect) as well as lentils are also FAILSAFE. We have used them in some recipes, but none of them have been that successful, so we hardly use them.

THE PLAN: Elimination, Challenges and Liberalizing
The first part of the plan is to be on an elimination diet for at least 3 weeks. You can choose between strict or moderate levels of restriction. We choose to be as strict as possible as this gives clearer results.

During this time you keep a daily diary of symptoms. I eventually drew up an excel document with each person's symptoms and we rated them on a daily basis. We got so much improvement that we just left off the zero's eventually, as there were so many of them.

I have an extra line on each day to keep track of anything that may be different for each person. Examples are Ruth getting lollies when she had blood tests done, or having hayfever because of being in a forest at Brownies.

Once you have had 5 days symptom free, you can start doing challenges. The idea is to introduce just one thing at a time for up to 7 days and then go back to elimination. An amine challenge would include food that are very high in amines (with no or very low salicylates and no preservatives ect). This picture from the RPAH handbook explaining dose and time (see link below). During challenges you want to have very high doses over a week, so that you have enough time to reach that threshold and see what reactions are going to happen.

We had a few people reacting very quickly to the different challenges, and not even getting through a full week of the challenge before going back to elimination.

Again, you stay on elimination until you have had 5 symptom free days before starting the next challenge.

Once you have done all your challenges and know what you are reacting to, then you can slowly bring foods back into your diet. This is called liberalizing your diet. You gradually re-introduce foods to establish the threshold for each food chemical.
During the challenges, you almost "overload" your body so that you can reach your threshold and see what the reactions are. At the liberalizing stage you want to try and introduce them slowly enough so that you don't cause reactions.

You can download the first 33 pages of the RPAH elimination diet for free here. Thresholds also make it a bit more complicated. This picture from this handbook explains that briefly (as does the one above).
The section in the RPAH handbook on liberalizing is available for free here.

At this point things got rather complicated for us with the range of reactions we had, and with being such a big family. So I will leave our experience for another post. Perhaps I will just note that even though this diet is probably one of the most difficult to do. It has been worth it. The changes we have experienced have far outweighed the hassle of the diet.

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