Herbal Health

Alternatives to commonly eaten foods

For sources of the more unusual foods, and addresses for mail-order purchases, see pp331-4. In all recipes, follow either the metric or imperial measurements, not a mixture of the two.

MILK

Goat’s milk can be bought in some healthfood shops and goat’s-milk powder is available by post. Because supplies are not covered by the same sort of regulations that govern cow’s-milk production, there is a risk of infection, and it is a good idea to boil goat’s milk before use, especially if giving it to children. There are two other drawbacks to this product: it has a very rank ‘goaty’ taste that takes quite a bit of getting used to, and it often provokes reactions in people who are already sensitive to cow’s milk.

Sheep milk is available in healthfood shops in some areas. It has a much less powerful taste than goat’s milk and is pleasantly creamy. Unlike cow’s milk, it freezes well, so you can buy it in frozen form. This milk may provoke cross-reactions in those sensitive to cow’s milk, but it is less likely to do so than goat’s milk.

Soya milk is made from pulverized soya beans, and its origin is evident in the flavour. Most brands have some sugar added. It is obtainable from most healthfood shops. To make your own, mix 165 gm (5 oz) of soya flour to a paste with a few spoonfuls of water, then slowly add 1 litre (1 Vi pints) of water, bring slowly to the boil, stirring continuously, then simmer for 20 minutes, stirring from time to time. Add a teaspoonful of honey; store in the refrigerator. Soya can readily provoke allergic/intolerant reactions, so it is not advisable to eat too much of any soya product. Soya desserts and ‘yoghurt’ are also available. Sugar-free forms of soya milk, and concentrated soya milk, both are available by post.

Creamed coconut is obtainable from Indian or West Indian groceries, and some healthfood shops. It can be used as a substitute for cream, if mixed with a small amount of warm water. Or you can just grate it directly on to fruit salad, chopped bananas etc.

Ground almonds can also be made into a cream substitute. Mix it to a paste with water and a little honey, then add more water until you get the right consistency.

Cashew nuts (unroasted) can be ground in a blender and mixed with water to form a cream substitute. Add honey and vanilla to taste. Dilute further to make cashew ‘milk’.

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Stage 1 – the ‘healthy-eating’ diet – should run for at least a month, but it can be continued for as long as you wish. Some flexibility is allowed during this stage – you can have the occasional meal off, but take all forbidden items in moderation, and avoid alcohol, tea and coffee. Stage 1 will go on longer than a month if you improve substantially on this diet -but in this case you will not be proceeding to Stage 2.

If you are going on to Stage 2, you should maintain the ‘healthy eating’ diet until you are ready to start.

Stage 2 will run for about three weeks if you don’t respond to the exclusion phase. If you do respond, then it will continue for two to three months. There must be no deviation from the diet during Stage 2.

Stage 3 will run for about three weeks if you don’t respond to the exclusion phase. If you do respond, then it will continue for two to three months. There must be no deviation from the diet during Stage 3.

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One important messenger molecule is interferon, whose main job is to combat viral infections. Interferon makes cells resistant to viruses. Some of the less beneficial effects of interferon only came to light when it was used as a medicine. Hepatitis B is a debilitating viral disease that is very difficult to treat. The discovery of interferon led to its use in hepatitis B, because it can stimulate the body to mount a more effective attack against the virus. But the patients who were receiving large doses of interferon suffered from unpleasant side-effects, including severe fatigue, headaches, dizziness, abdominal discomfort, bowel disturbances, nausea and joint pain.

This list of side-effects is remarkably similar to the symptoms of a mysterious and controversial illness that goes by the name of post-viral syndrome (PVS), chronic fatigue syndrome (CFS) or myalgic encephalitis (ME). In looking for the causes of this illness, most doctors have concluded that it must be psychosomatic. However, most cases seem to follow on from a viral infection of some sort, and 50 per cent of patients show a high level of antibodies to viral proteins. The parallel with interferon side-effects suggests an alternative explanation to the psychosomatic one – that the immune system has over-reacted to a viral infection and is continuing to produce excessive amounts of interferon. Alternatively, other lymphokines might be responsible for producing the symptoms – several others have similar effects.

If this is the case – and there is no definitive proof that it is – then interferon might also play a role in food intolerance. Perhaps there is some unknown immune reaction to food which stimulates the body to produce interferon, or other lymphokines, in damaging amounts. It is interesting that many PVS patients have been greatly helped by an elimination diet – it would seem that reactions to food are contributing to their symptoms. Some have also been helped by treatment for Candida overgrowth .

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Before any dietary investigation is started, however, the possible role of airborne and contact allergens should be considered. This involves a certain amount of detective work, thinking over times when the child is better, or much worse, and looking for clues as to what is causing these changes. Bear in mind that eczema is likely to fluctuate considerably anyway, and not every change will be in response to a change in the allergen load. What you should be looking for are major changes that occur regularly in response to a particular event – a marked improvement during holidays for example, or a deterioration when staying in a particular house.

If you feel that some airborne or contact allergen might be contributing to the eczema, then take whatever steps you can to eliminate it before embarking on dietary investigations. Reducing dust, damp and moulds in the house, keeping wool off the skin, avoiding low-temperature washing powders and rinsing clothes thoroughly after washing are basic measures that anyone with an eczematous child should try. If there are pets, then removing them temporarily, or keeping them away from the child, should be added to this list.

Non-specific irritants may be even more important than allergens, and these too should be eliminated. Simple measures include putting pure cotton clothing next to the skin, not using too much soap, and avoiding contact with chemical preparations as much as possible. Keeping a child’s fingernails short reduces the damage done by scratching, and not allowing the house to get too hot is also helpful – heat aggravates the itchiness in the skin. Special cotton clothing, and mitten-pyjamas, which alleviate the effects of scratching, can be bought by mail-order.

All these measures may take a little while to have any effect and you should allow several months to elapse before coming to any conclusions. If the eczema is still troublesome, it may be worth trying an elimination diet.

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Jane’s story

Jane’s health problems began as a baby. She had colic and vomited often, and at the age of three months developed eczema on her face and arms. Her mother had hay-fever every summer and her father had suffered from asthma as a child – both complaints are common allergies. Even before Jane was born, their family doctor was well aware that they were an atopic family – in other words, they were prone to allergies. As Jane grew older she developed asthma and hay-fever, although only mildly. Her asthma seemed to get worse when there was a cat in the room. Using extracts of grass pollen and cat fur, and inserting minute amounts of them under her skin (a skin-prick test), the doctor found that she was indeed allergic to both these substances – her arm came up in a red, itchy bump where the extract had entered the skin.

Once or twice during her early years, Jane’s mouth and tongue swelled up enormously after eating, and she had to be rushed to hospital. After thinking carefully about what she had eaten on these occasions, Jane’s mother concluded that it was peanuts that had caused this alarming reaction. The doctor used skin-prick tests again, and they confirmed that Jane had a food allergy -she was extremely sensitive to peanuts. Other skin-prick tests were negative, so it seemed that she could eat most foods safely.

Even though Jane avoided peanuts carefully from then on, there were occasional problems. One day when Jane was about eight, and her parents were holding a party, she handed round a bowl of nuts to the guests. Later she rubbed her eyelids, and they soon began to swell and itch furiously. Although her hay-fever and asthma subsided as Jane grew older, her sensitivity to peanuts remained the same.

As an adult, Jane had a successful career which involved a great deal of travelling and eating out. Wherever she ate she had to be careful to avoid anything with peanuts – even the slightest trace of them. All was well until Jane now in her thirties, ordered some cheesecake in a restaurant. She had asked the waiter if the brown powder on the surface of the cheesecake contained any nuts, and he assured her that it was pure chocolate. Usually it was – but t he chef had run out of chocolate that day and had been forced to use something else. Unfortunately for Jane, that something else was finely grated nuts, including some peanuts.

Within seconds of taking her first mouthful of cheesecake, Jane’s mouth itching. Her tongue began to swell and her breathing became difficult. She could no longer speak, and, as the swelling blocked her windpipe, she began to turn blue. Within minutes she had collapsed on the floor.

The colleagues she was dining with were horrified and had no idea what to do, but a stranger at the next table intervened. By an extraordinary, and lucky chance he was a doctor. Grabbing a spoon from the table, he pushed the handle over the edge of her tongue and managed to open up the blocked windpipe. As he did so, Jane gradually turned from blue to pink, but she was still in a state of collapse (known as anaphylactic shock) and her face still horribly swollen. Meanwhile, someone had telephoned the hospital, and another doctor arrived with the life-saving medicines that Jane needed. These were injected and she slowly regained consciousness.

Thereafter, Jane was even more careful about avoiding peanuts in her food. She realized that she could easily have died had it not been for the presence of a doctor. By scrupulously avoiding peanuts she has remained well.

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Relieving the itch is the first order of business, an essential step to take before you even begin to scout around for the cause of your misery. Not only will you welcome the comfort of relief, but you’ll also eliminate the danger of infection (and possible scarring) from continued scratching. There are plenty of effective ways to conquer the itch.

Ice cubes, rubbed on skin whenever you get the urge to scratch, take the fire out of inflammation.

Cold, wet dressings soothe eczema and help to stop not only itching but oozing. And the colder the dressing, the more effective, says Alexander A. Fisher, a professor of dermatology at New York University Postgraduate Medical School and author of a textbook on skin problems. ‘Wet dressings consisting of water with ice, made to the consistency of sherbet and applied with a cotton cloth for five to fifteen minutes and reapplied as necessary, are often well tolerated and beneficial,’ says Dr Fisher (Contact Dermatitis, Lea and Febiger).

We found an easy way to make Dr Fisher’s anti-itch slush. To break up the cubes, empty a tray of ice cubes into a plastic bag and pound it with a wooden meat mallet. Then empty the cracked ice into a blender with two tablespoons of cold water and, in several short bursts, blend into a mush. Wrap in cotton and apply to irritated skin.

Dr Fisher isn’t the only doctor who favors cold, wet treatment.

‘Cool compresses or ice packs relieve itching faster and more safely than most medications,’ says Nia K. Terezakis, a clinical assistant professor of dermatology at Louisiana State University.

Lotions of calamine and milk of bismuth, following wet compresses, bring down weeping, swelling and redness, says Dr Terezakis.

Night dressings of zinc oxide paste (available at chemists), applied on a closely woven cotton cloth, are also suggested by Dr Fisher.

Vinegar in water (2 fl oz/50 ml of vinegar in 2 pints/1.25 1 of water) is soothing.

Lukewarm water baths are extremely soothing, especially for inflammation around the genitals and buttocks or for widespread symptoms. A soothing bath is also a good way to soak off ointments and medications once they’ve served their purpose. Dr Fisher recommends 10 ? oz/280 g of colloidal oatmeal (available at chemists) to a tub of water. This mixture is called a ‘colloidal’ bath because the particles stay suspended in the water to soothe the skin rather than settling to the bottom of the tub. Other colloidals recommended by Dr Terezakis are: skimmed milk, powdered milk, cornstarch, baking soda, or a combination of any of these ingredients. (Colloidal baths do make the tub slippery, though, so be extra careful climbing in and out. A rubber bath mat is a good safeguard.) Depending on the extent of your problem, one to three baths a day should be helpful. As you heal, you’ll need to bathe less frequently.

Soaking in tepid water is comforting, even without colloidals. Whatever you do, avoid hot baths and showers.

Moisturize your skin by always applying a bland, non-allergenic moisturizing cream such as Nutraderm or Nivea Lotion after bathing or showering to prevent drying, itching and further irritation.

Humidify the bedroom in winter and dehumidify in summer to keep your skin comfortable.

Arthur L. Norms, professor of dermatology at Indiana University School of Medicine, recommends some further steps to reduce irritation and control itching and other symptoms.

Substitute 100 per cent cotton clothing, sheets and blankets for synthetics or synthetic/cotton blends.

Wash new clothing and sheets before they’re worn to get rid of chemicals used to stiffen fabric. We know a woman whose whole body broke out in an itchy, disfiguring rash after she slept on brand-new sheets. After several washings, they were finally safe to use.

Rinse all clothing and sleepwear in clear water after washing. Don’t use fabric softener or other laundry aids. And be sure to use low-suds detergents without enzymes, whiteners, bleach and other additives.

Avoid tight clothing, tight dressings and adhesive bandages. Anything that rubs against your skin is going to aggravate the situation, says Dr Norms.

Stay out of the sun. The last thing that red, inflamed or scaly skin needs is to be cooked with heat and light.

Rest. Healing takes energy. If your arm or leg is so bad that it’s swollen and red from top to bottom, you may have to rest it completely for a few days so it can heal itself successfully. In fact, if it’s your misfortune to have a whole-body skin rash, your doctor may order a few days of bed rest.

In more than nine people out of ten, reactions will be mild or moderate. Only 3 per cent react severely. If your skin problems are severe and widespread, covering 50 per cent or more of your body, don’t fool around with self-diagnosis. Body-wide involvement calls for medical attention and sometimes even special hospitalization to isolate the individual from all chemical exposure.

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The preventive measures outlined here apply to all drug reactions, including allergic.

Most important, if you have allergies, don’t self-medicate. As you can see, some of the most common causes of drug allergy – aspirin and other pain relievers – can be purchased without a prescription at the supermarket or corner store.

When your doctor does the prescribing, the cardinal rule is careful and conservative use of medications: the lowest doses, for as short a time as necessary.

‘The simplest way to reduce or prevent allergic drug reactions is to prescribe medication only when clearly indicated,’ writes Dr DeSwarte in the book, Allergic Diseases (J. B. Lippincott). ‘Medications, especially antibiotics, are often used inappropriately, too frequently and over a prolonged period of time.’

Too many people demand a ‘penicillin shot’ for every little cold or sniffle – unnecessarily upping the odds for an allergic reaction. Dr DeSwarte says that out of a group of thirty people who died from penicillin-induced anaphylaxis, only twelve really required penicillin.

Chances are, though, that sooner or later you will have a legitimate need for medication. Ideally, your doctor should be well versed in adverse reactions to the drugs he or she selects. But a quick glance at the cumbersome volumes which list dozens of possible reactions to thousands of drugs, makes it obvious that no doctor could possibly keep abreast of it all. They must be particularly cautious with newly introduced drugs, and be prepared for reactions which have not yet been reported. Penicillin, for example, was initially regarded as a very low-risk drug. As time passed and more doctors prescribed it, reactions appeared.

You can help your doctor guard against problems by looking up possible side effects yourself. My husband and I, for example, were planning a holiday in the Caribbean, so we asked our family doctor for an antibiotic to take along in the event we came down with Montezuma’s revenge or some other traveller’s scourge. He prescribed Minocin (minocycline hydrochloride), an antibiotic which he told us to take prophylactically – starting three days before we left – to stop any trouble before it began. He said that Minocin was widely used by people like ourselves who were headed for the tropics.

Before going to the chemist to have the prescription filled, I looked up Minocin in Physicians’ Desk Reference, which said that the drug can induce photosensitivity – a skin reaction to sunlight. That could be bad news for two people looking forward to a week of swimming and beachcombing. We took the drug anyway, but the knowledge of a possible reaction prepared us to discontinue its use at the first sign of red or itchy skin.

If you, your child or an elderly parent ever experience a drug reaction of any kind, be sure to jot down the name of the drug (both trade name and chemical name) and how you or they reacted. Ask your doctor or chemist for the names of suitable alternatives and possible hidden sources of related chemicals. Add that information to your home medical file and bring it to the attention of medical personnel should you or your relatives land in a hospital casualty department or change doctors. (That includes dentists.) Better still, buy a tag or card designating drugs to be avoided.

And last, when your doctor takes your medical history and asks if you’re taking any drugs, don’t forget to mention things like mouth-washes, vitamins, birth control pills, menstrual aids and suppositories. When it comes to drug allergy, you just can’t take anything for granted.

With these preventive measures, drugs should do what they’re meant to – help you get healthy again.

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Next to your bedroom, you spend the most time in your workplace. You might assume that people with industrial jobs have the most allergy problems. Not so, says Dr McGovern. Office workers – secretaries, clerical workers, administrative assistants, computer programmers and so on – suffer the lion’s share of work-related allergic complaints.

‘In almost every major office you will find people who are bothered by an allergy,’ notes Dr Falliers. Not too surprising, if you glance around the average office. Carbonless typewriter ribbons give off petroleum fumes. Photocopy machines gas out a host of chemicals. Paper is impregnated with formaldehyde and other chemicals – to say nothing of the ink. Then you’ve got vinyl chairs, and formaldehyde in the panelling, rugs and ceiling tiles. Felt-tip marking pens. Correction fluid. Fluorescent lights. Cigarette smoke. Potted plants. Devout users of perfume and aftershave lotion. All in all, enough to match the fumes in any chemical factory if you’re highly sensitive to chemicals.

Even if you could easily find a new job, you would have no guarantee the same problem wouldn’t arise in your new workplace. So your best bet is to stay put and make the best of it, and here’s how.

• Dilution is part of the solution. If you can, reduce the chemical content of your breathing atmosphere. Open a window and dilute the chemical concentration by ventilation. (Unless of course, a fleet of diesel trucks parks right outside your building. Or your office overlooks a parking garage.)

• Try to leave the building once or twice a day if the outdoor air pollution levels permit. Take a walk outdoors at lunchtime instead of spending the entire hour in the cafeteria.

• If you spend a lot of time on the phone, remove the wad of bacteria-killing cotton in the receiver. (Not all phones have it. To check yours, simply unscrew the mouthpiece on the receiver.)

• Cover the typewriter ribbon and well with a plain piece of cardboard.

• Plug in an air filter (see the section on air cleaning equipment later in this chapter for information on portable models).

Smokers in the workplace pose special problems. Banishing smokers to the rest rooms is really no solution at all, since nonsmokers eventually have to go to the bathroom, too. A lot depends on how co-operative your boss and co-workers are. Your doctor may be able to back you.

‘I have personally written letters to employers on behalf of a patient saying: “This person should stay away from smoke,” says Dr Falliers. ‘Most companies are willing to accommodate. Maybe they can move the person to a different work station. I’ve had a couple of flight attendants as patients, who got sick if they served the smoking section of planes. So the airline lets them serve only the front and someone else serves the back. But there aren’t always such easy answers.’

Of course, you may not necessarily be alone in your misery, and in an office situation, ’strength in numbers’ can more easily bring about change for everyone.

‘We’ve had buildings closed because 100 people got sick,’ says Dr McGovern. ‘Two people in one office would get sick, two others from the fourth floor would get sick, and so on, until one way or another they all wound up in my waiting room. In giving their history, they’d all say, “I work at such and such an address.” And I’d say, “Wait a minute! Other people working in that building are also getting sick. Let’s investigate.”

‘So I tell people to go to their union. Or get the names of other people who are allergic. Or write to the company and ask them to improve the ventilation in the building. Sooner or later, companies will find they can’t seal up the windows, blow smoke in everyone’s face and allow toxic indoor pollution to accumulate in the workplace. Too many people are being permanently disabled. Lawsuits by people with environmentally induced illnesses are increasing.’

For some, just getting the home environment cleared up will be enough to enable them to go to work and do their job. ‘Maintaining the home oasis can go a long way towards making unavoidable exposure in the workplace more tolerable,’ says Dr Rea.

‘After patients start to remove the chemicals in their office,’ says Dr McGovern, ‘and they clean up their house – mainly giving themselves a “safe” room – they’ll improve within a few days or a week. They’ll be able to think more clearly, or their joints will stop aching, et cetera, and they’ll notice the difference.’

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Do you feel worse:

– during periods of damp weather?

– when you walk into a damp, musty house or basement?

– if you sit in overstuffed furniture?

– if you’re near hay or straw (in a garden, in a barn or at a circus)?

– if you’re near a compost pile or leaf piles?

If you answered yes to any of those questions, chances are you’re allergic to moulds. Another ‘yes’ clue: Do you feel better:

– when there’s snow on the ground?

Moulds are a type of plantlike growth called fungi. Like pollen, their spores ride on the wind and cause allergies. Mildew is the black or white growth produced by mould spores. Rubbish bins, shower curtains and damp basements are the most familiar mould habitats. But moulds aren’t fussy – any place that is damp, warm, dark and poorly ventilated will do. And they’re not just found indoors. Check around your house for any leaks or damp spots that could harbor mould. The sooner you dry them out, the better.

Above all, reducing excess humidity in the house is the prime goal in controlling mould. One doctor reports that his own ‘mould asthma’ responded remarkably well to the addition of a dehumidifier in his bedroom. He managed to reduce the humidity to 50 per cent in the face of outside moisture levels of up to 88 per cent in foggy, humid Ventura, California. With the drop in indoor moisture came a marked decrease in the mould level in his room – and discontinued use of steroid drugs for the treatment of his asthma (Annals of Allergy).

Alfred Zamm, an environmentally oriented doctor in Kingston, New York, had this advice for mould sufferers; ‘I recommend buying the largest-capacity [dehumidifier] available, one equipped with a control that automatically turns it off when the humidity drops to an acceptable level.’ (Why Your House May Endanger Your Health, Simon and Schuster)

Unlike pollen, mould is not strictly a seasonal problem, although moulds tend to flourish when the temperature rises and diminish during the cooler months. An exceptionally rainy summer will promote a bumper crop of mould. Fair weather activities like raking leaves, gardening and mowing grass stir up mould spores, making it easy to mistake mould allergy for pollen allergy. Burning leaves in the autumn can also bring on an attack.

Mushrooms and yeast are related to moulds, so eating them can trigger a reaction in mould-sensitive people. And it’s not surprising that those same people can also develop symptoms after eating foods fermented with mould: sharp cheeses such as blue and Cheddar, baked goods, candied fruit, pickled or smoked meats and fish and soy sauce. The same goes for drinking beer, wine or cider, or using vinegar. Penicillin, too, is made from mould. If you’re allergic to mould, you may be allergic to penicillin.

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Food labels are far less complete than allergy sufferers and doctors would like. The law says that all ingredients must appear on the label, in descending order by weight. Additives such as

preservatives must be specified by name and/or E number. So far, so good. But flavourings – one of the most common causes of allergic reactions – do not have to be individually identified. As a rule, the more processed the food, the more flavourings it has, and as many as 125 chemical flavours can be used in a single processed food (40 is about average). Yet a manufacturer can list them all under the umbrella term ‘artificial flavouring’ without specifying the exact substances used.

Incidentally, it’s not unheard of for people to be allergic to natural flavourings – like cinnamon, vanillin or peppermint – as well as artificial flavourings. And that holds true for other natural additives. Papain, an enzyme derived from papayas and used to tenderize meat, has been known to trigger asthma in sensitive people. Sesame flour – widely used in cakes, breads and as a binder in meat products – may be made not only from sesame seeds but pulverized orange peel, so if you’re allergic to citrus you could react to it. Citric acid, a natural preservative, may come from corn or beet molasses, lemons or pineapple. Modified food starch may be made from wheat, corn, sorghum, arrowroot, tapioca or potatoes.

‘Food processors who do not label their products adequately place an unacceptable health burden on a rapidly growing segment of the public,’ says Joseph B. Miller, clinical associate professor at the University of Alabama Medical Center and a member of the food committee of the American College of Allergists (Annals of Allergy).

Your job will be much easier if you avoid packaged, processed food as much as possible, carefully selecting only those items which you and your family are sure to tolerate.

One last note: some people are so sensitive to plastic and the chemicals it imparts to food that they cannot tolerate food and packaged in plastic wrap or tubs. If you suspect plastic-wrapped food may give you trouble, find a butcher who sells meat in cellophane paper. Buy other foods in bulk or loose and store them in glass jars at home.

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