Slide 2 1 LEAP Elimination & Rotation Diet Protocol Training
Jan Patenaude, R.D. Director of Medical Nutrition Signet Diagnostic
Corp. Slide 3 2 Getting Started For this LEAP dietary training you
need: n A LEAP Immunocalm Diet Report (i.e. Sample patient LEAP
report) n Pen for note-taking Slide 4 3 Getting Started n n Lets do
a tour of the LEAP Immunocalm Diet Program Booklet. n n The LEAP
ImmunoCalm Diet is an elimination diet based on the individuals MRT
results. n n Each patient receives his or her own LEAP ImmunoCalm
Diet Plan Slide 5 4 Understanding MRT Test Results n MRT is a food
sensitivity test, not a food allergy test. n I know Im allergic to
strawberries. Why didnt it show up in my test results? n Regardless
of MRT results, patient should avoid known problem foods. n The
goal of LEAP is to help establish a healthy eating plan for all
patients, while eliminating all reactive foods from their diet.
Slide 6 5 Turn to your LEAP ImmunoCalm Diet Program Test Results
page Slide 7 6 LEAP ImmunoCalm Diet Phase 1 n Limited to 20 - 25
items or less n Consume freely. n Whole foods, cooked from scratch,
ideally n Organic recommended n Better to eat 4-5 smaller meals n
Drink plenty of water (64 oz/day) n Salt may be added in
moderation. n Withdrawal: May feel worse before you feel better n
Should see significant improvement in 7-10 days. Slide 8 7 Why cant
I just avoid my yellow and red foods? Answer: Assume reactive to
ALL untested foods until proven otherwise. Slide 9 8 THERES NOTHING
TO EAT! ILL STARVE! Answer: My phase 1 diet was a feast/banquet
compared to what millions of people in 3 rd world countries have to
eat. Just that realization made it easier. Slide 10 9 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. Slide 11
10 Food Chemical Reactions n Dose related n May not be enough in a
food antigen to trigger, but may trigger if enough of food is eaten
that contains a food chemical n 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)
n And, if no improvement in 7-10 days, suspect other hidden
chemicals Slide 12 11 Food Chemicals Tested n Acetaminophen,
Ibuprophen (Meds only) n Aspartame/Nutrasweet (may contain
maltodextrin-corn) n Benzoic Acid (If highly reactive, may want to
limit raspberries, cinnamon) n Caffeine Wean off gradually. Common
migraine/IBS/insomnia trigger n Candida Albicans (Naturally
present, not found in food) Slide 13 12 n 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.) n Fructose (Mostly dose related issue) n
Lecithin (Corn, eggs, soy-often dose related) n MSG n
Phenylethylamine and Tyramine (Common migraine triggers) Slide 14
13 n Polysorbate 80 (Sorbitol) n Nitrates and Nitrites (natural and
added- may want to test water.) n Saccharin-the pink stuff
(mouthwash, toothpaste) n Salicylic Acid (Aspirin, personal care
products and Food-dose related) n Sodium Metabisulfite -Sodium
Sulfite (Assume reactive to all sulfites) n Solanine (Nightshade
family) www.noarthritis.com Slide 15 14 Other Concerns n Yeast
(Brewers and Bakers) n Lactose May cause symptoms even if diary is
non-reactive n Sugar (Cane vs. Beet) n Coconut (May be very healing
to the gut. Soaps- sodium laurel sulfate.) n Mint (Mouthwash,
toothpaste, gum) n Cottage Cheese (dry curd) n Yogurt (plain, not
flavored) n Meds-PDR, inserts, www.rxlist.com Slide 16 15 SO I
STILL DONT KNOW WHAT TO EAT! n Food Idea List (Review with patient)
n Hopefully, you can be creative with combinations n Orange juice
concentrate, ginger and some leek with duck, chicken, fish n Oven
roasted vegetables, brushed with oil and seasoning n Use your
slow-cooker n Roast some meat, cook some grains, steam some
veggies, add oil/nuts n Pureed or mashed fruit and/or juice for
sauces Slide 17 16 Menu, Shopping & Cooking Ideas n Local Large
Health food stores (Trader Joes, Whole Foods, Wild Oats,
naturalgrocers.com, etc) n Farmers markets n References in LEAP
Booklet: Cookbook, Catalog listings, websites n Two more: How to
Cook Everything: The Basics by Bittman and Food Allergy Survival
Guide by Melina, Stephaniak and Aronson n LEAP Website
www.nowleap.com (LEAP Patient Section) and www.nutritionresults.com
Slide 18 17 Building a Menu n Review patients Phase 1 Foods n Get
creative. Can you come up with protein, starch, veggie and fruit
dessert for a meal? n Are there breakfast items available? If not,
is client willing to eat non-breakfast foods for breakfast?
Leftovers from last nights dinner? n If not, some rearrangement may
be in order. n Lets look at your clients leap results-brainstorm
ideas. n Picky Clients Share Learning to eat new foods. Slide 19 18
Consult 1: Approx 45-60 min n See LEAP Affiliate Physician Guide n
Eliminate all vitamins/minerals/herbs and OTC meds if possible, add
back when stabilized. n Summarize what youre about to covered n
Obtain patient verbalization that they are willing to follow phase
1 and keep food/symptom records. n Set a start date with patient.
Schedule F/U appt 7-10 days after patient plans to start diet.
Slide 20 19 Consult 2: 8-10 days after starting diet n Symptom
survey n If No Significant Improvement in 7-10 days, review
Food/Symptom records for: n Adherence n Pattern of symptoms with
1-2 items? n Dose related issues n IgE allergies n Chemical issues
n Lectin issues Slide 21 20 Consult 2: Continued n Fiber issues n
Lactose Intolerance (Should have been anticipated in Consult 1) n
Patient often knows/suspects what food is still a problem n
Eliminate suspect foods, and continue with phase 1 for a few more
days, until symptoms subside. n If nothing else, may suspect meds n
Continue to build menu with more meal ideas Slide 22 21 Consult 3:
Rotation Diet n 4-5 weeks after patient begins diet. (Start Phase
6/rotation diet) n Helps prevent new sensitivities from emerging. n
Have patient do another Symptom Survey, compare to earlier surveys
n 45 min 1 hour. Slide 23 22 Teaching Tips for Rotation Diet n
Arranged according to Food Families n If you move a food to another
day, move the entire family n If you eat a food in its own family,
and only eat it every 10 days, it doesnt really matter what day it
falls in. n 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) Slide 24 23 Teaching Tips for Rotation Diet
n Try to find a milk, an oil, a sweetener and a vinegar/sour for
each day. n Cows milk, goats milk, soy milk, rice milk, almond
milk, etc. n Sweeteners: Honey, cane sugar, apple juice
concentrate, saccharine, aspartame, brown rice syrup, corn syrup.
Try stevia and maple syrup. n 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. Slide 25 24
Teaching Tips for Rotation Diet n Keep a Kitchen/Personal Rotation
Calendar n Consider starting a new rotation day before the Dinner
(main) meal instead of at breakfast. n Label items with a black
marker: 1, 2 or 3 n Continue to add one new food a day. n When all
test foods have been added, start adding untested foods-Use Food
Family Guide. n If reactive to 2 or more foods in a food family,
add other foods in that family with caution. Slide 26 25 Teaching
Tips for Rotation Diet -more n 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. n In time, the rotation diet
should contain MANY more foods. n 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.
Slide 27 26 Food/Symptom Diary n Essential tool for sleuthing out
problems n Recommend them to ALL patients. n They are a hassle, but
a tool to getting well. n Think of it as playing diet detective. n
Forces patient to pay attention to diet and symptoms. Slide 28 27
FOLLOW-UP n One month and two months after starting rotation diet.
n Repeat Symptom Surveys (SF-36 forms?) n Monitor for adherence n
Review Food/Symptom Diary if desired n
[email protected] Slide 29 28 MOST DIFFICULT
PATIENTS n 65 year old, refuses to cook, only eats in local
restaurant (Probably not a great LEAP candidate.) n Client whos
never cooked a meal in 45 years of life, eats all meals out. n
Assess willingness to make major lifestyle changes before testing.
n Patient unwilling to do full elimination or rotation diet, but
still is thrilled with his results doing just an avoidance diet.
Slide 30 29 The best part of LEAP: Healthier, happier patients
