Mens Health Blog. Medical Blog

Pastry, pancakes and waffles can be made with rye flour although the results are heavier than with wheat, partly because rye flour is only available in wholemeal form. Putting the rye flour through a fine sieve first improves the quality by removing the larger pieces of husk from the flour, and adding some baking powder helps too. Pancakes can also be made with maize or barley flour, and taste pleasant although they are slightly rubbery – beat plenty of air into the mixture just before frying to improve the texture. Buckwheat flour is fairly protein-rich and makes a good pancake batter, but should be mixed with other flours to dilute the strong taste. Gluten-free mixes for pastry and pancakes can be bought by post and generally give excellent results.

Pasta made with gluten-free flour is obtainable by post. Or you can try rice noodles, obtainable in Chinese groceries, or buckwheat spaghetti, from healthfood stores.

Soya flour, gram flour and lentil flour are rich in protein, as well as carbohydrate. They can be used in baking, combined with other flours (see above under Gluten-free flours) and tend to improve the texture of pastry and pancakes.

Rice flour, potato flour, banana flour, chestnut flour, yam flour and other exotic flours are mostly low in protein. They are useful for making puddings and biscuits, or for thickening sauces (see below). Chestnut flour tastes sweet and nutty and is pleasant in shortbread or in a crumble topping for fruit, although it is rather heavy.

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You are probably suffering from caffeine withdrawal – or it might be the effects of cutting out alcohol. This is ‘cold turkey’ – the same sort of withdrawal symptoms that a heroin addict has, though nothing like as bad. You just have to keep going, in the knowledge that it will pass and you will then feel a great deal better than you did before. Not eating sugar might have similar effects until your body gets used to the idea.

It is most unlikely that you will still feel worse after two or three weeks. If you do, think about any other changes that have occurred. Could they be die cause? Or were you steadily getting worse anyway? If you’re sure it’s due to the diet then consider any new foods you are eating, or foods eaten in greater quantity than before. It may be that you are allergic or intolerant to such foods. Consider them suspect and cut them out in the exclusion phase of Stage 2. Alternatively, if you are eating a lot more fruit and vegetables than before, and if you are sensitive to pesticide residues, then this might explain your deterioration. Read Chapter Nine before going on to Stage 2.

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One discovery about enzyme deficiencies is particularly intriguing, because it may explain the link between hyperactivity in children and food colourings. Hyperactive children appear to be deficient in an enzyme known as phenolsulphotransferase-P or PST-P. This enzyme detoxifies various compounds, including a substance called p-cresol that is produced by bacteria in the gut. No-one has any idea how p-cresol might cause hyperactivity, but it is a phenol, and phenols can be toxic.

What is interesting about PST-P is that it can be inhibited by certain food colourings – in other words, the enzyme no longer works if those food colourings are present. If a normal, healthy child eats colouring of this type in moderation, it will not do any apparent harm because that child’s PST-P is fully active to begin with. But for a child with defective PST-P, the same amount of colouring could reduce the level of PST-P activity to damaging levels.

It is interesting that a high proportion of patients with migraine, who are affected by dietary triggers such as cheese and chocolate, also have a defect in PST-P. Wine, like some food colourings, appears to inhibit PST-P, and this may contribute to the effects of red wine in triggering migraines. It is likely that enzyme defects play a part in migraine, because migraine sufferers tend to be defective for certain enzymes, but exactly what goes wrong is far from clear. The chemicals that are under suspicion of triggering migraine – tyramine and phenylethylamine – are not detoxified by PST-P. Tyramine is detoxified by a related enzyme called PST-M, but this is generally not lacking in migraine sufferers. This is a puzzle that can only be sorted out by more research. For more on enzyme defects in migraine.

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Carbohydrates – the ’starchy’ substances in foods – are restricted to 80 gm per day. This effectively means no potatoes, bread, flour, rice, breakfast cereals, pasta or other starchy foods, except for one very small portion each day. The incidental carbohydrate in vegetables, nuts and other foods will account for most of your daily allowance. High-carbohydrate vegetables such as sweetcorn, peas, parsnip, lentils and broad beans should be avoided. Nuts can be eaten in moderation, but not cashew nuts as they are rich in carbohydrate. Continue to eat plenty of garlic and fresh, green leafy vegetables.

If the Candida proves resistant to these measures, then drug treatments may be the only answer. The drug most widely used is nystatin. Although this is available in tablet form it is often prescribed as a powder, to be taken mixed with water – this combats Candida in the mouth and throat, as well as in the intestines. Nystatin is not absorbed from the gut and is a remarkably safe drug when taken by mouth. However, there are rare instances of individuals proving sensitive to it, and vomiting and diarrhoea can occur at very high doses.

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The medical controversy about adverse reactions to food is compounded by a long-running dispute over the meaning of allergy. For a word that is scarcely more than 80 years old, it has had a very chequered career. A Viennese doctor, Baron Clemens von Pirquet, first used it in 1906 to mean ‘altered reactivity’. Von Pirquet was a paediatrician and he felt the need for a new medical term to describe certain reactions in his young patients. These changed reactions included the development of immunity to infection, on the one hand, and marked reactions to certain foods, pollen or insect stings, on the other. He was principally concerned with reactions involving the immune system, the set of cells that protect our bodies from infection. But he apparently intended his newly coined word to mean any altered response to the environment. In this context, environment means all the external things that can affect the body, whether in food or water, in the air we breathe, or in things that come into contact with our skin. Von Pirquet also introduced the word allergen to describe the substances that brought about these changed reactions.

At that stage, very little was known about how some of these reactions might arise. The following decades brought greater understanding, and the meaning of allergies was narrowed down – the development of immunity to disease was dropped from the definition, because it was obviously something quite different from adverse reactions to food, pollen or bee stings.

In 1925, the definition of allergy was narrowed down still further. Experiments had shown that many adverse reactions to pollen or food could be transferred from one person to another by injecting a small amount of blood serum into the skin. The area around the injection site became very sensitive to the allergen. This, and other evidence, indicated that the immune system really was at work in these cases, as von Pirquet seems to have suspected. Most of those working in the field decided to limit the definition.

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• The first thing to remember is the less fragrance the better. Perfumes and perfumed cosmetics are the major allergens. Besides the usual redness and irritation, they can do strange things in sunlight. A brownish or smoky streak may appear where perfume was applied to the skin, usually behind the ears or on the neck – a reaction unique to fragrances. Certain lipsticks and deodorant soaps, too, have been known to cause burning and irritation only under exposure to sunlight. If you still want to splash on a pleasant scent, make your own scented water by packing rose petals or lavender in a jar of cold water. Add a tablespoon of lemon juice. After ten days, strain and use as a subtle, refreshing perfume.

• Lipsticks are usually made of oil, waxes, dyes and perfumes. If you like the ‘wet look’ on your lips but react to the lanolin in lip gloss, smooth petroleum jelly over applied lipstick. If the perfume causes trouble, look for unscented lipstick.

• Use a sponge applicator, not your fingers, to apply foundation, lipstick and eye shadow. (Rubber-sensitive people should use latex or natural sponges.)

• Nickel-sensitive people should use only stainless steel eyelash curlers and tweezers. They may also have to avoid nail polish with a metal mixing ball – solvents in the polish may leach out nickel.

• Eye irritation is less likely if mascara is applied just short of the inner and outer corners of the eyes. Also, brush mascara only on the outer two-thirds of your lashes.

• When applying eye shadow or liner, leave a thin makeup-free zone along the edges. Never use liner on the inner rim of the eyelids.

• Wand-style applicators should be used for no longer than four months, to avoid the build-up of bacteria and the risk of eye infection. Also, do not spit on liner, mascara or eye shadow to moisten it – that, too, fosters growth of bacteria.

• If your makeup starts to wear off during the day, it’s safer to patch it up than to remove it and start all over again. This minimizes exposure.

• Use plain mineral oil to remove eye makeup. Commercial eye makeup removers are generally composed of mineral oil and fragrance. Non-oily removers, on the other hand, are harsh and drying.

• Never go to sleep at night without removing your makeup.

• Above all, don’t use any eye product that irritates your eyes in the hope that you will get used to it. The irritation will only get worse.

• If you find a product that agrees with you, stick with it. Jumping from one brand to another only increases the likelihood of exposing you to a new allergen.

• For a non-drying, alcohol-free astringent, combine four parts water to one part apple cider vinegar. Swab on with cotton balls.

• People allergic to corn should not use powders containing cornstarch.

• Apply nail polish carefully, to avoid bumping it against cuticle or skin. Also, nail polish is not allergenic once it has thoroughly dried, so allow ten to fifteen minutes before touching anything – especially your eyelids, face or neck.

• Be wary of cream and lotion collecting under your rings.

• Mouthwashes can create all kinds of problems on the soft, delicate tissues inside the mouth, including redness, ulcers and even ‘bald spots’ on the tongue. The reactions disappear as soon as the mouthwash is discontinued. If you feel you need a breath freshener, chew on a sprig of fresh parsley or suck on a whole clove.

• The hair dyes most likely to produce a reaction are the oxidation type and those containing the chemical paraphenyl-enediamine. The allergic reaction may occur a few hours after application and usually becomes full blown after one or two days – so a patch test done just before your hairdresser is about to dye your hair is really no predictor of reaction.

Other coloring methods – progressive dye, semi-permanent organic dyes (like henna) and hair rinses – seldom cause trouble. Ask your hairstylist to help you choose a less allergenic product.

• Sunscreen lotions are a must for sunbathing. But have you ever used a sunblock and got a reddened, blistery rash anyway?

You could be allergic to the fragrances or benzocaine in the product – or even to PABA, a highly effective and otherwise safe sunscreen ingredient. An effective alternative is sunscreens containing benzophenone.

• Fragrance-free deodorants and antiperspirants with aluminium chlorohydrate are less likely to cause allergic reactions.

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The questions most people ask about insect allergy are: How do I know if I’m allergic to insect stings? How can I tell if my child is allergic to them?

No one experiences a life-threatening reaction the first time they’re stung. A severe local reaction, however – exaggerated swelling, nausea, weakness and so forth – is almost a certain harbinger of potential and more severe systemic reactions. And, as is the case with other types of allergy, whether or not you ever experience that ominous first reaction depends on a number of factors:

What Bit You. Anyone who is allergic to bees is apt to be allergic to wasps, hornets and ants. However, the potency of insect venom varies from species to species, so some can cause more of a problem for you than others.

The Amount of Venom. Naturally, the more venom injected the more chance for a reaction. And more stings mean more venom. But venom levels can also vary for other reasons. In the early spring and late autumn, for instance, honey-bees carry around far less venom than they do at the peak of summer.

Other Allergy. Nearly one-third of people who are allergic to insects are allergic to drugs, especially drugs that are injected, like penicillin. Other than that, coexisting allergy doesn’t seem to have much bearing on susceptibility to insect stings.

Your General State of Health. Although it has no bearing on whether or not you’re allergic to insects in the first place, your general state of health may influence how well you tolerate a sting or bite. If you’ve ever had a run-in with any insect that resulted in anything more than a slight swelling, you should be on your guard against future encounters. And you should tell your doctor all the details. Don’t be macho – mild reactions are the best clues for predicting life-threatening reactions and shouldn’t be played down. The information can save your life.

Your doctor will also need to know what bit you. The problem is, most of us don’t know one insect from another and assume anything that stings is simply a bee. So if you possibly can, take the insect’s body to the doctor with you, even if it’s squashed. Lacking a body as evidence, some doctors stock photos of common stinging and biting insects – rather like mug shots used to help identify criminals.

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Allergic reactions to drugs are usually mild or moderately severe – no more than some itching or a few hives. But occasionally a drug reaction can be fatal. That’s why allergic people should learn all they can before they take any drugs, whether prescribed by a doctor or purchased over-the-counter.

Each drug has a number of known side effects – health problems caused by the drug, which doctors have learned to expect. An allergic reaction, on the other hand, is an unexpected reaction which people who respond to a drug with known side effects rarely have. One out of every four adverse reactions to drugs is allergic.

The chemistry behind drug allergies hasn’t been pegged down as an antigen-antibody reaction, or any other identifiable immune reaction. Just the same, the possible symptoms are identical to those of other allergies: skin rashes, asthma, hives, and shock. And reactions occur only after a prior, uneventful exposure to the drug or a chemically related substance. So doctors regard drug sensitivities as allergy in the true sense despite a lack of measurable immunological changes.

But how does your doctor know whether you are experiencing a side effect or an allergic reaction? For one thing, side effects, no matter how numerous and varied, are spelled out either on drug package inserts or in one of several reference books containing drug information, such as The British Formulary of Drugs: A Handbook of Psychoactive Medicines. More important, however, an allergic reaction follows a latent period – usually seven to ten days – after you first take the drug. In other words, your doctor starts you on penicillin today, but you may not react until next week. Then the next time you take penicillin, you may react immediately – and explosively. And if you’re allergic, you’ll react no matter how small the dose.

The skin is the organ most likely to suffer when you swallow a drug or get an injection that doesn’t agree with you. Here is a list of possible symptoms.

Itching. Alone or with other symptoms, itching is so characteristic of drug allergy that if you don’t itch, you probably aren’t really allergic.

Hives. Huge hives all over the body are almost a sure sign of allergy to certain drugs – notably penicillin, aspirin and related compounds (salicylates) or even allergy treatment extracts. Rashes. Drug-induced rashes come in a variety of shapes and hues, from bright red, itchy patches to bumps or scattered spots that resemble measles. Occasionally, the rash takes on a bluish tint. Whatever the form or colour, it usually centers on the trunk.

A mixed bag of eruptions known as erythema multiforme is the ultimate in drug-induced rashes. The blotches vary in size, shape and appearance, are usually distributed on the backs of the legs or forearms, and are frequently accompanied by fever, general discomfort, stomach and abdominal upset and joint pains. It’s reassuring to know that all clears up when the drug is discontinued.

Generalized Swelling (angioedema). This often affects the eyelids, lips, hands and feet. Broken Capillaries (purpura). These red or purple threadlike squiggles beneath the skin surface are less common but occasional signs of drug allergy.

Photosensitivity. Sunlight presumably alters certain drugs so that they readily form allergy-triggering substances in the skin. The resulting flare-up resembles contact dermatitis or eczema, and may not appear until days or months after the sun/drug encounter.

Scaling and Shedding of the Skin (exfoliative dermatitis). Needless to say, this is one of the more drastic symptoms of drug allergy. Sometimes the hair and nails fall out, too. Fever, chills and overall discomfort go along with it. Don’t worry about being taken by surprise, though; this problem doesn’t develop overnight. The trick is to alert your doctor to any patches of scaly skin early on, before things get out of control.

While the skin takes the brunt of our allergic encounters with drugs, the rest of the body is not off limits. Bronchial asthma can be caused by aspirin. (Most people who get this already have regular asthma.) Fever – rarely a consequence of other types of allergy – can develop as part of a drug reaction, and can easily be mistaken for a symptom of the illness that’s being treated. By far, though, anaphylaxis is the most severe and dangerous non-skin drug reaction, and one that’s most commonly caused by penicillin. With little or no warning, blood pressure drops, the pulse weakens, the throat swells closed and the individual collapses – all within minutes or even seconds after getting the drug. Anaphylaxis, by the way, is far more likely to occur after an injection than after oral medication.

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Beyond keeping our homes dust-free and mould-free, many of us are probably too clean for our own good – especially when it comes to allergies. Furniture polishes, window cleaners, aerosol sprays of all types, disinfectants, floor waxes, moth balls – all contribute to an invisible mist of chemical vapors in our homes. Most of these products are a combination of petroleum-based or coal-based ingredients, fragrances and complex chemicals.

‘One of the major factors in chronic illness today is the products we clean with,’ says Dan R. O’Banion, author of the books An Ecological and Nutritional Approach to Behavioral Medicine and The Ecological and Nutritional Treatment of Health Disorders (Charles Ñ Thomas, 1981).

Dr O’Banion is talking about chronic illness from chronic exposure. We all have heard the horror stories of people who mixed chlorine bleach with ammonia and keeled over dead. But repeated single, smaller exposures to these and several other products pose hazards of their own. ‘Even mild exposure to certain chemicals may lead to chronic bronchospastic responses [such as wheezing] or allergic reactions in susceptible persons,’ write Drs Rose H. Goldman and John M. Peters in the Journal of the American Medical Association.

The two worst household offenders are probably oven cleaners and air fresheners. Oven cleaners because they’re the strongest; anything that replaces good old elbow grease in battling six months of burned-on fat and pie drippings has to be pretty potent. And air fresheners – either scented aerosols or the perfumed ornaments slapped on the lid of a rubbish bin – because they add more chemicals to the home environment.

But you don’t need either of these products. Keep your oven clean by always wiping it out soon after you use it (and it’s still warm) or by scraping off dried grit with steel wool. And a far better – and cheaper – air freshener, suggests Dr Boxer, is an opened box of plain old baking soda. ‘That will absorb odours, not add them,’ he says.

Baking soda, in fact, is one of many simple, old-fashioned items that do the job of several expensive and odorous housekeeping supplies.

If you must keep strong commercial cleaners on hand, store them in a tightly sealed container, preferably outside the home in a detached storage shed. That includes: paints, solvents, lacquers, turpentine, lighter fluid, charcoal fire-lighters, glues, odorous soaps and detergents, polishes, mops and cleaning cloths, chlorine bleaches and ammonia. When you use them, be sure the windows are wide open and a fan is on. Afterwards, leave the area for several hours while the fumes dissipate.

When it comes to painting, refinishing and re-modeling, you may not have much choice of products. All may be highly odorous. In general, however, alkyd-base paints are better tolerated than latex or epoxy paints, whose odour seems to linger for months. If you’d like to test your personal tolerance to a particular product before making it a permanent part of your home, there are some ways to get an idea of what you can and cannot tolerate.

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What people miss most on a Rotary Diet is not so much their favourite foods but the spontaneity of eating what they want, whenever they want. A therapeutic diet of any kind takes at least some organization and planning. If you are in the habit of not deciding what to serve for dinner until you’re driving home from work at 5.15, a Rotary Diet will require some self-discipline. But the minor inconveniences are better than feeling miserable all the time. Feeling better, in fact, will reinforce your determination to stick with it and enjoy what you can eat all the more.

Doctors who treat food allergies with the Rotary Diet say people will have better luck if they follow a few basic rules.

1. For the first few weeks, try your best to avoid all foods to which you know you are even moderately allergic – giving yourself an allergic ‘rest period’. If you wish, you can start a Rotary Diet without that initial rest period. However, you’ll probably experience some symptoms for the first few cycles.

2. Learn about food families. Nature is full of surprises, and learning about relationships between foods can be fun. White potatoes and sweet potatoes are not related, for instance. Neither are tuna and prawns. Or raisins and prunes. Peanuts are not really nuts, but legumes. Ginger, clove and cinnamon are three totally different plants. So there is no such thing as an allergy to all spices. Or all nuts, for that matter. Or all fish. Chances are you can find suitable and appetizing alternatives to your favourite foods by choosing members of unrelated families.

Surprises work the other way, too. Asparagus is related to onions and garlic. Cucumbers are related to melons. Carrots are related to celery. Working out a Rotary Diet teaches you to think about foods in a new way.

3. Diversify your foods. By working in members of food families that are new and different for you, you make your menus more interesting and find it easier to stick to the diet. Within familiar food families, eat a variety of foods. Diversification also helps to prevent future allergies.

4. Stick to primary foods – fish, meat, poultry, fruits and vegetables – as close to their natural state as possible. Avoid secondary or combination foods – mixes, sauces, blends or packaged foods.

5. Similarly, rotate only wholesome, nutrition-packed food, not cupcakes, soda and the like. ‘I tell my patients to rotate and stay off junk food,’ said Dr Boxer. And stay away from alcohol, coffee and tobacco.

6. Select a minimum number of foods for each meal and fill up on them, rather than choose a potpourri of multiple foods. For instance, an eight-ounce portion of broiled fish, half a plateful of steamed broccoli and a large potato would comprise a typical Rotary Diet meal.

7. Whenever possible, avoid eating the same food more than once a day.

8. Grow as much organic, additive-free food as you can. Or buy organic food when you’re absolutely sure it’s the real thing and not a fake-labelled, high-cost rip-off.

9. Don’t forget to rotate spices, cooking oils and beverages. Soybean, safflower and sunflower oils, for instance, are derived from different families. Among herb teas, lemongrass, mint, sassafras, verbena, hibiscus and rosehips are unrelated to each other.

10. Write down everything you eat. Otherwise, it’s practically impossible to keep foods straight.

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