• franceswalker@thefoodinto

6 tips for label reading on the RPAH/FAILSAFE Elimination Diet

Updated: Mar 14



Reading ingredient lists on food labels as well as medication pamphlets when avoiding salicylates, amines, glutamates and some food additives when on the FAILSAFE or RPAH elimination diet is very tricky, but a few pointers may help you develop these high level skills, and learn more about foods in the process.


1: Avoid ingredients high in SAG chemicals

To recap: RPAH stands for Royal Prince Alfred Hospital elimination diet that eliminates significant food and environmental sources of salicylates, amines, glutamates (SAG) and problematic food additives.


If you have access to the food charts outlining content of salicylates, amines and glutamates (provided in 'Friendly Foods" or the handbooks by the RPAH allergy unit doctors and Head Dietitian- see in resources below) then you can use this as an excellent guide as an example of what foods to avoid.


FOOD LABELS: look at the ingredient list and look for any ingredient items that come from plants such as:

- vegetables: tomato, spinach, mushrooms

- citrus: lemon, lime, orange, pineapple

- juice: any juice

- herbs: any herbs such as basil, oregano, coriander, Italian herbs, mint, peppermint

- spices: any spices such as turmeric, chilli, 5 spice

- pepper (salt is permitted)

- seeds (poopy seeds ok): individual seeds such as sesame seeds, seeds in grainy bread, chia seeds

- coconut: coconut milk, cream, yoghurt, desiccated coconut

- honey

- cocoa

- vinegar


Check out the handbook for the rest.


2: Avoid certain food additives


Not all additives have to be avoided, only certain ones. Some, like like additive number 500 just mean simple items such as sodium bicarbonate so is fine.


Watch out for:

  • Artificial colours: 102, 104, 110, 132-3, 151, 155, 122-124, 127, 129, 142-3

  • Natural colour: annatto: 160b (anatto). NOTE: 160(a) is fine.

  • Flavour enhancers: 620-625, 627, 631, 635-7, 640-641

  • Preservatives: Sorbates (200-203, Benzoates (210-213, 216, 218, PABA), Sulphites (220-225, 228). Nitrates (249-252), Propionates (280-283)

  • Artificial antioxidants: 310-312, 319-321.

There are some natural antioxidants that are generally well accepted such as 300 (ascorbic acid), or 307-309 (the tocopherols).


Sometimes the problematic food additives may be listed by name instead of number so look out for words above such as benzoate or sorbate.




Note that the gluten free crumpets above are not suitable as they contain a preservative: potassium sorbate, listed at the end. Not listed by number, only by name.


3: If vegetable oil is listed need to find out what type of oil it is


Sometimes oil may be plainly listed as just 'vegetable oil'. It is important to know what type of vegetable oil it is.


Vegetable oils could mean low chemical oils such as rice bran oil, sunflower oil, Canola oil (= cotton seed oil), rapeseed oil or palm oil.


Vegetable oils could also olive oil or coconut oil which are high in salicylates and amines and are not acceptable.


The company may need be contacted to see what type of oil it is.


If the oil is cold pressed or expeller pressed means not as refined so may contain salicylates. Cold pressed oils best avoided (unless rice bran oil which did not have salicylates to begin with).


4: Check if the fat is less than 5g per 100g (see nutritional panel)


Check the nutritional panel. If the oil or fat is less than 5g/ml per 100g then there may be unlisted antioxidants.


There is a 5% labelling loophole that means if an ingredient is less than 5% of the food/drink item then the ingredients of that ingredient does not have to be stated (unless it is an allergen for example dairy or soy).


This is very relevant for foods that contain less than 5% oil as that oil carries a real risk of containing artificial antioxidants to stop the fat going rancid or off. Many high fat foods will contain more than 5% fat so these foods will need to have any artificial antioxidants listed.


In summery: If there is less that 5g of fat then there is the real risk of unlisted artificial antioxidants. Again, the company needs to be contacted to check on this.


5: FLAVOUR listed as an ingredient




If the flavour really hits you- avoid it like the plague! Big flavour = big glutamates!


The ingredients of FLAVOUR do not have to be listed (trade secret) although any additives or allergens do need to be listed.


If the food is a vanilla type of food then the flavour may just be vanilla (often commercial rather than natural) which is failsafe although the vanilla flavouring may not be tolerated by some.


Flavour could also harbour salicylates, amines and glutamates. Most savoury foods such as flavoured chips and savoury biscuits need to be avoided anyhow as contain flavour enhancers.


6: Watch out for TRICKY words


Tricky words are words that mean an ingredient may look ok but actually have some food additives, salicylates, amines or glutamates.


For example 'cultured dextrose". Dextrose itself is acceptable but when the dextrose can be used as a culture to produce a substance that is very similar to propionate (an artificial preservative). So cultured dextrose is to be avoided, and cultured other things like cultured rice also best avoided.


Yeast extract is also to be avoided as an ingredient as is high in salicylates, amines and glutamates. Meat extract is very high in amines and glutamates (both listed in the RPAH elimination handbook, 2011). Easy words to overlook, especially as 'yeast' as a word is acceptable on the diet, only to be avoided if you think you personally have issues with it.


TVP (textured vegetable protein) or HVP (hydrolysed vegetable protein) also need to be avoided as high in natural glutamates. Other hydrolysed proteins may also be problematic.


Organic sugar or cold pressed /organic oil indicate less processed and likely contain significant levels of salicylates (in the case of sugar) as well as amines (in the case of oils). An exception is rice bran oil which is not an issue if cold pressed as did not have any appreciable salicylates to begin with.


Take Home Message


When reading labels remember to:

  1. Check for any words that you know are high in salicylates such as citrus, lemon, tomato, herbs & spices, fruit flavour

  2. Check for certain food additives by number or class name (eg preservative) or name (eg sorbate)

  3. If oil is just listed as vegetable oil, need to know what type of oil it is

  4. Check fat content : if less than 5g per 100g then real risk of unlisted artificial antioxidants

  5. Be very wary of the ingredient "flavour'

  6. Check for sneaky ingredients such as cultured dextrose

HOW TO CHECK OUT IF A FOOD IS OK

  • Ring the company

  • Checking if the food is already termed a failsafe product through the Fedup website or the associated Facebook groups. A failsafe food means it has been already checked.

  • Ask your Dietitian: a specialist Dietitian in Food Intolerances may have already checked it out or will chase it up for you.

Ingredients change without notice, so always double check- even an old favourite.


Over time, one can get quite expert at identifying problematic ingredient words such as tomato, herbs, spices, pepper, onion and check for any food additives by name in foods. See blog on reading ingredients in medications to further enhance your label reading skills.


Updated 14/3/22


REFERENCES

RPAH elimination diet handbook: with food and shopping guide. Anne Swain, Velencia Soutter, Robert Loblay, 2019 (revised edition).

Friendly Food: the essential guide to managing common food allergies and intolerances. Anne Swain, Velencia Soutter, Robert Loblay, 2019 (revised edition).