Common traps when starting the FAILSAFE elimination diet
There are a few common traps when starting the failsafe (Royal Prince Alfred Hospital or RPAH) diet that seem to confuse most people.
As a quick recap: the RPAH elimination diet eliminates salicylates, amines, glutamates and certain food additives from the diet, and challenges to identify if these are causing food symptoms. FAILSAFE is the strict level of the RPAH elimination diet.
Why do so many recipes include spring onions when the spring onions are shown to be high in salicylates? What about corn? When is it ok and when is it not? Read on to find out more about these common pitfalls.
1. WHITE FLESH Potatoes
Only the white flesh potatoes are low in salicylates. The cream fleshed potatoes have moderate levels of salicylates.
That in itself is not confusing but the tricky bit is knowing how to find these elusive white flesh potatoes!
Recommended white fleshed potatoes (as per Fed up website): Coliban | Kennebec | Kestrel (sometimes can get at ALDIs) | Nadine | Sebago | Russet Burbank.
Apparently, they used to be easy to buy but now you need to actually find out the brand you are buying. Many leading supermarkets do not label their generic bags of potatoes, so trying for your local fruit shop may be needed.
ALDI in Australia do carry the Kestrel brand (white potato pictured above) which are also labelled!
Don't forget to wash well, and peel thickly as salicylates are concentrated under the skin. Discard any potatoes with a green colouring under the skin as it indicates the presence of glycoalkaloids which is a toxin (separate to the low chemical diet issue).
2. SHALLOTS OR SPRING ONIONS?
The terms shallots and spring onions seem to be used interchangeably. Another term- scallion- is also sometimes tossed into the ring! The idea is to choose the type which has very little bulb as shown in the picture above.
If there is quite a bulb at the end, or even very much looking like a small onion, don't use as will be high in salicylates.
For low FODMAPs use the green leafy tips only. Keep the bottoms in a jar with some water and watch them re-grow!
3. CORN FLOUR vs CORN STARCH
Corn flour (= maize flour) is high in salicylates and glutamates but when it is processed to corn starch ( = maize starch) it is ok as the salicylates and glutamates are processed out.
The problem here is quite annoying: there is no regulation about how the word corn flour is used in an ingredient list. So companies use the word corn flour or cornflour and it can be hard to know if they mean the flour version (high salicylate and glutamates) or the starch version (low salicylates and amines).
In this F.G Roberts plain GF flour, the ingredient is maize starch which is acceptable as it is the starch form of the corn or maize.
However if they decided to call this cornflour (which can happen) even though it is the starch form, it would be confusing. This product is suitable for the failsafe diet, and can be included unless you are also avoiding soy flour.
In this Mission Mexican corn wrap the ingredient is corn flour which is not the starch form in this case so is not suitable for the failsafe diet.
It is also made even less suitable by the preservatives 202 (preservative: potassium sorbate) and 282 (preservative: calcium propionate) and probably the flavour (trade secret!).
Corn starch can be further processed:
The corn or maize starch is further processed to produce dextrin, modified starches or thickeners, glucose syrup, corn-fructose syrup and caramel colour.
These will be on the label as, coming from corn for example dextrin (from maize) which is acceptable on the diet as the salicylates and glutamates have already been processed out previously.
These ingredients only need to be avoided if there is a suspected corn allergy.
Read: Does Corn Flour Contain Salicylates? for more info.
4. VEGETABLE OIL as an ingredient
If vegetable oil is listed as an ingredient, need to check what type of oil it is.
It could be olive oil or coconut oil both of which are high in salicylates and amines or it could mean sunflower, rice bran oil, canola oil (cotton seed oil) or palm oil which are low in salicylates and amines.
Cold pressed or expeller pressed oil also need to be avoided as they have been less processed so still retain salicylates or amines except for cold pressed rice bran oil which is low to begin with.
Furthermore, if the oil makes up less than 5% of the ingredients, it may contain unlisted anti-oxidants. This may not be relevant for some but often is for the more sensitive.
5. RAW SUGAR as an ingredient
Most types of sugar are low in salicylates so accepted on this diet in moderation. The exceptions are the less refined sugars such as molasses, treacle and the trickiest of all: raw sugar (high in salicylates).
Raw sugar is easy to miss as an ingredient. So read carefully! It has caught me out.
Note: Weet-bix does have raw sugar as an ingredient but it is in such a small amount is considered acceptable. Other wheat biscuit brands do no list raw sugar as an ingredient.
Also watch out for organic sugar: means the sugar is less processed so may contain higher levels of salicylates.
6. LIMITS ON SOME LOW CHEMICAL FOODS
Cashews are limited to 10 raw or lightly roasted per day (1/2 this amount for children) and pears to 2 daily (one pear for children).
Extra not on cashews: make sure they are raw or only lightly roasted, the more roasted cashews are moderate in amines.
While these foods are low in food chemicals- too much will tip over into the high categories so keep an eye on these limits, especially if following the strict level of the elimination.
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 Intolerancesmay have already checked it out or will chase it up for you.
Never get complacent- as ingredients change without notice, so always double check even an old favourite.
These are some of the common problems encountered when you first start the failsafe or RPAH elimination diet.
The white fleshed potatoes are not the common ones at the supermarket- you may have to search for them. ALDI's is a good start for the kestrel variety.
Spring onions or shallots are used interchangeably but really mean the slender long variety without much of a bulb.
Corn flour (or maize flour) as an ingredient is not suitable if it is actually the flour form but suitable if it is the starch form (or maize starch).
Vegetable oil as an ingredient needs to be questioned- it may not be suitable (for example if means olive oil) or could be ok (if it means for example sunflower oil).
Raw sugar as an ingredient- watch out- is high in salicylates.
Some foods low in salicylates and amines do actually have limits: pears and cashews are the best examples.
1. Food Intolerance Network. What's wrong with potatoes? Nothing! Except that it is so hard to buy white ones... Accessed June 12, 2018.https://fedup.com.au/news/blog/what-s-wrong-with-potatoes-nothing-except-that-it-is-so-hard-to-buy-white-ones
2. RPAH elimination diet handbook: with food and shopping guide. Anne Swain, Velencia Soutter, Robert Loblay, 2011 (revised edition).
3. Food Safety Authority of Ireland. Green potatoes. Accessed June 12, 2018. https://www.fsai.ie/faq/green_potatoes.html