Elimination diets – Important nutrients you may be missing out on.

If you or your child is dealing with a food allergy, than you are probably managing it with an elimination diet. “Elimination diet” describes when you avoid one or more foods, often because of food allergies. We have written about elimination diets in the past and have also shared a YouTube video to explain what an elimination diet is. 

Today I want to dive deeper into elimination diets. We’re going to use cow milk as the example food allergen. I want to share information about some nutrients that may be missing from food elimination diets. I’ll also cover how you can help ensure you or your child get enough of those important nutrients from the diet.

What’s so important about milk, anyway?

In North America:

  • most of us drink milk and eat a lot of foods made with dairy
  • milk and dairy (high in calcium) contribute to a lot of the calcium in Americans’ diets

Calcium is important for bone health, among other key body systems. Where, exactly, are we going with this? A question, which is: Do people who don’t (or can’t) consume milk and dairy consume enough calcium? Research has found over and over that they don’t. Research finds that children with food allergies (such as cow milk allergy (CMA)) have lower intakes of key nutrients, like calcium and protein, putting them at higher risk for malnutrition.

But does it matter if they consume less calcium than their non-allergic peers? Yes. Multiple studies found that children with CMA also had poorer bone status than children consuming dairy foods. Furthermore, studies show that children on a milk elimination diet can have poorer growth versus children without a milk allergy.

Basically research has found that children who avoid dairy have bones that aren’t as strong, and they may not be as tall as other children their age. So, it’s important that children consume enough calcium to develop strong bones. They also need to consume other key nutrients to help them grow normally.

But calcium is also important for older children and adults. Consuming enough calcium in adulthood helps us to keep bones strong and prevent fractures later in life. It’s important for lactating moms who avoid dairy as part of a maternal elimination diet to consume enough calcium while they breastfeed their infant. It’s also important for any teen or adult with a cow milk allergy to make sure they consume enough calcium.

We chose calcium because it’s a great example, but it’s not the only important nutrient in milk and dairy foods. Protein, vitamin D, and several other vitamins and minerals also come from milk and dairy. So, by avoiding milk and dairy, there is increased risk of deficiency of one or more of these nutrients.

How can you ensure there’s enough calcium in your diet?

When you or your child needs to stay away from milk-containing products, how do you ensure those vital nutrients for growth are being met?

Children on milk elimination diets who cannot breastfeed – especially under the age of 2 years – are recommended to use a hypoallergenic formula to supplement the diet. This is where amino acid-based formulas like Neocate can play an important role in nutrition. Neocate Splash and Neocate Junior products are an important source of hypoallergenic protein – in the form of amino acids. They also contain other important nutrients at levels that can supplement an elimination diet. Neocate also offers Neocate Nutra, which is meant to be used as a supplement to the diet and is high in calcium and also a good source of vitamin D, iron and zinc.

Many healthcare professionals and even parents assume that Neocate products, like Neocate Splash, are only for children. However, just because Neocate products are often used by teenagers and adults. Many older individuals use Neocate Junior or Neocate Splash as part of an elimination diet. Some teens and adults, especially those with high energy needs, can even use Neocate Splash or Neocate Junior as a sole source of nutrition.

How much Neocate does it take to meet calcium needs?

It’s important to know that calcium doesn’t only come from dairy foods. Dark leafy greens are another great source! The healthcare team – a registered dietitian nutritionist (RDN) in particular – can assess the diet for sources of calcium. This helps the healthcare team figure out how much more calcium is needed from a supplemental source like Neocate.

The below table shows how much Neocate Splash or Neocate Junior would be needed per day to meet someone’s full calcium needs, assuming it is taken as the only source of nutrition. Please note, these amounts of Neocate are specific to meeting 100% of calcium needs, and do not cover all of the nutrients someone needs. Your doctor and/or dietitian can help you ensure all other nutrient needs are being met.

Fluid ounces (fl oz) needed per day to meet 100% DRI for Calcium from Neocate Junior, Unflavored

Ages (and genders)

1-3 years

4-8 years
Males 19-70 years
Females 19-50 years

Females 51+ years
Males 71+ years

9-18 years
Females 14-18 years, pregnant/lactating
Calcium needs per day 700 mg 1,000 mg 1,200 mg 1,300 mg

Fluid ounces of
Neocate Splash or
Neocate Junior
to meet calcium recommendations

(fl oz, at standard dilution; 30 kcal/oz)

20 fl oz/d

28 fl oz/d

34 fl oz/d

37 fl oz/d
 

We hope this is helpful. Now you know that Neocate products can be used as a hypoallergenic source of calcium (and many other important nutrients!) as part of an elimination diet by children, teens, and adults.

What are some of your challenges with food allergy elimination diets?

-Christine & Rob

Last updated May 16, 2018

References

  1. Christie L, et al. Food allergies in children affect nutrient intake and growth. J Am Diet Assoc 2002.
  2. Rockell, et al. Two-year changes in bone and body composition in young children with a history of prolonged milk avoidance. Osto Int, 2005.
  3. Henriksen C, et al. Nutrient intake among two-year-old children on cows’ milk-restricted diets. Acta Paediatr. 2000.
  4. Jensen VB, et al. Bone mineral status in children with cow milk allergy. Pediatr Allergy Immunol 2004.
  5. Jorgensen, et al. Two-year changes in bone and body composition in young children with a history of prolonged milk avoidance. Ped All and Immun, 2004.
  6. Fiocchi et al, DRACMA Guidelines. J Allergy Clin Immunol. 2010

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Published: 08/16/2012
Comments
Rob McCandlish
Great questions, Lisa! 1) Neocate Splash does not cause diarrhea. However, it's digested differently than solid foods so you may need time to adjust. Consider gradually switching to it over the course of a day or two to help adjust. 2) I followed a Neocate-only diet myself for a few days - it was pretty easy! You can read more here: http://bit.ly/NeocateDiet 3) Neocate Splash offers complete, balanced nutrition, with a mix of simple and complex carbohydrates. Ask your doctor if you have concerns, but as long as you spread your Neocate Splash through the day, I wouldn't expect problems. Good luck! Rob
16/05/2018
LISA
+My allergist put me on Neocate Splash1+ for 5 days, but I have read might cause diarrhea and I am concerned just consuming this and no food since I am 66yrs old and hypoglycemic . what is your take on this
15/05/2018
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