FAILSAFE stands for Free of Additives, Low in Salicylates, Amines and Flavour Enhancers and is Sue Dengate‘s term for the comprehensive low-chemical, low-reactive exclusion diet formulated by allergists at the Royal Prince Alfred Hospital in Australia.
The failsafe diet is designed to treat intolerances or sensitivities to specific chemicals in foods. The diet is not designed to treat allergies. Reactions to food chemicals are pharmacological and dose-related rather than immune-system related, but they cause a number of symptoms that appear to be allergy-like. It is important to understand the difference between food allergy and food chemical sensitivity.
Though the failsafe diet has been around since the 1980s, few people have heard of it outside of Australia. A forerunner to the failsafe diet is the Feingold diet, an incomplete salicylate exclusion diet that is now outdated. Food chemical sensitivities are quite common, but a lack of knowledge about the syndrome means that symptoms are rarely understood by the layperson or the medical practitioner, and are usually dismissed as allergies, psychological, or idiosyncratic.
The failsafe diet is designed to exclude what are called “tasty foods”, that is, foods containing lots of reactive, aromatic, phenolic chemicals – foods and cosmetics with strong tastes and smells. In particular it excludes:
- About fifty artificial food additives including colours (like tartrazine, sunset yellow), flavours, preservatives and antioxidants (sulphites, nitrates, benzoates, sorbates, parabens).
- Salicylates (aspirin) and polyphenols (natural flavours, colours and preservatives) found in a wide range of fruits and vegetables.
- Neurotransmitters in food: free glutamates (MSG) and amines (histamine, serotonin, dopamine, phenylethylamine, tyramine and others) found in aged proteins and fermented foods like cheese, chocolate, game, and hung meat.
- Aromatic (strong smelling and tasting) chemicals found in perfumes, cleaning products, commercial cosmetics, and scented and coloured toiletries, especially mint and menthol products.
- Some pharmaceutical drugs, including aspirin, NSAIDS and other COX II inhibitors including ibuprofen, and the methyl-salicylates found in decongestants and anti-inflammatory creams.
From the 1950s onwards several researchers reported that the exclusion of aspirin and azo dyes produced beneficial results for a variety of symptoms with apparently unknown causes like urticaria, angioedema, eczema and asthma. Researchers realised there were a group of people who were suffering chronically from the symptoms regarded as the side-effects of aspirin. These include diverse symptoms such as skin problems and inflammatory disorders, breathing problems, digestive disorders, flu-like or hangover symptoms, chronic fatigue, chronic pain such as back pain, and mental and emotional changes like depression, irritability, anger and bipolar disorder. The patients were sensitive to the very small amounts of aspirin in fruits and vegetables.
The Feingold diet, developed by the US doctor Ben Feingold MD was one of the first attempts at a salicylate exclusion diet. Feingold found that not only did an exclusion diet help with the accepted chronic health problems associated with salicylate ingestion, it also affected the behaviour and emotional state of children and adults who did the diet, and was apparently the cause of what was in those days known as hyperkinesis or hyperactivity and is known today as Attention Deficit Disorder (ADD), and Attention Deficit Hyperactivity Disorder (ADHD). Since that time it has been found that food chemicals cause or aggravate a wider range of related conditions, including many Pervasive Developmental Disorders (PDDs), Oppositional Defiance Disorder (ODD), Obsessive Compulsive Disorder (OCD), learning difficulties, dyslexia, and autism spectrum conditions including Asperger’s syndrome.
Today many people involved in this field regard the original Feingold diet as only partially effective. Very little was known about the salicylate content of foods in Feingold’s day, and there are numerous anomalies in his diet as a result that can catch patients out. When Ben Feingold died, the Feingold diet was never updated to reflect new knowledge of food salicylate content that emerged in the 1980s, though an organisation still exists in his name in the US still promoting the original Feingold diet. Nevertheless, the diet excluded enough chemicals to produce statistically significant improvements in children’s behaviour and many parents continue to find it helpful in treating their children’s behaviour and health problems.
In the late 1970s and early 1980s a dietician called Anne Swain analysed hundreds of foods and worked in conjunction with the Royal Prince Alfred Hospital in Australia to develop the exclusion diet we now know as the failsafe diet. Researchers found that glutamates and biogenic amines in foods had similar effects on the body to salicylates, and these were also excluded from the final diet. Some individuals are sensitive to only one group of chemicals or the other, but many people appear to be sensitive to both groups of chemicals because of their similar effects on the body.
The full list of symptoms that can be caused by food chemical sensitivity is very long. It reads like a list of “modern diseases of unknown causes”, such as ADHD, autism, hypoglycaemia, stomach pains, tinnitus, hives and rashes, asthma, angioedema and urticaria, headaches and migraines, bladder irritability, GI disorders like GERD and IBS, nausea, chronic fatigue, pain syndromes, allergy-like symptoms, ear ache, sinusitis and nasal polyps, hyperactivity, memory loss and poor concentration, mood disorders such as depression and irritability, sleep problems, and pseudoanaphylaxis (see symptoms of salicylate sensitivity for the most common symptoms). Salicylates and amines have also been found to play a role in some stubborn instances of coeliac (celiac) disease that do not get better with the removal of gluten from the diet.(1)
In practice, the diet limits or excludes virtually all processed foods, many fruits and vegetables with a small number of exceptions, aged or preserved proteins like ham, well hung beef, game, and cheese, as well as prohibiting the use of commercially manufactured cosmetics and perfumes (particularly mint and menthol products) that contain large amounts of salicylates and other chemicals that cross-react in the salicylate sensitive such as benzoates. It also eliminates aspirin (acetylsalicylic acid), NSAIDs, and other COX II inhibitors. Paracetamol (tylenol, acetaminophen) is allowed on the elimination diet. It should also be noted that many psychoactive drugs like benzodiazepines, barbiturates and SSRIs can cause unpleasant or enhanced side-effects in food chemical sensitive individuals.
The diet is mainly composed of very fresh (non-vacuum-packed or hung) meat, chicken, and white fish, eggs, fresh dairy products (if tolerated) such as milk, yoghurt, cottage cheese, and butter, many but not all grains (if tolerated), peeled potatoes, beans and pulses, peeled pears, and a number of green vegetables including cabbage and Brussels sprouts. Strong flavours, additives, many exotic fruits and vegetables, and spices, are not allowed.
The diet is designed to be treated as an elimination/challenge test. It will take around four weeks on the elimination diet to see positive changes (in some this can be as little as two weeks or as long as three months). It is also important to exclude strong smelling toiletries and cosmetics like essential oils and perfumes from your environment, and to only use failsafe approved products, as chemicals are absorbed easily through the skin.
The diet must be treated as a scientific experiment. All of the variables in the experiment must be controlled by removing all of the reactive food chemicals at once. For some this also means excluding dairy products and gluten or grain products if they are suspected to cause problems. Any wholefood which is being avoided due to a suspicion that it is causing symptoms of ill health should continue to be avoided on the initial elimination diet in order to control the variables. The diet must be followed strictly. In the beginning, small deviations can potentially cause large, exaggerated relapses in symptoms.
Once the individual is feeling well on the diet (a process that can take from between two weeks to two months), they can begin the challenge tests. Each chemical is tested individually. Because food chemicals build up in the body and effects may not be apparent at first, it is important to conduct challenge tests that last for five to seven days. As well as glutamate, amine and salicylate challenges, these challenges should also include challenges of wholefoods that have been excluded, for example, dairy or grains. If the individual does not seem to react to any of these chemicals or foods, they can challenge different additives. Some individuals only have problems with certain additives, such as azo dyes, MSG, or sulphites.
People rarely dispute the effects of additives, but because the diet cuts out many fruits and vegetables, and because the symptoms of food chemical intolerance can be so wide-ranging, people may have knee-jerk worries as to the nutritional content of the diet. Rest assured it is very easy to reach and exceed the RDAs of vitamins on the diet, as animal foods, legumes, pulses, grains, and the allowed vegetables are rich sources of vitamins and minerals. In fact, as salicylates interfere with the absorption and metabolism of several vitamins in the body (vitamins C, K, pantothenate, folate and B12), vitamin status can improve. Because food chemicals disproportionately affect children, teenagers, young women of child-bearing age (especially pregnant, nursing and new mothers) and the elderly, what usually happens is that husbands, partners and fathers are sceptical of the value of the diet, but eventually come around when they see the effects of it for themselves on their partners or children.
Today, hundreds of medical studies back up the work of Feingold, Swain and others, and thousands of individuals can testify to its enormous usefulness in resolving their ‘idiosyncratic’ symptoms of ill health, not only those treated by the RPAH, but those who have found the diet independently through determination and research into their apparently ‘psychological’ illnesses. Despite this, awareness of the pervasive effects of food chemicals on our health and behaviour remains extremely low amongst the general population.
Please explore this site if you would like more information into the symptoms of food chemical sensitivities, and learn how to perform the exclusion diet.
- Faulkner-Hogg KB, Selby WS, Loblay RH. Dietary analysis in symptomatic patients with coeliac disease on a gluten-free diet: the role of trace amounts of gluten and non-gluten food intolerances. Scand J Gastroenterol. 1999 Aug;34(8):784-9. [PubMed]