Are low-pseudoallergen diets useful in the extended diagnostic programme of CSU?

Josefine Grünhagen discusses the use of low-pseudoallergen diets in relation to patients with chronic spontaneous urticaria symptoms.

Answer

The use of low-pseudoallergen diets is only recommended as part of the extended diagnostic programme of chronic spontaneous urticaria in patients with daily or almost daily symptoms.1  It is recommended to be instituted and maintained for a minimum of 3 weeks.1  The full list of foods which are allowed and those that should be excluded can be found in the table below.2

It is also important to note that the success rates of low-pseudoallergen diets can vary due to regional differences in food and dietary habits.1

Low-pseudoallergen diet - Allowed and prohibited foods2

 

Allowed

Prohibited

Food additives

Natural additives if not prohibited below

All industrially processed foods containing flavouring, preservatives, dyes and antioxidants

Basic food stuffs

Bread and rolls without preservatives, semolina, millet, potatoes, rice, durum wheat, noodles (without eggs), rice cakes (only containing rice and salt)

All other foods (e.g. noodle products, egg noodles, cake, French fries)

Fats

Butter, vegetable oils

All other fats (margarine, mayonnaise etc)

Milk products

Fresh milk, fresh cream (without carrageenan), curd, natural yogurt, cream cheese (unseasoned), small amounts of young gouda

All other milk products

Animal foods

Fresh meat, fresh ground meat (unseasoned), cold meat (self-made)

All processed animal food stuffs, eggs, fish, crustaceans

Vegetables

Salad (well-washed), carrots, courgette, Brussel sprouts, white cabbage, Chinese cabbage, broccoli, asparagus

Artichokes, peas, mushrooms, rhubarb, spinach, tomato and tomato products, olives, pepper

Fruits

None

All fruit and fruit products (including dried fruit such as raisins)

Spices

Salt, sugar, chives, onions

All other spices, garlic, herbs

Sweets

None

All sweets including chewing gum and artificial sweetener

Beverages

Milk, mineral water, coffee, black tea (non-aromatic)

All other beverages including herbal tea and alcoholic beverages

Bread/
sandwich fillings

Honey and the products previously mentioned

All bread fillings not mentioned

 

  • Josefine Grünhagen

    She completed her training as a dietitian at Charité - Universitätsmedizin Berlin and is an allergological certified dietary specialist.

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  • References

    1. Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, et al.  The EAACI/GA2LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update.  Allergy. 2014;69(7):868–87.
    2. Zuberbier T, Chantraine-Hess S, Hartmann K, Czarnetzki BM. Pseudoallergen-free diet in the treatment of chronic urticaria. A prospective study. Acta Derm Venereol. 1995 Nov;75(6):484–7.

     

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