The six food elimination diet (SFED) is an alternative to the elemental diet for eosinophilic esophagitis. This diet eliminates cow’s milk protein, soy, wheat, egg, peanut/tree nuts, and seafood. Although this diet is less restrictive and better accepted than an elemental diet, the results are not as impressive.
Many patients choose this diet as a more realistic alternative to the elemental diet to treat eosinophilic esophagitis, but unfortunately by eliminating these 6 foods (and everything that contains these foods), this diet is also challenging and can be difficult to follow.
To follow the six food elimination diet carefully it is best to return to a whole foods approach. All fresh and plain frozen vegetables are allowed, as well as all fresh and plain frozen fruit. 100% fruit and vegetable juices are acceptable. Plain meats including beef, chicken, turkey, pork and lamb are allowed as long as they are not breaded or prepared with the eliminated foods, as well as gluten free grains.
A complete list of foods allowed on the SFED can be found at www.apfed.org/restricteddiets.pdf.
When done as a test for food allergies, the elimination diet is followed for 4 to 7 days. After the 4 to 7 days, each food is added back, one at a time, each one taking 4 to 7 days. If a reaction is observed upon reintroduction of a food, the child is considered allergic to that food.
Children with eosinophilic esophagitis usually follow the diet for 6 weeks. If symptoms improve, the diet is continued. If no improvement is seen a close look at the diet by a qualified dietitian or doctor should occur, looking for hidden food allergies or accidental ingestion of a suspected allergen, and further testing is needed to determine appropriate treatment.
In determining which diet is best for your child with eosinophilic esophagitis, it is important to consider all options. The elemental diet is considered the gold standard but the SFED may be easier to follow.
Still not sure? Check out our article comparing the SFED to the elemental diet.