{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:22:39Z","timestamp":1791922959528,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T00:00:00Z","timestamp":1759017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Human Nutrition Diet"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Food hypersensitivity describes a range of nonimmune food related reactions of varying aetiology causing gastrointestinal and extraintestinal symptoms. This study aimed to evaluate if the low\u2010chemical diet improves gastrointestinal and\/or extraintestinal symptoms, and whether specific food challenges induce symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective clinical audit was conducted on files from 2011 to 2022 from a gastrointestinal specialist dietetic practice. Fifty eligible patient files were identified, all of whom had been recommended to follow a low\u2010chemical diet. One research dietitian extracted data on diet implementation, symptom change during the Restrictive Phase, and symptom provocation during the Rechallenge Phase. Descriptive statistics were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort was predominantly female (80%), mean age 47 years (range 7\u201385). At baseline the most common gastrointestinal symptom was diarrhoea (22\/50, 44%), and extraintestinal symptom was nasal congestion (14\/50, 28%). Improvement in at least one symptom following the Restrictive Phase occurred in 88% (44\/50). The Restrictive Phase was followed for 2\u201378 weeks, and unintentional weight loss was documented in 24% (2\u201310\u2009kg). The Rechallenge Phase duration ranged from 5 to 191 weeks, with 96% (48\/50) reporting symptom provocation following at least one challenge. Salicylate challenge most commonly induced diarrhoea (16%), bloating (16%), and itch (14%), while amine challenge induced abdominal pain (10%) and nausea (8%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients reported an improvement in gastrointestinal and extraintestinal symptoms, but commonly experienced prolonged dietary restriction. Rechallenge with salicylates and amines provoked symptoms; but this may be confounded by other diet and non\u2010diet factors. High\u2010quality trials with isolated food chemical components are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jhn.70134","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T05:57:16Z","timestamp":1759125436000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Outcomes and Food Triggers Following Low Food Chemical Diet Implementation: A Retrospective Audit of Dietetic Practice"],"prefix":"10.1111","volume":"38","author":[{"given":"Zoe","family":"Cooke","sequence":"first","affiliation":[{"name":"Department of Food, Nutrition and Dietetics La Trobe University Bundoora Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Lynam","sequence":"additional","affiliation":[{"name":"Department of Food, Nutrition and Dietetics La Trobe University Bundoora Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Barrett","sequence":"additional","affiliation":[{"name":"Diet Solutions Glen Iris Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica R.","family":"Biesiekierski","sequence":"additional","affiliation":[{"name":"Department of Food, Nutrition and Dietetics La Trobe University Bundoora Australia"},{"name":"Human Nutrition Group, School of Agriculture, Food and Ecosystem Sciences The University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina","family":"Trakman","sequence":"additional","affiliation":[{"name":"Department of Food, Nutrition and Dietetics La Trobe University Bundoora Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline J.","family":"Tuck","sequence":"additional","affiliation":[{"name":"Department of Food, Nutrition and Dietetics La Trobe University Bundoora Australia"},{"name":"Department of Allied Health Swinburne University Hawthorn Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,28]]},"reference":[{"issue":"21","key":"e_1_2_10_2_1","first-page":"359","article-title":"The Differential Diagnosis of Food Intolerance","volume":"106","author":"Zopf Y.","year":"2009","journal-title":"Deutsches Arzteblatt International"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12984"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu11071684"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.14561"},{"key":"e_1_2_10_6_1","unstructured":"Allergy ASoCIa \u201cFood Intolerance \u201dhttps:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/food-intolerance."},{"issue":"8","key":"e_1_2_10_7_1","first-page":"137","article-title":"Salicylate Intolerance: Pathophysiology, Clinical Spectrum, Diagnosis and Treatment","volume":"105","author":"Baenkler H. W.","year":"2008","journal-title":"Deutsches Arzteblatt International"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13072228"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14596"},{"key":"e_1_2_10_10_1","unstructured":"A.Swain \u201cThe Role of Natural Salicylates in Food Intolerance \u201d (master's thesis University of Sydney 1988)."},{"key":"e_1_2_10_11_1","unstructured":"A. S. V.SwainandR.Loblay Royal Prince Alfred Hospital Elimination Diet Handbook: With Food & Shopping Guide(Allergy Unit Royal Prince Alfred Hospital 2011) Revised Edition https:\/\/www.slhd.nsw.gov.au\/rpa\/allergy\/resources\/foodintol\/ff-handbooks.html."},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13051638"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13601-015-0078-3"},{"issue":"4","key":"e_1_2_10_14_1","first-page":"303","article-title":"Exploring the Association Between Ingestion of Foods With Higher Potential Salicylate Content and Symptom Exacerbation in Chronic Rhinosinusitis. Data From The National Chronic Rhinosinusitis Epidemiology Study","volume":"57","author":"Philpott C. M.","year":"2019","journal-title":"Rhinology"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814555836"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21678"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13030991"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/13590840120103094"},{"issue":"1","key":"e_1_2_10_19_1","first-page":"24","article-title":"Benefits of a Histamine\u2010Reducing Diet for Some Patients With Chronic Urticaria and Angioedema","volume":"61","author":"King W.","year":"2000","journal-title":"Canadian Journal of Dietetic Practice and Research: A Publication of Dietitians of Canada = Revue Canadienne De La Pratique Et De La Recherche En Dietetique: Une Publication Des Dietetistes du Canada"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.12578"},{"issue":"6","key":"e_1_2_10_21_1","first-page":"10","article-title":"The Effect of Dietary Glutamate on Fibromyalgia and Irritable Bowel Symptoms","volume":"30","author":"Holton K. F.","year":"2012","journal-title":"Clinical and Experimental Rheumatology"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12092593"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13778"},{"issue":"5","key":"e_1_2_10_24_1","first-page":"305","article-title":"Histamine Intolerance\u2010Like Symptoms in Healthy Volunteers After Oral Provocation With Liquid Histamine","volume":"25","author":"W\u00f6hrl S.","year":"2004","journal-title":"Allergy and Asthma Proceedings"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13041262"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000485"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2022-327260"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu14071513"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.105"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom12030454"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-018-5045-0"},{"key":"e_1_2_10_32_1","doi-asserted-by":"crossref","unstructured":"J.Rindfleisch \u201cFood Intolerance and Elimination Diet \u201d inIntegrative Medicine(WB Saunders 2012) 776\u2013788.","DOI":"10.1016\/B978-1-4377-1793-8.00068-6"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.4162\/nrp.2010.4.2.142"},{"key":"e_1_2_10_34_1","volume-title":"Elimination Diets Treasure Island","author":"Malone J. C. D. S.","year":"2024"}],"container-title":["Journal of Human Nutrition and Dietetics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jhn.70134","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T12:33:34Z","timestamp":1761914014000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jhn.70134"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,28]]},"references-count":33,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/jhn.70134"],"URL":"https:\/\/doi.org\/10.1111\/jhn.70134","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/JHN.70134\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JHN.70134\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JHN.70134\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JHN.70134\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JHN.70134\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JHN.70134\/v3\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JHN.70134\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JHN.70134\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JHN.70134\/v3\/response1","asserted-by":"object"}]},"ISSN":["0952-3871","1365-277X"],"issn-type":[{"value":"0952-3871","type":"print"},{"value":"1365-277X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,28]]},"assertion":[{"value":"2025-07-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70134"}}