Context: The rotary diversified
diet, which involves food elimination and rotation of remaining allowed
foods, is commonly used in the management of environmental illness. No
studies have considered patient adherence while evaluating the effectiveness
of the diet in controlling symptoms.
Objective: The study examined the
severity of patients' perceived symptoms and dietary adherence during treatment
with a rotary diversified diet.
Design: A prospective and exploratory
study using purposive sampling and the following data collection methods:
personal interviews, symptom severity questionnaires, and food records
to assess dietary adherence.
Setting: Private clinic of a Toronto,
Ontario physician specializing in environmental medicine.
Patients or other participants:
Twenty-five female residents of Toronto, Ontario (aged 25-67 years) diagnosed
with environmental illness.
Intervention: Patients were treated
with a rotary diversified diet for 16 weeks.
Main outcome measures: Symptom severity
and dietary adherence were assessed after 4, 10, and 16 weeks of treatment.
Adherence was assessed by comparing food records to the diet prescription.
Results: At 16 weeks, patients reported
a 50% decline in symptom severity for 5 of the 6 symptom categories assessed
and for all categories combined. Those with closer elimination and rotation
adherence reported a greater decline in gastrointestinal symptoms at 4
and 10 weeks of treatment, respectively. Improvement in total symptom severity
was associated with closer rotation adherence at 10 weeks. Patients experienced
difficulties in adhering to the diet.
Conclusions: Results suggest that
the diet, if followed, is beneficial, especially in improving gastrointestinal
symptoms. Further evaluation of its effectiveness is limited by its complexity
and the nature of environmental illness. Because the diet is difficult
to follow over time, patients require extensive nutritional counseling
and support.
Rotational Diets:
5 Day Balanced
Menu 1926 Calorie Rotation Diet (Segregated fats, omega 3 & arginie
balanced)
5 Day Limited
Low Cal Menu - 1412 Calorie Rotation Diet (High Starch, Low Fat)
Five
Day Pentad cycle of Cuisines - sequences of the 5 cuisines during the
five seasons of the year.