Symptom relief and adherence in the rotary diversified diet, a treatment for environmental illness.
BACKGROUND
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.


METHODS
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.


METHODS
Private clinic of a Toronto, Ontario physician specializing in environmental medicine.


METHODS
Twenty-five female residents of Toronto, Ontario (aged 25-67 years) diagnosed with environmental illness.


METHODS
Patients were treated with a rotary diversified diet for 16 weeks.


METHODS
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.
Department of Nutritional Sciences, University of Toronto, Ontario, Canada.
Jennifer P
JP
Taylor
Magdalena M
MM
Krondl
Adele C
AC
Csima
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D015331:Cohort Studies; D015930:Diet Records; D019587:Dietary Supplements; D018876:Environmental Illness / Q000175:diagnosis* / Q000178:diet therapy* / Q000517:prevention & control; D005260:Female; D005512:Food Hypersensitivity / Q000517:prevention & control; D005518:Food Preferences; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D009864:Ontario; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016387:Women's Health