Symptom relief and adherence in the rotary ...



Title Symptom relief and adherence in the rotary diversified diet, a treatment for environmental illness
Author(s) Jennifer P. Taylor, M. M. Krondl, A. C. Csima
Journal Alternative Therapies in Health and Medicine
Date 2004
Volume 10
Issue 4
Start page 58
End page 64
Abstract 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.


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.


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.


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.


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.


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.

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