When I'm working with clients suspecting a food sensitivity, the topic of food sensitivity tests comes up regularly. The current gold standard for assessing food sensitivities is an elimination diet. In practice, I have found that using more specific tools, like the MRT test (mediator release test) and the dietary LEAP protocol can help personalize the elimination diet, allowing many clients to more efficiently achieve substantial differences in their quality of life and reductions of their symptoms. So, what is the MRT test and what is the LEAP protocol?
What is the LEAP Protocol?
The LEAP Protocol is a food sensitivity elimination diet based on an individual's results from the MRT test (Mediator Release Test) designed to help reduce inflammation in the body. LEAP stands for Lifestyle Eating And Performance Protocol.
In the world of food sensitivities, elimination diets are often the gold standard for identifying food sensitivities, those "triggers" of undesirable symptoms in certain individuals. Based on an individual's personal history, there are a variety of common elimination diets that may be considered: Whole30, low FODMAP, Specific Carbohydrate Diet, Autoimmune Protocol, Gut and Psychology Syndrome (GAPS) Diet, etc.
In both my professional and personal experience, the problem with these elimination diets is that they still aren't tailored to the individual. This is why it's not uncommon for some to try these diets and still not feel better. For example: hop on to any large message board or group for individuals that have irritable bowel syndrome (IBS), and you'll find some that swear by low-FODMAP and that it helped them, but you'll find others that felt no improvement on the diet.
That's because while some of these elimination diets may be designed for certain disease states, they still are not one-size-fits-all. The list of "safe" or "approved" foods that come with any of these elimination diets may still be a sensitivity or "trigger" for inflammation in your body, resulting in still not feeling better or having any decrease in symptoms. (Even foods like chicken, that are commonly thought of as "safe", or even "benign" flavorings like vanilla bean and the popular anti-inflammatory spice turmeric can still be a sensitivity for some individuals, triggering undesirable symptoms.)
With the LEAP protocol you work with a Registered Dietitian who is also a Certified LEAP Therapist to create a customized elimination diet based off your individual MRT blood test results.
Now, let's chat a little about this blood test - the Mediator Release Test.
What is MRT Testing?
The Mediator Release Test (MRT) is a food sensitivity test identifying foods and food chemicals/ additives that are causing food sensitivity reactions by adding more inflammation to the body.
There are significant clinical and immunological complexities associated with food sensitivities. Despite all this, the single common denominator of all diet-induced inflammatory reactions is proinflammatory and proalgesic mediator release from white blood cells. All the negative side effects a food sensitivity sufferer endures can be tied back to the release of mediators like cytokines, histamine, leukotrines, prostaglandins, and more from white blood cells, like neutrophils, monocytes, eosinophils, and lymphocytes.
The Mediator Release test works by using a patented combination of flow cytometry and proprietary impedance technology to measure subtle volumetric changes in lymphocytes, neutrophils, monocytes, and eosinophils. Volumetric changes after food or food-chemical challenge are quantified and reported as either 'Non-Reactive,', 'Moderately Reactive,' or 'Reactive' and form the basis for the LEAP Eating Plan. At the time of this writing, MRT currently tests for 170 different foods and food chemicals.
The LEAP Protocol Eating Plan
The LEAP Eating Plan basically consists of eating only MRT-tested, safe foods and ingredients for a determined period of time (typically 4-6 weeks). The protocol is designed to:
- Reduce the level of inflammation and related symptoms as quickly as possible.
- Through oral challenges, identify any additional contributors to symptoms not caused by delayed hypersensitivity reactions, in order to create a safe, customized diet.
- Identify clients or symptoms that need more rigorous follow-up or referral to another medical team member.
- Transition the client to a normalized, long-term healthy eating pattern that is easy to implement.
Also, as someone who is super passionate about individualized health and nutrition to fit individual needs, I feel it's super important to note that the LEAP protocol does allow for flexibility. Whether you have different health conditions, lifestyles, taste preferences, religious backgrounds, cooking skills, etc., the program is able to be customized to your needs and preferences.
The LEAP Protocol has 3 Phases
LEAP Diet Phase 1
The LEAP Diet phase 1 is 10-14 days in duration, where only tested, safe items are consumed. The goal is to quickly reduce inflammation, achieve a noticeable reduction in symptoms and create a new baseline for later oral challenges.
LEAP Diet Phase 2
The LEAP Diet phase 2 is 20-35 days long and is where other tested foods are added to the diet through oral challenges, so other immune and non-immune reactions that might be impacting the client's health may be unmasked (i.e. fat malabsorption, IgE allergies, fructose intolerance, etc.). The goal is to identify more safe foods.
LEAP Diet Phase 3
The LEAP Diet Phase 3 is 30-60+ days long, or as needed. The goal is to continue to expand and "normalize" the diet by continuing to challenge with any remaining MRT-tested foods, untested foods, or both. As you move forward, the goal is more dietary variety to help provide a nutrient dense diet and a healthy microbiome.
Who Is the LEAP Diet For?
The LEAP diet is for anyone that need helps managing a chronic inflammatory condition, which includes irritable bowel syndome (IBS), polycystic ovarian syndrome (PCOS), ulcerative colitis, gastroesophageal reflux disease (GERD), chronic migraines (not related to menstrual cycles), eczema, etc.
Who is the LEAP Diet Not For?
If you have an eating disorder or a history of an eating disorder, the LEAP diet is NOT for you. I am very protective of helping my clients maintain or achieve a more mindful relationship with food, and while LEAP may be a clinically appropriate elimination diet for qualifying individuals, it may likely be too triggering for anyone with a current or history of an eating disorder.
The LEAP diet also isn't for anyone who isn't motivated. I can help facilitate changes in your health, but you're the one that has to be willing to do the work.
LEAP Diet and Weight Loss
The LEAP diet is not a weight loss diet - it is not for you if you're looking for an easy weight loss solution. Weight loss is not the goal with LEAP; improved health through decreased inflammation and associated symptoms is the goal.
That said, due to decreased inflammation and often improved healthy eating behaviors for many clients (i.e. less ultra processed foods), there can sometimes be a correlation between the LEAP diet and weight loss.
How I Integrate LEAP in My Practice
If you've spent a few moments on my website, my Instagram, or other platforms, you know that I'm not a fan of unnecessary food restriction. That said, I've also voiced frustration with the "all foods fit" phrase that's often parroted, because realistically - all foods don't always fit for all individuals.
I often work with individuals with food allergies, intolerances, and sensitivities. There have been times that clients have come to LEAP only eating a handful of foods because they are so tired of feeling bad and not knowing what is making them feel worse. Using something like the mediator release test and LEAP under the guidance of a Registered Dietitian and Certified LEAP Therapist can be a very efficient process that results in MORE food options, flexibility, and freedom for these clients.
MRT Test Insurance and Cost
Health insurance networks do not cover the cost of the MRT test. Many Certified LEAP Therapists I've networked with share that clients are often able to successfully use their FSA/ HSA funds to cover the cost of the test and nutrition services.
Sadly, many health insurance networks also do not cover the cost of nutrition consults and care with a registered dietitian. Some may have coverage, but only for a limited number of appointments in limited scenarios (i.e. only covering nutrition appointments relating to diabetes mellitus or chronic kidney disease).
The Mediator Release Test is a costly test, and this, along with the fact that multiple nutrition consults with your dietitian are necessary during the LEAP protocol, can make MRT and LEAP cost-prohibitive for many.
Many CLT dietitians try to absorb some of the costs to their clients by creating packages that bundle their services for the LEAP diet protocol with the MRT test. All dietitians structure their private practices differently, though, so it is best to find a dietitian who is a Certified LEAP Therapist near you and inquire how they structure and price things.
Initial Investment vs Long-Term Health Savings
However, many LEAP clients do find that while the initial investment of doing MRT and LEAP is high, it may save them money in the long run with less frequent medical visits and other care needed. While every case is individual, there have been cases reported where a LEAP client's symptoms improve so much that a surgery may be avoided. Again, while each individual case is unique, there have also been many instances where clients have returned to a visit with their primary care physician and their PCP has taken them off some/ all medications due to such an improved difference in their health.
Clinical Research on MRT and LEAP
In full transparency, at the time of publishing this article, there are no published peer-reviewed studies on MRT or the LEAP protocol. This is something that Oxford Biomedical Technologies, the laboratory that runs the MRT and provides Certified LEAP Therapist training, is well aware. They have been raising millions of dollars and are currently progressing on a clinical study investigating the effectiveness of LEAP for IBS-D. In the meantime, there are some instances of MRT/ LEAP data presented or published elsewhere. I highly recommend checking out this comprehensive overview on food sensitivity testing, along with current evidence on LEAP and MRT from Functional Nutrition Answers.
Final Thoughts on MRT and LEAP
As with any laboratory test or dietary protocol, the MRT test and LEAP diet are not for everyone. But if you're someone who has a chronic inflammatory condition like IBS, PCOS, ulcerative colitis, GERD, or many others, checking out Mediator Release Testing and the LEAP dietary protocol may be of interest to you.
I highly recommend searching for dietitians that are certified LEAP therapists near you for more information.
LEAP logo and MRT description image both from the nowleap.com website.