Elimination Diets

What is an elimination diet, and should I do one?

Everybody’s body responds to foods differently. While it's possible to have an allergy, sensitivity, or intolerance to any given food, the most common culprits include alcohol, coffee, corn, dairy, eggs, peanuts and tree nuts, shellfish, soy, and wheat. Food allergies, intolerances, or sensitivities may provoke unpleasant symptoms such as bloating, gas, diarrhea, constipation, unexplained weight changes, nutritional deficiencies, etc.

The idea with an elimination diet is to remove potential food triggers and then carefully add them back into your diet to determine whether they're to blame for your reactions.

Yes, It’s a commitment, but an elimination diet remains the gold standard for identifying food sensitivities.

What to remove?

A thorough elimination diet generally removes gluten, dairy, soy, eggs, corn, beef, beans, coffee, citrus fruits, nuts, and nightshade vegetables.

You can certainly personalize and eliminate all grains, for example.

Another tip: consider removing any other foods you eat frequently. For example, do you eat chicken or green beans every day? If so, try replacing them during the elimination experiment. You may find that you’ve become intolerant to one of your staples because you’re eating it daily.

The length of an elimination diet can vary, but most seem to do well following a program for around three to four weeks. Don’t make things more complicated. Macronutrient ratios, calories, etc., aren’t significant during an elimination diet. The only crucial thing is to avoid the foods discussed above wholly.

At the end of the three weeks of elimination, reintroduce a single food group for one day only. And then monitor your symptoms for two days. For example, you might decide to reintroduce dairy on a Monday. That day you could eat some cheese, and drink a glass of milk. While getting right back to your elimination diet, monitor for any abnormal reactions on Tuesday and Wednesday.

If you have no observable symptoms, you may try reintroducing another food (i.e., eggs) on Thursday. You can continue this process for a couple more weeks, reintroducing one new food every few days until you’ve determined what foods may cause you an issue (if any). The point is to eliminate the foods and then slowly reintroduce them, one at a time so that you can monitor yourself for symptoms.

The whole process will take approximately 5-6 weeks and, at the end of the experiment, you’ll know a heck of a lot about how your body responds to different foods.

What to look for

Pay attention to how you’re feeling. Monitor your sleep, mood, energy, digestion, bowel habits, etc. I recommend keeping a journal during the elimination phase and tracking any physical, mental, or emotional signs and symptoms. If you feel better during the elimination period (i.e., more energy, better sleep), it may indicate that the food you commonly eat is causing you a problem.

The second thing to watch for is symptoms – negative or positive – during the reintroduction. Negative reactions can include:

· insomnia

· fatigue

· joint pain and or inflammation

· skin breakouts or rashes

· headaches

· bowel changes or GI pain

· bloating

· brain fog

· sinus or other respiratory issues

Because you’ll be introducing eliminated foods one at a time, you can be very observant of food-related changes. Virtually anything different than you felt during the previous three weeks could be a symptom, negative or positive.

In addition to the general elimination, specific types of elimination diets, such as a low FODMAP diet, are used for patients suffering from irritable bowel syndrome (IBS). The low FODMAP diet eliminates certain short-chain carbohydrates—gluten, lactose, fructose, and sugar alcohol—that ferment in the gut and cause bloating, abdominal pain, diarrhea, or constipation.