Elimination diets are tricky, but they can help you figure out which foods your body doesn’t love.
Food allergies, intolerance, or sensitivities can cause bloating, gas, severe diarrhea, constipation, unexplained changes in weight, or nutritional deficiencies, says Maxine Yeung, RD, CPT, the founder of The Wellness Whisk. Kerry Clifford, RD, LDN, with Fresh Thyme Farmers Market, says that sometimes they may also cause non-GI problems such as headaches, migraines, skin rashes, acne, joint pains, mood changes, low energy levels, runny noses, hives, and itchy eyes.
Although it may be scary to think about, it’s important to understand the difference between a food allergy, food sensitivity, and food intolerance.
When you have a food allergy, your immune system reacts to certain proteins in food. This can cause physical reactions like hives, itching, swelling, or diarrhea. In rare cases, it can also cause anaphylaxis.
Food sensitivity and intolerance are two different things. Intolerance means your gut is sensitive and cannot handle certain types of food. This can result in diarrhea, bloating, and stomach discomfort.
It is possible to be allergic to everything, but it is most common to have allergies to alcohol, coffee, corn, dairy, eggs, peanuts and tree nuts, shellfish, soy, and wheat.
Although everyone does not have the same reaction to these foods, an elimination diet, which involves taking out certain foods from your diet and then slowly reintroducing them back in, can help determine which food is causing discomfort. However, when done correctly, it takes time, patience, planning, and professional advice to figure out what is best for your body.
What is an elimination diet?
An elimination diet is not a weight loss program or diet in the traditional sense. Rather, it is a two-part process that can last anywhere from three to eight weeks.
According to WH advisor Samantha Nazareth, MD, a gastroenterologist who practices in New York City, the first step to determining whether food triggers are to blame for reactions is to remove potential trigger foods from your diet. Then, you can carefully add each food group back into your diet, observing reactions for at least three days. Symptoms of food sensitivities can range from belly pain to nasal congestion.
When someone has food triggers that make their symptoms worse, we can help by changing their diet to improve functions like digestion, absorption, and inflammation.
There are certain types of elimination diets that are used for specific conditions. The low-FODMAP diet is used to treat conditions like irritable bowel syndrome (IBS) and small intestine bacterial overgrowth (SIBO). This diet eliminates certain short-chain carbohydrates that can cause bloating, abdominal pain, diarrhea, and/or constipation.
Patients with IBS may not be able to absorb short-chain carbs, which could be why they experience gas, severe bloating, and altered bowel habits (like diarrhea, constipation, or both). “Eliminating the FODMAPs allows them to, first of all, feel better, but then add them back in slowly to figure out what specific carbs/foods are causing their issue,” McMahon explains.
Can I do an elimination alone or do I need help from a pro?
Clifford says that it is important to consult a professional before embarking on an elimination diet, to ensure that the diet is being conducted effectively and that nutritional needs are still being met. Without professional supervision, it is easy to become deficient in nutrients such as fiber and vitamin D.
A low-FODMAP diet is best done under the care of a physician and/or nutritionist.
It’s important to talk to your doctor about any issues you have with disordered eating or anxiety before eliminating any foods from your diet. People who have a tendency to control their eating may start to restrict their food intake or become fixated on “good” and “bad” foods if they do not have a plan or support system in place. A health professional can help you follow your elimination diet in the healthiest way possible.
How to do an Elimination Diet: 4 Strategies to Start Your Elimination Diet Protocol
If you are trying to follow an elimination protocol, simply avoiding allergenic and inflammatory foods for a few weeks is not enough.
- The Elimination Diet Strategy: Time Matters
But they are exactly that – miracles. They are not the norm. Think about how long you have felt below average. Months, or even years, right? So why would you give up after just ten days? You may not experience any change in symptoms after a week or two, but that should not stop you from continuing what you are doing! I have seen plenty of “10-day miracles”, where people see a change in just three days, but they are not the norm.
After eliminating certain foods for a certain amount of time, most people need to follow the program for at least 3 weeks or 21 days to see any real progress. I usually tell people to follow the protocol for 6 weeks, because that’s about how long it takes for the human immune system to “reset” itself. For people who have been feeling sick for years, I usually have them follow the approach for 12 weeks before reintroducing foods.
- Elimination Diet Food Lists & Having a Healthy Gut
Most of your health as a human being is determined by the health of your gut. Therefore, your food choices matter a great deal.
Almost 80% of the immune system is located in the digestive tract. This can be thought of as a microscopic village inside the intestinal wall. The goal is to have this village be full of bacteria that are hard-working and keep out invaders. These bacteria help to regulate the immune response.
Inflammation of the gut is caused by bad bacteria taking over from the good bacteria. To rebuild the good bacteria, we need to focus on two key points.
- a) Strict removal of inflammatory foods (as well as any we may have a known food intolerance to). Doing so, dramatically decreases overall inflammation. Our immune system begins to heal as a result.
- b) Incorporate more phytonutrients, prebiotics, probiotics, and more protein-rich food sources.
Unfamiliar terms? That’s OK, here’s a quick cheat sheet:
The beautiful colors on fruits and vegetables are phytonutrients, which are chemical substances that help protect plants and humans from a damaging environment.
Probiotics are good bacteria that are found primarily in our gut. These good bacteria help to maintain the microbial balance in our digestive tract while also improving digestion and immune health. Some great examples of foods that contain probiotics include sauerkraut, kimchi, Kombucha tea, coconut kefir, and Kvass.
Prebiotics are undigestible plant fibers that function as food for probiotics. Prebiotics promote the growth of probiotics. Common prebiotics include raw garlic, leeks, Jerusalem artichoke, onions, acacia gum, and ripe bananas.
Some food sources that are high in protein are chicken, fish, legumes, grass-fed beef, and seeds like hemp, chia, and flax.
Powerful Elimination Diet Food List:
- Kombucha Tea
- Use Phytonutrients as Your Secret Weapon
Try to eat a variety of colorful fruits and vegetables each day to get a lot of phytonutrients and antioxidants. Phytonutrients and antioxidants are chemicals and substances that occur naturally in plants. They help our body fight free radicals and promote natural healing and detoxification in our organs.
These nutrients protect us from things like heart disease, cancers, Alzheimer’s, and other degenerative diseases. The hidden gems referred to are phytonutrients and antioxidants. These nutrients are most famous for protecting plants from outside invaders such as bugs and fungi. When we as humans consume phytonutrients and antioxidants, we receive an extra line of defense from the outside world. This protects us from things like heart disease, cancers, Alzheimer’s, and other degenerative diseases.
The importance of this concept is especially noticeable in athletes. The cells in athletes’ bodies experience stress every day from the training they go through. Antioxidants are especially helpful in reducing this stress. I believe that phytonutrients and antioxidants are essential in decreasing the inflammation that burdens athletes’ bodies.
- Decrease Your Toxic Burden
If you’re trying to reduce inflammation and feel better overall, why fill your body with toxins? It would be counterproductive to eat healthy foods only to then drink diet soda, which would be like taking two steps forward and five steps back.
So you don’t eat processed foods, which is great. But have you looked at the rest of the food in your kitchen? You should check the quality of your home’s water, for example. And avoid heating food in plastic containers. Also, buy organic produce, and meat and poultry that come from animals that were fed grass and had lots of space to roam. That’s because more research is showing that these products contain more nutrients and fewer contaminants than meat and poultry from animals that were raised in crowded conditions and fed mainly grain.
The Environmental Working Group has a list of produce that would be best to buy organic. With animal protein, it is more cost effective to buy quality protein straight from the sources than the grocery store.
These toxic chemicals promote disease and rob us of nutrients that our bodies need to function properly. It’s unfortunate that such a large portion of our food has been tampered with by the inclusion of preservatives, additives, artificial flavors and sugars, pesticides, insecticides, and herbicides. These chemicals are harmful and prevent our bodies from getting the nutrients they need.
Foods that are high in toxins can be found in processed and conventionally grown foods. Eating these foods can put a lot of stress on your liver. It’s a good idea to eat fresh, whole foods while you’re eliminating toxins from your diet.
Okay, so I’ve kept a food journal for a few weeks—now what?
The best time to start a new eating plan is when you know you will have complete control over what you eat. This means that vacation is not the best time to start.
“I’ve seen people make a lot of other changes in their lifestyles and medications at the same time they start an elimination diet,” says Yeung. “This makes it much harder to figure out which foods are causing the symptoms.”
If you want to know if a probiotic is working, she recommends taking it while eliminating soy from your diet, as this will help to isolate the probiotic’s effect.
On the day you start your diet, get rid of all the foods you plan to eliminate. It’s important to have a doctor or dietitian’s supervision when doing this, as cutting out entire food groups can make it hard to get the nutrients you need.
How long does an elimination diet last?
Most elimination diets last from three to eight weeks, although you may see results much sooner, according to Dr. Pekow. He adds that, for food intolerances to certain food groups, the benefit of the diet can be felt within days.
Take your time when eliminating certain foods from your diet. A few weeks of elimination will allow your body to get used to the new diet and give your gut time to heal.
Things that can damage the lining of the gut and make it more permeable include irritants like food allergens, explains Dr. Nazareth. This can weaken the “security system” so that things that shouldn’t enter the body, like bugs, can now do so and cause inflammation, bloating, gas, and diarrhea.
This means that, in consultation with your doctor or dietitian, you will determine how long to do the elimination diet, which will depend on the food you are avoiding. However, it will take your body a week or two to recover from any foods that may cause problems.
Although it might be tempting to stop the elimination diet early, Yeung says it’s crucial to stick to it. “Many people give up on the diet prematurely because they start feeling better soon after they begin, but if you do that, you risk getting rid of foods that you don’t necessarily need to, because you didn’t go through the reintroduction phase,” she says. “This could lead to unbalanced diets and stop you from being able to eat foods that you might really enjoy and can tolerate.”