Elimination Diet

What is the Elimination Diet?

The most accurate test for uncovering reactive foods and individual food sensitivities is the elimination diet. The Institute for Functional Medicine (and many other professionals who practice functional medicine) consider it the “gold standard” for discovering the foods that are causing your symptoms.

Elimination diets are a helpful self-healing tool because they allow you to experiment with specific foods that you suspect are causing reactions, and allow you to notice the symptoms that disappear and reappear when you consume that food.

In contrast to other diets that simply exclude foods that are problematic to many, an elimination diet can help you determine your own individual food intolerances, which may differ from others — even if those people have the same symptom(s) and/or condition(s). In this way, an elimination diet can help you figure out your individual food triggers and your specific response to each trigger food.

This allows us to tailor the diet to the person, not to the dietary philosophy. 

During the elimination diet, you will eliminate the most common problematic foods and potential food sensitivities, then re-introduce the foods back in, one at a time. Then you will carefully observe and record your reaction to each food, to determine if you are sensitive or not.

When we eat the foods that our body is sensitive to on a daily basis, it is very difficult to connect the problematic foods with the symptoms we experience. For example, people who have a dairy sensitivity but continue to eat dairy several times a day might feel tired or have joint pain, congestion, bloating, and acid reflux on a daily basis, but won’t be able to link the symptoms to the specific foods they are eating.  

This is because every time we eat a reactive food, our bodies become depleted in their ability to protect themselves from the antigenic foods, and the reactions become less specific and more chronic. If the food continues to be consumed, the body will become sensitive to more and more foods over time. 

However, once the sensitizing food is eliminated for a few days to a few weeks, you should feel better and experience less bloating, normal bowel movements, more energy, and a general relief of symptoms. When you’re exposed to the food again, your body will produce a stronger, more specific reaction, allowing you to recognize which particular food is problematic. This is called the elimination diet. 

How to Do an Elimination Diet 

An elimination diet requires you to remove the most common food sensitivities from your diet for a period of three weeks. It is imperative during this time that you do not “cheat” at all by eating even a small amount of any of the foods that have been removed. Doing so could cause a reaction and interfere with your results. 

There are three important steps to the elimination diet: 

  1. Decide which foods you are going to eliminate. The Basic Elimination Diet (below) is a good place to start. However, you may also wish to consider eliminating other foods beyond this list. Sometimes the foods we are most drawn to or eat most often are the ones that are causing us the most symptoms. 

I suggest asking yourself questions like: 

  • What foods do I crave?
  • What foods feel like they’d be hard to give up?
  • What foods do I eat the most?
  1. Avoid the foods you are eliminating. This step is crucial! Again, even the smallest amount of a specific food type that you are avoiding could cause a reaction, so it is important that you are vigilant and avoid all traces of the food for three weeks. Check food labels carefully, and be extra careful if you are eating out, as it’s difficult to know all of the  ingredients used in restaurants. It may be best to avoid eating out during this elimination period to avoid any cross-contamination that might skew your results. 
  2. Reintroduce the challenged foods. If your symptoms have improved after three weeks, you can start adding the foods back in, one at a time. Paying attention to any reactions you may have to particular foods will help you identify your personal food sensitivities. I’ll detail the steps for conducting food reintroductions in a minute.

The Basic Elimination Diet 

Most people will begin with the Basic Elimination Diet, which targets the most common food sensitivities, and will be effective at uncovering problematic foods for a large group of people. 

The foods to be eliminated on the Basic Elimination Diet are: 

  • Alcohol
  • Gluten
  • Dairy
  • Soy
  • Eggs
  • Corn
  • Nuts
  • Shellfish
  • Preservatives

The following order should be followed when reintroducing foods: 

  • Eggs
  • Nuts*
  • Shellfish
  • Corn
  • Preservatives
  • Soy*
  • Dairy*
  • Gluten*

If your symptoms did not improve after the initial three-week elimination, you may have other food intolerances that need to be eliminated. In this case, the Advanced Elimination Diet (below) is a good next step. 

The Advanced Elimination Diet 

Some people will find that they are still experiencing food sensitivities after doing the Basic Elimination Diet, and will need to dig deeper by eliminating another group of foods. 

The foods to be eliminated on the Advanced Elimination Diet are:

  • Gluten 
  • Dairy
  • Soy
  • Eggs
  • Corn
  • Nuts
  • Alcohol
  • Shellfish
  • Preservatives
  • Beef
  • Pork
  • Citrus
  • Nightshades
  • Seeds
  • Grains (gluten free)

Your symptoms may be the same as those you experienced with the Basic Elimination Diet, but they may be unique to your body, so be sure to write everything down. 

They can be reintroduced in the following order (most importantly, introduce dairy and gluten last, as they’re the most difficult to digest): 

  • Beef
  • Pork
  • Citrus
  • Nightshades
  • Seeds
  • Grains (gluten free)
  • Eggs
  • Nuts
  • Shellfish
  • Corn
  • Alcohol
  • Preservatives
  • Soy
  • Dairy
  • Gluten

Reintroducing Foods 

After three weeks of following an elimination diet, you will add each food back in, one by one, in the order in which they appear in the list (as outlined above). Wait four days between reintroducing each food, and carefully observe and write down any reactions you may experience. Tracking your experience with each food in a food journal can help to identify any sensitivities. Keep in mind, it may take anywhere from an hour to a few days to experience a reaction. 

Be sure to track any and all symptoms, even if mild. Including Postnasal drip, congestion, cough, wheezing 

Constipation, diarrhea, bloating, gas, burping 

Increased heart rate, palpitations 

Acne, eczema, itching, rash 

Joint aches and pains, swelling 

Headaches, dizziness, somnolence, irritability, fatigue, depression 

It is recommended eating one serving of the food to be trialed, and keeping to only one food group per reintroduction. For example, don’t “test” by eating an entire pizza, because you won’t know what you’re reacting to. (The gluten in the crust? The dairy in the cheese? The nightshades in the sauce?) 

If a food doesn’t cause symptoms during a reintroduction challenge, it is unlikely to be a problem food and can be added back into your diet. However, if at any point you experience a reaction, stop consuming the food and continue to reintroduce the rest of the foods on the list.

Again, be sure to wait at least four days between foods before trying the next one. 

After all of the foods have been reintroduced, you should have a clear picture of which foods your body is sensitive to, and you’ll know which foods you need to avoid in order for your gut to begin the healing process.

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