Elimination Diets
An elimination diet is a nutritional strategy designed to eliminate specific foods for a set period of time, in order to identify any that may be contributing to an individual’s symptoms. In most cases, the food will be removed from one’s diet for a period of 10 days, or up to 4 weeks, and then reintroduced in small quantities to assess any adverse reactions. The lining of our digestive tract is designed to stop antigens from entering our bloodstream, but if we are allergic or sensitive to certain foods, this system can break down. This may result in increased gut permeability and certain foods causing or worsening an individual’s symptoms. Therefore, the foods removed from the diet should be specific to the individual’s symptoms or condition. Sometimes one may choose to eliminate several food groups at once and then reintroduce those foods one at a time, while other times one may eliminate one food group at a time. This is a common strategy to identify food allergies or sensitivities, especially in individuals who are suffering from gastrointestinal upset and can be more accurate than other testing procedures for specific conditions. The benefit of this method is that it is highly individualized, more convenient than clinical testing, and focuses on how the individual feels, rather than what they are told based on other forms of data.
Why do an Elimination Diet?
An individual may choose to follow an elimination diet if they are experiencing symptoms related to their gastrointestinal, cardiovascular, dermatologic, psychological, or neurological systems. Elimination of different types of foods is necessary for different types of conditions. For example, an individual with IBS may eliminate dairy, wheat, and eggs while an individual with ADHD may eliminate apples, artificial sweeteners, and an array of food additives and preservatives. When triggering foods are identified, the individual may need to continue avoiding that food indefinitely. To start an elimination diet, take a journal of what you eat during a week, and note when you experience certain symptoms. A practitioner should work with you to review this diary and determine what foods may be triggering your symptoms before you make an effort to plan out which foods you will be eliminating.
Who Should Not Do an Elimination Diet?
While an elimination diet can be useful in certain situations, it is not for everyone. For example, there are many food allergy or sensitivity tests that can be equally, if not more, accurate in determining if one has a sensitivity to certain foods. Celiac disease, for example, can be determined through a blood test or biopsy. An elimination diet also takes careful planning, preparation, and a long-term commitment. This can make it an extremely difficult diet to follow. It is also common that one may eliminate incorrect foods specific to their conditions and not observe any relief in symptoms, requiring further testing or diets. Individuals who have previously struggled with eating disorders or the avoidance of certain foods also should not be prescribed an elimination diet, as it can compound existing food fears or create new ones. Malnutrition may also be a risk for individuals not under the care of a practitioner assessing their total dietary intake.
Challenges
As previously noted, an elimination diet takes a lot of preparation and planning. In some cases, one may totally have to change the staple foods in their diet. It can also make eating out difficult if foods contain unknown ingredients. In order to successfully complete an elimination diet and receive the most benefit from it, the individual must be active in their effort at all times.
My Experience
I have had a long history of sensitivities to certain foods, and have used an elimination diet in conjunction with other testing to find solutions for myself. While I generally like to use food sensitivity/allergy testing as a guide, there are a lot of foods that do not show up on these tests that contribute to my symptoms. For example, I’ve never had a test tell me that I am allergic or sensitive to tree nuts. However, if I consistently eat tree nuts, my symptoms reappear. I have found that using saliva, blood, or stool tests gives me a roadmap of what things I should look out for, while I rely mostly on my own experience to determine what I should or should not eat.
OUR FAVORITE FOOD SENSITIVITY TEST:
An elimination diet is arguably one of the most personal ways to determine what you can and cannot tolerate. The time and effort required also make it one of the most difficult methods as well. If you are interested in attempting an elimination diet, you should consult with a nutrition practitioner to ensure you are meeting your total nutritional needs, eliminating the right foods, and reintroducing foods at the appropriate time.
References:
- David Rakel. Integrative Medicine E-Book. Vol 3rd ed. Saunders; 2012. Accessed June 26, 2022. https://search-ebscohost com.scnmlib.idm.oclc.org/login.aspx?direct=true&db=nlebk&AN=475747&site=ehost-live
- Rivera E, Assiri A, Guandalini S. Celiac disease. Oral Dis. 2013;19(7):635-641. doi:10.1111/odi.12091
- Chehade M, Brown S. Elimination diets for eosinophilic esophagitis: making the best choice. Expert Rev Clin Immunol. 2020;16(7):679-687. doi:10.1080/1744666X.2020.1801419
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