Reintroducing Foods

Reintroduction

The reintroduction phase of the elimination diet involves gradually reintroducing one food at a time to identify potential trigger foods. Here are the specific instructions for the reintroduction of foods.

Choose one food

Begin by choosing one food that you want to reintroduce, such as dairy products, and make sure to select the purest form of that food, free from additives, preservatives, or flavorings.

Start with a small amount

Start with a small amount of the food in the morning, such as a teaspoon of milk or a small piece of cheese, and consume it on an empty stomach. If you don’t notice any symptoms after 24 hours, then eat two larger portions the next day. Monitor symptoms and/or triggers for 2 additional days.

Monitor your symptoms

Symptoms that can be associated with a food reaction include headaches, digestive upset, skin rashes, joint pain, and fatigue.

Record your symptoms in a journal or on the computer. Keep a detailed record of any symptoms that you experience, including the type of symptom, the time it occurred, and the severity of the symptom.

Proceed with caution

If you do not experience any symptoms, you can assume that the food is safe for you to eat. However, if you experience mild symptoms, you may want to try the same food again in a few days to confirm that it was the food that caused the symptoms. If you experience severe symptoms, such as anaphylaxis, seek medical attention immediately.

Wait before reintroducing another food

Wait the full 48 hours before introducing another food. This allows you time to determine if the symptoms you experienced were due to the food you reintroduced or something else.

Repeat the process

Repeat this process with each of the foods that you want to reintroduce, until you have identified all of your trigger foods.

Sample Schedule

Here’s a sample schedule for reintroducing foods back into the diet after the elimination phase

Day 1 – Gluten

Start with a small amount of gluten, such as a slice of bread or a serving of pasta, and consume it on an empty stomach. Wait 24 hours to monitor for any symptoms or reactions. If zero symptoms manifest, then the next day, consume two larger portions of gluten, such as a sandwich or a pasta dish. Wait an additional 48 hours to monitor for symptoms. Record any symptoms in a food journal.

Day 4 – Dairy

Start with a small amount of dairy, such as plain yogurt or cheese, and consume it on an empty stomach. Wait 24 hours to monitor for any symptoms or reactions. If zero symptoms manifest, then the next day, consume two larger portions of the same dairy product. Wait an additional 48 hours to monitor for symptoms. Record any symptoms in a food journal.

Day 7 – Eggs

Start with a small amount of eggs, such as one hard-boiled egg, and consume it on an empty stomach. Wait 24 hours to monitor for any symptoms or reactions. If zero symptoms manifest, then the next day, consume two larger portions of eggs, such as scrambled eggs or an omelet. Wait an additional 48 hours to monitor for symptoms. Record any symptoms in a food journal.

Day 10 – Nightshades

Start with a small amount of nightshades, such as a slice of tomato or a piece of bell pepper, and consume it on an empty stomach. Wait 24 hours to monitor for any symptoms or reactions. If zero symptoms manifest, then the next day, consume two larger portions of nightshades, such as a salad with tomato and bell pepper. Wait an additional 48 hours to monitor for symptoms. Record any symptoms in a food journal.

Day 13 – Nuts and Seeds

Start with a small amount of nuts or seeds, such as almonds or sunflower seeds, and consume it on an empty stomach. Wait 24 hours to monitor for any symptoms or reactions. If zero symptoms manifest, then the next day, consume two larger portions of nuts or seeds, such as a nut butter sandwich or trail mix. Wait an additional 48 hours to monitor for symptoms. Record any symptoms in a food journal.

Day 16 – Citrus Fruits

Start with a small amount of fruit, such as two slices of an orange, and consume it on an empty stomach. Wait 24 hours to monitor for any symptoms or reactions. If zero symptoms manifest, then the next day, consume two larger portions of the same fruit or other citrus fruits such as grapefruit or clementine’s. Wait an additional 48 hours to monitor for symptoms. Record any symptoms in a food journal.

Day 19 – Soy

Start with a small amount of soy, such as a serving of tofu or soy milk, and consume it on an empty stomach. Wait 24 hours to monitor for any symptoms or reactions. If zero symptoms manifest, then the next day, consume two larger portions of soy, such as a stir-fry dish or soy-based meat alternative. Wait an additional 48 hours to monitor for symptoms. Record any symptoms in a food journal.

Day 22 – Corn

Start with a small amount of corn, such as a serving of corn on the cob or corn chips, and consume it on an empty stomach. Wait 24 hours to monitor for any symptoms or reactions. If zero symptoms manifest, then the next day, consume two larger portions of corn, such as a serving of popcorn or a corn-based dish. Wait an additional 48 hours to monitor for symptoms. Record any symptoms in a food journal.

Day 25 – Cooking Oils

Start with a small amount of cooking oil, such as olive oil or coconut oil, and consume it with a meal. Wait 24 hours to monitor for any symptoms or reactions. If zero symptoms manifest, then the next day, consume two larger portions of cooking oil, such as using it for cooking or in a salad dressing. Wait an additional 48 hours to monitor for symptoms. Record any symptoms in a food journal.

Day 28 – Shellfish

Start with a small amount of shellfish, such as a single shrimp or scallop, and consume it on an empty stomach. Wait 24 hours to monitor for any symptoms or reactions. If zero symptoms manifest, then the next day, consume two larger portions of shellfish, such as a small serving of a mixed seafood dish. Wait an additional 48 hours to monitor for symptoms. Record any symptoms in a food journal.

Potential Reaction/Symptoms

Reactions can include a variety of symptoms and vary from person to person:

• Gastrointestinal issues – constipation, diarrhea, gas, bloating, abdominal pain
• Fatigue
• Mood issues – depression or anxiety
• Headaches
• Aches and pains in joints and muscles
• Skin issues – eczema, rash, itchy skin, flushing
• Nasal or sinus congestion
• Sleep disturbances

If a food does provoke a reaction, continue to avoid that food for another three to six months before attempting the reintroduction process again. Consult with your physician if it was a severe reaction.

In the event that symptoms are not resolved after an elimination diet, assuming other pathology has already been ruled out, it may be appropriate to explore other possible sensitivities to foods that contain histamines, nightshades, salicylates, or oxalates.