How to do an Elimination Diet

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What is the Elimination Diet?

Many people experience chronic symptoms that they assume are either a normal part of life or perhaps just a sign of aging. They may not be aware that certain foods in their diet can be triggering these symptoms and are not accustomed to making connections between what they eat and how they feel.

For stubborn health issues that are not responding to medical treatments, an elimination diet may be helpful for resolving symptoms as well as improving overall health and well-being.

An elimination diet is the process of temporarily removing certain foods from the diet that potentially may be contributing to body dysfunctions. This process gives the body an opportunity to heal and return to optimal health.

People may not realize that the foods they habitually eat are manifesting into symptoms. Unlike food allergies that elicit an immediate allergic response, food sensitivities or food intolerances bring on symptoms that may not show up until several days after eating the offending food.

Reasons for implementing an elimination diet

Modern day diets typically contain many foods that slow both digestion and metabolism, as well as create hormonal imbalances. This leads to blood glucose dysregulation and inflammation, which are the underlying root causes of many chronic diseases.

Consumption of foods that are triggering continuous reactions becomes problematic for gut health. Over time the gut becomes inflamed which can lead to increased intestinal permeability, otherwise known as leaky gut. A leaky gut puts a strain on the immune system which can lead to a variety of problems, such as mental health issues, skin issues, autoimmune disorders, and more.

It’s important to note that elimination diets are not meant to be a permanent style of eating. Optimal nutrition ideally includes a wide variety of foods to maximize nutrient intake. The goal is to eventually reintroduce as many foods as possible back into the individual’s diet for the best health outcome.

What types of health conditions are helped by an elimination diet?

Anyone who is experiencing chronic symptoms may be a good candidate for an elimination diet.  Individuals who suspect that certain foods are problematic for them or who have a family history of autoimmune disorders can also benefit from an elimination diet.

Some common chronic symptoms that foods can trigger:

  • Digestive problems – bloating, constipation, diarrhea, gastritis, GERD
  • Headaches and migraines
  • Rhinitis
  • Sinusitis
  • Low energy and fatigue
  • Mood swings, anxiety, depression
  • Skin problems – eczema, acne
  • Musculoskeletal aches and pains
  • Asthma

The benefits of doing an elimination diet

In natural medicine, an elimination diet is an excellent tool that provides clues for determining what diet and lifestyle modifications are best for an individual.

After approximately three weeks of following an elimination diet, chronic symptoms may diminish or disappear.

By giving the body a break from potential food triggers, the gut has an opportunity to heal resulting in decreased strain on the immune system. Inflammation is reduced, gut microbiome balance is improved, while also decreasing oxidative stress and toxic burden on the body.

After completion of the elimination diet, it may even be possible for an individual to develop tolerance of the foods that were previously provoking symptoms. For others, they will have developed a better sense of what foods they need to limit or avoid in order to feel their best.

While it can be challenging to adhere to an elimination diet, the potential health benefits and relief of chronic symptoms is worth the effort. Some individuals find the first several days most difficult, as their bodies are feeling withdrawal from the foods they have been habitually eating. Take comfort in knowing that these withdrawal feelings do pass and many people often experience increased energy and vitality along with diminishing symptoms after the first week.

Common Food Triggers

Elimination diets remove foods that have been identified as common triggers of symptoms or dysfunctions in the body.

Elimination diets typically exclude:

  • Dairy – butter, cheese, heavy cream, ice cream, milk, sour cream, yogurt
  • Gluten – barley, rye, spelt, wheat
  • Beverages – alcohol, coffee, soft drinks
  • Meat – beef, veal, pork, processed meats
  • Chocolate
  • Corn
  • Eggs
  • Legumes – peanuts, soy
  • Shellfish
  • Refined grains and sugar
  • Processed foods

Dairy can be inflammatory and is known to trigger gastrointestinal symptoms in many people because it contains both lactose and casein. Lactose is problematic for those that do not have sufficient amounts of the lactase enzyme. Casein binds to receptors on nerve cells that slow peristalsis or digestion of food. This is a common sensitivity that slows down digestion and metabolism, leading to leaky gut.

Gluten can cause digestion problems and affects the immune system. It contains gliadins that are harmful to the lining of the intestines which also leads to leaky gut.

Alcohol contributes to inflammation and puts a burden on the liver.

Coffee, especially when consumed in larger quantities, affects blood sugar balance and elevates stress hormones, both of which have a huge impact on overall health.

Refined grains and sugar put stress on the body by creating blood sugar imbalances and an unhealthy balance of gut microbes. Processed foods contain additives and trans fats that are inflammatory to the gut.

Food Reintroduction

After following the elimination diet for 3 weeks, it is essential to reintroduce foods properly. Without reintroducing foods properly, there is no way of knowing what food or foods potentially were triggering symptoms.

There is no particular order to follow when reintroducing foods. Usually, an individual may choose to start by reintroducing the food that is missed the most.

Foods are reintroduced one at a time for two days, before moving on to the next food. An example of this process is outlined below for reintroducing egg as the first food and peanuts as the second food.

Day 1: Eat a generous amount of eggs throughout the day.

Day 2: Do not reintroduce any new foods.

 Record any observations made in regard to symptoms in a journal for both days. If there are no reactions to corn during this two-day period, it is fine to include corn going forward and the next food may be reintroduced on day three.

Day 3: Eat a generous amount of peanuts throughout the day.

Day 4: Do not reintroduce any new foods.

As with the first food, record any observations made in regard to symptoms in a journal for both days. If there are no reactions to peanuts during this two-day period, it is fine to include peanuts going forward and the third food may be reintroduced on day five, and so on.

Reintroduce one food at a time in a pure form. In other words, do not reintroduce a food that has a combination of ingredients or additives because if a reaction does occur, it will be able impossible to determine which ingredient triggered the reaction. For instance, in the example above, when reintroducing peanuts, consume raw peanuts or peanut butter with no additives as opposed to eating peanut butter on crackers, which contain gluten, or a peanut butter cookie, which contains multiple ingredients.


Reactions during reintroduction

If a food does provoke a reaction, continue to avoid that food for another three to six months before attempting the reintroduction process again.

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

In the event that symptoms are not resolved after three weeks of an elimination diet, it may be appropriate to explore other possible sensitivities to foods that contain histamines, nightshades, salicylates, or oxalates.

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