Elimination diets are dietary programmes designed to clear the body of foods and chemicals that an individual may be allergic or sensitive to, helping the body handle and dispose of these substances. These diets require the removal of certain foods or food categories from the diet. Elimination diets are considered to be the “gold standard” for determining if an individual has a food reaction. 90% of all acute food allergies re associated with 8 key foods:
- Milk, egg, peanuts, wheat (gluten), soy, fish, shell fish and tree nuts (e.g.walnuts, cashews & almonds)
What to remove
The best elimination diets remove the largest number of foods. Generally speaking, the more restrictive the better. Yes, it’s more work. But, as with most things, the more work, the greater the payoff.
To begin with, a good elimination diet will remove gluten, dairy, soy, eggs, corn, pork, beef, chicken, beans/lentils, coffee, citrus fruits, nuts, and nightshade vegetables. That might sound like a lot, but it leaves plenty of options for a satisfying diet comprised primarily of rice, meat (i.e. turkey, fish, lamb), most fruit, and most types of vegetables.
The following table gives an example of what to include and exclude during an elimination diet.
|Foods to include||Foods to exclude|
|Fruits||Almost all fresh fruit||Citrus fruits|
|Vegetables||Almost all fresh raw, steamed, sautéed, or roasted vegetables||Tomatoes, eggplant, potatoes (sweet potato and yams are okay)|
|Starch||Rice*, buckwheat*||Wheat, corn, barley, spelt, kamut, rye, oats, all gluten-containing products|
|Legumes||Soybeans, tofu, tempeh, soy milk, all beans, peas, lentils|
|Nuts and seeds||All nuts and seeds|
|Meat and fish||Fish, turkey, lamb, wild game||Beef, chicken, pork, eggs, cold cuts, bacon, hotdogs, canned meat, sausage, shellfish, meat substitutes made from soy|
|Dairy products and milk substitutes||Unsweetened rice milk*, coconut milk||Milk, cheese, cottage cheese, cream, yogurt, butter, ice cream, non-dairy creamers|
|Fats||Cold-expeller pressed olive oil, flaxseed oil, coconut oil||Margarine, butter, processed and hydrogenated oils, mayonnaise, spreads|
|Beverages||Drink plenty of fresh water, herbal teas (e.g. rooibos, peppermint, etc.)||Alcohol, caffeine (coffee, black tea, green tea, soda)|
|Spices and condiments||Sea salt, fresh pepper, fresh herbs and spices (i.e. garlic, cumin, dill, ginger, oregano, parsley, rosemary, thyme, turmeric)||Chocolate, ketchup, mustard, relish, chutney, soy sauce, barbecue sauce, vinegar|
|Sweeteners||Stevia (if needed)||White or brown sugar, honey, maple syrup, corn syrup, high fructose corn syrup, desserts|
*May also be removed if you suspect specific sensitivities to grains.
As mentioned, this is a fairly restrictive elimination diet. There are lists available on the Internet allowing more, and sometimes fewer, foods in the diet. The key here is to not get too dogmatic. Self-experimentation rules the day. So try different things and see what works for you.
The only caveat here is that the more you remove, the more likely you are to discover foods you’re intolerant to, which is a good thing for your health.
And here’s another tip: consider removing any other foods you eat frequently. For example, eat turkey or asparagus every day? If so, try replacing them during the elimination experiment. You may find that you’ve become intolerant to one of your daily staples because you’re eating it so frequently.
How long should the diet be?
The length of an elimination diet can vary depending on your age and the severity of symptoms. Children can usually see benefit from a 7-10 day elimination diet, while most adults seem to do well following the program for around three to four weeks.
Just don’t make things too complicated on yourself. Macronutrient ratios, calorie intake, etc. aren’t very important during an elimination diet. The only really important thing is to completely avoid the foods discussed above.
Also, during the elimination diet, be sure you consume adequate amounts of water. Anywhere from 2 to 4 liters daily should do the trick.
Of course, it’s not the purpose of the elimination diet to get rid of all
the foods above forever. That would be awful. Rather, the point is to eliminate the foods and then slowly reintroduce them, one at a time, so you can monitor yourself for symptoms.
So, at the end of the three weeks of elimination, reintroduce a single food group for one day only. And then monitor your symptoms for two days. For example, you might decide to reintroduce dairy on a Monday. That day you could eat some cheese, ice cream, and drink a glass of milk. While getting right back to your elimination diet, monitor for any abnormal reactions on Tuesday and Wednesday.
If you have no observable symptoms, you may try reintroducing another food (i.e. eggs) on Thursday. You can continue this process for a couple more weeks, reintroducing one new food every few days, until you’ve determined what foods may cause you an issue (if any).
The whole process will take approximately 5-6 weeks and, at the end of the experiment, you’ll know a heck of a lot about how your body responds to different foods.
What to look for
Diet impacts everything. The key to the approach is this: pay attention to how you’re feeling. For example, you’ll want to monitor your sleep, mood, energy, digestion, bowel habits, etc.
In fact, we recommend keeping a journal during the elimination phase and tracking any physical, mental, or emotional signs and symptoms. If you feel better during the elimination period (i.e. more energy, better sleep), it may indicate that a food you commonly eat is causing you a problem.
The second thing to watch for is symptoms – negative or positive – during the reintroduction. Negative reactions can include:
- joint pain and/or inflammation
- skin breakouts or rashes
- bowel changes or GI pain
- brain fog
- sinus or other respiratory issues
Because you’ll be introducing eliminated foods one at a time, you can be very observant of food-related changes. And virtually anything that is different than you felt during the previous three weeks could be a symptom, negative or positive.
Interestingly, some people actually report increased energy when a given food is reintroduced. Unfortunately this may be created by a stress response to the particular food. And that’s actually a negative thing. So it’s important to keep a log of all reactions – positive or negative.