The Complete Guide to Elimination Diets
Elimination diets have become increasingly popular as a way to identify food sensitivities, alleviate gastrointestinal issues, and improve overall health and wellbeing. But what exactly are elimination diets and how do they work? This comprehensive guide will provide an overview of elimination diets, explain the different types, and offer guidance on following an elimination protocol safely and effectively.
- What Are Elimination Diets?
- How Do Elimination Diets Work?
- Why Follow an Elimination Diet?
- Types of Elimination Diets
- Elimination Diet Guidelines
- Step-By-Step Elimination Diet Protocol
- Frequently Asked Questions
- How long should I eliminate foods for?
- What if I accidentally get exposed to eliminated foods?
- Will eliminating foods negatively affect my health?
- How will I know if a food causes a reaction?
- What should I do if I react to a food I reintroduce?
- When can I reintegrate foods I tolerate?
- How long should I stay on my personalized diet?
- More Frequently Asked Questions About Elimination Diets
- What are some other common food triggers I may want to eliminate?
- How do I ensure I am getting adequate nutrition on an elimination diet?
- What ingredients should I watch out for on food labels?
- How do I handle eating out and travel during an elimination diet?
- What are some substitutions I can use in recipes that call for eliminated ingredients?
- Will I experience any withdrawal or detox symptoms when eliminating certain foods?
- How long after a reaction should I wait before challenging that food again?
- What happens after I complete the elimination and reintroduction process?
- How can I make my personalized diet as nutritious as possible?
What Are Elimination Diets?
Elimination diets involve removing certain foods or food groups from your diet in order to determine if they are causing adverse reactions. Foods are eliminated for a period of time, usually 2-6 weeks, and then gradually reintroduced while monitoring symptoms.
The most common food triggers are gluten, dairy, eggs, corn, soy, nuts, citrus fruits, nightshade vegetables (tomatoes, eggplants, peppers, potatoes), processed foods, alcohol, and caffeine. However, individuals can be sensitive or intolerant to any food.
How Do Elimination Diets Work?
Elimination diets work by giving the body a break from potential inflammatory or allergy-triggering foods. This allows irritated areas of the gut to heal and eases symptoms like gas, bloating, diarrhea, constipation, acid reflux, congestion, headaches, fatigue, skin issues, joint pain, and more.
Once symptomatic relief has been achieved through the elimination phase, foods are slowly reintroduced. This is done one at a time while watching closely for the return of symptoms. Reactions indicate an intolerance or sensitivity to that food.
The best approach is to eliminate suspect foods for 30 days, followed by reintroduction and challenging of one food every 72 hours. Keeping a detailed food and symptom journal is crucial during elimination diets.
Why Follow an Elimination Diet?
There are several key reasons for trying an elimination diet:
- Identify food intolerances or allergies causing symptoms
- Confirm a suspected food sensitivity
- Relieve gastrointestinal issues like IBS
- Improve conditions like eczema, migraines, joint pain, chronic fatigue
- Pinpoint reactions that may mimic anxiety or ADHD
- Discover problematic ingredients like additives, preservatives, dyes
- Reduce inflammation throughout the body
Research indicates that elimination diets can be beneficial for a wide array of health problems. Even eliminating certain foods for a short period can help reset the immune system and gut function.
Types of Elimination Diets
There are several different elimination diet protocols:
Comprehensive Elimination Diet
This involves removing the most common trigger foods all at once for 4-6 weeks:
- Citrus fruits
Such a strict protocol should only be followed under the guidance of a registered dietitian who can ensure nutritional completeness.
The Autoimmune Protocol (AIP)
The AIP diet aims to calm inflammation in autoimmune conditions. It eliminates:
Additional foods like certain spices, oils, and sweeteners may also be removed.
Low FODMAP Diet
FODMAPs are fermentable carbohydrates that can trigger IBS symptoms. A low FODMAP elimination diet removes:
This is typically implemented in two phases under the guidance of a dietitian.
This eliminates all wheat, barley, rye, and other gluten-containing grains. It is essential for those with celiac disease or non-celiac gluten sensitivity.
All milk products are eliminated, including cheese, yogurt, butter, ghee, cream, custard, and whey protein.
Sugar Elimination Diet
Sugar is removed in all forms, including honey, maple syrup, agave, high-fructose corn syrup, etc. Artificial sweeteners are also eliminated.
As the name implies, Whole30 cuts out:
- Sugar (real & artificial)
The program lasts for 30 days. It is meant to help improve metabolic, gastrointestinal, and mental health.
Elimination Diet Guidelines
If you decide to try an elimination diet, be sure to:
- Consult with your healthcare provider, especially if you have a health condition or take medication
- Work with a registered dietitian to ensure nutritional adequacy
- Read ingredient labels carefully
- Cook at home as much as possible
- Plan ahead for social, travel, or dining out situations
- Reintroduce foods slowly and keep a symptom journal
- Don't stay on an overly restrictive diet long-term without medical supervision
Be prepared for some challenges but remember that the effort is well worth it to discover problematic foods causing health issues.
Step-By-Step Elimination Diet Protocol
If you want to try an elimination diet yourself, follow these steps:
1. Choose Your Elimination Diet
Decide which version best suits your needs, symptoms, and medical conditions. The comprehensive approach removes the most foods while a targeted diet eliminates specific foods.
2. Remove Eliminated Foods
Read all product labels and clear your kitchen of eliminated foods. This includes condiments, sauces, seasonings, canned goods, snacks, baking ingredients, non-dairy milks, nutritional supplements, and more.
3. Stock Up On Allowed Foods
Shop for produce, proteins, fats, herbs/spices, teas, olive oil, nuts/seeds (if allowed), rice, quinoa, coconut, and any other approved ingredients. Meal planning is essential.
4. Follow Diet Strictly
Do not cheat as this can trigger symptoms and skew results. Be vigilant about label reading and aware of cross-contamination when dining out.
5. Record Symptoms
Document symptoms daily including energy levels, digestion, pain, congestion, sleep, focus, mood, cravings, etc. This helps assess reactions when reintroducing foods.
6. After 4 Weeks Begin Reintroducing
Choose one food to reintroduce every 3-4 days while continuing to avoid all other eliminated foods. Watch closely for reactions.
7. Challenge Each Food
Reintroduce all foods using the same individual challenging protocol. Document any reactions that occur. These indicate an intolerance or sensitivity.
8. Create A Personalized Diet
Based on your reintroduction results, create your own customized diet that excludes problematic foods and includes those that are well tolerated.
Following these steps will provide invaluable information about how different foods impact your body. This allows you to optimize your diet for improved health and reduced symptoms.
Frequently Asked Questions
Still have some questions about tackling an elimination diet? Here are answers to some common queries:
How long should I eliminate foods for?
Experts recommend 4-6 weeks for the elimination phase. This gives the body enough time to calm inflammation and identify clear reactions upon reintroduction.
What if I accidentally get exposed to eliminated foods?
Try your best to be very strict during the active elimination phase. If you do get exposed, restart the full elimination period again. Just one small slip up can influence results.
Will eliminating foods negatively affect my health?
There are some nutritional considerations, especially on very restrictive diets. Work with an RD and supplement if needed to prevent deficiencies. Most elimination diets are safe for 4-6 weeks.
How will I know if a food causes a reaction?
Watch for the return of any symptoms you experienced prior to the diet or the emergence of new symptoms like digestive upset, congestion, headache, rash, joint pain, fatigue, etc.
What should I do if I react to a food I reintroduce?
Eliminate that food again for at least 3-6 months. After this period, cautiously try reintroducing it again to see if the same reaction occurs. If so, you likely have an intolerance or allergy.
When can I reintegrate foods I tolerate?
After the full elimination and challenging period, you can add back in foods you did not react to. Do this one at a time while monitoring symptoms.
How long should I stay on my personalized diet?
Most experts recommend following your customized elimination diet for at least 3-6 months to allow for complete healing of the gut and immune system.
Elimination diets require commitment but can be incredibly useful tools for identifying food triggers. Key takeaways:
- They involve removing foods for a period before systematic reintroduction
- Benefits include relieving GI issues, inflammation, skin conditions, headaches, and more
- Various protocols eliminate common triggers like gluten, dairy, grains, nightshades, etc.
- Work closely with a healthcare practitioner to implement elimination diets safely
- Strictly avoid eliminated foods, carefully reintroduce, and keep a symptom journal
- Create a tailored diet excluding reactive foods you identify
In a nutshell, elimination diets help you pinpoint problem foods so you can personalize your diet and optimize your health. With proper planning and support, an elimination diet can be life changing!
More Frequently Asked Questions About Elimination Diets
What are some other common food triggers I may want to eliminate?
Some other foods that are frequent triggers for sensitivities include soy, eggs, shellfish, citrus fruits, peppers, garlic, onions, beans, lentils, chickpeas, peas, peanuts, tree nuts, caffeine, sodium nitrates, MSG, sulfites, artificial sweeteners, food dyes, preservatives like BHT and BHA, and more. Work with a dietitian to determine which foods to start with for your elimination diet.
How do I ensure I am getting adequate nutrition on an elimination diet?
Be sure to focus on eating a colorful variety of allowed vegetables, high quality proteins, healthy fats, and safe starches like rice and quinoa. Take a multivitamin and any needed supplements recommended by your healthcare provider. Working with a dietitian helps prevent nutritional deficiencies.
What ingredients should I watch out for on food labels?
Carefully inspect ingredient lists for any eliminated foods, including additives like soy lecithin, maltodextrin, carrageenan, wheat starch, whey protein, and rice syrup. Also look for sulfites, nitrates, MSG, and other preservatives. Call manufacturers if you are unsure about certain ingredients.
How do I handle eating out and travel during an elimination diet?
Scour restaurant menus online before going out to eat and call ahead if needed. For travel, pack safe snacks and non-perishable foods. Ship allowed ingredients to your destination in advance. Explain your dietary needs to family or friends you are visiting. Be prepared to avoid Problem foods.
What are some substitutions I can use in recipes that call for eliminated ingredients?
Some recipe modification options include using coconut milk or nut milks instead of dairy milk, coconut oil or olive oil instead of butter, almond flour instead of wheat flour, apple cider vinegar instead of white vinegar, dates or maple syrup instead of refined sugar, tamari instead of soy sauce, and avocado instead of mayonnaise.
Will I experience any withdrawal or detox symptoms when eliminating certain foods?
It is possible when going off sugar, caffeine, dairy, or wheat especially. Symptoms may include headaches, fatigue, irritability, brain fog, changes in bowel movements, changes in sleep patterns, cravings, etc. Stay hydrated, get enough rest, and be patient as symptoms resolve.
How long after a reaction should I wait before challenging that food again?
Experts typically recommend avoiding any reactive food for at least 3-6 months after a noticeable reaction. This allows the immune system to calm down before retryIng the food. When re-challenging, go very slowly starting with a small amount.
What happens after I complete the elimination and reintroduction process?
Use your results to create your own customized diet tailored to the foods that work best for your body long-term. Continue avoiding reactive foods while enjoying non-reactive foods. Some people periodically re-challenge eliminated foods to see if intolerances resolve over time.
How can I make my personalized diet as nutritious as possible?
Focus on getting a wide array of vegetables, high quality protein sources, healthy fats like avocado, olives, coconut, nuts/seeds if tolerated, antioxidant-rich fruit, and gut-friendly fermented foods. Meet with a dietitian periodically to ensure you are meeting all of your nutritional needs.