How to Do an Elimination Diet

Food sensitivities, intolerances, and allergies are becoming more and more common (and yes, they are different from one another!).

There are a few reasons that may be driving this, but I believe it is in large part due to the amount of stress we are under, paired with the amount of processed, nutrient-deficient foods we (as a society) have in our diets.

Each of these things on their own are enough to cause problems in the digestive system, but so many of us are dealing with stressful jobs, families, lives, etc. And how do we cope? Convenient, quick, processed foods. A recipe for a damaged gut.

Add to that the amount of chemicals we’re exposed to on a daily basis (our bodies can only tolerate so much) and you’ve got an environment ripe for serious inflammation. With 70% of the immune system living in our gut, it’s vital that we take care of anything that may be damaging it.

The standard protocol for determining your food triggers is an elimination diet. You can take tests for allergies, but sensitivities and intolerances are murkier when it comes to accuracy. Plus, testing an be expensive.

But you need to eat, so doing an elimination “experiment” on your own meets your basic food needs while also helping you uncover the root of your problems.

What is an elimination diet?

First thing’s first. Simply put, an elimination diet is a short-term method of determining food sensitivities. It’s the removal of potentially inflammatory foods for a period of time, usually three or four weeks (but at the very minimum, two weeks), then reintroducing those foods one by one to determine which ones are triggering your symptoms.

Basically, you remove the foods to let your body calm down from whatever inflammation it’s experiencing. You get back to equilibrium. Disease is the end stage of inflammation, so we want to nip it in the bud.

This makes it much easier to figure out whether you’re allergic or sensitive to a particular food.

What’s the difference between a food allergy, food sensitivity, and food intolerance?

I know, it all sounds the same, and it probably all feels the same when you get down to it—like crap. But there are a few differences:

• A food allergy is is when your body sees a certain food as an invader and triggers your immune response, aka the allergic reaction. You typically will notice symptoms almost immediately, if not within the first 30 minutes. Symptoms can be quite serious even from a small amount. You are likely already aware of which foods cause this reaction in your body.
• A food sensitivity is a digestive system response, rather than your immune system. It often arises when we don’t have the right enzymes to break down a certain food, or our body doesn’t recognize the food (as with many processed additives). A sensitivity is the same as an intolerance, and it’s estimated that upwards of 20% of the world’s population experiences food intolerances. Some people with intolerances can have small amounts of trigger foods before they experience symptoms. 

Why do an elimination diet?

A lot of the time we treat our problems with medications or supplements. While it allows you to cope with symptoms, it doesn’t do anything to address why they’re there in the first place. If we don’t know why they’re happening, how can they go away?

Some people also just go through life feeling crappy, and have resigned to the idea that this is just how life is. Your body breaks down as you age. You’re supposed to feel like shit and that’s just what’s in the cards for you.

Others don’t even realize they feel so badly! It just becomes the new normal and it isn’t until they remove the inflammatory foods that they realize just how terrible they felt, and how much better they can feel.

You can also develop allergies at any point in life. When new food allergies or sensitivities appear, it can often be due to imbalances in gut health, which is worth exploring through an elimination diet, among other tools.

How to do an elimination diet

You know your body better than anyone, so think about which foods you suspect might be giving you trouble before following any specific protocol. Start with those.

Trouble can be defined as gas and bloating, diarrhea, stomach aches, headaches, joint pain, acne, eczema — any number of triggers, really. If you’ve suspected any issues, write it down.

If you’re unsure of the cause, consider eliminating the most common allergens:

• Wheat/Gluten
• Dairy
• Corn
• Soy
• Eggs
• Peanuts
• Shellfish
• Tree nuts

Some elimination diets go further and remove nightshades, citrus, beef, chicken, pork, and legumes.

Unfortunately, the most successful elimination diets are the most restrictive. The more you remove, the more you’ll be able to test with.

However, unless you’re dealing with some serious health issues that need to be resolved immediately, it may be okay to do this in stages so it’s less overwhelming (talk to your doctor about the best route for you).

If paired with your personal list, this seems too restrictive and overwhelming for you, I suggest starting with wheat and dairy, as those are the most common irritants I find in my practice.

Eliminate these foods from your diet, ideally for about 4 weeks, or until your symptoms begin to improve noticeably.

It’s easier said than done. You’ll want to prepare before starting:

• Get into meal planning, stat. It can be as simple as writing down where your food is coming from that day. Or it can be as ambitious as making every meal from scratch. The key is knowing ahead of time so you’re not panicking when it’s time to eat.
  
  
• Going out to eat? Again, plan ahead. Check out the menu ahead of time to see what’ll work for you. Nothing? Call the restaurant (just not during peak lunch or dinner hours) and see if there’s anything they can do. Nothing? Be prepared to suggest a restaurant that works for you.

Note: This is T E M P O R A R Y!!!!

Elimination diets are not intended to be long-term, especially if you’re on a particularly strict protocol. You may be depriving your body of important nutrients if you keep out whole food groups for too long (IF they are not an issue for your body).

Another note: TALK TO YOUR DOCTOR before doing this! If you suspect an actual allergy, you must do this under the guidance and supervision of a medical professional. Allergies can be dangerous, potentially life-threatening, and you need to treat them accordingly.

Elimination Diet Reintroduction

Now that you’re back on an even keel, you’re probably feeling pretty great. It’s time to test that. You’ll want to continue planning ahead here.

Choose the foods that you will reintroduce one by one (they must be separate, otherwise you won’t actually know what the trigger is if you are having multiple possibilities at once). Plot it out on a calendar and leave at least two days in between reintroducing the next food.

Say you’re reintroducing wheat. Here’s how it can look.

• Day 1: Have a little wheat at every meal (toast with breakfast, farro on a salad at lunch, a side of pasta with dinner)
• Days 2-3: Go back to your elimination diet protocol.
• Day 4: Move on to the next category and repeat Day 1-3.

These days off in between are essential. Some reactions don’t show up for a day or two, so you want to avoid reintroducing too many things at once otherwise you won’t know what’s causing what.

If you feel fine, consider it OK to eat that from now on and move on to the next category. If not, now you know that food is an issue for you and you can keep it out of your diet.

I highly recommend keeping a food diary during this period and recording what you ate, how you felt afterwards, and if it affected anything in the bathroom (aka the food/mood/poop/sleep diary) so it’s easier to keep track and see patterns.

Personalizing Your Diet

Now that you know what your food triggers are, you have the information you need to personalize your ideal diet.

This is simply putting into action what you’ve learned about you and your body the last few weeks, and why it’s imperative to take notes!

There’s not much to this step, you just make more informed choices about what to eat from here on out. You are empowered by knowledge of how certain foods make you feel, and can make intentional decisions about what’s on your plate. And that’s that!

Need guidance with your elimination diet? I’m happy to talk about being part of your care team. Contact me here.