How to do the Elimination Diet: A Detailed Guide

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elimination diet

An elimination diet might assist a person in identifying items that cause discomfort or allergy symptoms.

In general, the diet should be short-term and implemented under the guidance of a healthcare practitioner. There may be both hazards and benefits.

Learn about the many types of elimination diets, the stages, types, and the potential advantages and concerns in this article.

A. What is an Elimination Diet?

According to Trusted Source, food sensitivity or intolerance affects up to 20% of the world’s population. An elimination diet is one method for identifying the foods or chemicals that are causing the symptoms. It may be recommended by dietitians and allergy specialists.

Some food groups and individual foods can exacerbate symptoms of gastroesophageal reflux disease (GERD), migraine, autoimmune disorders, and irritable bowel syndrome (IBS), among other health problems, and a doctor may recommend an elimination diet for anyone unclear of their triggers.

The diet forbids the consumption of several foods that have been linked to the onset of symptoms. A person gradually resumes eating these items, one at a time, until they can determine which ones have caused or aggravated their symptoms. They will be able to avoid these foods in the future.

An elimination diet is a meal plan that eliminates or restricts specific meals or substances to determine which foods or ingredients you may be sensitive to or allergic to.

It’s not about losing weight. You aren’t trying to burn off some extra calories or lose weight.

An exclusion diet is most commonly used when you and your doctor suspect that certain foods are causing your allergy symptoms. You’ll need to work with your doctor to make sure you’re getting all of the nutrients you require.

If you have a severe food allergy or have experienced a severe allergic reaction known as anaphylaxis, don’t do it. If this is the case, you must identify your trigger food as soon as possible to avoid it.

You should discuss this with your doctor. Some food allergies can be detected using blood and skin tests. Before you can safely try an elimination diet on your own, you may need them.

B. What is food sensitivity? What are Non-IgE reactions and food intolerance?

“A food intolerance or food sensitivity arises when a person has difficulties digesting a particular meal.”

– according to the American Academy of Allergy, Asthma, and Immunology.

Non-IgE-mediated reactions

Food allergies that do not result in anaphylaxis are referred to as this medical term. An anaphylactic reaction is an allergic reaction that can be fatal. An immunoglobulin E (IgE)-mediated response is another name for it.

Although non-IgE-mediated reactions are not life-threatening, they can nonetheless hurt a person’s health.

A person’s immune system reacts to specific meals as if they were toxic if they have a food allergy. Children and adults in the United States are affected by these allergies, with 5% of children and 4% of adults suffering from them.

Non-IgE-mediated allergic responses can cause the following symptoms:

  • constipation
  • diarrhea
  • Eczema atopical
  • hives
  • insomnia
  • terrible stomach ache
  • vomiting

A doctor may recommend an elimination diet if a person has any of these or additional symptoms that aren’t related to a recognized medical problem.

elimination diet
brooke lark/ Unsplash. Copyright 2022.

Food intolerances

Elimination diets can also aid in identifying the foods that cause intolerances. These problems aren’t the same as food allergies, and they don’t involve the immune system.

Food sensitivities occur when the gut reacts negatively to specific meals and components, as opposed to allergies, which involve the immune system.

When a person has an intolerance, they may have trouble digesting particular meals, which can be uncomfortable. 15–20 percent of the population is affected by intolerances.

Food intolerance symptoms might include:

  • stomach discomfort,
  • bloating, and
  • headaches
  • a surplus of gas
  • diarrhea
  • migraine

C. What symptoms may an Elimination Diet treat?

An increasing body of data suggests that food allergies can cause a variety of unpleasant symptoms.

Food sensitivities, for example, have been associated to:

  • ADD/ADHD
  • Bloating
  • brain fog
  • Depression
  • Diarrhea
  • Fatigue
  • Fatigue
  • Obesity
  • Pain
  • rashes
  • Aches and pains in the stomach, among other things.

That’s a long list! You might be wondering if food sensitivities affect the gut, how come symptoms appear all over the body—in the skin (rashes), the brain (headaches), or the joints (pain)?

Our gastrointestinal (GI) system is responsible for much more than just digestion and absorption of food. Surprisingly, the GI tract possesses its autonomous neurological system (aka the enteric nervous system).

As a result, the GI tract is densely packed with neurotransmitters, hormones, chemical messengers, enzymes, and microorganisms. Indeed, it is the home of 70% of your body’s immune system!

Food sensitivities may also contribute, either directly or indirectly, to a variety of other digestive disorders, such as microbial imbalances, motility issues, detoxification abnormalities, and intestinal permeability.

This explains why gut issues can manifest themselves in a variety of ways, including migraines, chronic pain, eczema, other rashes, and cognitive fog, among many other symptoms and health issues.

So it stands to reason that if you have food sensitivities, going on an elimination diet for a few weeks could be the most profound nutritional shift you ever make. For some, the outcomes might feel nothing short of magical.

D. How Does Elimination diet Work?

An elimination diet consists of two parts:

  • The elimination phase (avoidance)
  • The reintroduction phase (challenge)

Elimination phase

The first step is to quit consuming the suspect foods. You’ll need to check food labels carefully and inquire about restaurant preparation methods. Keep a food diary and track everything you consume, as well as how you feel afterward.

While you attempt this, your doctor will keep an eye on you for a few weeks.

Foods to avoid when on an elimination diet include:

  • Citrus
  • Milk
  • Eggs
  • Wheat and gluten, as well as rye, barley, and malt vinegar, are all sources of gluten.
  • Shellfish
  • Edamame, miso, natto, soy sauce, soy milk, tempeh, textured vegetable protein, and tofu: all soybean products.
  • Peanuts, peanut butter

Always keep food additives in mind. Some have been reported to cause allergic reactions in some people:

  • Desserts, high fructose corn syrup, honey, jam, maple syrup, raw cane sugar, white sugar, brown sugar, corn syrup, coconut sugar
  • Things with the suffix -amine (histamine, tyramine, octopamine, and phenylethylamine)
  • Colors added to meals artificially (tartrazine and dyes derived from coal tar)
  • Aspartame is a sugar substitute (artificial sweetener)
  • Preservatives butylated hydroxyanisole and butylated hydroxytoluene
  • Disaccharides such as lactose and other disaccharides
  • glutamate monosodium (flavor enhancer)
  • Nitrates and nitrites are two types of nitrates (preservatives)
  • Sulfites, benzoates, and sorbates are all types of sulfites (preservatives)
  • Tragacanth, sometimes known as agar-agar, is a type of agar-agar (thickeners or stabilizers)

It’s possible that you won’t need to avoid all of these items at the same time. If you suspect that consuming dairy products makes you feel unpleasant, you should start by avoiding them.

Another excellent technique is to develop a list of all the items you can eat and categorize them as follows: proteins, veggies, carbs, and healthy fats.

Then, if you need to put together a quick supper, choose one item from each of those four categories.

In other words, you could have salmon for protein, broccoli for vegetables, brown rice for carbs, and avocado oil for fat. The oil could then be used to roast the broccoli and fish, which could be served alongside the brown rice.

Make sure you eat foods that have the same nutrients as the items you’re avoiding.

For example, if you’re instructed to cut off dairy products for a while, you’ll want to hunt for calcium-fortified foods. (Soy is a good source, but check your plan to see if it’s allowed.) A nutritionist can assist you in creating a shopping list. ​​​​​​​

elimination diet
louis hansel/ Unsplash. Copyright 2022.

Reintroduction (challenge) phase

After you’ve removed any potential food allergy triggers, gradually reintroduce suspect items one by one. This procedure assists you in determining which foods are problematic.

As you reintroduce each food, keep track of any symptoms you have in your food diary.

If you return a meal and have any of the following symptoms, get immediate medical attention and discontinue the elimination diet until your doctor thinks it’s safe to resume:

  • Swelling of the throat
  • Hives or a rash that appears suddenly
  • Breathing problems

The final stage is to stop consuming the problematic foods one by one. This time, the list should be shorter. The idea is to see if your symptoms go away permanently.

It’s important to remember that you might be sensitive to food without being allergic to it. Even so, the elimination diet might help you figure out which foods you should avoid.

If your symptoms go away after you stop eating a particular food or component, your doctor should request blood or skin testing to confirm your food allergy diagnosis. This method can be used to diagnose some, but not all, food allergies.

E. Types of Elimination Diets

Elimination diets come in a variety of forms. A healthcare practitioner can advise you on which foods to avoid and return to gradually.

Some people just need to avoid dairy or wheat, but other elimination diets, such as the:

1. Low FODMAP diet

FODMAP is an abbreviation for Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols.

This demands a person to forgo many fruits, dairy products, and artificial sugars to eliminate fermentable oligosaccharides, disaccharides, monosaccharides, and polyols from their diet. This is a frequent therapeutic method for IBS.

Meats, poultry, fish, eggs, and cold cuts are acceptable on the low FODMAP diet, as are lactose-free dairy products, hard cheeses, mozzarella, and sherbet; nuts and seeds; some fruits, such as bananas, berries, oranges, and melon; and certain vegetables, such as kale and cucumbers.

You reintroduce the eliminated foods you’ve been avoiding after two to six weeks to see which ones are creating digestive discomfort or other symptoms and then alter your diet accordingly. Experts recommend working with a qualified dietician.

2. Few-foods diet

This is the most stringent elimination diet. You are only allowed to eat a limited number of things. Because it isn’t a healthy diet, you shouldn’t stick to it for long.

On this level 3 severe exclusion diet, only the following items are permitted:

  • Apples
  • Beets
  • Apricots
  • Asparagus
  • Sugar made from cane or beets
  • Carrots
  • Cranberries
  • Chicken
  • Lettuce
  • Honey
  • Lamb
  • Olive oil
  • Pears and peaches
  • Pineapple
  • Rice (including rice cakes and cereal)
  • safflower oil
  • Salt
  • Sweet potatoes
  • White vinegar

Whatever method you select, remember to stay hydrated by drinking plenty of water.

3. Autoimmune protocol diet

This is also called the AIP diet, and it is mostly recommended by healthcare professionals to treat autoimmune illnesses.

4. Fasting elimination diet

It entails drinking only water for up to five days before gradually reintroducing food categories. Such type of diet should only be followed with your doctor’s approval, as it might be harmful to your health.

Lactose-free, sugar-free, gluten-free, and wheat-free diets are examples of other elimination diets.

elimination diet
vitalii pavlyshynets/ Unsplash. Copyright 2022.

F. Benefits of an Elimination Diet

An elimination diet can help you identify particular food allergens (ingredients to which you are allergic) and pinpoint a specific food allergy.

Elimination diets can aid in the discovery of the source of symptoms such as dry, itchy skin (dermatitis) and stomach discomfort.

Without an elimination diet, one can only make educated guesses regarding the causes and effects.

Are you bloated as a result of the onions you had for lunch? Was it the beer, or was it the other way around? Is the bloating caused by something other than food, such as eating too quickly?

This supposition becomes considerably more challenging when:

  • Symptoms appear outside of the gut. Did you wake up with a migraine as a result of the wine you had with dinner? Or are you just thirsty? Or maybe you didn’t get enough sleep? Similarly, was the skin rash caused by something you ate, or by contact with perfume, detergent, or another irritating substance?
  • Certain foods can be consumed in modest quantities without causing symptoms. For example, one square of chocolate may not cause difficulties, but what if you consume half a bar? Your body is rebelling.
  • The onset of symptoms is delayed. You eat little red pepper and feel OK. Then, a few days later, your joints become achy and swollen. Yes, it is feasible.

An elimination diet assists you in determining the underlying root of such issues once and for all.

The safest strategy to manage a food intolerance or allergy is to understand your food triggers and avoid them. With your doctor’s advice, you can develop a healthy, safe, and individualized food plan by carefully following an elimination diet.

Aside from allergies and intolerances, these diets may aid in the management of the following symptoms:

  • ADHD, or attention deficit hyperactivity disorder
  • IBS and other gastrointestinal problems
  • GI eosinophilic disorders
  • autoimmune condition
  • Crohn’s disease
  • migraine

G. Risks of an Elimination Diet

If you are allergic to certain foods, reintroducing them into your diet could be dangerous. Small amounts of food may be fine in some cases, but greater servings may cause difficulties. You may experience a severe food allergy reaction. If you eat a certain meal and develop a rash, throat swelling, or difficulty breathing, seek medical attention straight away.

Eliminating a food or food group may result in a nutritional shortage. Careful planning, nutrition, and food swaps, on the other hand, can be beneficial. This is why it is critical to get medical advice before, during, and after an exclusion diet.

Another factor to consider is that restricted diets can be difficult to adhere to and may hurt one’s quality of life.

A 2017 study discovered that parents of children on exclusion diets for non-IgE-mediated food allergies gave their children poorer quality of life scores than parents of children with sickle cell illness or intestinal failure. The elimination diet group’s parents reported greater anxiety, feeding issues, and social isolation as a result of the diet.

H. What You Should Know About Elimination Diets

It’s worth remembering that elimination diets can be extremely difficult. It takes time and effort to keep a complete food diary and to eliminate things from your diet. The most crucial thing to understand before embarking on an elimination diet is that you must be extremely conscientious about it.

If you’re removing eggs, you must abstain from all egg-containing foods for a complete eight days before reintroducing them. Even in baked goods, even a modest amount might cause results to be skewed.

Most people will need to cook their foods during the elimination diet procedure because most establishments cannot guarantee that food will not be contaminated with potential allergies.

But, in the end, the journey is worthwhile. An elimination diet, when combined with clever testing, is the best model for diagnosing food allergies and intolerances.

I. How long does the Elimination diet take to be effective?

This is determined by your body and the elimination diet you choose. Some people notice changes within the first few days of starting an elimination diet, but it can also take several weeks or even months to observe a difference.

Here are two illustrations:

  • Whole30 is a diet that eliminates frequent trigger foods such as ultra-processed meals, artificial additives, grains, dairy, and legumes. It is intended to endure for a full 30 days.
  • The FODMAP elimination diet can be followed for three to four months. A FODMAP diet eliminates foods high in carbohydrates that can irritate your digestive system. It consists of an initial low-FODMAP diet elimination phase followed by a lengthy reintroduction approach in which excluded items are gradually reintroduced.

However, whether you choose the Whole30, the FODMAP elimination diet, or another plan, it all depends on your body.

Also, please note that it takes time for your body to flush out the trigger foods, and even more time for your body to stop reacting. If your reactions don’t improve straight away, keep going—and keep in touch with your doctor.

While an exclusive diet can be beneficial for some people, it may not be appropriate for everyone, and food may not be the source of the problem. Your doctor or healthcare provider can provide specialized medical advice and undertake allergy tests. Consultation with a nutritionist or licensed dietitian may also be beneficial.

J. Tips for Success

  • Allow roughly a week to prepare before beginning your elimination diet. Make a list of how you are feeling right now, including physical, mental, and emotional symptoms. Then, look for recipes that will work with your elimination diet, and make sure you understand how to properly prepare the items you’ll be eating.
  • Prepare for success by purchasing all of the components for your meals.
  • Prepare your meals for the week. Make as many lunches and dinner preparations as possible early in the day (or even early in the week).
  • Take away the temptation. Go through your refrigerator and cupboards and get rid of any things you’ll be avoiding. Don’t rely solely on willpower!

Throughout the process, keep a record of your symptoms, emotions, and energy levels. Remember that an elimination diet is the ultimate kind of self-experimentation.

Elimination Diet
Kirill tonkikh/ Unsplash. Copyright 2022.

K. Takeaway

Elimination diets might assist you in determining which foods your body cannot accept.

If you’re having symptoms that you believe are related to your diet, an elimination diet may help you figure out which items are causing them.

Elimination diets, on the other hand, are not for everyone. Children should not undertake an elimination diet unless they are under the supervision of a doctor or a nutritionist. Keeping a diet journal, eliminating foods, and then reintroducing them are not simple undertakings. Commitment to the process is essential.

Similarly, individuals who have known or suspect allergies should only undergo an elimination diet under the advice of a doctor.

Finally, it’s vital to remember that exclusion diets should only be used for a short period because long-term limitations might lead to nutritional deficits.

We hope that this article cleared all your doubts and questions about the elimination diet.

Please share your thoughts, questions, and suggestions with us in the comment section!

[Read more articles on our website, Icyhealth.]

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While at times contributed by guest authors, our content is medically reviewed periodically by professionals for accuracy and relevance. We pride ourselves on our high-quality content and strive towards offering expertise while being authoritative. Our reviewers include doctors, nurses, mental health professionals, and even medical students. 

Do note that any information found on the site does not constitute legal or medical advice. Should you face health issues, please visit your doctor to get yourself diagnosed. Icy Health offers expert opinions and advice for informational purposes only. This is not a substitute for professional medical advice.

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