Brenda Khan
An elimination diet is a short-term method that helps identify foods that a person's body cannot tolerate well. It is often used to help those with a sensitive gut, food intolerance, or food allergy to identify which foods contribute to their symptoms. Elimination diets are controlled experiments that focus on changing a single dietary variable at a time. They involve removing foods known to cause uncomfortable symptoms and slowly reintroducing them while testing for symptoms. The entire process, including elimination, takes roughly 5–6 weeks. During this time, a food journal is maintained to document what is eaten and how it affects the person. While on an elimination diet, fruits, most vegetables, grains, meat, fish, dairy substitutes, fats, beverages, and spices are allowed.
| Characteristics | Values |
|---|---|
| Purpose | Identify food intolerances, allergies, and sensitivities |
| Duration | 5-6 weeks |
| Food Journal | Yes |
| Reintroduction of Eliminated Foods | Yes, one at a time, in small quantities |
| Medical Supervision | Recommended |
| Food Groups Allowed | Fruits, vegetables, grains, meat, fish, dairy substitutes, fats, beverages, spices, condiments |
| Example Foods Allowed | Rice, buckwheat, quinoa, turkey, lamb, salmon, coconut milk, olive oil, herbal tea, black pepper, apple cider vinegar |
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What You'll Learn
Fruits, vegetables, grains, meat, dairy substitutes, fats, beverages, spices, condiments
An elimination diet is a restrictive diet that helps determine food intolerances and alleviates symptoms of certain diseases. The diet typically focuses on whole, unprocessed foods free from common allergens and irritants. The foods included in an elimination diet vary depending on the individual's health needs and the intensity of the diet. Here is a breakdown of the food groups that are typically allowed on an elimination diet:
Fruits
Most fruits are allowed on an elimination diet, as they provide essential vitamins and minerals. However, citrus fruits like oranges, grapefruits, and orange juice are generally avoided due to their high acidity and potential to trigger intolerances.
Vegetables
Most vegetables can be included, except for nightshades such as tomatoes, peppers, eggplants, white potatoes, cayenne pepper, and paprika. Vegetables provide vitamins and minerals and can be cooked in healthy fats or oils.
Grains
Gluten-free grains such as rice, buckwheat, quinoa, oatmeal, and corn tortillas are recommended. These grains provide complex carbohydrates and fibre. However, wheat, barley, rye, and other gluten-containing foods are typically avoided in an elimination diet.
Meat
Meat is typically included in an elimination diet, but the type of meat depends on the diet's intensity. In a low-intensity elimination diet, lean meats such as chicken, turkey, lamb, pork, and beef are allowed. For a more restrictive diet, only grass-fed or lean cuts of wild game and cold-water fish like salmon may be included. Processed meats, cold cuts, and shellfish are generally avoided.
Dairy Substitutes
Dairy products are often eliminated, and substitutes like coconut milk, unsweetened rice milk, and coconut yogurt are used instead. This is because dairy can be a common allergen and may exacerbate conditions like eczema and irritable bowel syndrome.
Fats
Healthy fats are an essential part of an elimination diet. Cold-pressed olive oil, flaxseed oil, and coconut oil are recommended for cooking proteins or vegetables. However, some people may need to avoid animal fats, butter, margarine, hydrogenated oils, mayonnaise, and spreads due to digestive issues or intolerances.
Beverages
Water and caffeine-free herbal teas are the primary beverages allowed on an elimination diet. Caffeine-rich drinks, alcohol, and sugary drinks are typically avoided due to their potential to trigger digestive issues or irritate certain conditions.
Spices, Condiments, and Others
Black pepper, fresh herbs, and most spices are allowed, except for cayenne pepper and paprika. Apple cider vinegar, pumpkin seeds, and sunflower butter can also be included. However, garlic and onion are often eliminated in a low FODMAP diet, and artificial sweeteners should be avoided.
It is important to note that an elimination diet should be tailored to the individual's specific needs and symptoms. Working with a dietitian or clinician can help ensure a safe and effective elimination diet plan.
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Food triggers and allergies
An elimination diet is a short-term method to identify food intolerances, sensitivities, and allergies. It involves removing foods that are known to cause uncomfortable symptoms and then reintroducing them later while monitoring for symptoms. This process helps pinpoint trigger foods and rule out foods that the body does not tolerate well. Elimination diets are particularly beneficial for individuals with IBS, ADHD, migraines, eosinophilic esophagitis, and skin conditions like eczema.
Food intolerances and sensitivities are prevalent, with up to 20% of people worldwide experiencing some form of food intolerance. Symptoms of food intolerance may include constipation, headaches, heartburn, fatigue, bloating, and trouble swallowing. These symptoms can worsen 1 to 3 hours after consuming the offending food, making it challenging to determine if diet is the root cause.
To identify food allergies, blood and skin tests are commonly used. However, even with these tests, diagnosing food allergies can be complex. In such cases, doctors often recommend a food challenge, which is considered the "gold standard" for allergy diagnosis. This involves administering small doses of suspected allergens under medical supervision and monitoring for symptoms.
Elimination diets can be an effective tool for identifying food allergies, intolerances, and sensitivities. It is important to note that food allergies are distinct from intolerances and sensitivities. Food allergies involve the immune system, while intolerances and sensitivities relate to the body's ability to digest certain foods. When embarking on an elimination diet, it is crucial to proceed under the guidance of a medical professional, especially for those with known or suspected food allergies. Reintroducing a food allergen may trigger a severe reaction called anaphylaxis.
Some common food triggers and allergens include proteins in peanuts, chicken eggs, and cow's milk, wheat, gluten, soy, dairy, citrus fruits, nightshade vegetables, corn, pork, eggs, seafood, and nuts. Additionally, certain food additives, such as those ending in "-amine" (histamine, tyramine, octopamine, and phenylethylamine) and artificial food colours (tartrazine and coal tar-derived dyes), can also trigger allergy symptoms in some individuals.
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Reintroduction of eliminated foods
An elimination diet is a short-term method to identify food intolerances, sensitivities, and allergies. It involves removing foods that may be causing uncomfortable symptoms and then reintroducing them while monitoring for symptoms. This process helps to identify trigger foods, which can then be removed from the diet to prevent adverse reactions.
The reintroduction phase of an elimination diet is a crucial step in identifying trigger foods and establishing a long-term diet that excludes specific foods or food groups. During this phase, eliminated foods are slowly and individually reintroduced to the diet over a period of 2 to 3 days while monitoring for any adverse symptoms. It is important to start with small quantities of the food and gradually increase the amount over the course of the day. This cautious approach helps to ensure that any serious adverse reactions are avoided. If no symptoms occur, it is safe to assume that the food group is acceptable and another food can be reintroduced. However, if symptoms do occur, the food is identified as a trigger and should be excluded from the diet.
The entire elimination diet process, including the reintroduction phase, typically lasts for 5 to 6 weeks. It is important to seek advice from a medical professional, such as a doctor or dietitian, before starting an elimination diet, especially if you plan to eliminate many food groups. Eliminating too many food groups at once can lead to nutritional deficiencies and increase the risk of malnutrition or orthorexia (a fear of food). Additionally, reintroducing food allergens should be done with caution as it may trigger anaphylaxis, a dangerous condition.
The order in which foods are reintroduced after an elimination diet depends on the specific reasons for avoiding them and their impact on digestion. For example, if certain foods were avoided due to acid reflux, it is important to be cautious when reintroducing them as they may increase acid in the stomach. Working with a professional can help to navigate this process and determine the appropriate foods to include and avoid.
To summarize, the reintroduction phase of an elimination diet involves slowly and individually reintroducing eliminated foods while monitoring for symptoms. This process helps identify trigger foods and establish a long-term diet that excludes problematic foods or food groups. It is important to seek professional guidance and proceed with caution to ensure a safe and effective reintroduction of eliminated foods.
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Elimination diet recipes
An elimination diet is a short-term method to identify food intolerances, sensitivities, and allergies. It involves removing foods that may be causing uncomfortable symptoms and then reintroducing them while testing for symptoms. This process can help people with IBS, ADHD, migraines, and skin conditions like eczema.
Nourishing Meals' Full Elimination Diet
The Full Elimination Diet is a comprehensive version of the Basic Elimination Diet, designed for those with complex, chronic, or unresolved symptoms. It involves removing a wider range of foods that may be causing inflammation, immune dysregulation, digestive dysfunction, or neurological symptoms.
Nourishing Meals offers a free 7-day trial of their therapeutic diet plan, which includes over 1,400 member-only recipes. They also provide Elimination Diet-compliant recipes, meal plans, and grocery lists for members.
EatingWell's Elimination Diet Meal Plan
EatingWell's meal plan is created by registered dietitians and is easy to follow and delicious. It excludes the eight foods most commonly associated with food intolerances, sensitivities, and allergies: milk, eggs, tree nuts, peanuts, wheat, soy, fish, and shellfish. The plan can be modified to meet specific calorie needs, with options for 1,500 and 2,000 calories.
Low-FODMAP Diet
The low-FODMAP diet is an elimination diet often used to help people with irritable bowel syndrome (IBS). It limits certain types of carbohydrates that can cause gastrointestinal distress. While some high-FODMAP foods like milk and wheat are excluded, other high-FODMAP foods like onions and beans are included. Thus, this diet may not be suitable for those with intolerances to the latter.
Sample Elimination Diet Foods
While specific recipes were not provided, Healthline offers a list of foods that are allowed on an elimination diet:
- Most fruits, excluding citrus fruits
- Most vegetables, excluding nightshades
- Grains like rice, buckwheat, or quinoa
- Meats like turkey, lamb, and wild game
- Cold-water fish like salmon
- Dairy substitutes like coconut milk and unsweetened rice milk
- Fats like cold-pressed olive oil, flaxseed oil, and coconut oil
- Beverages like water and caffeine-free herbal teas
- Spices and condiments like black pepper, fresh herbs and spices (excluding cayenne pepper and paprika), and apple cider vinegar
Body's Immediate Response to Diet Changes
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Pros and cons
An elimination diet involves removing foods from your diet that you suspect your body can't tolerate well. It is a short-term method that helps identify food intolerances, sensitivities, and allergies. It may benefit people with IBS, ADHD, migraines, and skin conditions like eczema.
Pros
Elimination diets can help identify food sensitivities and intolerances, removing common trigger foods. They can help alleviate symptoms like bloating, gas, diarrhoea, constipation, and nausea. They can also be used to manage symptoms of diseases. With this knowledge, you can decide to avoid foods that make you feel unwell or limit them so that any adverse symptoms are minimal. Elimination diets are tried-and-true methods of determining food intolerances and can be done with the guidance of a medical professional.
Cons
Elimination diets are very restricting and can cause a nutritional deficiency if too many food groups are eliminated. They can be a considerable amount of work and may not always agree with you, sometimes even making people feel worse. A common side effect is weight loss, which may be beneficial or not depending on the individual. People who are underweight or have difficulty maintaining a healthy weight are not good candidates for an elimination diet. Elimination diets can also be challenging for pregnant and lactating women, growing children, adolescents, and the elderly. Additionally, reintroducing a food allergen may trigger a dangerous condition called anaphylaxis.
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Frequently asked questions
An elimination diet is a short-term method that helps identify foods that a person's body cannot tolerate well and removes them from their diet. It is used to help those with a sensitive gut, food intolerance, or food allergy to identify which foods contribute to their symptoms.
The most common food allergens eliminated are milk, eggs, tree nuts, peanuts, wheat, soy, fish, and shellfish. Other common foods eliminated include animal fats (lard), butter, corn, margarine, shortening, and other vegetable oils.
Some foods that are typically allowed on an elimination diet include arrowroot, barley, buckwheat, rice, millet, oats, rye, sweet potatoes, tapioca, white potatoes, yams, fruits (excluding citrus fruits), vegetables (excluding nightshades), grains, meat (like turkey and lamb), fish (like salmon), dairy substitutes (like coconut milk), fats (like olive oil), beverages (like water and herbal tea), and spices (like black pepper and fresh herbs).
