Food sensitivities can cause all kinds of symptoms from asthma, to eczema, to joint pain, to indigestion, to depression, fatigue and more. Many people who suspect food sensitivities are curious about how to conduct an elimination diet. In this article I will outline the basic steps of how to conduct an elimination diet and what foods are eliminated in a comprehensive elimination diet.
Basic Steps of Food Elimination & Rechallenge Diets
A food elimination diet needs to be conducted strictly in order to get good results. It helps to think of it as a short term experiment in order to collect information about health.
- Assess and record symptoms.
- Choose foods to eliminate.
- Eliminate foods for the prescribed period of time (usually 6+ weeks).
- Reintroduce the foods one at a time and note response.
- Wait until symptoms subside before reintroducing next food.
- Create a long term plan including avoidance of food sensitivities and treatment of the root cause.
Paying attention to the symptoms as they change throughout this experiment is very important.
*Food elimination diets and rechallenge diets should be approached with caution for people with a history of disordered eating. Consult a professional for guidance.
Choosing Foods to Eliminate
An integrative doctor or nutritionist will look at diet diaries, health history, and current symptoms to form a hypothesis about what types of food intolerance might be present. If a specific type of food sensitivity is suspected, then a targeted elimination diet may be preformed.
If the type of sensitivity is unclear, a comprehensive elimination diet that involves the removal the most commonly problematic foods can be undertaken.
These are the foods that I ask patients to eliminate during a comprehensive elimination diet.
- Wheat
- Barley
- Rye
- Dairy
- Eggs
- Soy
- Corn
- Strawberries
- Shellfish
- Sugar & artificial sugar
- Preservatives, additives, and food colors
- Caffeine
- Citrus
- Tropical fruits
- Tomato
- Potato
- Peppers
- Eggplant
- Peanuts
- Ground nuts
- Yeast
- Processed foods
- MSG
- Mustard
- Alcohol
Length of Elimination and Reintroduction Periods
In a comprehensive elimination diet, foods are completely eliminated for 6 weeks then reintroduced one at a time. The food being reintroduced is eaten several times per day for 3 days. If no symptoms arise, then the patient is considered tolerant to that food and we move on to the next food to test. If symptoms arise, then the food is removed from the diet and the patient is considered intolerant to that food. We need to wait until the symptoms have resolved before moving on to the next food to be reintroduced.
If a patient reacts to a food, their symptoms usually subside in a couple days but can persist for a week or more. It is important that symptoms are completely gone before reintroducing the next food to avoid confusion.
Summary
Elimination diets are tools used in integrative health to assess food sensitivities. Food sensitivities include both allergies and intolerances. Elimination diets are generally conducted by removing suspect foods until the symptoms have disappeared and then reintroducing them in a controlled manner to see if symptoms return.
