What is an Elimination Diet and When Should You Do One?

Weight loss is not the goal of every diet. Some are structured to improve your health or well-being. That’s the purpose of an elimination diet. It’s a way of eating that helps you identify foods that your body doesn’t respond well too. Food intolerances are common; up to 20% of the population has one or more food intolerances.

Are you experiencing digestive symptoms and you aren’t sure what’s causing them? Are you convinced it’s related to your diet, but aren’t sure which foods are the culprits? An elimination diet could help crack the mystery of what is causing your symptoms and help you track down the foods your body reacts poorly to. It involves removing certain food groups for a period and then adding them back in while you monitor your symptoms. Based on how your body reacts, you will know what foods you should avoid or avoid in larger amounts.

Human beings are all a little different. Foods that one person thrives on may cause health issues for others. Some people have food allergies that cause an immediate reaction that can be life threatening, like a peanut allergy, but food sensitivities or intolerances are also common. These non-immune mediated reactions to foods can cause a wide variety of symptoms from digestive disturbances to fatigue. Food intolerances can come from having an enzyme deficiency. For example, lactose intolerance occurs when your digestive tract doesn’t produce lactase enzyme to digest lactose (a milk sugar) properly.

Why Do People Do Elimination Diets?

The most common reason people do an elimination diet is because they have digestive issues, like bloating or indigestion. Digestive problems are uncomfortable and can disrupt quality of life, but sometimes it’s hard to pinpoint what is causing the problem. There are many factors that could be the culprit: certain foods, stress, or even your environment. An elimination diet helps identify whether diet plays a role in your symptoms and what the trigger foods are. Doing an elimination diet can help you:

  • Find out if your symptoms are food-related
  • Identify trigger foods
  • Determine what foods are safe for you to eat and which to avoid

How an Elimination Diet Works

Doing an elimination diet is simple. You take certain foods out of your diet for a period (1-2 weeks). Then, one by one, you add the eliminated foods back into your diet and see how you feel. If a food causes a negative reaction or triggers symptoms, it’s a trigger food, and you’ll want to avoid that food in the future.

A true elimination diet removes all foods to which you may have an allergy or sensitivity, then systematically adds back in each food group to find out what bothers you. As you do this, you document your symptoms in a food journal.

Elimination diets can help uncover a variety of issues, such as lactose intolerance or gluten sensitivity. Some people may also be sensitive to other components in foods such as salicylates, amines, or FODMAPs.

An elimination diet isn’t something you have to do on your own. It’s helpful to work with a professional, such as a registered dietitian or doctor, who can collaborate with you to ensure there aren’t other issues causing your digestive symptoms. Always talk to a healthcare professional first to ensure you don’t have other health issues that are causing your symptoms.

Steps to Implementing an Elimination Diet:

  • Eliminate all the foods that you think may be causing problems. The most common ones are gluten, soy, tree nuts, fish, legumes, and dairy.
  • After a couple of weeks, begin gradually introducing foods one at a time and documenting your symptoms for 2-3 days. If a food causes symptoms, it’s a trigger food and one to avoid.
  • Identify all trigger foods and exclude them from your diet.
  • If your symptoms don’t resolve after three weeks of removing all possible trigger foods, see your doctor. It’s unlikely your symptoms are due to a food intolerance.

The Importance of Keeping a Journal

During the reintroduction phase of your elimination diet, you’ll introduce foods back into your diet one by one. During this period, it’s important to keep a food journal to track any symptoms, including mood changes and sleep patterns. You can also note how you feel after eating certain meals and compare these feelings to how you feel after eating meals that contain foods from other food types.

If your symptoms return after eating a certain type of food (especially gluten or dairy products), eliminate that food from your diet. Elimination diets can also be used to identify diet triggers for irritable bowel syndrome (IBS) and migraines and determine whether certain foods cause or worsen your symptoms.

Work with a Doctor or Qualified Nutritionist

If you find you have food intolerances, a nutritionist can build you a customized diet plan that doesn’t include trigger foods and help you maintain adequate nutrition after you eliminate these foods. If you have a lot of trigger foods, it’s even more important to consult with a nutritionist to avoid nutritional deficiencies.

The Bottom Line

Elimination diets help you discover what your body can and cannot tolerate. That’s the essence of an elimination diet: take out the most likely culprits, find out whether it affects your symptoms, and reintroduce the foods one at a time to determine your body’s response. It can give you a clearer idea of how your body responds to particular foods and how to best structure your diet.

References:

  • “How to Do an Elimination Diet and Why – Healthline.” 02 Jul. 2017, healthline.com/nutrition/elimination-diet
  • “Elimination Diet – Whole Health Library – Veterans Affairs.” 04 Dec. 2020, va.gov/WHOLEHEALTHLIBRARY/tools/elimination-diets.asp.
  • “The Elimination Diet – UW Family Medicine & Community Health.” fammed.wisc.edu/files/webfm-uploads/documents/outreach/im/handout_elimination_diet_patient.pdf.
  • Ly V, Bottelier M, Hoekstra PJ, Arias Vasquez A, Buitelaar JK, Rommelse NN. Elimination diets’ efficacy and mechanisms in attention deficit hyperactivity disorder and autism spectrum disorder. Eur Child Adolesc Psychiatry. 2017 Sep;26(9):1067-1079. doi: 10.1007/s00787-017-0959-1. Epub 2017 Feb 11. PMID: 28190137; PMCID: PMC5591346.
  • Tuck CJ, Biesiekierski JR, Schmid-Grendelmeier P, Pohl D. Food Intolerances. Nutrients. 2019 Jul 22;11(7):1684. doi: 10.3390/nu11071684. PMID: 31336652; PMCID: PMC6682924.
  • org. “What is an Elimination Diet?”

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