What is the deal with an elimination diet?

The theory behind an elimination diet is you remove all foods from your diet which could be causing a negative reaction in your body.  Then you slowly test each one individually so you can identify what foods you might have an issue with.  Let me put this right up front – an elimination diet is not easy – this takes time, energy and effort. If you want to get answers the easy way, ask your doctor to run food allergy blood testing. However, be aware this testing can be expensive and is usually not covered by insurance.

There are a few benefits of using an elimination diet to determine what foods your body might be having a reaction to.  The first is that you do it yourself – no expensive lab work needed. The second, and perhaps most important is that it helps train you to listen to your body, this is an invaluable skill and if you missed my post on eating mindfully, please read it here before continuing.

Important information before starting

If you do decide to try an elimination diet, consult with your physician before making any changes to your diet.  They will have important information on how these dietary changes may impact any existing health conditions, something no blog writer will be able to tell you.

I want you to feel this happy and full of energy in your body!

It is also important to note, this is not a long-term diet plan, the purpose of an elimination diet is to determine what food(s) out of a much larger set of possible suspects is causing a reactive condition in your body.  You will not get sufficient nutritional support for long-term health from an elimination diet over an extended period of time.

Before you decide to embark on the journey of an elimination diet, please read this entire post.  Then do more research and craft a plan that resonates for you. If after doing your research, this still feels overwhelming but you would really like to try an elimination diet, seek out a registered dietitian, health coach, or doctor who can support you through the process.

What is a reactive response

Throughout this discussion I will be talking about reactive responses or conditions in your body.  What I am referring to is any of a large number of ways that you may feel unwell. Reactive responses are different for each person and for each food.  They may include: any permutation of digestive unease or distress (I think of these as the Pepto Bismol symptoms), bloating or gas, acne or other skin conditions, headaches/migraines, shortness of breath or trouble getting a deep breath, runny nose/extra mucus production, sore throat, foggy head, lethargic feeling, and more.

What I am not referring to is a full blown allergic reaction.  This process is not designed to be used with food allergies which require immediate medical attention upon consumption.

Would giving up a few foods be worth it for you to feel this great?

As you move through this process, you will start to be able to connect reactive responses to certain foods or meals, this will help you in identifying which foods you need to eliminate from your diet on a more long-term basis.

Getting started

Before you eliminate anything from your diet, the first step is to gather information on any foods you might have an issue with.  Read my article on mindful eating here.  Using these guidelines, keep a journal of what you eat for a week.  Note if you have a reactive response to a food or meal as you are eating it, or if you notice a reactive response a few hours later.  

After you have been tracking your responses to food for a week, sit down with your journal, see if there are any common threads – for example, did you have indigestion an hour later every time you ate a sandwich?  What are the common ingredients in all of your sandwiches? If they were all different, you might have an issue with wheat (the bread). Once you identify any common threads, write down the foods or ingredients you are questioning on a list.

If you were unable to connect any foods to a reactive response, that is ok.  I have had times when my body was so busy reacting to the food I ate that there was never a break which allowed me to “reset” and distinguish one episode of feeling not-great from another.

What to eliminate

Start with any food or ingredient you identified in the previous step.  To that list, I would suggest adding several foods which are common intolerants:

• Eggs
• Milk (cow’s milk is very different from goat and sheep, and is the most difficult to for humans to digest, however, I would suggest eliminating all animal milks)
• Soy
• Wheat/Gluten
• Caffeine
• Sugar
• Nightshade Vegetables (including potatoes, peppers, eggplant, tomatoes)

It will be hard at the beginning but the rewards are so worth it!

If you were not able to identify any foods in the previous step, this is a good place to start.  This list is now your possible reactive list.

Please note, if you have eaten any of these things and have a true allergy to them, you would know – what we are testing for is intolerances, not allergies which result in emergency room trips.

Alcohol and Recreational Drugs

If you drink alcohol and/or use any recreational drugs, I strongly encourage you to abstain during the duration of your elimination diet process.  While they may not be the cause of any reactive conditions, they do serve to cloud the communications from your body. As a result, it will be much more difficult to truly listen to the messages your body is sending you.  

An elimination diet is not an easy process, I can’t imagine you want to go through all this trouble and be unable to get clear results just because you didn’t want to give up your glass of wine with dinner for a few weeks.  You may even find that you feel better when abstaining and choose to reduce or eliminate these things from your life even after you complete the elimination diet process.

Watch for hidden ingredients

Yup, you are going to need to get really friendly with your raw ingredients.

Your elimination diet will be made up of foods which do not contain any ingredients on your possibly reactive list.  In order to do that it is important that you understand the other names these ingredients might be listed as.  

For example, the whey in your protein bars is a milk derivative, cheese in a cauliflower pizza crust – same thing, if you have a milk intolerance, it is likely you will also react to these items.  Caffeine is not just coffee and black tea, it is also soda and chocolate. Soy and wheat end up on labels under dozens of different names.  If you are new to reading food labels, I love the Grocery Store Adventure Guide which provides helpful information in a fun format!

Again, do your research to be sure you are able to identify any of the food which are on your possible reactive list when reading food labels.  The best way to ensure your elimination diet does not contain any possible reactive ingredients is to cook your food from scratch as much as possible.  This means no packaged sauces or prepared snacks. Dinner might be grilled chicken, some sauteed or steamed vegetables (not nightshades) and rice. Remember, when I said this was not going to be easy!

Clear out your system

Once you have done your research on the ingredients on your possible reactive list, come up with a meal plan for at least three weeks.  Eat just the “safe” foods on your elimination diet for at least one week. Continue to keep your food diary as before noting what you eat at each meal or snack, and if you have any reactive symptoms.  At the end of that week, check in, how are you feeling?  

By now you should be starting to remember what healthy feels like!

If you feel much better, then you are ready to start testing foods, continue on to the next section.

If you are not noticing a change in your reactive symptoms, review your food journal, add any possible additional reactive foods to your list and remove them from your diet.  Continue on the remaining “safe” foods for another week. Check in again. If you feel much better, continue to the next section.  

If you still notice no change in your reactive symptoms, you are either still eating a food which is causing an issue, or your issue may not be food related.  First review your food journal, do you notice any more possible reactive foods which should be eliminated? At this point, check back in with your doctor – remember you consulted with them before beginning this adventure – and seek their opinion.

Testing your foods

Once you are feeling better, you can start testing each individual food.  Review the post on mindful eating here, although at this point you are probably getting to be a pro at eating mindfully!

Pick a food to get started (I would suggest starting with the foods you think are least likely to be reactive).  For one day, eat as much of that ingredient as you want added into your regular elimination diet. And you want to try and eat as much as possible – we are trying to overload your system to see if there is a response.  Here is the catch, make sure that you are not combining ingredients – for example, on caffeine day you would drink your coffee black – no milk or sugar, and have unsweetened chocolate.

Feel free to celebrate every time a food on your list tests as non-reactive!

Take careful notes of what you eat and any reactive response you have.  At the end of the day assess how you feel. The following day, return to your elimination diet only.  Continue to take note of how you feel and of any reactive responses you have. If you found there was no reaction to the food, add that to a new safe list, do not return it to your diet yet, but know that once you are through the process, you should be able to eat it!  You can now continue on to your next food on day three.  

If you did have a reactive response to the food on day one, then add that to your no-go list.  Continue on your elimination diet only until you get back to the point where you are feeling good again.  Then continue the process with the next item from your list.

Safe foods and no-go foods

Once you have gotten through each item on your list, you will hopefully have a large list with safe foods and a smaller list with no-go items on it.  At this point, I would suggest returning all of the foods that tested safe to your diet. Make sure you keep all possible options of the no-go foods out of your diet.

Eat a wide variety of foods from your new safe diet for a week.  Continue to eat mindfully, paying close attention to any reactive symptoms you might have.  After a week with no reactive symptoms, you can begin to drill down on your no-go list. Many of the items above are grouped into categories, you can now break them into individual component and test for reactivity the same way you tested as a group.  For example, if you added milk to your no-go list, you can test cow’s milk, goat’s milk and sheep’s milk on separate days.

Make sure you are leaving at least 24 hours between testing groups and longer if you have a reactive response.

I’m finally done – now what

Once you finally get through testing and drilling down on all of your foods, you now know what to avoid (and what reaction you will get if you don’t avoid it).  This knowledge is power – you have the control over how you feel now! I know that eating bread causes a certain reaction. When I am in a restaurant and a delicious bread basket is delivered to the table, I can make a decision – is it worth it to me to eat a piece of that bread knowing how I will feel the next day (spoiler alert – it usually isn’t).

Hopefully by now you feel this relaxed and at ease!

Continue to eat mindfully, being aware of any reactive responses you have going forward.  Your body changes over time, and food which you did not have a reaction to during the initial testing can become a problem in the future.  Otherwise, enjoy your newfound sense of health and wellbeing as well as a much deeper connection to, and level of communication with, your body.

So, I read all that and it seems like too much work, and I think there is one thing that I really have an issue with. . .

Great!  If you have already been able to drill down on the one thing you think you are reacting to, then you can do a mini-elimination diet.  That is what I do now when I have a reactive response I think is caused by a specific food.

To test for just one thing, eliminate that food (or category of food) from your diet for a week or two until you are no longer having a reactive response.  If the reactive response does not change by eliminating that food, the food was most likely not the issue, again, here is where I suggest you visit your doctor for their opinion.  

Once you are feeling well, there is a difference from the above testing, you are going to have just a little of the suspect food on the first day of testing.  If you have a reactive response, there is your answer – you most likely will want to eliminate that food from your diet.  

If you don’t have a reactive response, try to introduce a little more each day.  It may be that you can handle the item in moderation but not in excess – important information to know.  You may also have eliminated a food which you do not have an issue with mistakenly – then you can celebrate keeping that food in your diet!

Wishing you a diet filled with foods which nourish and support your body!