Think you might have a food allergy, but aren’t sure what exactly could be to blame? Experiencing digestive issues or skin flare-ups, but can’t seem to figure out the solution to make them go away? Well, an elimination diet might be exactly what you need.
An elimination diet is a short-term eating plan that eliminates certain foods that may be causing allergies and other digestive reactions — then reintroduces the foods one at a time in order to determine which foods are, and are not, well-tolerated.
The main reason for doing an elimination diet is to pinpoint exactly which foods are the culprits for digestive and other health-related issues when someone is experiencing ongoing symptoms, and she can’t seem to figure out what’s causing them. Symptoms that might drive someone to do an elimination diet include persistent diarrhea, bloating, constipation, eczema and acne.
It’s estimated that 15 million adults in the U.S. alone suffer from food allergies — about 4 percent of the adult population and about 8 percent of children. (1) But these numbers don’t even take into account food “intolerances” or food sensitivities that don’t show up on allergy tests, so this means the real numbers are likely a lot higher. It’s just another reason to test an elimination diet.
Which Foods Are Removed During an Elimination Diet and for How Long?
Eight foods account for about 90 percent of all food-allergy reactions: milk, eggs, peanuts, nuts, wheat/gluten, soy, fish and shellfish. (2)
Elimination diets range in terms of what exact foods are permitted and eliminated, but most will cut out all common allergens, including:
- Refined/added sugar
- Eggs, in some cases
- Usually all packaged, processed or fast foods
- Certain nightshades
Most elimination diets last for about 3–6 weeks. It’s believed that antibodies — the proteins your immune system makes when it negatively reacts to foods — take around three weeks to dissipate. So this is usually the minimum time needed for someone to fully heal from sensitives and to notice improvements in their symptoms.
What Symptoms Can an Elimination Diet Help With?
Even when someone may think that they already eat a healthy diet, if they still battle health issues that they can’t resolve, an elimination diet is usually extremely useful for identifying which suspected foods are truly the cause. Even if you’ve opted to have a food allergy test done at a physician’s office in the past, you still might be missing something because it’s common for allergy tests to show negative results for underlying food sensitives that are not true allergies yet can still cause negative symptoms.
A food allergy is an overreaction of the immune system to a specific food protein, but similar effects can happen even when someone doesn’t test positive for an allergy. When food protein is ingested that isn’t well-tolerated, it can trigger a range of reactions that may cause symptoms like: rashes, hives, swelling, trouble breathing and various digestive (GI tract) pains.
Identifying and removing allergies and sensitivities is vital to overall health. When you struggle with an ongoing, unidentified sensitivity, your body constantly sends out inflammatory responses that can cause harm in multiple ways. Food sensitivities and allergies are correlated with an increased chance for developing:
- Chronic fatigue
- Nutrient deficiencies
- Mood disorders, including depression and anxiety
- Skin flare-ups like eczema, hives and acne
- Autoimmune disorders
- Atherosclerosis (hardening of the arteries, a precursor to heart disease)
- Cognitive decline and neurodegenerative diseases, including Parkinson’s and dementia
- Learning disabilities like ADHD
- Trouble sleeping or insomnia
- Adrenal fatigue
- Muscle and joint pain, such as from arthritis
- Weight gain and obesity
- Migraine headaches
- Kidney and gallbladder problems
6 Benefits of an Elimination Diet
1. Uncovers Unknown Food Allergies
It’s very common to experience ongoing digestive problems even when eating an overall healthy diet. Why? Because all it takes is one or two unidentified food allergens to make a big impact.
For example, 52 patients with Eosinophilic esophagitis — an esophageal disorder predominantly triggered by food allergies — underwent an elimination diet as part of a 2014 study published in the Journal of Allergy and Clinical Immunology. Seventy percent of patients experienced remission!
During the study, patients cut out four major food-allergen groups for a six-month period: dairy products, wheat, eggs and legumes. In 65–85 percent of patients, just one or two food triggers were responsible for causing the disorder. Milk was identified as a major allergen in 11 patients (50 percent of patients in total), eggs in eight patients (36 percent), wheat in seven patients (31 percent) and legumes in four patients (18 percent). (3)
The patients had no idea that they were allergic to such foods, so they didn’t respond to past treatment methods until the allergens were identified. They only finally experienced improvements and relief when specific allergens were removed long-term. Removing certain allergic foods is the most obvious and essential step for food allergies natural treatment.
2. Helps Reduce IBS Symptoms
When 20 patients with irritable bowel syndrome (IBS) underwent elimination diets as part of a 2006 study conducted by University of Kansas Medical Center, 100 percent of patients experienced significant improvements in digestive symptoms. (4)
Elimination diets were based on the results of tests done to identify patients’ food and mold panels. After six months of being on the elimination diets and also taking probiotics, patients were reassessed – and every single one reported improvements in bowel movements and control over IBS symptoms. Researchers also found that 100 percent of the patients had increased levels of beneficial bacteria present within the gut flora.
3. Useful for Healing Leaky Gut Syndrome
In many cases leaky gut syndrome is the underlying cause of allergic reactions, autoimmune disease and body-wide inflammation. Leaky gut occurs when the lining of the digestive tract develops tiny holes that allow specific substances to pass through into the bloodstream, damaging your system. (5)
Leaky gut is a major contributor to autoimmune diseases like Chron’s and ulcerative colitis. Development of leaky gut can also cause malabsorption of vital minerals and nutrients — including zinc, iron and vitamin B12. It’s believed that leaky gut is commonly caused by gluten intolerance but can also result from a range of other food allergies and sensitives, too.
4. Provides Relief for Skin Irritations Like Eczema and Acne
Strong evidence exists that skin conditions like eczema and acne are related to undiagnosed food allergies.
For example, a study done by the Institute of Special Medicine in Rome found a strong relationship between eczema symptoms in adults and food allergens. When 15 adults with eczema were put on an elimination diet, 14 of them experienced significant improvements in skin-related symptoms.
Nuts, tomatoes, milk, eggs and cereal grains were the most common allergens, with six out of 15 patients testing positive for allergies to at least one of these foods. Another eight patients were suspected for having at least a food intolerance to one food, resulting in 93 percent of subjects (14 of 15) improving when all foods were eliminated. (6)
5. Helps Prevent or Treat Learning Disorders like ADHD and Autism
Common food allergens, such as gluten and pasteurized dairy products, may increase the risk of developing ADHD and autism because proteins from these foods can cause intestinal permeability. This occurs when substances leak through the gut and then recirculate within the bloodstream, sometimes acting in the brain like an opioid drug. Once substances make it to the bloodstream, they come into contact with large numbers of immune cells that trigger inflammation.
High intakes of sugar, in addition to deficiencies in zinc, selenium, iron and omega-3 fatty acids, also worsen ADHD symptoms. When researchers from the Developmental Brain-Behaviour Laboratory at the University of Southampton analyzed the effects of three different diets in children with ADHD, restrictive elimination diets were beneficial in lowering symptoms. (7)
Many other studies, like one done in 2012 by the Division of Neurology at the Children’s Memorial Hospital in Chicago, conclude that ADHD symptoms are lower in children when sugar is reduced in their diet, additive and preservatives are removed, and fatty acid supplements such as omega-3s are given. (8)
6. Combats Migraine Headaches
Elimination diets are an effective and inexpensive therapeutic strategiy for patients who suffer from frequent migraine headaches.
When 21 patients went on an elimination diet — removing common allergens that were identified as part of a pre-screening IgG antibody test — the majority of patients experienced significant improvements in symptoms compared to when they first began the diet. Following the elimination diet, patients reported significant differences in the number of migraine attacks they experienced monthly, the duration of attacks and the level of pain intensity. (9)
How to Do an Elimination Diet
Here are the steps to follow in order to effectively do an elimination diet:
- Stop eating all common allergen/sensitive foods from the list below for about three weeks. Removing foods is the key step in an elimination diet, as you will begin to figure our unknown allergies or sensitivities.
- During this time, carefully read food labels to make sure you’re really avoiding even trace amounts of these foods. You may want to keep a food journal during these three weeks to record how you’re feeling. This will come in handy when you begin reintroducing the foods later on.
- After three weeks, reintroduce one food group at a time. Eat the suspicious food daily if you can for about 1–2 weeks and record your symptoms. Notice any changes in symptoms between the elimination phase and the reintroduction phase.
- If symptoms return after beginning to eat one of the suspicious foods, you can confirm that this food is a trigger by eliminating it once again. The goal is to see if the symptoms clear up once again when the food is removed. You can see that the process is a bit of trial and error, but it shouldn’t take more than 4–6 weeks to pinpoint foods that can finally improve your symptoms for good.
Biggest Foods Offenders to Avoid During an Elimination Diet:
- Citrus fruits
- Hydrogenated oils
- Added sugars
- Sometimes alcohol and caffeine
- Sometimes vegetables from the nightshade family
Why these foods? In the U.S. alone, over 1.5 million people suffer from sensitivity to gluten, according to a group of researchers out of the University of Maryland. Large percentages of people react to gluten with a type of negative inflammatory response – either from a gluten allergy, intolerance or sensitivity.
Dairy allergy is also common because standard dairy pasteurization destroys necessary enzymes that can cause allergies. In North America, most cattle contain a type of protein known as beta casein A1, which is a common trigger for both food and seasonal allergies.
Why cut out soy and corn? For starters, soy and corn are the two biggest GMO crops in the world. Around 90 percent (or more) of corn and soy products are derivatives of genetically modified seeds. Peanuts and citrus fruits also commonly cause allergic reactions.
Meanwhile, many studies show that when you are allergic or sensitive to one common allergen, such as soy, there’s a good chance you’re also allergic to another, such as peanuts. This is because protein particles in common allergen foods closely resemble one another and cause similar inflammatory reactions. (10)
Hydrogenated oils create chronic inflammation throughout the body and can induce disease. On the other hand, good fats are essential to hormone production, weight loss, cellular healing and anti-inflammation.
Sugar is an anti-nutrient offering insignificant amounts of vitamins and minerals, plus it causes elevated glucose and insulin levels that promote inflammation and low energy.
Certain alcohols, like red wine or gluten-containing beers, can create allergic reactions and digestive symptoms. But even when they don’t, it’s best to eliminate all alcohol to help the body detoxify itself. Alcohol can increase yeast and harmful bacteria growth in the gut, lower energy levels, depress your mood and only complicate existing health-related issues.
What about nightshades? If you are a person that struggles with food sensitivities, allergies, autoimmune disease, inflammatory bowel disease or leaky gut syndrome, then there is a chance that a class of vegetables called nightshades could be contributing to your health condition. Nightshade vegetables are completely healthy for most people, but for a few it can act as a trigger similar to wheat or dairy and cause major immune reactions. The most commonly eaten nightshades are potatoes, tomatoes, eggplant and peppers.
Foods to Include During an Elimination Diet:
During an elimination diet, try to make about 40 percent of your plate fresh vegetables, 30 percent “clean” sources of protein, 20 percent healthy fats and the remaining percent whole-food carbohydrates and fruit. In many ways, it will resemble a Paleo diet eating plan.
Most of your plate should be taken up by vegetables that are ideally organic, plus small amounts of fresh fruit. Vegetables that are especially good choices for a healing diet include: all leafy greens, cruciferous vegetables like broccoli, cauliflower and Brussel sprouts, artichokes, fennel, celery, cucumbers, squash, mushrooms, show peas, radishes, sprouts, sea vegetables, berries and fresh herbs.
Fifty percent of your plate should come from high-quality proteins and healthy fats. Aim to include plenty of “clean” protein sources – such as organic, grass-fed meat and poultry, wild-caught fish, cage-free eggs (unless you suspect an egg allergy) and small amounts of sprouted beans.
Healthy sources of fats include coconut products such as coconut oil, olive oil, nuts, seeds and avocados.
You may want to try giving up all grains for a period of time, even gluten-free grains like quinoa and gluten-free oats — this is also a key step in the low FODMAPs diet. If you do want to include grains, make them about 10 percent of your food intake or less, plus stick with gluten-free, sprouted and ideally organic grains.
Why and How Does an Elimination Diet Work?
A very large proportion of our immune system, roughly 70 percent, is actually held within our digestive tract, specifically in the gut. Therefore, our gut and brain have a very close working relationship. Every time we put something into our mouth and it travels through our digestive tract, our gut sends signals to our brain – and vice versa.
Within the gut, we have what is called the enteric nervous system, a series of neurotransmitters that are capable of sending chemical messages to the brain that trigger the release of digestive enzymes, hormones and inflammatory responses.
This back-and-forth communication is how we know when we are hungry and when we are full. It’s also how our gut and brain work together to communicate signs of a food intolerance, allergy, bacterial infection or a nutrient deficiency. When you eat something that triggers a “red flag,” your immune system and brain react by creating inflammation — swelling, pain, tenderness and sometimes visible redness that are all a result of the body’s white blood cells attempting to protect us from infection of foreign organisms.
During an elimination diet, someone cuts out all culprit foods, usually for about a month or so, and then reintroduces them one by one to see how they feel when they eat the food once again. If the inflammatory responses stop when the food is removed but then return once reintroducing the food, then it’s clear that the food should be eliminated altogether.
Who Specifically Should Do an Elimination Diet?
It’s recommended by most healthcare professionals that everyone do a form of an elimination diet at least once in their life, since many people don’t even realize that they have symptoms until they experience what it’s like to live without them.
For example, you might think that you have frequent headaches or acne breakouts because it runs in your family, but after doing an elimination diet you might notice these symptoms in fact resolve when you make changes to the foods you eat.
People who can especially benefit from doing an elimination diet include:
- Anyone struggling with autoimmune disease or metabolic syndrome
- People with body aches and pains caused by inflammation
- Those with skin irritations, blemishes and rashes
- Anyone with low energy levels despite eating a healthy diet
- Anyone with known food allergies that is still experiencing symptoms (since oftentimes one type of allergy, such as gluten, can be linked to other kinds of sensitivities, such as dairy)
Best Foods to Have During an Elimination Diet, Plus Recipe Ideas
- Bone broth: Broth contains collagen and the amino acids proline and glycine that can help heal your damaged cell walls.
- Raw milk and cultured dairy: Contains both probiotics and a healthy source of amino acids that can help heal the gut. Pastured kefir, yogurt, amasai, grass-fed butter and raw cheese are some of the best.
- Probiotics and fermented foods: These help replenish good bacteria and crowd out bad bacteria in the gut. They contain organic acids that balance intestinal pH and reduce acidity and inflammation. Try sauerkraut, kimchi, kombucha and natto.
- Coconut products: The MCFA’s in coconut are easier to digest than other fats and nourish a healing gut. Try coconut oil, coconut flour, and coconut kefir (which also contains probiotics and protein)
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