Food serves as fuel, and you need a balance of nutrients to stay healthy and active, but occasionally not everything you eat agrees with your body. The tough aspect is: Which meal is to blame? Fortunately, you may determine that with the aid of an elimination diet.
According to Maxine Yeung, RD, CPT, the founder of The Wellness Whisk, food allergies, intolerances, or sensitivities can cause unpleasant symptoms including bloating, gas, severe diarrhea, constipation, unexplained weight changes, or nutritional deficiencies. According to Kerry Clifford, RD, LDN, of Fresh Thyme Farmers Market, they can occasionally also lead to non-GI problems like headaches, migraines, skin rashes, acne, joint pains, mood swings, poor energy, runny noses, hives, and itchy eyes.
Food allergies happen when your body’s immune system reacts physically to specific food proteins. Joel Pekow, MD, a gastroenterologist and associate professor of medicine at the University of Chicago, notes that it frequently comes with “hives, itching, occasionally swelling of the tongue and lips, and rarely anaphylaxis.” He continues, “They can also occasionally occur with GI difficulties like stomach pain, diarrhea, nausea, or vomiting.”
Now, food intolerance and sensitivity are essentially the same thing. Your gut sensitivity makes you intolerant to some foods, which is referred to as food intolerance or food sensitivity. According to Dr. Pekow, you should prepare for diarrhea, bloating, and stomach discomfort.
Although anything can cause an allergy or intolerance, alcohol, caffeine, maize, dairy, eggs, peanuts and tree nuts, shellfish, soy, and wheat are the most frequent culprits.
However, not everyone responds the same way to certain items. Clarity on the items causing discomfort can be obtained by an elimination diet, which entails removing specific foods from your diet and then gradually returning them to determine the culprit. Finding out what is best for your body requires time, patience, planning, and professional guidance when done correctly.
What is an elimination diet?
Despite being referred to as a “diet,” it has nothing to do with traditional dieting or weight reduction. Instead, an elimination diet is a two-step procedure that takes three to eight weeks to complete.
According to WH expert Samantha Nazareth, MD, a gastroenterologist with a practice in New York City, you should first eliminate suspected food triggers before cautiously reintroducing them to your diet to ascertain whether they’re to blame for your symptoms. “Reintroducing each food group must wait at least three days since sometimes symptoms, which might range from stomach pain to nose congestion, can be delayed.”
Once [triggering] items are recognized, Yeung continues, “we may change a person’s diet to assist alleviate their symptoms and other bodily processes including digestion, absorption, microbial balance, and inflammation.”
Additionally, there are particular kinds of elimination diets, including the low-FODMAP diet, which is prescribed to people with diseases like irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO). “The low-FODMAP diet excludes some short-chain carbohydrates—gluten, lactose, fructose, and sugar alcohols—that ferment in our gut and may result in bloating, stomach pain, diarrhea, and/or constipation,” explains Liz McMahon, MPH, RDN, a Philadelphia-based dietitian who focuses on gut health.
According to study, short-chain carbohydrates are not absorbed by IBS patients, which may account for their experience of gas, extreme bloating, and irregular bowel movements (think: diarrhea, constipation, or both). In order to determine whether specific foods or carbohydrates are the source of their problem, McMahon says that eliminating the FODMAPs first helps patients feel better.
Can I do an elimination alone or do I need help from a pro?
Consult a specialist before starting an elimination diet so they can make sure you’re following the diet properly and are still able to achieve your nutritional demands, advises Clifford. After example, it’s simple to fail to acquire enough fibre if you try to avoid gluten. Additionally, cutting out dairy may increase your chance of having low calcium and vitamin D levels. These problems won’t arise because of your RD.
The same is true for more specialized elimination diets, such a low-FODMAP diet; it is better to follow these plans while under the supervision of a doctor and/or dietitian.
According to Yeung, it’s also crucial to discuss any past or present disordered eating or anxiety concerns you may have with your doctor. An elimination diet may lead to dietary restriction or an overemphasis on “good” and “bad” foods, especially in people who have an inclination to regulate their eating. Your doctor can assist you in ensuring that you adhere to your elimination diet in the most physically and mentally healthy way possible.
How should I begin an elimination diet?
Keep a food and symptom record before beginning an elimination diet to help detect patterns between eating behaviours and symptoms, advises Yeung. This will make it easier for you and your healthcare provider to decide which food or foods you should try to cut out.
For instance, you can decide to try cutting out tree nuts if you frequently get itchiness after consuming walnuts and almonds. It’s entirely feasible that you’ll opt to cut out several different foods or food groups.
The most crucial thing is to eat normally and meticulously record everything you consume and how you feel afterward. Before making any selections about what you’ll try cutting, track for at least a few weeks.
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It can be tempting to start your elimination diet the moment you identify a potential link in your log. Don’t. Instead, continue eating regularly, keep tabs on your symptoms, and begin making plans. According to Meghan Sedivy, RD, LDN, of Fresh Thyme Farmers Market, on day one of your diet you should feel knowledgable about the precise things you’ll need to avoid, ready with lots of well-rounded dishes, and ready to read food labels with confidence.
Okay, so I’ve kept a food journal for a few weeks—now what?
When deciding on a specific day to begin, pick a time when you are confident that you will have total control over what you eat (and don’t eat). Therefore, the greatest time to try anything like this isn’t when on vacation.
Once you’ve settled on a time to start the program, be careful not to change your lifestyle at the same time. In addition to beginning an elimination diet, many people also adjust their medications and lifestyles, according to Yeung. This makes identifying the dietary causes of the symptoms considerably more difficult.
For instance, if you start taking probiotics and stop eating soy at the same time, it may be difficult to tell whether your symptoms are being affected by the supplement or the elimination. This is the only lifestyle modification you should be making while on your elimination diet.
When this starting day eventually comes, go ahead and immediately eliminate all foods and food groups. Once more, it’s crucial to perform this under a doctor’s or RD’s supervision. After all, gaining the nutrients you require will require assistance if you are avoiding dairy, gluten, seafood, and nuts, according to Sedivy.
How can I make sure to get all my nutrients if I’m not eating so many things?
Hey, take a breath! That is a lot. It’s not as difficult as it might appear to maintain your consumption of vital nutrients while on an elimination diet, though.
Along with working with a professional, such as a dietitian or doctor, McMahon advises starting (or continuing!) to take a basic multivitamin without any extra “superfoods” or “food powders,” as they may contain the things you’re seeking to avoid. It’s not a bad idea to choose a vitamin with calcium and vitamin D if you’re giving up dairy or one with B vitamins if you’re giving up wheat and gluten, depending on what food(s) you’re cutting out.
Additionally, McMahon advises elimination dieters to keep things as straightforward as possible to reduce stress throughout the process by ensuring that each meal consists of the following three components: Healthy fats—avocado or EVOO—carbohydrates—vegetables like spinach or broccoli or grains like brown rice or quinoa—protein—lean meats like chicken or fish—healthy fats—avocado or EVOO. Together, these elements will keep you feeling energized and full, which is essential, especially when you’re cutting out foods.
What can I eat during the elimination phase?
According to Dr. Pekow, what you can consume truly relies on what you’re avoiding and the reason you’re doing so.
However, according to Amber Pankonin, RD, the creator of Stirlist, there are several foods that are low in FODMAPs and are acceptable to consume during a straightforward elimination phase.
- Grains: Quinoa, brown rice, and polenta
- Protein: Chicken, tuna, beef, and pork
- Nuts and seeds: Pumpkin seeds, walnuts, almonds, flax seed
- Vegetables: Arugula, broccoli, cucumbers, green beans, kale, radishes
- Oils: Avocado, olive, and coconut oil
How long does an elimination diet last?
It might last from three to eight weeks on average. However, according to Dr. Pekow, you should typically notice (and feel) a difference very quickly. He continues, “The advantage [of exclusion] might be felt within days for dietary intolerances to certain food groups.
Don’t rush the procedure, though. A few-week-long exclusion phase “gives the body time to acclimate to a new diet and also allows the gut lining—the barrier between what we eat and the rest of the body—to rebuild,” according to Dr. Nazareth.
According to Dr. Nazareth, irritants like food allergies can harm the lining and weaken the “defence system,” making it easier for things like germs that shouldn’t enter the body to do so and cause inflammation, bloating, gas, and diarrhea.
However, the duration of your elimination diet will mostly rely on the food(s) you’re giving up, and your doctor or nutritionist can assist you with this decision. Nevertheless, it takes your body a few days to a week to recover from any possibly triggering foods.
Yeung thinks it’s crucial to persevere through the process despite the temptation to give up early. “Many people end the elimination diet too soon because they feel better right away, but by doing this, you run the risk of eliminating items that you may not need need to because you didn’t go through the reintroduction period,” the expert advises. This might lead to unbalanced diets and prevent you from consuming things that you might otherwise truly like and tolerate.
When can I start reintroducing foods—and how?
Before reintroducing foods, we often advise patients to go on an elimination diet for four to six weeks, according to Dr. Pekow. Depending on the food you are eliminating from your diet and the reason you’re doing it, there can be a lot of variation in when you should expect to see improvements (or not), but seeing a qualified dietitian will help you choose the best time, he says.
So start the challenge phase of reinstating one food group at a time after four to six weeks of eliminating everything that could be a trigger for you. I’ll say it again: one at a time. Yeung claims that you are causing symptoms by doing this.
Remember to keep track of everything while you’re at it (i.e., throughout the full elimination and reintroduction process). Hey, hey, I understand what you’re thinking: yet another logging session? But heed the advice of experts like Clifford, who emphasizes the significance of tracking repeatedly. Write down the meals you consumed, how much you ate, and where you bought them, she advises.
Spend some time considering whether you can tolerate some serving sizes but not others, how you feel after eating, whether your energy levels or digestion vary, and how you feel after eating. You may log this information in a journal, a phone app, or a food diary.
What about the foods that still bother me? Should I keep eating them?
Knowing whether you have a food allergy, intolerance, or sensitivity is vital, but understanding what to do with that knowledge is even more crucial.
She gives the example that if you have lactose intolerance, eating lactose won’t damage you. (However, you could encounter some unpleasant side effects like flatulence or diarrhea.) But if you consume gluten and have celiac disease (which has been verified by an intestinal biopsy), you may damage your gut’s capacity to effectively absorb the nutrients your body requires, increasing your risk of vitamin deficiencies, according to Dr. Nazareth. To completely understand your condition and take care of your body, talk to your doctor or registered dietitian (RD).