Although food intolerances are far less severe than food allergies, they can still cause some uncomfortable symptoms. It’s estimated that between 2–20% of people worldwide may suffer from a food intolerance. Although food intolerances are far less severe than food allergies, they can still cause some uncomfortable symptoms.

The best way to identify food sensitivities, intolerances and allergies is to do an elimation diet.

They remove certain foods known to cause uncomfortable symptoms and reintroduce them later while testing for symptoms.

For decades, allergists and registered dietitians have used elimination diets to help people identify foods that they do not tolerate well.

What Is an Elimination Diet?

An ‘elimination diet' is a diet in which you remove foods that you think your body cannot tolerate well, and then reintroduce them later one at a time to see if there is a reaction.

The low FODMAP diet is a short-term plan that can last anywhere from 5 to 6 weeks. It is used to help people who have a sensitive gut, food intolerance, or food allergy identify which foods are causing their symptoms.

An elimination diet may help improve symptoms such as bloating, gas, diarrhea, constipation and nausea.

If you have identified a food your body does not tolerate well, you can remove it from your diet to prevent uncomfortable symptoms.

There are many diets that require you to either eat or remove certain types of foods.

However, you should not try an elimination diet if you have a known or suspected food allergy, as reintroducing a food allergen may trigger a dangerous condition called anaphylaxis.

How Does It Work?

The elimination phase can last up to four to six weeks. An elimination diet is divided into two phases: elimination and reintroduction. The elimination phase, in which you avoid foods that may trigger allergies or sensitivities, can last up to four to six weeks.

The Elimination Phase

To begin the elimination phase, you will remove any foods you suspect trigger your symptoms from your diet for a short period of time, typically 2-3 weeks.

Some people can't tolerate certain foods, and there are some foods that are known to cause discomfort. Eliminate these foods from your diet to see if it helps.

Nuts, corn, soy, dairy, citrus fruits, nightshade vegetables, wheat, foods containing gluten, pork, eggs and seafood are some of the foods that can cause inflammation.

You can try eliminating certain foods to see if your symptoms improve. If you don't see a difference after a few weeks, it's probably not due to food and you should talk to your doctor.

The Reintroduction Phase

The next stage is to slowly start reintroducing the foods you eliminated from your diet.

Each food group should be introduced individually, over 2–3 days, while looking for symptoms. Some symptoms to watch for include:

  • Rashes and skin changes
  • Joint pain
  • Headaches or migraines
  • Fatigue
  • Difficulty sleeping
  • Changes in breathing
  • Bloating
  • Stomach pain or cramps
  • Changes in bowel habits

You can tell that a food group is fine to eat if you experience no symptoms while reintroducing it.

If you experience negative symptoms like those mentioned above when you eat a certain food, then you have successfully identified a trigger food and should remove it from your diet.

The entire process, including elimination, takes roughly 5–6 weeks.

You should speak to a doctor or dietitian if you're thinking of cutting out whole food groups, as this could lead to nutritional deficiencies.

SUMMARY:

An elimination diet is a diet where you remove foods that you think are causing you discomfort, and then introduce them back into your diet one at a time to see if there are any symptoms.

What Can’t You Eat on an Elimination Diet?

The best elimination diets are the most restricting.

The greater the number of foods you exclude from your diet during the initial elimination phase, the more likely it is that you will identify which foods trigger uncomfortable symptoms.

Foods that are commonly removed during the elimination phase include:

  • Citrus fruits: Avoid citrus fruits, such as oranges and grapefruits.
  • Nightshade vegetables: Avoid nightshades, including tomatoes, peppers, eggplant, white potatoes, cayenne pepper and paprika.
  • Nuts and seeds: Eliminate all nuts and seeds.
  • Legumes: Eliminate all legumes, such as beans, lentils, peas and soy-based products.
  • Starchy foods: Avoid wheat, barley, corn, spelt, rye, oats and bread. Also avoid any other gluten-containing foods.
  • Meat and fish: Avoid processed meats, cold cuts, beef, chicken, pork, eggs and shellfish.
  • Dairy products: Eliminate all dairy, including milk, cheese, yogurt and ice cream.
  • Fats: Avoid butter, margarine, hydrogenated oils, mayonnaise and spreads.
  • Beverages: Avoid alcohol, coffee, black tea, soda and other sources of caffeine.
  • Spices and condiments: Avoid sauces, relish and mustard.
  • Sugar and sweets: Avoid sugar (white and brown), honey, maple syrup, corn syrup and high-fructose corn syrup, agave nectar, desserts and chocolate.

If you have suspicions that other foods not included on this list make you feel nauseated, you should remove them from your diet as well.

SUMMARY:

An elimination diet that is effective will restrict your food choices, which will in turn help you to identify which foods act as triggers.

What Can You Eat on an Elimination Diet?

Even though an elimination diet is very restrictive, you can still make healthy and delicious meals.

Some foods you can eat include:

  • Fruits: Most fruits, excluding citrus fruits.
  • Vegetables: Most vegetables, excluding nightshades.
  • Grains: Including rice and buckwheat.
  • Meat and fish: Including turkey, lamb, wild game and cold-water fish like salmon.
  • Dairy substitutes: Including coconut milk and unsweetened rice milk.
  • Fats: Including cold-pressed olive oil, flaxseed oil and coconut oil.
  • Beverages: Water and herbal teas.
  • Spices, condiments and others: Including black pepper, fresh herbs and spices (excluding cayenne pepper and paprika) and apple cider vinegar.

To stay motivated during this restrictive phase, try designing new recipes and experimenting with herbs and spices to add delicious flavor to your dishes. This will help you stay excited about cooking and try new things.

SUMMARY:

Even though elimination diets are limited in what you can eat, there are plenty of other healthy and delicious options to choose from.

Other Types of Elimination Diets

The Paleo diet is a type of elimination diet that is based on foods that are thought to have been eaten by early humans. There are several types of elimination diets in addition to the traditional one described above. The Paleo diet is one type of elimination diet that is based on foods that are believed to have been eaten by early humans.

Here are a few different types of elimination diets:

  • Low-FODMAPs diet: Removes FODMAPs, which are short-chain carbohydrates that some people can’t digest.
  • Few foods elimination diet: Involves eating a combination of foods that you don’t eat regularly. One example is the lamb and pears diet, which is popular in the US, where lamb and pears are not commonly eaten.
  • Rare foods elimination diet: Similar to a few foods diet, but you can only eat foods that you rarely ever eat, as they are less likely to trigger your symptoms. Common foods on a rare food diet include yams, buckwheat and starfruit.
  • Fasting elimination diet: Involves strictly drinking water for up to five days, then reintroducing food groups. This type of diet should only be done with permission from your doctor, as it can be dangerous to your health.
  • Other elimination diets: These include lactose-free, sugar-free, gluten-free and wheat-free diets, among others.

 

What are the benefits of an elimination diet?

An elimination diet is a way to figure out which foods may be causing you problems by using experimentation and observation based on how your body responds to different foods. For example, if you have headaches and they go away when you stop eating certain foods, but then come back when you start eating chocolate again, that's a strong sign that chocolate could be causing your headaches.

An elimination diet allows you to rule out possible food sensitivities, so that you can more accurately identify the culprits behind your symptoms.

Are you bloated because of something you ate, such as the onions at lunch, or from something non-food related, such as eating too quickly?

This guesswork gets even more difficult when:

  • Symptoms show up outside of the gut. Did you wake with a migraine because of the wine you had with dinner? Or are you just dehydrated? Or maybe you didn’t sleep well? Similarly, was that skin rash caused by something you ate—or was it caused by contact with a perfume, detergent, or some other irritating substance?
  • You can eat small amounts of certain foods without symptoms. For example, one square of chocolate might not cause problems, but when you eat half a bar? Your body rebels.
  • Symptoms are delayed. You eat some red pepper and feel fine. Then days later, your joints are achy and swollen. Yep, it’s possible.

An elimination diet is designed to help you identify which foods are causing you problems.

Is it a food sensitivity? Or just normal digestion?

People sometimes think they are allergic to certain foods when really they are just having a normal body reaction to foods that cause gas during digestion.

Try slowly introducing Brassica vegetables, beans, legumes, raw onion, and raw garlic to your diet. You may also want to take a probiotic supplement that contains Lactobacillus rhamnosus GG to help your digestive tract adjust.

What are the side effects of an elimination diet?

Elimination diets are ones where you stop eating certain foods for a period of time, typically to see if they’re causing you problems. If you're thinking of starting an elimination diet, here are a few things you should know. Whenever you make a big change to your diet, your body is likely to have some negative reactions. This is especially true with elimination diets, where you cut out certain foods for a period of time. If you're thinking of starting an elimination diet, there are a few things you should be aware of.

Some people feel great right away after starting taking medication, but others may feel worse before they start feeling better.

The reason an elimination diet is such a drastic change is because it is like starting high-intensity interval training after being out of shape for years.

If you go from eating a lot of caffeine, sugar, and processed foods to not eating any of these things, you will especially notice a difference.

When you first stop taking the medication, you may experience withdrawal symptoms such as headaches, fatigue, irritability, or skin flare-ups for a few days to a week.




What are the most common food sensitivities?

Based on data we’ve gathered from the thousands of clients we’ve coached, we can say pretty confidently that the following categories tend to cause the most problems:

  • Gluten
  • Dairy
  • Eggs
  • Sweeteners (example: sugar)
  • Soy

Types of elimination diets

In this article, we’ve included a food list for one type of elimination diet, but many other elimination diets exist. They include:

The whole foods elimination diet

There are many additives in highly-processed foods that can irritate the gut and cause sensitivities in people. These include food colorings, sugar alcohols, monosodium glutamate (MSG), and sulfites.

A diet rich in minimally-processed whole foods can help reduce or eliminate food chemicals while boosting overall health. These foods often contain fiber and other nutrients that nourish the digestive tract.

Eliminate just 1 food or food category

If you're confident that you know which food is causing your problems, this is the best option. For example, if you know from past experience that you feel terrible after eating dairy, you would eliminate dairy from your diet for 3 weeks. After that, you would reintroduce it to see how you feel.

Eliminate up to 4 foods

If you believe that certain foods are causing you problems, eliminating them from your diet is a great option. Only remove 1-4 foods at a time so that you can be sure which ones are causing the issue.

The Precision Nutrition Elimination Diet

We usually refer to this as the “elimination diet medium” because it offers a way to remove foods gradually, rather than removing so many foods at once that it seems overwhelming.

A list of recommended foods and foods to avoid will be provided later in this article.

The full elimination diet

This diet excludes a wide range of foods, including many types of meat, legumes, grains, nuts, and seeds—even a wide variety of fruits and veggies.

A professional should be consulted before attempting this diet as it is highly restrictive.

The FODMAP elimination diet

FODMAP stands for:

Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols

These carbohydrate fibers are not fully absorbed in the small intestine. Many people without Irritable Bowel Syndrome (IBS) can handle this incomplete digestion without issue. However, people with IBS may experience a range of bothersome symptoms, such as gas, distension, pain, diarrhea, and/or constipation.16

Many people with IBS find that their symptoms are alleviated by following a low-FODMAP diet.

The FODMAP diet is a more specialized form of elimination diet than others, requiring a more complex reintroduction phase.

If you have been diagnosed with IBS and think you may have a problem with FODMAPs, you will need the help of someone who is qualified to provide medical nutrition therapy, such as a nutritionist who has been trained in the FODMAP approach.

The Academy of Nutrition and Dietetics has a Find an Expert page, where you can find a registered dietitian nutritionist in your area. Additionally, Monash University has a FODMAP dietitian directory18,19 which can help you find a registered dietitian nutritionist who specializes in the FODMAP diet.

Can you do an elimination diet if you’re pregnant or breastfeeding?

You need many nutrients to grow and feed a baby, so it is not recommended to make sudden changes to your diet.

Though this may be the case, you may also experience a variety of uncomfortable issues when you are pregnant or nursing, such as gas, bloating, and acid reflux.

If you think that the food you are eating is making your symptoms worse, tell your doctor or nurse midwife.

After being evaluated by a specialist in integrative medicine and/or medical nutrition therapy, you may be able to remove and reintroduce a small number of foods that are believed to cause the majority of food sensitivity issues.

How does an elimination diet work?

There are three phases to an elimination diet: the prep phase, the removal phase, and the reintroduction phase.

Prep phase (7-9 days)

You will prepare for the removal phase during the prep phase.

This section is crucial to the success of the diet, so don't overlook it. Those who take a week to prepare ahead of time will do much better than those who try to start immediately.

Some of the things you'll do to prepare for the elimination diet include keeping a food journal to help you figure out which foods trigger your symptoms, as well as which foods you need to avoid during the removal phase. This will help make the diet more tailored to your individual needs.

You will also need to spend time preparing your meals, which includes finding recipes, buying groceries, and organizing your kitchen.

Removal phase (3 weeks)

If you want to heal your gut, you need to remove trigger foods from your diet. This means no more gluten, dairy, or eggs.

Phase 3: Reintroduction phase (3+ weeks)

Now is the time to slowly start to add the eliminated foods back into your diet, testing them one at a time and closely monitoring for any reactions.

The removal phase: What to expect

During the removal phase of an elimination diet, you exclude 1 or more foods from your diet.

If you eliminate certain foods from your diet, you might see an improvement in your symptoms in a short amount of time. This could include clearer skin, more energy, and regular bowel movements.

Although this is a good result, it's not always a sign that the removal stage is working. For example, eating more whole foods, fewer processed foods, and smaller portions can also lead to improved energy, fewer GI symptoms, and a overall sense of well being.

The only way to know for certain if you have a food sensitivity is by reintroducing the food item back into your diet during the reintroduction phase.

It is also important to know that not everyone will feel better right away.

As some people withdraw from caffeine, sugar, and other foods, they may feel worse before they start to feel better.

Risks of an Elimination Diet

The risks of elimination diets include malnutrition, social isolation, and anxiety.Malnutrition can occur when you eliminate certain food groups from your diet and don't replace them with others that provide the same nutrients. Social isolation can happen when you can't eat the same foods as your friends and family. And anxiety can arise from the stress of planning and following an elimination diet.

Elimination diets should only be followed for a short amount of time, typically four to eight weeks.

Stopping an elimination diet after a short period of time is recommended, as continuing it could cause nutrient deficiencies from cutting out certain food groups.

People with known or suspected allergies should not do an elimination diet without the supervision of a doctor.

Elimination diets are not ideal for children as they could stunt their growth.

Children are also more likely to have severe reactions, like anaphylaxis, when reintroducing a food group. This is because their bodies can become extra sensitive to foods after avoiding them.

The Bottom Line

Elimination diets can help you to figure out which foods your body can't tolerate well.

If you think your symptoms may be caused by your diet, try an elimination diet to figure out which foods are causing them.

People who should not try an elimination diet are children and unless supervised by a doctor or dietitian.

If you have known or suspected allergies, you should only do an elimination diet under the supervision of a doctor.

It is worth mentioning that only short-term elimination diets are safe, as long-term ones might lead to nutrient deficiencies.