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How To Complete An Elimination Diet Suited To You
Elimination diets are commonly used tools in functional medicine. The food we eat is the foundation of our wellness yet, some foods, even seemingly healthy ones, may triggers unwanted symptoms in some people. It is estimated that between 2–20% of people worldwide may suffer from some form of a food intolerance. An elimination diet is the process of removing a food or group of foods from a person’s diet for a set period of time. The absence of the food(s) and then careful reintroduction of the item(s) helps determine whether specific foods or ingredients in foods contribute to unwanted symptoms. Elimination diets are individualized based on each patient’s history, eating patterns, and overall symptom picture.
What is an elimination diet?
Elimination diets are commonly used tools in functional medicine. The food we eat is the foundation of our wellness yet, some foods, even seemingly healthy ones, may triggers unwanted symptoms in some people. It is estimated that between 2–20% of people worldwide may suffer from some form of a food intolerance. An elimination diet is the process of removing a food or group of foods from a person’s diet for a set period of time. The absence of the food(s) and then careful reintroduction of the item(s) helps determine whether specific foods or ingredients in foods contribute to unwanted symptoms. Elimination diets are individualized based on each patient’s history, eating patterns, and overall symptom picture.
Why complete an elimination diet?
Food sensitivities can be responsible for a variety of symptoms. You may benefit from completing an elimination diet if you struggled with any of the following symptoms:
Bloating
Heartburn
Distention
Constipation
Diarrhea
Fatigue
Difficulty sleeping
Skin rashes
Headaches
Low mood
Common types of elimination diets:
FODMAP Diet: This diet eliminates foods high in certain carbohydrates (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) that can be difficult to digest and may cause digestive symptoms such as bloating, gas, and diarrhea. It is often used to manage irritable bowel syndrome (IBS) or other functional gastrointestinal disorders.
Gluten-Free Diet: This diet eliminates all sources of gluten, a protein found in wheat, barley, rye, and some other grains. It is necessary for individuals with celiac disease, an autoimmune disorder triggered by gluten, and may also be followed by those with non-celiac gluten sensitivity.
Dairy-Free Diet: This diet eliminates all dairy products, including milk, cheese, yogurt, and butter. It is commonly followed by individuals with lactose intolerance, a condition in which the body has difficulty digesting lactose, the sugar found in dairy products. It may also be followed by individuals with milk protein allergies.
Specific Carbohydrate Diet (SCD): This diet eliminates complex carbohydrates, disaccharides, and certain grains. It is often used to manage digestive disorders such as Crohn's disease, ulcerative colitis, and celiac disease.
Low-Histamine Diet: This diet restricts foods that are high in histamine or release histamine in the body. It is followed by individuals with histamine intolerance, a condition characterized by an inability to properly break down histamine, leading to symptoms such as headaches, flushing, hives, nasal congestion and digestive issues.
Whole30: Whole30 is a 30-day elimination diet that removes grains, legumes, dairy, added sugars, processed foods, and certain food additives. It is designed to reset eating habits, identify food sensitivities, and promote overall health and well-being. It is not specifically designed for a particular health condition.
Autoimmune Protocol (AIP) Diet: The AIP diet eliminates foods that may trigger inflammation and exacerbate autoimmune conditions. It eliminates grains, legumes, dairy, eggs, nightshade vegetables, nuts, seeds, refined sugars, and processed foods. The AIP diet is often recommended for individuals with autoimmune diseases who are looking to manage their symptoms and reduce inflammation. It eliminates potential trigger foods to support immune system regulation.
Six Food Elimination Diet: This diet is often used in the diagnosis of food allergies in children. It helps identify specific allergenic foods that may be causing symptoms such as skin rashes, digestive issues, or respiratory problems. It eliminates the most common allergenic foods, including milk, eggs, peanuts/tree nuts, soy, and wheat.
These are just a few examples of elimination diets, and there may be variations or combinations of these diets based on individual needs and specific health conditions. It's important to consult with a healthcare professional or registered dietitian before starting an elimination diet to ensure proper guidance and monitoring throughout the process.
What to expect on an elimination diet:
Duration of the Diet: During the elimination phase, you will remove certain foods from your diet based on the specific type of elimination diet you are following. This phase typically lasts for a few weeks to several months, depending on the diet and your individual needs.
Potential Withdrawal Symptoms: Some people may experience withdrawal symptoms when cutting out certain foods, particularly those containing caffeine or sugar. These symptoms can include headaches, irritability, and fatigue. These effects should subside after a few days as your body adjusts.
Improved Symptoms: If you have food sensitivities or intolerances, you may notice a reduction in symptoms during the elimination phase. For example, digestive issues, skin problems, or respiratory symptoms may improve as you remove trigger foods.
Food Reintroduction: After the elimination phase, you will start reintroducing the eliminated foods one at a time in a systematic manner. This is usually done over several weeks, and each food is reintroduced individually, allowing you to observe any reactions.
Identification of Food Sensitivities: The primary goal of an elimination diet is to identify any food sensitivities or intolerances. By reintroducing foods one by one, you can pinpoint which ones are causing adverse reactions.
Increased Awareness of Eating Habits: Elimination diets often require careful reading of food labels and increased awareness of ingredients. This can lead to improved knowledge about the foods you consume and better eating habits.
Emotional Challenges: Elimination diets can be challenging, especially if you have to give up favorite foods or make significant dietary changes. This might cause some emotional ups and downs during the process.
Support and Guidance: Having a healthcare professional or registered dietitian guide you through the elimination diet can be highly beneficial. They can help you plan your meals, monitor your progress, and provide support throughout the process.
Reintroduction Reactions: Some individuals may experience reactions when reintroducing certain foods. These reactions could be mild or more severe, depending on the level of sensitivity. If you experience severe reactions, it's essential to stop consuming the food and consult with a healthcare professional.
Is there a blood test to use instead of completing an elimination diet?
There are many lab tests availalve that measure certain antibodies or biomarkers in the blood that are associated with an immune response to specific foods. They claim to identify which foods might be triggering adverse reactions in individuals. However, food sensitivity tests have many challenges including lack of standardization, difficulty interpreting the significance of IgG antibodies and potential cross-reactions between foods. Food sensitivities are complex and can involve various immune mechanisms. Blood tests often oversimplify the process by focusing on just a few markers, potentially missing other important factors.
Due to these limitations, many healthcare professionals and experts still consider elimination diets as the gold standard for identifying food sensitivities or intolerances. Elimination diets allow for a more comprehensive and personalized approach, and they are more likely to provide accurate results in identifying specific trigger foods.
If you are considering food sensitivity testing, it's crucial to consult with a qualified healthcare professional who can help you understand the limitations and implications of the test results. They can also guide you on the most appropriate approach to identifying and managing potential food sensitivities based on your unique health needs and history.
Relish Health offers a Whole30-style, physician-guided elimination diet. The 50-day program guides you through removal of specific foods from your diet for 30 days. This 30-day period is proceeded by 10-days of preparation and followed by 10 days of careful food reintroduction. The course provides step-by-step instructions, meal plans, and resource guides. During the months of January and September, Dr. Leazenby is available to answer questions and provide encouragement through facebook and live zoom classes.
Functional medicine approach to healing autoimmune disease
Autoimmune disease represents an inappropriate immune response. The solution to reaching symptom control and disease remission is supporting the immune system to behave more normally. In conventional medicine, powerful immune modulating drugs are often prescribed. In functional medicine, there is a focus on restoring balance in the body by addressing lifestyle, diet, gut health and nutritional deficiencies among other factors. Conventional and functional approaches are not mutually exclusive and can be used together. The ultimate goal is to lower chronic inflammation that triggers symptoms flare-ups and disease progression.
An autoimmune disease is a condition in which the body’s immune system mistakenly attacks the healthy cells of the body rather than a germ like a bacteria or virus. The type of autoimmune disease is named based on the organ(s) being targeted by the body. Some autoimmune diseases target only one organ. For example, Hashimoto’s thyroiditis involved damage of the thyroid. Other autoimmune diseases, like systemic lupus erythematosus (SLE), affect the whole body.
Addressing the autoimmune process
Autoimmune disease represents an inappropriate immune response. The solution to reaching symptom control and disease remission is supporting the immune system to behave more normally. In conventional medicine, powerful immune modulating drugs are often prescribed. In functional medicine, there is a focus on restoring balance in the body by addressing lifestyle, diet, gut health and nutritional deficiencies among other factors. Conventional and functional approaches are not mutually exclusive and can be used together. The ultimate goal is to lower chronic inflammation that triggers symptoms flare-ups and disease progression.
It all starts in the gut
About 70 percent1 of the body’s immune system is located in the lining of the gut and is influenced by the health of the gut microbial community2. The immune system here plays a vital role in keeping the body healthy by providing a fine balance between the elimination of invading pathogens and tolerance to healthy self-tissue. Alterations to the gut lining and gut microbial community can cause immune imbalance, leading to autoimmune disorders.
Supporting intestinal health is essential for a healthy immune system and is the ideal place to start a healing journey. The health of the body’s microbiome and gut lining are directly influenced by things like metal health/stress management, diet and sleep3 quality.
Use diet to heal autoimmune disease
Healing the gut with nutrition requires an individualized treatment plan based on what is happening in the gut. A detailed assessment of symptoms combined with specialized testing can provide direction for treatment that may involve correcting microbiome imbalances, parasitic infections or overgrowth patterns.
Nutrition tips to reduce inflammation and help manage autoimmune symptoms
1. Identify your trigger foods.
When the gut lining is unhealthy, people may develop sensitivities to foods. These foods can then perpetuate chronic inflammation. Food trigger will vary person to person and will be different depending on the autoimmune disorder involved. There are certain foods that are common triggers for inflammation and are best avoided with autoimmune disease, such as grains, gluten, dairy, refined and added sugars, alcohol and coffee for a period of time. Once symptoms are improved, these foods are reintroducing slowly back into the diet in a systematic way.
2. Try an autoimmune paleo diet (AIP).
If avoiding top pro-inflammatory foods listed above does not provide relief, then moving to an advanced paleo diet approach may be helpful. An Autoimmune Paleo Diet (AIP) further restricts foods that may be inflammatory including removing all grains, dairy, gluten, legumes, nuts, seeds, nightshade produce, processed foods, and vegetable oils, as well as sugar and sweeteners from your diet to identify foods that may trigger a flare-up. Not everyone needs a diet this restrictive to find relief and healing, but an AIP intervention can be very powerful for healing. An AIP diet can be very restrictive and is not meant for long-term use. The elimination phase of the diet lasts 30 days and is followed by a structured reintroduction phase.
3. Focus on eating a variety of healthy foods.
A common mistake people make when trying to follow an anti-inflammatory diet for autoimmune diseases is restricting the list of foods they eat and eating those same foods over and over again. Focusing eating a variety of foods from the exhaustive list of vegetables, fruits, proteins, etc. that are included in the diet provides healing nutrients like phytonutrients, antioxidants and omega-3’s for healing. Adding a variety of fruits and vegetables into your diet can also help prevent intolerances and ensure you’re getting a spectrum of vitamins and minerals.
4. Address nutrient deficiencies.
Nutritional insufficiencies and deficiencies are common in the US. In people with autoimmune disorders vitamins A and D, omega-3 fatty acids and minerals like zinc and magnesium are especially important for healing. Addressing gut health to optimize nutrient absorption and eating a nutrient dense diet are imperative steps toward healing. Filling up on vitamin A-rich foods, like beef liver and wild Alaskan fermented cod liver oil, and vitamin D-rich foods, such as sardines and salmon can be helpful. For foods that are excellent sources of zinc, go for oysters, beef, crab, turkey, and chicken. And those that are high in magnesium, check out mackerel, spinach, Swiss chard, and avocado. In some cases, adding strategic supplementation to address deficiencies is important. If you have an autoimmune disease, talk to your doctor about regularly checking your levels of these key nutrients.
Addressing autoimmunity requires a personalized approach. Talk with Relish Health to begin your healing journey.
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References:
1. Vighi G, Marcucci F, Sensi L, Di Cara G, Frati F. Allergy and the gastrointestinal system. Clin Exp Immunol. 2008;153 Suppl 1(Suppl 1):3-6. doi:10.1111/j.1365-2249.2008.03713.x
2. Wu HJ, Wu E. The role of gut microbiota in immune homeostasis and autoimmunity. Gut Microbes. 2012;3(1):4-14. doi:10.4161/gmic.19320
3. Smith RP, Easson C, Lyle SM, et al. Gut microbiome diversity is associated with sleep physiology in humans. PLoS One. 2019;14(10):e0222394. Published 2019 Oct 7. doi:10.1371/journal.pone.0222394