An elimination diet can take many forms and can be different from practitioner to practitioner based on their experiences, some variations are listed below. For complete specifics of foods to choose and foods to exclude, meet with an experienced practitioner.
Standard elimination diet
Used most frequently when there are unexplained/generalized symptoms or to simply “reset” the system. Variations of this diet, along with additions of specific foods, supplements and lifestyle changes can work well for a detox. This diet eliminates the most common food allergens and can be done with all the foods listed below or just with possible suspects. It eliminates:
• Peanuts, tree nuts, seeds
• Processed meats
• Nightshade vegetables (peppers, potatoes, eggplant, tomatoes, paprika – usually associated with joint pain)
FODMAP Elimination Diet
This stands for Fermetable Oligo, Di and Monosaccharides and Polylos. This diet limits certain types of carbohydrates that may be poorly absorbed and can contribute to gastrointestinal symptoms. It seems to be particularly beneficial in individuals with irritable bowel syndrome who have diarrhea, gas and bloating. FODMAPs include:
• Lactose: dairy products such as milk, yogurt, cottage cheese, ice cream
• Fructose: high fructose corn syrup, agave, honey and certain fruits
• Fructans: wheat, rye, inulin, certain vegetables
• Galactans: chickpeas, lentils, kidney beans, soy, certain vegetables
• Polyols: xylitol, sorbitol, mannitol, maltitol, isomalt, certain fruits and vegetables
This protocol is as much a gut healing protocol as an elimination diet. It is meant to repair gut health (in order to optimize the immune system – remember 80% of the immune system is found in the gut) and identify possible food triggers of autoimmunity. It is one of the more restrictive diets as it eliminates:
• Legumes (beans, including soy and peanuts)
• Nightshade vegetables
• Nuts and Seeds
• Seed spices (nutmeg, cumin, fennel, dill, coriander, anise)
• Sugar (limited quantities of honey and maple syrup permitted)
IgG Based or Food Testing Based
Foods are eliminated based on individual results of food sensitivity testing (such as testing from ALCAT labs or LEAP MRT testing). Some programs eliminate “high” responding foods for 6 months, “medium” for 3 months and “low” for one month with controlled reintroduction after.
These diets are not meant for the long haul, but are intended so that individuals can gather more information about their body’s individual tolerance. When the elimination phase is complete (usually 4-6 weeks), reintroduction of each food item can begin one by one. It is important to space the reintroductions far enough apart so you can distinguish if your symptoms are related to the food you are testing. It is also important to use the most “pure” form of the foods. For instance, if you are testing eggs, choose a hard-boiled egg or fried egg instead of a gluten free muffin that contains eggs. This way the results are clearly related to that food. A general reintroduction guideline looks like this:
• Day 1: three servings of eliminated food are consumed in one day
• Day 2-4: eliminate tested food and observe for symptoms
• Day 5: if no symptoms, test new food. If symptoms, wait until symptoms resolve to test the next food. Keep this food out of your diet until all foods are tested.
It’s important to note that a FODMAP introduction may look slightly different, because often times these foods are tolerated in threshold amounts over a specific period, so while a small amount may be well tolerated, a larger amount may cause symptoms. A food diary is very helpful to track symptoms during this phase of the diet.
Working with a nutrition professional (such as a registered dietitian) can be very helpful during this time to prevent nutritional gaps, alleviate boredom and help interpret results.
Living with Food Sensitivities
Although it can be challenging living with food sensitivities, it is not impossible. With good planning and guidance (and knowing which questions to ask!), you can successfully avoid your problem foods and improve the overall quality of your life. For some individuals, these restrictions may not be life long and you may be able to reintroduce some of these foods at a later period as your system changes and adjusts. Continued compliance will ensure success!
Laura Palazzolo Kraus MS, RDN
Clinical Dietitian – EGSMC