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Integrative Nutrition

How to do an Elimination Diet - A Complete Guide

You’ve been eating healthy, balanced meals on a consistent basis and getting a solid amount of sleep each night, yet something doesn’t quite feel right. Maybe it’s occasional bloating, a rash that comes and goes, or a feeling of fatigue despite a good night’s sleep. This type of discomfort can occur in your body periodically, despite the fact that everything you’re eating seems “good” on paper.

These symptoms are likely signs of a larger issue at hand. Our body speaks to us when it isn’t receiving the right nourishment, whether it’s the form of digestion issues or an acne breakout. Each of us have a bio-individual makeup that responds to certain foods and even lifestyle practices, causing a unique reaction in your body.

A self-guided elimination diet may be the answer to your worries. The elimination diet can illuminate potential food intolerances and sensitivities through a process of eliminating certain foods or food groups, and then gradually reintroducing them. If symptoms are severe, it’s best to consult with a medical professional or registered dietitian for a more thorough examination that could include a blood or allergen test. Nutrition experts can help you determine which foods you may need to eliminate, making sure that you maintain a balanced and nutritional diet in the process. 

What is an elimination diet?

The elimination diet is a food plan that eliminates common food allergies and food groups in order to test your body’s reaction, which could be physical or emotional. Using a food journal is a great way to take note of these changes or reactions in your body. This is known as the gold standard for identifying food allergies or intolerances. 

Many people decide to pursue an elimination diet because they are experiencing physical symptoms such as fatigue, headaches, acne breakouts, brain fog, achy joints, frequent colds or immune system dysfunction, bloating, gas, and indigestion, as well as emotional symptoms such as mood swings, irritability, and anxiety or depression.

The elimination period works to clear your body of foods and chemicals that you may be allergic or intolerant to, supporting the microbiome and reducing inflammation in the process. Researchers have found that conducting an elimination diet can help alleviate or resolve ADHD, celiac disease, irritable bowel syndrome (IBS), and leaky gut syndrome. 

At its core, an elimination diet can help you get the most out of your health goals by identifying the foods that work for you and your body’s needs. When you eliminate the foods that cause a bad reaction in your body, you can find yourself with more energy, cleared headspace and a more focused approach towards life. 

Working with a Health Coach can provide extra support as you navigate implementing the diet, as they are able to help you evaluate whether certain foods are causing a trigger reaction within your body. With sustained effort, you will become more aware and in control of how you feel on a daily basis.

How does the elimination diet work?

Below, we’ll outline exactly how to get started with an elimination diet, what reintroduction means, and how to do it.

  1.  How to get started with an elimination diet

First, identify the foods that you will eliminate from your diet. This list typically includes the most common allergy-inducing foods, such as:

  • Gluten

  • Dairy

  • Peanuts

  • Soy

  • Corn

  • Refined sugar 

  • Eggs

A registered dietitian may suggest that you try the low FODMAP diet, specifically prescribed when patients suffer from irritable bowel syndrome (IBS). FODMAPs stands for Fructose, Oligosaccharides, Disaccharides, Monosaccharides and Polyols (sugar alcohols). These are short-chain carbohydrates (sugars) that are more difficult for some to digest. These include:

  • Fruits with high fructose like apples, apricots, cherries, figs, mangoes, and nectarines.

  • Nightshade vegetables like tomatoes, eggplant, peppers, and white potatoes. 

  • Dairy products like cottage cheese, cream cheese, milk, quark, ricotta and yogurt.

  • Legumes like red kidney beans, split peas, and baked beans.

  • Dense wheat products like bread, pasta, biscuits, and pastries.

  • Garlic and onions.

 What makes these carbohydrates potentially difficult to digest is that they will ferment in the gut, causing unpleasant feelings in the gastrointestinal (GI) tract, most notably gas, bloating, and diarrhea or constipation.

Once you’ve settled on the foods you want to eliminate, create a list in your food journal, allowing space for you to later identify patterns in your eating habits and symptoms. You can tackle the list with the help of a Health Coach, who can help you set goals to stick to the elimination diet and provide a supportive space for you to discuss anything that comes up during the process.

     2. How long should the elimination diet last?

The recommended elimination process is at least 21 days. After the 21 days have passed (3 weeks), you can begin slowly reintroducing foods - one at a time -  in order to observe your body’s reaction.

     3.  How do you reintroduce foods?

The key is choosing one food at a time. Eat it once or twice over the course of 2 to 3 days. Evaluate how you feel. Sometimes you’ll feel lousy right away, and other times it’ll take a few hours or a whole day before symptoms arise, which is why you eat the same foods repeatedly over a few days. If the first reintroduced food doesn’t result in any symptoms, try reintroducing another food from your elimination list. You can follow this method with each food, closely observing your body’s reaction.

If any of the foods cause a flare up in old symptoms, you can test your theory by avoiding the food completely for another 2 weeks to see if the symptoms clear up. Finally, reintroduce the food to see if the symptoms appear again. By this point you should see a clear cause and effect reaction, indicating that you may have an intolerance or allergy to this food. 

Oftentimes, the initial symptoms you’re experiencing may not go away within the 21-day elimination period, indicating that your intolerance may be to a different food than what was on your list. Speak with a registered dietitian or your doctor about what other foods or factors could be causing you discomfort.

     4. Setting yourself up for success on an elimination diet.

Prepare for the diet by planning out your meals, enlisting a support system, and stocking your fridge and pantry with approved food options. This can help ensure that the process is as easy and smooth as possible, and you’re prepared especially when you feel like cheating with a bowl of ice cream or a late night salty snack.

As you make these kinds of drastic diet changes, it’s important to try to keep other things in your life as consistent as possible. This relates to environmental changes, as well as supplement and medicine use. The goal is to be able to attribute your progress to the changes in your diet. The elimination diet can be challenging your first time, but this physical and mental preparation can help you get in the right headspace to carry it out successfully.

What are the pros and cons of the elimination diet?

As with any major changes you may make to your life, there will be pros and cons associated with those changes. 

Pros of an elimination diet

  • It’s temporary. 

The elimination diet is a process of trial and error, not a permanent lifestyle change. Though it feels restrictive at first, it is not going to keep you from enjoying new foods in the future. The goal is to identify the ingredients in your regular meals that may be causing a greater issue for your body’s health.

  • It focuses on feeding your body with whole foods.

We could all use more whole foods in our diet. This includes healthy carbohydrates such as brown rice, quinoa, and sweet potato, and nutrient-dense vegetables like broccoli, cauliflower, and leafy greens (all cooked to make them easier on your digestion!). These foods will keep you satiated longer, keeping your body happy as it experiences changes in your diet.

  • It embraces bio-individuality.

The elimination diet is not a one size fits all food plan, allowing you to  take a look at your current food choices and find alternatives or fixes that best suit your needs. By focusing on how each food makes you feel by eliminating and then reintroducing it, you are better able to tune in to your body and recognize the signs it’s sending you, no matter how subtle. Learning to listen to your body is key for strengthening your sense of self and fully embracing your unique bio-individuality. 

Cons of an elimination diet

  • It can affect your energy levels at the start.

Your body can develop an attachment to the foods you eat on a regular basis. Any significant change in your diet may alter your energy levels at the start. Your body is taking the time to adjust to a new eating routine, and may result in decreased energy levels as your body reconciles how to best source fuel to keep you going.

  • It’s not always a foolproof method. 

There are many variables that could come up so use your judgment and continue exploring the root of your symptoms. It could be that you’re reacting to something in your environment that isn’t food, or that your symptoms are caused by stress, or some other internal imbalance. This is where working with nutrition and wellness experts comes in, such as Health Coaches and registered dietitians, as they may be better able to help you connect the dots between the foods you’re eating or the lifestyle practices you’re engaging in that could be causing your physical and emotional symptoms.

  • It can be triggering for people who have overcome or are managing eating disorders.

The elimination process is restrictive, potentially triggering you to resort to unhealthy habits. This process can be especially difficult for people who have had struggles with eating disorders or even disordered eating, as the drastic change is in the beginning can be jarring. This is why it’s important to prepare and create a clear plan with your health providers while continuing to document each step of the diet. 

Finding your healthy balance.

The overriding goal of the elimination diet is to find a plan that works best for you. It’s a chance for you to balance your current diet and find a new plan that keeps you healthy, happy, and energized on a daily basis. There are so many variables that could be triggering or worsening your symptoms, so it’s important to communicate with a Health Coach or a dietitian throughout the process.

Whether it be an issue with a specific food, external stressors, or an internal imbalance, an elimination diet can illuminate the next step in your journey towards holistic health. The IIN Curriculum covers key nutrition and holistic lifestyle concepts, providing a framework for students to enhance their health and make impactful changes in their own lives, as well as in the lives of their health coaching clients! Check out a Curriculum Guide today to find out more.

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