What Is An Elimination Diet? How To Do It And Why?

What Is An Elimination Diet

Many people across the globe suffer from food intolerance, sensitivity, and allergies. An elimination diet is the most effective method to identify the problematic food items and help you get a personalized meal plan, keeping all the micronutrient supplies in adequate amounts.

This method is widely used by dieticians and allergists to combat various health conditions. 

What Is An Elimination Diet?

Your body may be sensitive, intolerant, or allergic to certain food groups. An elimination diet is a method to remove those provocative food items or triggers from your diet and substitute them with safer options. 

The removal of food items and replacing them with substitutes are equally important in an elimination diet plan. Otherwise, a person, especially children, can suffer from malnutrition. 

To begin with, an elimination diet can be very helpful in combatting common digestive problems like constipation, diarrhea, bloating, and nausea. It is also useful in combatting more severe conditions like IBS, ADHD, eczema, etc. 

What Are The Types of Elimination Diet?

Elimination diet plans will vary based on your requirements. Go through the common types of elimination diets. I have arranged the types based on the strictness or restrictions in the diet plan. 

Simple Modified Diet

As the name suggests, this is a simple form of elimination diet. The doctor will ask you to quit one food item. You may also need to leave the two most prominent food triggers: wheat products and dairy items. 

Your doctor or dietician will suggest gluten-free alternatives like quinoa, brown rice, buckwheat, millet, etc. 

Moderate Intensity Diet

This is stricter than the simple modified diet. You will have to leave two or more groups of food items for around 2-3 months. The dietician will ask you to quit two or more things from the following chart.

  • Wheat 
  • Nuts
  • Dark and milk chocolate
  • Dairy products
  • Eggs
  • Caffeinated drinks, including tea, coffee, and soft drinks
  • Alcohol
  • Animal and vegetable fats
  • Nightshade vegetables
  • Citrus fruits
  • Legumes
  • Baked items with yeast 

Since you must bunk two or three items in the diet for quite some time, you need to be particular about taking the recommended substitutes.

Also, you may find it difficult to leave animal proteins completely. So, you can include poultry meat into your diet under the supervision or guidance of your dietician. Poultry items are less likely to cause allergic reactions. 

Strict Few Foods Diet

This is the strictest form of elimination diet you will come across. In this plan, your dietician will only allow you to have certain food items. 

As you have to chuck off most food groups from your diet, a strict elimination diet can only be maintained for a very short time. Otherwise, you may suffer from malnutrition.

Following food items are allowed in the level 3 or strict elimination diet plan.

  • Honey
  • Beet
  • Apple
  • Apricot
  • Carrot
  • Chicken
  • Asparagus
  • Beet or cane sugar
  • Cranberries
  • Lettuce
  • Olive oil
  • Lamb
  • Pineapples
  • Pears
  • Peaches
  • Rice
  • White vinegar
  • Sweet potatoes
  • Salt
  • Safflower oil

It does matter whether you follow a simple, moderately intense, or the strictest diet plan. You have to drink a lot of water to keep yourself hydrated. 

Other Elimination Diet Types

Along with the common or traditional elimination diets, there are other plans. But all these need to be followed only when a certified dietician recommends. 

Nevertheless, these less common elimination diet types are:

Low FODMAPs Diet

This elimination diet plan is followed to combat irritable bowel syndrome. In this plan, you will need to quit the short-chain carbohydrates that your body cannot digest properly.

Rare Foods Elimination Diet

In this type of elimination diet, the dietician will ask you only to eat food that you rarely have. These food items are considered safer and unlikely to be provocative as you seldom consume them. Common food items included in this diet plan are starfruit, buckwheat, and yams.

Few Foods Elimination Diet

This diet plan may sound a little weird to you, but this practice is well-known in the USA these days. In this plan, you will include two food items that you don’t usually eat together. The most common example of the few foods elimination diet plan is the pear and lamb diet. 

Fasting Elimination Diet

This is the toughest elimination diet plan you will come across. In this plan, you will need to drink only water for five days, and then all the food groups will be introduced slowly. 

This diet plan should be followed under the constant supervision of a doctor and dietician. It can be fatal for your health.

Barring these elimination diet plans, some other types are also recommended by dieticians. These include wheat-, gluten-, sugar-, and lactose-free diets.

How Does Elimination Diet Work?

The elimination diet works in two phases. In the first phase, certain food items are eliminated or excluded from your diet list, and in the second phase, those excluded items are reintroduced one by one.

The Elimination Phase

In this phase of an elimination diet, you have to stop taking food items you have noticed to trigger some health problems. Food items that are usually known to cause discomfort are also excluded from your diet plan.

Some common food items to be eliminated in this stage are:

  • Seafood
  • Pork
  • Eggs
  • Citrus fruits
  • Tomatoes, white potatoes, eggplants, peppers, or other nightshade vegetables
  • Corn
  • Soy
  • Dairy
  • Nuts
  • Wheat food items with gluten, etc.

Usually, the elimination phase continues for two to three weeks. However, the elimination period can last up to eight weeks in some specific cases, like IBS.

Once you have completed the elimination period, you must get back to your dietician or doctor to reintroduce the excluded items one by one. 

The Reintroduction Phase

In the reintroduction phase, your dietician will bring back all the excluded food items into your diet one by one. Once an excluded food group is introduced, its triggers will be observed for two to three days. During those days, there also will be experimentation in the portion sizes.

You have to be extremely alert in this reintroduction phase as you need to identify the following symptoms and report them immediately. 

  • Joint pain
  • Bloating
  • Rashes
  • Breathing difficulty
  • Migraine
  • Fatigue
  • Cramps and stomach pain
  • Bowel problems
  • Difficulty in sleeping

The entire elimination diet plan, including the elimination and reintroduction phase, can take between 1.5 to 3 months. 

What Are The Benefits Of Elimination Diet?

An elimination diet has many benefits, as, throughout the process, you need to keep a record of the food items you are avoiding during the elimination phase. Once the elimination phase is over and the excluded food items are introduced, a medical practitioner will keep track of the changes you face.

In this way, you can identify food items you are allergic, sensitive, or intolerant to. So, you will know which food item can be behind common health issues like dermatitis or stomach discomfort.

So, at the end of an elimination diet exercise, your dietician will be able to provide you with a personalized meal plan to lead a healthy life. 

Overall, an elimination diet is known to be beneficial for combatting the following medical conditions.

  • Eosinophilic esophagitis
  • Irritable bowel syndrome
  • Attention deficit/hyperactivity disorder
  • Chronic migraines
  • Eczema and other skin conditions

What Are The Risks Of Elimination Diet?

If you don’t get the elimination diet chart prepared by a dietician, you will likely suffer from a deficiency of essential micronutrients or malnutrition.

There can be some other risks of following an elimination diet. During the reintroduction phase, sometimes a small portion of a food item can be safe, but with an increase in the portion, the same food item can cause severe allergic reactions.

So, if you have any excluded food item in the reintroduction phase and experience rashes, swelling of the throat, and breathing problems, you must seek medical help immediately. 

Is There Any IBS Elimination Diet? How To Follow It?

Yes, an elimination diet can combat IBS. Usually, a low-FODMAP diet is recommended for a person suffering from IBS. FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.” These are short-chain carbohydrates, and absorbing them can be difficult for some people.

In the IBS elimination diet, the elimination plan needs to be followed for two to eight weeks. After that, the eliminated items will be reintroduced into your diet plan, and if no symptoms are observed initially, the portions of the same things are changed to be sure of the trigger items. 

Usually, the following items are excluded while making an IBS elimination diet plan.

  • Alcohol
  • Tea and coffee
  • Soda
  • Vegetables like cauliflowers, beets, celery, garlic, peas and asparagus
  • Fruits like apples, pears, peaches, mangoes, etc. 
  • High-fat and processed food items
  • Food items with added preservatives
  • Food and drinks with barley, rye and wheat
  • Seeds, nuts, lentils, legumes, and beans

All the FODMAP food items are not reintroduced at the same time. Once a particular group is introduced and its tolerance level is assessed, the next group is included in your meal planner. 

However, symptoms of IBS are almost the same as gallbladder attacks. So, be careful about the right diagnosis before you go for this diet plan. 

Migraine Elimination Diet: A Brief Overview

To understand how a migraine elimination diet can be effective, you must understand the relationship between migraines and diet

The Relation Between Diet And Migraine

First, you must understand that if including certain elements in your diet causes migraine, those can be called provocative ingredients. Further, migraines caused by the consumption of these provocative elements will be seen as dietary triggers. This is different from food allergy. 

The problem with the identification of these provocative elements is that the reports can be biased. Along with the item consumed, the amount of the food item and when it is consumed are also factors to be considered.

Also, medical conditions like low blood glucose and medicines for asthma, erectile dysfunction, hormonal imbalance, and the ones with nitrate can cause migraines. 

So, a minimum observation period of three months is mandatory before eliminating certain provocative elements from your diet to alleviate migraines.

Food Items To Avoid To Alleviate Discomfort In Migraine 

Some common elements are excluded in an elimination diet meal plan for migraine. However, remember that food triggers vary from one person to another. So, there are multiple possibilities.

A person can be affected by one or multiple elements mentioned to be excluded in the elimination diet meal planner. Some other people may suffer from migraines triggered by the consumption of any food item not mentioned in the plan.

Nevertheless, here are the items that are eliminated to combat migraines or headaches.

Food Items To EliminateSubstitutes
Caffeine drinks like tea, coffee, colas, energy drinks with Herbal teas without caffeine
Monosodium Glutamate, or MSG present in some Chinese food items, salty snacks, and seasoned salts Natural flavoring using natural spices and herbs
Cocoa, milk, or dark chocolateWhite chocolate
Processed meatFreshly cut and cooked meat
Sweeteners with aspartame and/or saccharin Other sweeteners 
Champagne, mayo, ketchup, red wine, mustard, dark drinksDistilled vinegar and vodka
Citrus and overripe fruitsApples, berries, mangoes, berries, apricots, melons, etc. 
Onions, beans, tomatoes, pea pods, sauerkrautOther veggies
Yogurt, aged cheese, buttermilk, sour creamCream cheese, American cheese, ricotta, cottage cheese

Along with all these items mentioned, freshly baked items or processed soy can trigger migraines. So, you can eliminate these items from your diet. 

The Takeaway

If you are about to follow an elimination diet, you must consult with an expert dietician. Elimination diet plans are restrictive, and you need to know about the elimination diet recipes or close alternatives to deal with your sudden cravings.

At the same time, only a competent dietician can substitute the trigger elements with beneficial alternatives so that malnutrition does not harm you.

Creating an allergy elimination diet or any other elimination diet aims to find food items that impact your health and exclude them from your food intake. Dieticians always try to keep the substitute options wide open for you, and they also control the portion size to eliminate food triggers. 

Once the plan is ready, you only need to stock the recommended items in your kitchen and try exciting recipes. 

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