Suspect you might have a sensitivity to gluten or dairy, but aren't sure which is the culprit? You might be considering trying an elimination diet. This short-term eating plan has gained popularity recently as a way to identify potential food issues, including allergies, intolerances, and triggers of irksome symptoms—from bloating, joint pain, and fatigue to skin issues like eczema.
While there’s no one-size-fits-all protocol, an elimination diet typically involves two phases. In the first, several foods are eliminated for at least four weeks, sometimes eight. Then, those foods are added back, one at a time.
If a reintroduced food doesn’t cause symptoms to return, it may be left in the diet, or at least ruled out as a trigger. Any that do cause problems are permanently eliminated to alleviate, and sometimes resolve symptoms. If you're thinking of trying this type of experiment, here are five important things you should know.
Most elimination diets involve eight foods
These eight common foods are responsible for most allergies: Wheat, milk and milk products (like cheese and yogurt), eggs, soy, fish, shellfish, tree nuts (almonds, walnuts, pistachios), and peanuts. However, an elimination diet may involve nixing other foods depending on your personal symptoms.
They aren't just for allergies
While many try an elimination diet because of suspected allergies, it can be a helpful test for other health issues as well. People with inflammatory conditions such as arthritis or psoriasis, for example, may eliminate refined sugar, processed foods, and nightshade vegetables, as well as gluten, dairy, and soy. Someone who has irritable bowel syndrome may eliminate FODMAPS. (These are foods like apples and onions that contain substances fermented by gut bacteria, which produces a build-up of gas.) A different set of foods may be eliminated for migraines, or gastroesophageal reflux disease (GERD). And sometimes people need to address a mix of health conditions, which is why I often customize elimination diets for my clients.
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Beverages may be included too
I'm always in favor of eliminating both regular and diet soda, as well as other sugary drinks, like sweet tea and lemonade due to their added sugar or artificial sweetener content. But for some clients, I also recommend removing coffee, alcohol, and sometimes tea. Again, it depends on the symptoms or problems we're trying to address. I find that for chronic bloating and digestive problems, coffee and alcohol are generally problematic. So when other trigger foods are eliminated but these drinks aren't, symptoms don't improve.
Some clients tell me they can't possibly live without their morning cup of coffee, or evening glass of wine. But the primary goal of an elimination diet is to see what it feels like when your body is no longer exposed to something it doesn't agree with. So if you can commit to giving up java and booze for just one month, you'll have the chance to find out if you feel better without them.
Accuracy is key
I've had clients tell me they tried an elimination diet on their own with no results. But it turned out most of them unknowingly made mistakes. For example, some eliminated wheat products like bread and pasta, but continued to eat other forms of wheat, such as cous cous, farro, and spelt. Others eliminated more foods than they needed to, which made them feel exhausted and famished. And since many forgot to check ingredient lists, they ended up eating a ton of soy or dairy additives without realizing it. To do the test right, it's important to choose your foods strategically, follow through consistently, and make sure you're getting balanced nutrition for the duration of the diet.
Seek out expert guidance
An elimination diet can be an effective tools for discovering foods or beverages at the root of chronic health problems. And the results can truly be life-changing. But this kind of dietary shift is a big commitment, and needs to be executed correctly. So here's my best advice: Don't do it on your own. Seek out a registered dietitian nutritionist who is experienced with elimination diets, and allow him or her to guide you. For more tips, check out my post 6 Things You Should Know About Working With a Nutritionist.
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Cynthia Sass is a nutritionist and registered dietitian with master’s degrees in both nutrition science and public health. Frequently seen on national TV, she’s Health’s contributing nutrition editor, and privately counsels clients in New York, Los Angeles, and long distance. Cynthia is currently the sports nutrition consultant to the New York Yankees, previously consulted for three other professional sports teams, and is board certified as a specialist in sports dietetics. Sass is a three-time New York Times best-selling author, and her newest book is Slim Down Now: Shed Pounds and Inches with Real Food, Real Fast. Connect with her on Facebook, Twitter and Pinterest.