Elimination diets are a great option for identifying food sensitivities and intolerances. They are far less expensive than formal testing — testing that can often be inconclusive.
Elimination diets involve avoiding certain foods which may cause discomfort or symptoms — then strategically reintroducing them later while monitoring for signs and symptoms.
If you think you might have a food sensitivity or intolerance, an elimination diet could help you figure out which foods you need to avoid.
How it Works
You remove certain foods from your diet that:
- You believe your body is unable to tolerate, or
- Are commonly known to cause issues
You reintroduce the foods one at a time after 3-4 weeks — unless symptoms are still present — in which case another 2 weeks is recommended.
If the extra time still doesn’t result in reduced or improved symptoms, then more foods may need to be removed temporarily
- Choose one food to reintroduce first, and have 3 servings of it across the day. Monitor for reactions. If there is a reaction then that food needs to be removed. If for the next 2 days there is no reaction, then that food is considered “safe”
- Return to the elimination diet and wait another 2 days before reintroducing another food.
- Typically the diet lasts up to 8 weeks, depending on how many foods need to be removed and reintroduced
Elimination diets can help people with a sensitive gut identify which foods are causing digestive discomfort or other suspected intolerance reactions such as headaches or fatigue.
People who suspect they have a true food allergy should only embark on an elimination diet with medical supervision. This will ensure that if you reintroduce a food allergen, you will be safe from anaphylaxis — a severe, potentially life-threatening allergic reaction.
Benefits for Specific Conditions
As well as helping to identify foods causing your intolerance or sensitivity, an elimination diet can also alleviate the symptoms of specific health conditions including:
Leaky Gut Syndrome
Leaky gut syndrome occurs when the small spaces (tight junctions) in the intestinal lining become stretched. This allows the passage of undigested food particles, toxins, and bacteria into the bloodstream.
It can also cause widespread inflammation and malabsorption of essential nutrients such as vitamin B12, iron, and zinc. An elimination diet can reduce the intake of foods that trigger inflammation. It can help the body heal the intestinal lining.
Many food intolerances can exacerbate autoimmune conditions. Elimination diets can alleviate symptoms of autoimmune conditions such as Sjogren’s syndrome, Celiac disease, ulcerative colitis, and rheumatoid arthritis.
One of the most commonly eliminated foods for autoimmune conditions is gluten — a substance present in wheat and other cereal grains.
Irritable bowel syndrome (IBS) is a condition that affects the gastrointestinal system, causing gas, bloating, constipation and/or diarrhea. In a 2006 study conducted by the University of Kansas Medical Center, 20 patients suffering from IBS underwent elimination diets. The results were impressive: 100 percent of patients experienced a reduction in symptoms. (Drisko et al., 2006)
Abdominal bloating is a common symptom of food intolerance shown to be associated with skin conditions such as acne, rosacea, and eczema. (Zhang et al., 2008)
In an Italian study, patients with eczema were put on an elimination diet which removed nuts, eggs, cereal, milk, and tomatoes. It was found that 10 of the 14 patients had either a food allergy or intolerance. (Pacor et al., 1990)
Elimination Diet Plan
Several elimination diet plans have been shown to be successful. Though they each differ slightly, there are some common foods which are typically taken away. These include:
Other elimination diet plans are more extensive and also call for the elimination of shellfish, nuts, grains, and nightshade vegetables.
The elimination diet protocol is comprised of two main phases.
- The first is the elimination phase. The type and number of foods eliminated depends on your symptoms and the recommendations of the healthcare practitioner supervising the protocol.
- The second phase is where you reintroduce foods systematically. Any foods that trigger symptoms should be avoided altogether. Foods that don’t trigger any symptoms can become part of your regular diet.
Types of Elimination Diets
Here is a general overview of some of the most commonly used elimination diets, for you to consider and compare.
The Easy Elimination Diet Plan
Duration: Four phases each comprised of 21 days.
Foods to exclude:
- Phase one — Gluten, eggs, soy, and dairy.
- Phase two — Shellfish, peanuts, and corn.
- Phase three — Fish and tree nuts.
- Phase four — Refined and artificial sweeteners.
Although the easy plan takes longer than some of the other elimination diets, it allows you to eliminate fewer foods at a time, thus narrowing down problematic ingredients. This makes it a good option for figuring out which foods you are sensitive to.
The Whole30 Elimination Diet
Duration: 30 days
Foods to avoid: Gluten, soy, corn, dairy (except for clarified butter), sugar and artificial sweeteners, all grains, legumes and pulses, peanuts, and food additives.
Foods to include: Meat, fish, poultry, eggs, root vegetables, other vegetables, nuts, seeds, fruits, herbs, and spices.
The Whole30 diet can help you identify food intolerances, heal digestive issues, boost your immune system, and improve your energy.
Other benefits of this elimination diet include healthier sleep patterns and improvements in the condition of your skin and hair.
The Autoimmune Paleo Protocol (AIP)
Duration: 6-8 weeks
Foods to avoid: Gluten, soy, corn, dairy (except for clarified butter), nightshade vegetables, eggs, legumes, pulses, peanuts, tree nuts, seeds and seed-based spices, tapioca, and gums.
Foods to include: Meat, fish, poultry, non-nightshade vegetables, fruits, herbs, and non-seed spices.
The AIP is one of the more restrictive elimination diets. The purpose of this is to remove any ingredients which could cause an adverse reaction that generates antibodies. If you have already been diagnosed with an auto-immune disorder, and you suffer from severe symptoms or a high antibody count, this elimination diet may be for you.
The Low FODMAP Diet
Foods to avoid: Gluten, soy, corn, dairy (except for certain cheeses), fruits, high fructose sweeteners, legumes, pulses, members of the onion family, and other vegetables with a high inulin content.
Foods to include: Any food deemed low FODMAP by the Monash University app. Small servings of moderate FODMAP foods.
FODMAPS is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols — the fermentable sugars found in certain dairy, grains, and fruits, and vegetables.
Many people find this elimination a little difficult. It removes many aromatic foods that make meals taste good. It can also be hard to keep track of all the foods to avoid. Furthermore, many of the eliminated foods contain important nutrients.
If you have not tried an elimination diet before, it might be easier to try a simpler one than the Low FODMAP diet.
However, the Low FODMAP elimination diet is one of the most effective ways to support recovery from small intestinal bacterial overgrowth (SIBO). SIBO is a severe digestive disorder. It causes bacteria which usually grows in the colon to develop in the small intestine. Symptoms include:
- Abdominal pain
- Gas and bloating
The ultimate goal with SIBO is to gradually reintroduce all of the foods. That's because eliminating FODMAP foods for a long time may cause nutritional deficiencies and a lack of diverse fiber.
Is the Elimination Diet Right for You?
If you are feeling sluggish, experiencing gas and bloating, and other digestive symptoms such as heartburn, constipation or diarrhea, you might benefit from an elimination diet.
Which one you choose will largely depend on your symptoms, your dedication, and the recommendations of your doctor.
Your healthcare practitioner might also suggest you add a prebiotic or probiotic supplement to your diet. We recommend any of these three: