How to start an elimination diet

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As mamas, sometimes we’re so busy taking care of everyone else that we ignore our own health. Take a minute to notice if you are experiencing symptoms that change with no apparent reason. This could be joint pain, constipation or diarrhea, as well can canker sores and rashes. These symptoms may suddenly disappear, regardless of whether you eat organic, low carb and low histamine or paleo diets. You might benefit from an elimination diet if this is the case.
There are so many different diets out there now that it’s nearly impossible to keep up. You can choose from low carb and high fat (LCHF), keto or high protein/lowfat, paleo, an autoimmune diet, GAPS, vegetarian, vegan, raw, and many more. Some diets seem to do miracles. However, some people may have worse reactions to the same diet. That is why?
The fact is that every person is unique. Healthy and nutritious food for one person can cause health problems for someone else. This can happen over time. It’s all due to individual food allergies, sensitivities, and intolerances. 
The easiest, most cost-effective way to determine if what we’re eating is causing some of our unexplained symptoms and affecting our overall health is to do an elimination diet.

What’s an Elimination diet?

The elimination diet involves removing foods from your diet most likely to trigger food allergies. During that time, you’ll watch for a change in symptoms, and after they have subsided, you’ll slowly reintroduce foods and watch how your body responds. There are a couple of ways to do an elimination diet—an aggressive approach and a moderate approach.

A Aggressive Approach

It is important to restrict the most frequent offenders quickly, such as gluten, dairy and soy. Eliminating one or more common inflammatory foods will reduce inflammation and other symptoms quickly. 
It may prove difficult to follow a strict elimination diet with all the family members at once. If that’s the case, another option is the moderate approach. 

Moderate Approach

Moderate approaches to food sensitivities are basically the reverse of an elimination diet. You will start with a short list of food items to be eliminated, like dairy and gluten. You should also keep a medical journal while you experiment to monitor any improvement. Continue to experience symptoms, so you can slowly increase the number of foods you eliminate until symptoms disappear completely.
You’d be surprised at how significant it can make a big difference to eliminate some foods. Sometimes it can be life-changing.

Food allergies and sensitivities.

What causes an elimination diet? Allergies, intolerances, and sensitivities to food. Although food intolerances and sensitivities are often confused, they can be quite different. I’ll explain each in detail, but in a nutshell, food allergies and sensitivities involve the immune system, while food intolerances occur as a result of improper digestion. 

What’s a Food Allergy and How Can It Affect You?

Food allergies are caused by the immune system making IgE antibodies to protect itself from a certain food. IgE antibodies stimulate histamine release into the bloodstream. Symptoms can be almost immediate. Itching, hives or itching may occur, as well as joint pain and vomiting. Anaphylactic reactions can also be caused by IgE food allergy, which could prove to be fatal. 
Most food allergies, particularly in children, are caused by dairy, eggs, tree nuts peanuts, peanuts and soy. 

What’s a Food Sensitivity and How Can It Be Used?

A food sensitivity also involves the immune system but is often triggered by different antibodies—the IgG, IgA, or IgM antibodies. Although symptoms of food sensitivities may not be as obvious as a food allergy, they are more prevalent. You may experience symptoms such as anxiety, depression, weight loss, brain fog, headaches or attention deficit. The symptoms of food sensitivities may be present for hours or days.

What is a food intolerance?

A food intolerance refers to an inability to tolerate a specific food. It is not an immune-system reaction. This could be due to enzyme deficiencies, an inadvertent response from the gut bacteria or inflammation. Unsavorable effects can be caused by the inability to digest the food. These symptoms could include:

  • Constipation
  • Diarrhea
  • Cramping
  • Congestion
  • Gain weight
  • Headache
  • Fatigue
  • Mind fog 
  • Anxiety
  • Bloating
  • Vision blurred 
  • Depression 
  • Eliminating food sensitivities or intolerances is an excellent way to find out. 

    Is it possible for food reactions to occur? Everything starts with our gut

    Our only access point to the outside through food and drinks is our digestive tract, also known as our gut. If it is exposed to chemicals that our bodies react to, this makes it susceptible to serious damage. 
    One layer of cells makes up the gut lining. It is made of tight junctions that prevent small, undigested proteins and particles from reaching the bloodstream. The gut lining can become inflamed by exposure to emotional, psychological, and chemical stressors. This causes the tight junctions to break down, and digestion to fail. You may have heard this referred to as a “leaky gut.”  
    When the gut becomes “leaky,” large particles and proteins begin to get into the bloodstream, triggering the immune system to attack unrecognizable substances, like undigested food proteins. The immune system will trigger an immune reaction every time a foreign protein is eaten. The gut is where 70% of the immune system lives, according to researchers. When our gut gets damaged from outside toxins it can eventually affect our immune system.
    In the gut, enzymes are produced or stored for digestive, neurotransmitter, bacteria and other chemical functions. They are then transported throughout the body to various areas, including the brain. Damage to the gut causes enzymes and neurotransmitters to stop functioning, an overgrowth of bacteria, and chemical reactions that are necessary for different physiological processes. The result is problems in digestion, constipation or depression, anxiety, brain fog and skin reactions. The gut can be damaged and the whole body will suffer. 
    There is good news—I promise! You can fix leaky gut by eliminating triggers and including healing foods like bone broth. These previously harmful foods are no longer able to enter our bloodstreams and trigger immune reactions. Say goodbye to all food reactions.

    Are You a Candidate for an Elimination Diet

    An elimination diet might be a good option if your children are suffering any of the conditions or symptoms listed. 

  • Constipation, bloating or diarrhea are all symptoms of digestive problems.
  • A variety of skin abnormalities such as acne and eczema can occur, including rashes, itches, or psoriasis.
  • An autoimmune condition
  • ADHD
  • Joint pain
  • Asthma
  • Depression and other mood disorders
  • Headaches
  • Migraines
  • Sensitivities about food
  • Allergies to food
  • Dark circles under eyes
  • Sinus congestion
  • Learning disabilities
  • What foods to eliminate

    You can choose to take either an aggressive or modified approach when you do an elimination diet. It all depends on your personal preference and how it works for you. 

    Aggressive Approach Food Elimination List

    Let’s first look at what foods should be eliminated with an approach that is more restrictive but will provide faster results. You will have a better chance of identifying the food causing your symptoms if you eliminate more. 
    It is possible to eliminate the following food items for up to 4 weeks. 

  • Gluten
  • Dairy
  • Soy
  • Corn
  • Eggs
  • Tree nuts
  • Peanuts
  • Refined sugar
  • Alcohol
  • Coffee
  • Caffeine
  • The Seeds
  • Peanuts and beans are two examples of legumes.
  • Nightshade vegetables (potatoes, peppers, eggplant, tomatoes)
  • Citrus fruits, in certain cases
  • Artificial sweeteners
  • Artificial colorings
  • Flavor enhancers, like monosodium glutamate (MSG)
  • If this sounds overwhelming to you, consider a different approach.

    Modified Approach Food Elimination List

    These are the top 8 foods that you should eliminate by using this modified approach:

  • Gluten
  • Dairy
  • Soy
  • Corn
  • Eggs
  • Tree nuts
  • Sugar refined
  • Peanuts
  • If you are unable to remove all of these foods, then try removing gluten and milk. You can then eliminate any other food items as necessary. You can make the transition to an elimination diet easier on your family and refrigerator by using a modified method. 
    No matter which method you use, it may be hard to eliminate the foods our children are familiar with. There are many options for substitution and recipes that will make the transition easier for both you and your kids.

    What is the best time to avoid trigger foods?

    One of the questions that I always get with an elimination diet is, “Will I have to follow this diet forever?!” The answer is no, not usually because the whole idea behind an elimination diet is to determine which specific food or food groups are causing reactions and eliminate only those foods.
    The elimination only needs to last a short time… only a few weeks. A Journal of Pediatric Allergy and Immunology article states that 98% of participants in a group of 129 reported significant improvements in inflammation symptoms in just four weeks. Some studies however have shown relief in symptoms as quick as 3 days. 
    Relief for children is generally more immediate than that of adults. Often, relief occurs within seven to ten days.
    It doesn’t matter how quick or slow you see results, the best thing to do is to stick to your elimination program for three to four weeks. These food allergies and sensitivities are not something that happened overnight. It may take the immune system longer than four weeks to reduce symptoms and calm down. Some people may require six to one year to get rid of all symptoms. 
    You might require other treatments if symptoms persist. Still, don’t get discouraged. We all have different needs and require different care. 

    Food Reintroduction

    Following the elimination process for 3-4 weeks can make the reintroduction phase very enjoyable. However, please pay very close attention to symptoms and determine if you’re feeling dramatically better, or if you need more time. Is your condition completely resolved? Are you feeling more energetic and happier? Are your hair and skin looking healthier? If so, reintroduction may begin!
    It’s important to properly reintroduce these foods into your diet. Below are some steps you can follow to properly reintroduce the food.

    Step 1. 

    For two consecutive days, only one food/food group can be introduced at a given time.
    Example: Let’s say you decide to reintroduce eggs on days 29-30 following a 28-day elimination. You can have eggs many times in those two days. They can be eaten scrambled or hard-boiled in an egg salad. Tip: Egg yolks tend to be less troublesome than egg whites.
    Next, we’ll take a break from them again.

    Step 2

    Return to elimination after two days. If symptoms from before elimination are present again, you can continue to eliminate eggs for longer periods of time. If this happens, it is a sign that the gut healing benefits of the elimination program are incomplete. To heal your gut, you may require additional time and/or interventions. 
    If you would like more information on ways to heal a leaky gut, see Chris Kresser’s article, 9 Steps to Perfect Health: How to Heal Your Gut Naturally.

    Step 3

    If there’s no increase in symptoms or any other unpleasant changes within those four days, then you are most likely not reactive to this food. You can then reintroduce another food like sunflower seeds. You can continue this until all foods have been reintroduced. Once you’ve identified the triggers, it is possible to identify them.

    Pay attention to these symptoms

    There are many more bodily functions than just digestion to be aware of as you’re identifying food reactions. For instance, symptoms could include:

  • Fatigue
  • Sleep disturbances
  • Acne
  • Depression and mood swings
  • Constipation/diarrhea
  • Headaches
  • Bloating
  • Mind fog, or diminished mental clarity
  • Slowness
  • Hyperactivity
  • You may experience a change in your period
  • Any differences that are not noted during elimination can be added.

    What is the duration of symptoms?

    Reintroduction can cause a specific type reaction. The time that it takes to resolve the reaction will vary depending on how severe the reaction is. IgE-mediated food allergy symptoms usually disappear in a few hours. Food sensitivities or intolerances can last from several hours up to days, depending on how much was consumed and the inflammation response. 

    Can Food Intolerances be Reversed?

    If the root cause is identified and treated, the effects of intolerances to food can be reduced or even reversed. A leaky gut can often be the culprit. After the gut barrier heals, some foods that are reactive can be safe eaten in moderation. 
    However, it is important to remember that food is often one of the biggest culprits in causing a leaky gut to begin with, so don’t assume that once reactions disappear that the food can be consumed in excess.

    It’s not enough to test for food allergies, sensitivities and intolerances.

    A skin test or blood test is used for most food allergy and sensitivity testing. These tests can be inaccurate and require that the test subject has been exposed to the affected foods. Multiple strings of amino acid that make up food proteins are found in foods. Food allergy and sensitivity testing identify an immune reaction that is specific to one strand protein. It is difficult to obtain accurate information because of the many variations in proteins and chemical compositions found in various foods. 
    Food intolerances can’t be diagnosed by testing for antibodies to proteins. It will be necessary to examine your digestive health and genes in order to identify if you suffer from food intolerances. 
    It is better than to test food reactions using laboratory testing. Instead, you should look deeper into gut testing and how genetics play a role in food reactions. Viome would be a good choice for your gut health, and 23andme.com is great for genetic testing.
    This article was medically reviewed by Madiha Saeed, MD, a board-certified family physician. We recommend you speak with your doctor.
    Did you ever succeed with an elimination diet. Please share your thoughts and experience with us. 

    Sources:

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    3. Lozinsky A, Meyer R, Shah N, et al. Eliminating gastrointestinal food allergy symptoms using diets that are not Ig E-mediated is the fastest way to improve your symptoms. Pediatric Allergy & Immunology [serial online]. August 2015. 26(5):403-408. Available at: Academic Search Complete. Ipswich MA. April 25, 2018.
    4. Gamlin L. Brostoff J. Food sensitivity and rheumatoidarthritis. Pharmacol Environ Toxicol. 1997;4(1-2):43-9.
    5. Nigg JT. Elimination and restriction diets for ADHD. Child Adolesc Psychiatr Clin N Am. 2014;23(4):937-53.
    6. Food Allergy Research & Education® (FARE). Food Allergy Research & Education® (FARE). April 25, 2018, Accessed.
    7. Malterre, T. (2016). The Elimination Diet. New York: Boston.

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