A little over a decade ago, I started noticing weird health problems. Things with my skin, and my digestion. Even my menstruation was a mess. I couldn’t find any answers. Doctors said I was fine or that things were in my head. In spite of test results proving otherwise, they dismissed me. I knew something was wrong though, so I turned to something I could easily experiment with – my food. I know I’m not alone, though. Many ambitious women with chronic illnesses find themselves increasingly frustrated by inexplicable and frequent health symptoms. If you’re looking for options, an elimination diet might be the solution. However, before you get too far down the rabbit hole, let’s explore some elimination diet dos and don’ts, and set you up for success.
What is an elimination diet?
An elimination diet involves removing foods you suspect are not well-tolerated by your body. They also go by the name “exclusion” or “healing diets.” Maybe you aren’t even sure if particular foods give you issues, but you are desperate for relief. This is where an elimination diet can be helpful. It’s simple in theory. You start by removing foods or types of foods from your diet for a period, then reintroduce them one at a time. During the “reintroduction” you note symptoms or reactions you experience. This method is particularly useful for identifying triggers for symptoms such as bloating, skin rashes, headaches, or migraines. It can even help you triggers for unexpected symptoms like brain fog, fatigue, and so forth. Common culprits often include gluten, dairy, soy, and certain additives, which are eliminated, and later methodically reintroduced to monitor potential reactions.
There are multiple ways to do an elimination diet, depending on your goals and outcomes. You can do something extremely strict like FODMAPs or Autoimmune Protocol (AIP), or you can start more simply, depending on your needs. For example, a very common and popular way to start an elimination diet is to pull all gluten and dairy from your diet. These are big changes, but it can still be less overwhelming than pulling out a majority of food groups, to start. Always consult your doctor or nutritionist when embarking on an elimination diet, as they are not for everyone.
Understanding food reactions
Before going too far down the elimination diet rabbit hole, it’s helpful to (re)explain a few terms. This will be helpful in sifting through language you may encounter, along with understanding things you may experience along the way. Here are a few definitions, in case you need a reminder:
Food allergies: These occur when the immune system mistakenly identifies a harmless food protein as a threat, leading to a rapid immune response. These are called IgEallergies. This is an accute immune system reaction, with near immediate physical response. This is the most severe type of reaction and these aren’t usually surprises. Most people are already aware, since they can be dangerous. An allergist can test using skin prick or blood tests to identify specific allergens, but they only test for the IgE reactions. Common symptoms include hives, swelling, or more severe reactions like anaphylaxis. Foods like peanuts, shellfish, and eggs are frequent allergens.
Food sensitivities: These are less severe than allergies and do not involve an immune system overreaction, but may still cause discomfort. There is debate in the medical community that sensitivities are an immune system IgG reaction. Symptoms often include stomach pain, fatigue, and joint pain, often occurring hours or even days after consuming the offending food.
Food intolerances: This involves the digestive system rather than the immune system. For example, lactose intolerance results from the body’s inability to digest lactose due to a lack of necessary enzymes. This leads to bloating, diarrhea, and gas. With intolerances, you aren’t going to die, but you will be uncomfortable, at best.
Five strategies for success – Elimination diet dos
Deciding to do an elimination diet is a big deal, so it’s best to go into it completely informed. That’s what I wanted to provide a guide of the elimination diet dos and don’ts. It’s easier to learn from someone else’s mistakes. There are also many ways to succeed and fail, so let’s break down some of the lessons I learned, along the way.
Strategy 1: Proper planning
Begin by consulting with a healthcare provider to ensure the diet fits your health profile. Plan your meals to include all necessary nutrients, preparing lists of foods to avoid and suitable alternatives to ensure a balanced diet. Understand what you are trying to accomplish. Questions like “what do I hope to achieve,” or “what would I like to be different, by the time I’m done with this diet.” Once you have that, you can get crystal clear on how you will answer the questions and achieve your goals.
Strategy 2: Keeping a detailed food diary
Document every meal, snack, and your body’s reactions. This diary will be crucial in identifying patterns and specific food triggers, guiding your reintroduction phase. This is one of the least fun things about this endeavor, but it also provides the most value. Remember, not all reactions happen immediately, so food journals can take out the guess work. You can also use this later, to look for trends or patterns.
Strategy 3: Introducing foods one at a time
Introduce one food group at a time, with a gap of 3-5 days. Notice any symptoms that come up during that period. This meticulous tracking helps identify specific food sensitivities accurately. As mentioned earlier, not all reactions are immediate and could take days to present. This is why introducing one food at a time is critical. Otherwise, you may not know what really caused you any issues.
Strategy 4: Listening to your body
Nobody knows your body more than you. No coach, no doctor, and no app. Pay attention to subtle body signals. Some signs, like bloating, gas, and borborygmus are obvious. However, things like brain fog, joint pain, or disrupted sleep may not be as obviously connected to food. Some people even have strange dreams only when eating spicy food, so look around and see what comes up.
Strategy 5: Seeking support
Engage with a dietitian, nutritionist, wellbeing coach, or doctor, and consider joining support groups. Sharing experiences and tips can provide motivation and additional insights that enhance your diet journey. Elimination diets are hard! There is no way around it, and even if you start your elimination diet with one thing, it can still be difficult. Having others who understand your journey helps boost confidence and helps you see it through.
Five things to avoid – Elimination diet don’ts
Understanding things that make you successful is one thing, but what are the traps and pitfalls you need to look out for? We talked about the elimination diet dos, so let’s talk about the don’ts. Knowing what to avoid is often as helpful, if not more, than knowing what to do. Again, here are a few things I’ve identified in my own experience, to help make the process a bit easier.
Mistake 1: Rushing the process
Look, I want a pill too, but most things that are worth it, aren’t easy. With that in mind, take it slow. Go easy and get as much information and healing as you can out of each phase. You want to ensure enough time to experience reintroductions, gut repair (as necessary), and learning. Since reactions can take several days in some cases, you need time for your body to reintegrate foods that may have been gone for a bit. Give yourself enough time to ensure your observations are accurate and reflective of true sensitivities and not a reactive response to a desired food.
Mistake 2: Not Having Clear Goals
Remember strategy #1 about having a plan? This is where it circles back. Be clear on what you hope to gain from the elimination diet. This impacts how you proceed with the diet and even what you are seeking. For example, if you want to see less bloating, you may only focus on certain types of foods and look for signs or feelings of bloating. If you want to “feel better,” that’s more difficult and it isn’t clear, so you may find the elimination diet more frustrating than necessary. Figure out what questions you want to answer and define your success criteria, before even starting. The reward far outweighs the effort in this case.
Mistake 3: Ignoring other lifestyle factors
Ignore other important lifestyle factors such as stress, sleep, and exercise, at your own peril. These things impact how your body reacts to foods. They’re often also part of the larger issue, which many hope an elimination diet will identify. For example, if your sleep is poor, you have an increased risk for developing things like type 2 diabetes and cardiovascular disease. When you are low on sleep, your digestive function suffers, which can further affect your sleep. It’s a vicious cycle, if not evaluated together. As a singular human, all our parts are tied together, so we must take all these things into consideration.
Mistake 4: Neglecting nutritional balance
One of the main reasons doctors discourage eliminating entire food groups is because you risk nutritional deficits. This is where working with a nutritionist or dietician can support your diet experiments. It’s difficult ensuring your diet remains nutritionally complete, even when certain foods are eliminated, so you may require some help. In some cases, supplementing with vitamins or minerals, may also be necessary. If you don’t navigate this carefully, you may end up creating more problems than you solve, so use caution here.
Mistake 5: Overlooking psychological stressors
Life can get real lifey. It often seems to happen when we’re in the middle of some other hard thing, too. That’s why it’s important to manage your mental health through this process, too. I will repeat – this is hard to do. It’s also temporary, and having support around you, will ease the mental burden on you, too. Additionally, we already know that our mental state can impact our digestion, so be gentle on yourself. If it feels like too much, take a break. Do what you are able to do and take breaks. There is no race, nobody is keeping score, and there are no rules. Do you best and keep going.
What else does science have to say
Research supports that elimination diets are effective in identifying food sensitivities and managing symptoms. There is also an assumption if you go on an elimination diet you will also find something you are intolerant or sensitive to. Those things aren’t necessarily true, but they can tell you what doesn’t make you feel your best. A study published in the journal Nutrients noted that targeted elimination diets based on allergy testing significantly improved symptoms for patients with non-celiac gluten sensitivity.
Contraindications: Who Should Not Try an Elimination Diet
It’s important to note, not everyone should undertake an elimination diet. Those with a history of eating disorders, pregnant or breastfeeding persons, and individuals with certain medical conditions, should consult their health professionals before starting. The risk of nutritional deficiencies or exacerbating health issues makes professional guidance crucial. Additionally, since these diets can be highly restrictive. People recovering from eating disorders or disordered eating, may feel triggered and risk relapse with elimination diets. It can also be risky for people susceptible to things like orthorexia.
All things considered, for many women juggling career, family, and health, an elimination diet offers a methodical approach to tackling unexplained symptoms. I found it incredibly helpful in relieving symptoms of inflammation, joint pain, and major skin issues, when I couldn’t get support from conventional clinicians. With careful planning and execution, it can improve your quality of life by identifying and eliminating potential dietary triggers.
Before you go
If you need support navigating an elimination diet, I’m here to help. Hopefully this guide to elimination diet dos and don’ts has already provided some information to get you on the right path. As a certified functional medicine health coach, I have extensive knowledge and personal experience of this process, and I’m here to help. If you are hungry for more content, you can always check out Wellspiration or follow my personal healing journey on Substack. As always, wishing you abundant health and limitless joy!
Medical Disclaimer:
These statements have not been evaluated by the Food and Drug Administration (FDA). Information provided in this blog post is for educational and informational purposes only and should not be considered as medical advice. The content is not intended to be a substitute for professional medical advice, diagnosis, treatment, cure or prevention of any disease. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition.
Resources:
- Leonard MM, Cureton P, Fasano A. Indications and Use of the Gluten Contamination Elimination Diet for Patients with Non-Responsive Celiac Disease. Nutrients. 2017; 9(10):1129. https://doi.org/10.3390/nu9101129
- Khanijow, V., Prakash, P., Emsellem, H. A., Borum, M. L., & Doman, D. B. (2015). Sleep Dysfunction and Gastrointestinal Diseases. Gastroenterology & hepatology, 11(12), 817–825.
- Chaudhry, B. A., Brian, M. S., & Morrell, J. S. (2023). The Relationship between Sleep Duration and Metabolic Syndrome Severity Scores in Emerging Adults. Nutrients, 15(4), 1046. https://doi.org/10.3390/nu15041046