Processed foods, pesticides, medications, and toxins damage the gut microbiome which in turn drives a range of digestive, autoimmune and neurological illness. Various “Healing diets” work to heal the gut and calm the immune system and vary depending on the gut, genetics and environment.
The Elimination Diet
The elimination diet allows for a systematic method to identify foods which are causing ailments and unpleasant physical reactions.
The identification of offending foods, followed by the exclusion of these foods will reduce overall inflammation and allow healing to take place.
Common triggers will be eliminated from your diet, and then each food will be challenged individually in order to assess whether or not it is a trigger of your symptoms.
Who is this diet for?
The elimination diet is beneficial for anyone who experiences local or systemic discomfort but is unable to pinpoint the triggers of these symptoms.
Anyone with digestive incompetence will highly likely be reactive to some foods and therefore, healing the gut will also be a focus of this protocol. Optimal digestion will aid in protecting the body from inflammation caused by large food particles being absorbed into the bloodstream through a hyperpermeable intestinal wall.
This diet is not intended to heal people with classic IgE food allergies (eg: anaphylactic peanut allergies).
Allergy Vs. Intolerance- What is the difference?
A true allergy is an immune reaction to a protein component of a certain food. It is a response mediated by IgE antibodies and reactions usually occur immediately after ingesting the offending food. In the case of an allergy, multiple organs may be affected and in the worse case, it can be life threatening. Anaphylactic shock is an example of this.
An intolerance does not involve an abnormal response of the immune system, however, it can still involve multiple organs and cause a wide variety of symptoms. An intolerance is triggered by food chemicals and can be influenced by numerous factors, such as:
- Deficiency of specific enzymes (eg: lactase and lactose intolerance)
- Digestive disorders such as irritable bowel syndrome can make you more sensitive to foods and cause intolerances.
- Genetic mutations can affect the ability of an enzyme to degrade specific chemicals found in food, such as diamine oxidase and its ability to break down histamine.
- Physical and emotional stress can induce aversions and reactions to certain foods.
- Autoimmune diseases, such as Coeliac disease. Although there is immune involvement, it is a delayed hypersensitivity response and is not a classic food allergy.
Symptoms of food intolerances
Symptoms vary from person to person, and as they can affect multiple organs, they may manifest differently. Below is a table of some common symptoms, this is not an exhaustive list.
Skin |
Digestive system |
Nervous system |
Respiratory tract |
| Hives
Swelling Erythema Eczema Psoriasis |
Cramping, bloating, pain
Reflux, indigestion Heartburn, nausea |
Anxiety, restlessness
Irritability Brain fog, fatigue Headache Migraines |
Sneezing, wheezing, tightening of airways
Runny nose |
The more sensitive you are to a food, or a chemical in that food, the lower your threshold will be, and the less you will be able to tolerate it. The duration of the reaction that is experienced is also varied, reactions often last a few hours, however, they may go on for days.
General Elimination
Commencing the process by undergoing a general elimination for 1-3 weeks allows for the majority of common offending foods to be assessed.
The following foods are the most common triggers and need to be avoided:
- Eggs
- Dairy (milk)
- Gluten
- Fish
- Shellfish
- Peanuts
- Other nuts
- Corn
- Soy
- Tomatoes
- Oranges
- Chocolate
- Caffeine
- Alcohol
These foods are then reintroduced to challenge the body and assess any reactions.
A diet diary should be kept during this period in order to track symptoms which you may experience.
Challenging a food
The challenging process will take 6 weeks, with each challenge taking 3 days each. A food will be reintroduced, and any symptoms that are experienced will be recorded. The symptoms are highly likely to be caused by a reaction to that particular food. That food is then removed from the diet to see if the symptoms subside.
- Continue the elimination diet even during the challenge phase, as only one food group is challenged/reintroduced every 3 days.
- On the day of the challenge, eat 3 servings of the food in multiple separate meals. However, if you notice a reaction to a food straight away, do not eat any more of it.
- After any reaction, revert to eating the elimination diet.
- After the challenge day, resume the elimination diet and observe symptoms for two days, and let symptoms settle before challenging a new food.
- If a food that is challenged does not cause any symptoms, it is still excluded from the diet until all challenges are complete.
- If you react to a certain food, it is ideal to avoid that food for 6 months and then reintroduce it slowly.
Your practitioner will help you with a specific challenging protocol to follow.
What to eat on the elimination diet
Allowed |
Avoid |
|
| Fruit & Vegetables | All fresh fruit vegetables | Corn, Tomatoes, citrus (oranges, lemons, limes, grapefruit) |
| Nuts & Seeds | Coconuts, water chestnuts | All nuts and seeds |
| Meat & Poultry | All fresh meat and poultry | Small goods and cold cuts, sausages, salamis, crumbed meats |
| Fish & Seafood | All fish and seafood
|
|
| Eggs | All eggs and products containing eggs | |
| Grains | Gluten free grains- rice, quinoa, buckwheat, millet, millet, amaranth | wheat, rye, barley, oats, spelt |
| Legumes | Lentils, chickpeas, kidney beans, black eyed peas, navy beans, butter beans | Soy and all soy products |
| Oils | Olive and coconut oil | Butter, nut oils, vegetable oils (sunflower, canola, flax seed, macadamia, walnut, sesame) |
| Sauces/condiments | All fresh herbs and spices, coconut milk, curry paste | Tomato sauce, chilli sauce, soy sauce, oyster sauce, lemon juice, tahini, peanut butter, pesto, mayonnaise, some dips, |
| Dairy products | All dairy products | |
| Drinks | Herbal tea, fresh fruit juices that don’t contain citrus or tomato, soda water | Coffee, black tea, green tea, chai, milk and flavored milk, lemonade, tomato juice, orange juice |
| Sweeteners | Stevia, molasses, raw honey, maple syrup, small amounts of conventional sugar | Candy, lollies, chocolate, artificial sweeteners, corn syrup |
Meal options for the elimination diet
Below is a sample menu of various meal options for the elimination diet
Breakfast |
Lunch & Dinner |
Snacks |
| Sautéed greens
Avocado Mushroom Organic bacon Buckwheat pancakes, maple syrup, berries GF muesli (buckwheat, quinoa), fruit, coconut yoghurt, coconut milk. Quinoa porridge, coconut milk, maple syrup, fruit Smoothie: rice/pea protein, greens, banana, berries, coconut water, rice milk. |
Grilled chicken/beef
Brown Rice Sautéed vegetables Gluten free pasta, bolognese sauce (without tomato) Ginger chicken stir-fry with Asian greens and rice noodles Mixed salad (greens, avocado, black beans, carrots, cucumbers) and grilled chicken breast. Apple cider vinegar and olive oil dressing. Roast lamb, roast vegetables, salad. Slow cooked meat with vegetables, mashed cauliflower. |
Vegetable sticks, eggplant dip.
Rice crackers and homemade hummus without tahini. Frozen berries, coconut yoghurt and maple syrup. Guacamole and rice crackers |
Points to note about the elimination diet
- Usually, within one week of the elimination diet, people experience an improvement in their symptoms.
- Do not reintroduce or challenge with a food unless there has been an improvement of 50% or greater in symptoms.
- If after 3 weeks there has been no improvement in symptoms, you may need to pursue a more in depth elimination diet which addresses increased sensitivity to a variety of other foods including amines, salicylates, yeast, preservatives etc…
- If after 3 weeks there has been no improvement on the more extensive allergen elimination diet, it is highly likely that the symptoms are not due to food and an alternative approach to assessment and treatment should be implemented.
- After removing an offending food from the diet for 1-3 weeks, the body can become hypersensitive to potential triggers, ingesting a trigger may result in an exaggerated reaction. Reintroduction of certain foods may carry a risk. Do not challenge a food which has brought about a severe reaction in the past (difficulty breathing, swelling of the mouth and tongue). Do not challenge a food that you have never eaten before.
References
Turnbull JL, Adams HN, Gorard DA, 2014, ‘Review article: the diagnosis and management of food allergy and food intolerances’, Alimentary Pharmacology and Therapeutics, 41(1): 3-25.
Swain AR, Soutter VL, Loblay RH. Friendly food: recipes for life. Royal Prince Alfred Hospital Allergy Unit. Murdoch Books, Sydney 2002.
http://www.cs.nsw.gov.au/rpa/allergy/resources/foodintol/friendlyfood.cfm
Diet Profile Research and Writing:
Kimberly Kushner BHSc (Nutritional Medicine), BHSc (Naturopathy) for MINDD