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I recently saw an Internet meme depicting a woman sharing a recipe with her friend, proudly proclaiming its compliance with her gluten-free, dairy-free, egg-free, fat-free, and soy-free diet. The punch line? It was a plate full of ice.

It seems like every time we turn around, a new suspected food villain emerges. Each trip to a natural grocer shows more and more “something”-free options: gluten-free chips, dairy-free yogurt, low-FODMAP salad dressing. Since when did so many foods become enemies of our health? Or, the better question to ask is, are they actually?

Is eliminating groups of food necessary?

Like several nutrition questions, the most accurate answer is, “it depends.”

When it comes to true food allergies or Celiac disease (which should both be handled under medical supervision), it’s no surprise that elimination of the culprit is necessary. But the removal of certain foods can be a useful tool in other situations as well. Outside of food allergies, we can also experience adverse reactions stemming from intolerances or sensitivities.

Intolerances primarily manifest with overt issues from trouble breaking foods down. One example is lactose intolerance, which is the inability to break down milk sugar. Sensitivities, however, are a little more ambiguous and tricky.

The food we eat can have far-reaching, systemic impacts on how we feel. Digestive issues can manifest in obvious ways, such as bloating, reflux, constipation, or diarrhea. However, they may also show up with some surprising symptoms, such as trouble focusing, patches of dry or scaly skin, headaches, and more.

Clients I’ve worked with have even determined food culprits to be behind their joint pain, low energy, sinus congestion, mood swings, and trouble sleeping.

Temporarily eliminating food groups and reintroducing them strategically— like you do on an elimination diet — can serve as a method to help you identify if an intolerance or sensitivity is at the root of your unwanted symptoms.

If you do determine any issues, elimination may need to be a more permanent part of your nutrition plan. If that is the case, be sure to work with a dietitian and doctor to make sure your long-term plan is nutritionally complete.

What is an elimination diet?

An elimination diet is a short-term, complete removal of specific foods (or groups of foods) for a designated amount of time. It is followed by a step-by-step reintroduction to methodically test food tolerance.

Depending on your individual needs, the elimination phase can last somewhere between two and 12 weeks. The length of the reintroduction phase depends on how many types of foods were removed.

Here are some examples of foods that might be eliminated:

  • Common food sensitivities, such as gluten, dairy, eggs, and soy
  • Nuts and seeds
  • Nightshades, a category of fruits and vegetables that include a compound called solanine. Examples include tomatoes, eggplant, goji berries, bell peppers, chili peppers, and white potatoes.
  • Foods high in histamine, an inflammatory compound involved in immune health. Examples include tuna, mackerel, pork, chicken, spinach, fermented foods, and alcohol.
  • Foods high in salicylates, a compound plants produce to defend themselves. Examples include tomato sauce, juice, wine, tea, and herbs.
  • Complex carbohydrates, such as legumes, potatoes and grains
  • High FODMAP foods, or foods that contain fermentable oligo-, di-, mono-saccharides, and polyols. These are carbohydrates that can be difficult for some people to digest, and are found in foods such as garlic and onion.
  • All grains and pseudo-grains, such as corn and quinoa

There are a lot of different elimination diet options, each touted towards specific ailments and promising certain benefits.

Some approaches are selective, while others are more comprehensive. A selective elimination diet may only remove one or two foods, such as gluten and dairy. A more comprehensive one may exclude a much broader range of foods, such as all grains, dairy, corn, nuts, and nightshades.

Generally speaking, a full two to four weeks of 100 percent commitment lays the groundwork for success, provided you are also focused on supporting your overall digestive health during the process: chew your food thoroughly, heighten your attention to stress management, and consider extra gut-friendly supplemental support.

At the end of the elimination phase, you’ll reach the most important stage of the diet: the reintroduction phase. During this, one eliminated food is reintroduced at a time, followed by three to five days of elimination again. If no issues arise, the food is likely to have the green light to be a regular part of your eating routine. However, if you notice discomfort or concerns from reintroduction (e.g. nasal congestion, aches, puffiness, etc.), you may want to reconsider. 

The ultimate goal should be to have as inclusive of a diet as possible while optimizing healthy physiology and a healthy relationship with food. 

The most important aspects of an elimination diet are its short-term nature (there should be an end date) and its purposeful reintroduction plan. Again, the goal should be the inclusivity of as many foods as possible that work well for you and that you tolerate.

Can I just do a food sensitivity test?

It’s often the potential non-digestive symptoms that can make identifying gut issues (like intolerances and sensitivities) a bit tricky. Because they appear to offer a quick and easy answer, food sensitivity tests are growing in popularity. However, since there are various ways the body can react adversely to foods, various testing methodologies exist — some with more validity than others.

Food sensitivity testing may serve as a starting point or guideline (or at the very least, another piece of information in the puzzle), but it’s important to remember that every test has its limitations.

Reactions to food can stem from whether or not the foods are broken down appropriately, as well as how your immune system responds to them. Due to the incredible complexity of digestion and the immune system, there is no single test that can identify all types of potential negative reactions.

For those who are willing, the gold standard in determining adverse reactions to food (outside of true allergies) is through an elimination diet. If you choose to utilize a food sensitivity test, consider timing it before you kick off your elimination diet so that you can use that information to help customize your plan.

Who may want to consider an elimination diet?

Determining whether an elimination diet is right for you — and what type to follow — is highly individualized.

Typically, those who have significant symptoms and have been struggling for a longer duration of time have a higher readiness to change. In these cases, it’s often appropriate to take a more comprehensive and planned approach to find relief.

For those who are simply curious but generally feel well, keeping a food journal and trialing the removal of a few select foods a time can be a helpful starting point.

Who may not want to consider an elimination diet?

Elimination diets are not appropriate for anyone who has a history of disordered eating. Those who are young (and still growing), pregnant, breastfeeding, or have certain underlying medical conditions will want to exercise extra caution and work with their medical team before starting an elimination diet.

How do I do an elimination diet?

For those who are not navigating a specific health concern and are curious about how to individualize their nutrition, it’s helpful to think of an elimination diet as an experiment that will help determine which foods work well for you and which ones do not. There are some tricks to success, as well as potential pitfalls to avoid.

Here are some of my tips:

  • Spend an adequate amount of time planning. Find compliant recipes, plan out your grocery list, and shop for approved foods. You might notice that some recipes call for ingredients that are unfamiliar to you, such as coconut aminos (a soy sauce substitute) or alternative flours, such as teff or tigernut.
  • Remove temptations and non-approved foods from your home if possible.
  • Plan non-food-related social events when possible, such as a workout class, art lesson, or bowling.
  • Aim to minimize takeout and restaurant food, as well as caffeine and alcohol.
  • Pick back up with the plan at your next eating opportunity if you have a misstep.
  • Work with a medical practitioner and qualified nutrition professional to ensure you have enough variety to help prevent nutrient deficiencies and boredom, as well as to customize your supplement approach to fill in any potential gaps.

If you are generally healthy and are taking more of an experimenting approach, your food plan can be pretty straightforward and tailored to help determine if you feel better excluding common food sensitivities.

You can choose to include quality meat, fish, and poultry sourced from healthy animals raised on their natural diet, lots of colorful vegetables and fruit (organic when possible), adequate unprocessed fats and oils, and real-food, gluten-free carbohydrate sources such as sweet potatoes.

When you’re focused on eating this way, it’s easier to stomach (forgive the pun) the commitment to remove several common food sensitivity culprits, including gluten, dairy, soy, peanuts, eggs, shellfish, corn, and sugar.

Sound familiar? These food groups are all purposefully and mindfully eliminated on the Life Time D.TOX program. While some of these foods — such as eggs — are generally considered healthy and encouraged on a balanced and complete nutrition program, imbalances in gut health and immune system function can create challenges in how our bodies respond to them.

The truth is, if you’re stuck with uncomfortable symptoms, you do not truly know what role — if any — some of these foods could be playing.

From my experience, you’ll see the most success if you meet with a nutrition professional before, during, and after your elimination diet to help you plan, troubleshoot, and guide your reintroduction.

Still on the fence?

Before you start building internet memes about being on an ice and water elimination diet, check out this sample of what you could eat in a day while you’re trialing an elimination diet of common sensitivities:

  • Breakfast: Turkey sausage patties made with Celtic salt, sage, thyme, and rosemary, served with a side of cinnamon-roasted sweet potato wedges and some berries.
  • Lunch: Seasoned grilled chicken with an olive oil and basil vinaigrette over organic mixed greens and a side of melon cubes.
  • Dinner: Shredded grass-fed beef roast made in a slow cooker with oregano, savory spices, rainbow carrots, and root vegetables.

With the right plan, an elimination diet can be surprisingly simple and delicious.

Our nutrition team has seen and heard countless testimonials and case studies from those who have committed to a short-term elimination diet, prioritized healthy mealtime habits, supplemented strategically, followed through with step-by-step food reintroduction, and most importantly, listened to their bodies.

These clients often found renewed energy, weight loss, reduction in aches and pains, improved digestion, and clearer skin.

The most amazing part is that although an elimination diet is designed to be temporary, we’ve heard story after story of people who were initially hesitant to start, but ended up surprising themselves by continuing without including several of these foods as part of their routine. They felt the benefits they experienced were well worth giving up problematic foods.

During the diet, you’ll discover one of two things: your body either thrives on an all inclusive, whole foods diet, or your metabolism, wellness, and energy are in a much healthier, happier state with a balanced diet that excludes specific foods that do not make you feel like your best self.

We live in a food landscape that often pulls us in every direction but healthy. While an elimination diet may not seem like the easiest approach at first consideration, is it really easier to not do anything and perhaps remain stagnant in a stage of health that is anything less than stellar? In most cases, a short-term elimination diet is well worth a try.

Keep the conversation going.

Leave a comment, ask a question, or see what others are talking about in the Life Time Health Facebook group.

Samantha McKinney, RD, CPT

Samantha McKinney has been a dietitian, trainer and coach for over 10 years. At first, her interests and experience were in a highly clinical setting in the medical field, which ended up laying a strong foundation for understanding metabolism as her true passion evolved: wellness and prevention. She hasn’t looked back since and has had the honor of supporting Life Time’s members and nutrition programs in various roles since 2011.

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