If you suspect that certain foods or drinks are negatively impacting your health or causing discomfort after eating, you might consider trying an elimination diet. This approach, while not always evidence-based, can offer valuable insights into how foods affect your body, especially when guided by a nutrition expert. This article provides a detailed overview of the 21-day elimination diet, including meal plans and recipes.
Understanding the Basics of an Elimination Diet
An elimination diet is a temporary eating pattern designed to help you identify potential links between your dietary intake and food sensitivities. It is a personalized approach that should be undertaken with the guidance of a registered dietitian. A dietitian can ensure that your meals remain nutritionally balanced and assist you in tracking your symptoms.
Most elimination diet protocols follow these three steps:
- Elimination: Remove certain foods from your diet and observe any changes in your symptoms. Keep a food journal, use an app, or record voice memos to track your symptoms. If you feel better after removing these foods, continue to avoid them.
- Maintenance: Maintain the elimination of trigger foods.
- Reintroduction: Gradually reintroduce the eliminated foods back into your diet. Work with your dietitian to establish the threshold (or portion size) you can tolerate without experiencing discomfort. This step is crucial for maintaining a diverse diet in the long term.
Common Foods to Limit
When following an elimination diet, it's common to limit foods associated with intolerances, including:
- Dairy: Milk, cheese, yogurt, and ice cream.
- Wheat: Bread, pasta, and most baked goods.
- High FODMAP foods: Foods with carbohydrates that are difficult to digest, such as wheat, soy milk, shallots, garlic and artificial sweeteners.
- Histamine: Various foods can be high in histamine or trigger its release in the body.
- Food additives: Artificial colors, flavors, and preservatives.
You may also have sensitivities to foods not listed above. Tracking your dietary intake and documenting your symptoms after eating can help you identify patterns and discuss your concerns with a healthcare professional.
Read also: Is a Vegetarian Elimination Diet Right for You?
Sample 21-Day Elimination Diet Meal Plan
The following meal plan addresses common food intolerances and is designed to help you identify potential food sensitivities. It is nutritionally balanced but limited and should not be followed long-term. Consult your dietitian for appropriate serving sizes and variety.
Week 1
- Breakfasts
- Overnight oats with unsweetened soy milk, chia seeds, raspberries, and blackberries.
- Egg omelet with spinach, red bell pepper, shredded sweet potato, and cracked black pepper.
- Cold cereal (puffed rice) with diced apple, cinnamon, and lactose-free milk (dairy or plant-based alternative).
- Hot oatmeal with strawberries, nut butter, and ground cinnamon.
- Smoothie with coconut milk, banana, spinach, nut butter, and plain lactose-free Greek yogurt.
- Four-ingredient pancakes with egg, mashed banana, chickpea flour, and baking powder.
- Savory porridge with cooked oats, bamboo shoots, bok choy, and an egg, dressed with sesame oil and low-sodium soy sauce.
- Lunches
- Sandwich with sourdough bread, smashed chickpeas, shredded lettuce, sprouts, mint, and yellow mustard.
- Quinoa bowl with black beans, shredded lettuce, tomato, and cilantro, dressed with garlic-infused olive oil and lime.
- Lettuce wraps with shrimp, diced cucumber, julienned turnip, pumpkin seeds, and mayonnaise.
- Lentil soup with carrots, celery, and spinach, using low-sodium chicken or vegetable broth and spices (no garlic or onion powders).
- Grilled chicken sandwich with whole wheat bread, cucumber, lettuce, and mayonnaise.
- Tofu bowl with cooked quinoa, zucchini, red bell pepper, and tomato, with feta and olive oil.
- Tuna with olive oil, fresh basil, diced bell pepper, walnuts, and goat cheese, served with a whole wheat English muffin.
- Dinners
- Baked salmon and roasted sweet potato, served with a green leafy salad.
- Extra-lean ground beef tacos with corn tortillas, diced tomato, shredded lettuce, lactose-free sour cream (optional), and mild green chilies.
- Grilled cod with brown rice and roasted vegetables (carrots, bok choy).
- Air-fryer tempeh with cooked millet and sautéed spinach, peppers, and carrots, dressed with sesame oil and seeds.
- Roasted pork loin with apples, herbed quinoa, and a green leafy salad.
- Five-bean chili with tomato, green bell pepper, fresh corn, carrots, and paprika seasoning.
- Grilled chicken breasts with squash and a leafy green salad.
Week 2
- Breakfasts
- Overnight oats with unsweetened soy milk, chia seeds, oranges, and passionfruit.
- Egg omelet with shredded kale, red bell pepper, and goat cheese, served with rye bread.
- Cold cereal (Cheerios) with diced banana, cinnamon, and lactose-free milk (dairy or plant-based alternative).
- Hot oatmeal with kiwifruit, nut butter, and ground cinnamon.
- Smoothie with lactose-free milk, blueberries, lemon zest, spinach, nut butter, and plain lactose-free Greek yogurt.
- Four-ingredient pancakes with egg, mashed banana, shredded sweet potato, and baking powder.
- Savory porridge with cooked oats, bell pepper, shredded carrots, and an egg, dressed with sesame oil and low-sodium soy sauce.
- Lunches
- Open-faced sandwich with rye bread, air-fried lentil cakes, shredded lettuce, and horseradish.
- Wheatberry bowl with chickpeas, shredded lettuce, tomato, mint, basil, and feta, dressed with garlic-infused olive oil and lime.
- Lettuce wraps with extra firm tofu, diced cucumber, julienned carrot, sunflower seeds, and hot sauce.
- Lemon chicken soup with carrots, celery, and Swiss chard, using low-sodium chicken or vegetable broth and spices (no garlic or onion powders).
- Grilled eggplant sandwich with sourdough bread, tempeh, cucumber, lettuce, and mayonnaise.
- Tofu bowl with cooked buckwheat, kale, red bell pepper, and carrot, with goat cheese and olive oil.
- Canned salmon with olive oil, fresh oregano, capers, cucumber, lemon juice, and green pepper, served with wheat-free crackers.
- Dinners
- Baked trout and roasted squash, served with a kale salad.
- Ground turkey tacos with corn tortillas, diced tomato, shredded lettuce, lactose-free sour cream (optional), and olives (optional).
- Grilled chicken thighs with brown rice and roasted vegetables (eggplant and bell peppers), flavored with soy sauce and sesame seeds.
- Air-fried tofu on wheatberries with sautéed Swiss chard, peppers, and turnips, dressed with avocado oil and sunflower seeds.
- Spinach salad with roasted chickpeas, orange slices, fresh bell pepper, cucumber, carrots, and feta cheese, drizzled with olive oil and lemon juice.
- Baked cod with fresh pineapple and green bell pepper salsa, served with a baked yam.
- Grilled shrimp with spaghetti squash and a leafy green salad.
Week 3
- Breakfasts
- Overnight oats with unsweetened soy milk, chia seeds, dragonfruit, and pineapple.
- Egg omelet with Swiss chard, tomato, and feta cheese, served with sourdough bread.
- Cold cereal (quinoa flakes) with diced orange, ground clove, and lactose-free milk (dairy or plant-based alternative).
- Hot oatmeal with passionfruit, nut butter, and ground cinnamon.
- Smoothie with silky tofu, strawberries, lime zest (and juice), nut butter, and plain lactose-free Greek yogurt.
- Four-ingredient pancakes with egg, mashed banana, almond flour, and baking powder.
- Savory porridge with cooked oats, eggplant, bok choy, and an egg, dressed with sesame oil and low-sodium soy sauce.
- Lunches
- Sandwich with sourdough bread, sliced turkey, shredded lettuce, tomato, and yellow mustard.
- Buckwheat bowl with roasted kidney beans, fresh baby spinach, tomato, basil, and feta cheese, dressed with garlic-infused olive oil and lime.
- Lettuce wraps with chicken, diced tomato, cucumber, bell pepper, and a drizzle of tahini.
- Black bean soup with carrots, sweet potato, celery, kale, and fresh cilantro, with lime juice, low-sodium chicken or vegetable broth, and spices (no garlic or onion powders).
- Grilled sirloin steak rice wraps with rice noodles, cilantro, mint, cucumber, carrot, and baby spinach, dipped in sweet and sour sauce.
- Hard-boiled egg served over cooked sorghum, eggplant, zucchini, and fresh tomato, with aged parmesan and olive oil.
- Tuna cakes made with mayonnaise, lactose-free plain Greek yogurt, dill, lemon zest, egg, and red bell pepper, served with wheat free crackers.
- Dinners
- Baked cod and roasted sweet potato and eggplant, served with a leafy green salad.
- Tofu tacos with corn tortillas, diced tomato, shredded lettuce, and lactose-free sour cream (optional).
- Grilled chicken skewer with brown rice and roasted vegetables (oyster mushrooms and radish), flavored with soy sauce and sesame seeds.
- Air-fried tofu on quinoa, sautéed spinach, green chili pepper, and freshly shredded carrots, dressed with avocado oil and pumpkin seeds.
- Shredded kale salad with roasted lentils, blueberries, cucumber, carrots, olives (optional), and goat cheese, drizzled with olive oil and lemon juice.
- Turkey meatballs served on spaghetti squash, garnished with olive oil, fresh basil, and aged parmesan cheese.
- Grilled pork chop with roasted summer squash and a leafy green salad.
Week 4
- Breakfasts
- Overnight oats with coconut milk, chia seeds, almonds, and raspberries.
- Egg omelet with sweet potato, tomato, and goat cheese.
- Cold cereal (puffed quinoa) with strawberries, walnuts, and lactose-free milk (dairy or plant-based alternative).
- Hot oatmeal with pineapple, fresh coconut, and ground cinnamon.
- Smoothie with silky tofu, blueberries, cocoa powder, nut butter, and plain lactose-free Greek yogurt.
- Four-ingredient pancakes with egg, mashed banana, oat flour, and baking powder.
- Savory porridge with cooked oats, pumpkin, Swiss chard, and an egg, dressed with sesame oil and low-sodium soy sauce.
- Lunches
- Sandwich with rye bread, egg salad, and shredded lettuce.
- Brown rice bowl with white beans, fresh arugula, green beans, parsley, tomato, pine nuts, and lemon juice, dressed with garlic-infused olive oil and lemon.
- Lettuce wraps with pineapple salmon ceviche (skip the onion), diced tomato, cucumber, and bell pepper.
- Turkey soup with carrots, sweet potato, spinach, and dried rosemary, using low-sodium chicken or vegetable broth and spices (no garlic or onion powders).
- Sandwich with almond butter, fresh blueberries, lemon zest, and sunflower seeds.
- Ground turkey patties served on a wheat free bun with mayonnaise, tomato, and lettuce.
- Crab salad with mayonnaise, lactose-free plain Greek yogurt, mustard, and diced celery, served with wheat free crackers.
- Dinners
- Baked herring stuffed with fresh basil, parsley, rosemary and lemon, served with roasted potato and carrots and a leafy green salad.
- Shrimp tacos with corn tortillas, diced tomato, shredded lettuce, green chili pepper, fresh corn, and lactose-free sour cream (optional).
- Grilled chicken breasts with quinoa and roasted seasoned vegetables (tomato and turnips), flavored with soy sauce and sesame seeds.
- Air-fried salmon on wheatberies with sautéed collard greens and carrots, topped with fresh cilantro.
- Stir-fry vegetables (bok choy, carrot, green bean) with tofu and peanuts, garnished with cilantro and served with brown rice.
- Baked lentil balls served on spaghetti squash, garnished with olive oil, fresh basil, diced tomato, tahini, and feta cheese.
- Grilled squid with lemon and herb brown rice and a leafy green salad.
Snacks
Mix your snacks throughout the week, including:
- Fresh fruit with sliced cheese.
- Fresh fruit with nut butter.
- Fresh-cut vegetables with avocado dip.
- Rice crackers with hummus.
- Trail mix with nuts.
- Lactose-free yogurt with fruits and nuts.
Who Should Consider an Elimination Diet?
There's no specific demographic for an elimination diet, as it's not an evidence-based approach. Consider it if you suspect that foods or drinks are causing symptoms like bloating, changes in stool habits, or gas. It's crucial to work with a registered dietitian for guidance.
Reintroducing Eliminated Foods
The elimination diet is temporary; you should reintroduce eliminated foods gradually. Reintroduce items slowly and methodically. Reintroducing everything at once will make it difficult to identify the specific foods causing your symptoms. Your dietitian can help you create a reintroduction plan.
Additional Meal Plan Ideas
Here are some additional meal plan ideas for a week-long elimination diet:
Read also: Comprehensive guide to the IC diet and food list.
Day 1
- Breakfast: 1 cup hot rice cereal, 1 cup strawberries, 1 cup herbal tea
- Lunch: 4-6 oz. chicken breast, Apple Fennel Watercress Salad, 1 cup herbal tea
- Dinner: 4-6 oz. baked salmon, 1 cup steamed broccoli, ½ cup cooked rice, 8 oz. water
- Snacks: 1 cup raspberries, 1 cup vegetable broth, 1 cup herbal tea
Day 2
- Breakfast: Berry coconut smoothie
- Lunch: 4-6 oz. chicken breast, 1 cup lightly sauteed green beans in olive oil, ½ cup cooked rice, 8 oz. water
- Dinner: 4-6 oz. chicken breast, 1 cup cauliflower rice, 1 cup cooked asparagus, 8 oz. water
- Snacks: 1 pear, 1 cup herbal tea
Day 3
- Breakfast: Sweet potato breakfast hash with ground bison, 1 cup herbal tea
- Lunch: Chicken salad with strawberries, cucumber, avocado, and olive oil, 8 oz. water
- Dinner: Chicken and ginger “fried” cauliflower rice, 8 oz. water
- Snacks: Fresh melon with a honey drizzle, 1 cup herbal tea
Day 4
- Breakfast: 1 cup puffed rice cereal, 1 cup rice milk, ½ cup blueberries, 1 cup herbal tea
- Lunch: Shredded chicken burrito bowl, brown rice, roasted veggies, greens, olive oil, and sea salt, 8 oz. water
- Dinner: Zucchini noodles with meatballs, 8 oz. water
- Snacks: Beetroot hummus with carrots and celery, 1 cup herbal tea
Day 5
- Breakfast: 1 cup hot rice cereal, 1 cup strawberries, 1 cup herbal tea
- Lunch: 4-6 oz. chicken breast, 1 cup lightly sauteed green beans in olive oil, ½ cup cooked rice, 8 oz. water
- Dinner: Chicken burger, avocado mash, oven-roasted sweet potato “fries,” 8 oz. water
- Snacks: 1 clementine or kiwi
Berry Coconut Smoothie Recipe
Blend the following ingredients together:
- ¾ cup unsweetened vanilla coconut milk beverage
- ½ cup frozen mixed berries
- ½ cup frozen sliced banana
- 1 Tbsp unsweetened shredded coconut
- 1 tsp honey
- 3 ice cubes
Apple Fennel Watercress Salad Recipe
Combine all ingredients in a salad bowl:
- 2 Tbsp fresh lemon juice
- 1 Tbsp white wine vinegar
- 3 Tbsp extra virgin olive oil
- 2 tsp honey
- 1/4 tsp salt
- 3 cups chopped baby spinach
- 1 bulb fennel, chopped (white part only)
- 2 heads Belgian endive, thinly sliced
- 1 small Fuji apple
What to Eat and What to Avoid
During the elimination phase, it's crucial to know what foods to include and exclude.
Foods to Avoid:
- Dairy Products: Milk, cheese, yogurt, and ice cream due to lactose intolerance, milk allergy, or other sensitivities.
- Nuts and Seeds: All tree nuts, nuts, seeds, nut butter, or foods containing these products.
- Legumes: Black beans, kidney beans, lentils which contain FODMAPs.
- Eggs: One of the top eight common food allergens.
- Wheat: Wheat, barley, corn, spelt, rye, oats, and bread due to gluten content.
- Nightshade vegetables: Tomatoes, peppers, eggplant, white potatoes, cayenne pepper, and paprika.
- Soy: A common allergen or irritant.
- Shellfish: Another of the eight common allergens.
- Fats: Butter, margarine, hydrogenated oils, mayonnaise, and spreads.
- Certain spices and condiments: Garlic and onion, particularly, which are eliminated in a low FODMAP diet.
- Caffeine-rich beverages: Caffeine can cause frequent contractions in the digestive tract and increase stomach acidity.
- Artificial sweeteners: Aspartame, diet drinks, and sugar-free products.
Foods to Eat:
- Fruits: Most fruits, except citrus fruits.
- Vegetables: Most vegetables, except nightshades.
- Grains: Gluten-free grains like rice, buckwheat, and quinoa.
- Meat and Fish: Turkey, chicken, lamb, wild game, and cold-water fish like salmon.
- Dairy Substitutes: Dairy-free alternatives like coconut milk and unsweetened rice milk.
- Fats: Healthy fats like cold-pressed olive oil, flaxseed oil, or coconut oil.
- Beverages: Water and herbal teas without caffeine or additives.
Benefits of an Elimination Diet
Following an elimination diet can offer several potential benefits:
- Identify Problematic Foods: Helps determine which specific foods may be causing an immune system response.
- Reduce IBS Symptoms: May improve irritable bowel syndrome (IBS) symptoms like bloating, abdominal cramps, and gas.
- Reveal Gut Microbiome Interactions: Can help you learn which foods may be causing an imbalance in your gut microbiome.
- Determine Underlying Medical Conditions: Can assist in identifying underlying medical conditions that affect the digestion and absorption of food.
Tips for a Successful Elimination Diet
- Rethink Your Meals: Don't limit yourself to traditional breakfast foods.
- Meal Prep Staples: Prepare basic food items that can be used in different meals.
- Cook Enough for Leftovers: Freeze leftovers for future meals.
- Keep a Food Diary: Record what you eat and how you feel to identify trigger foods.
- Stay Positive: Maintain a positive mental state throughout the process.
- Adjust as Needed: Modify your diet based on your body's signals.
Other Elimination Diet Options
- Paleo Diet: Modeled after what our Paleolithic ancestors ate, focusing on whole foods like meat, vegetables, fruits, nuts, and seeds.
- Low-FODMAP Diet: Removes fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) to reduce gas, bloating, and diarrhea.
- AIP (Autoimmune Protocol) Diet: A stricter version of the Paleo diet that also removes eggs and nightshades.
Read also: Understanding the AIP Diet