Deciding to embark on a diet is a crucial step toward a healthier lifestyle. An elimination diet can help identify food sensitivities and intolerances that may be causing health problems. This article provides a comprehensive guide to elimination diets, including a detailed meal plan, recipes, and tips for success.
What is an Elimination Diet?
An elimination diet is a temporary eating plan designed to identify foods that may be triggering adverse health symptoms. Healthcare providers often recommend this diet to pinpoint food-related sensitivities, intolerances, and allergies. The diet involves removing a wide range of foods for a specific period and then gradually reintroducing them one by one to monitor any negative reactions. Foods that do not cause symptoms can be included in the diet going forward, allowing for a more personalized and symptom-free eating plan.
Why Consider an Elimination Diet?
Many individuals consume a variety of foods daily and may experience issues like gas, bloating, or skin rashes, making it difficult to pinpoint the exact triggers. An elimination diet offers a structured approach to identify these triggers. The gut plays a crucial role in overall health, with extensive research highlighting the connection between gut health and the heart, brain, and immune system. Optimal gut health ensures the body's ability to absorb nutrients, keeping it functional and healthy. In contrast, poor gut health can lead to various symptoms.
Functional medicine healthcare practitioners often use an elimination diet to remove foods that are known to commonly cause food allergies, sensitivities, or food intolerances to see if symptoms improve.
How Does an Elimination Diet Work?
An elimination diet typically lasts for two to four weeks, though the duration may vary based on individual needs and healthcare provider recommendations. The process involves three main phases:
Read also: Is a Vegetarian Elimination Diet Right for You?
1. Elimination Phase
During this phase, suspected trigger foods are eliminated for a short period, usually two to three weeks. Common trigger foods include dairy, certain grains, certain sweeteners, legumes, soy, nuts, shellfish, and eggs. The goal is to determine if symptoms are caused by food or another trigger. If symptoms persist after removing trigger foods for two to three weeks, consulting a doctor is advisable.
2. Reintroduction Phase
The reintroduction phase involves gradually reintroducing eliminated foods back into the diet, one food group at a time, over two to three days. It's crucial to observe for any possible symptoms, such as rashes, joint pain, headaches, fatigue, bloating, or changes in bowel habits. If no symptoms occur, the food is likely safe to eat. However, if negative symptoms appear, the food should be removed from the diet.
Before starting the elimination diet, you should look for any symptoms you previously experienced. Additional symptoms to watch for include:
- Rashes and skin changes
- Joint pain
- Headaches or migraines
- Fatigue
- Difficulty sleeping
- Changes in breathing
- Bloating
- Hives
- Stomach pain or cramps
- Changes in bowel habits
3. Maintenance Phase
The maintenance phase involves continuing to follow an eating style that excludes any foods identified as triggers during the reintroduction period. A variety of foods from different food groups should be included, avoiding only those that cause symptoms.
Types of Elimination Diets
Different types of elimination diets are aimed at helping different conditions and symptoms. Some common types include:
Read also: Comprehensive guide to the IC diet and food list.
- Low-FODMAP Diet: This diet removes FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), which are short-chain carbohydrates that some people have difficulty digesting. FODMAPs can cause gas, bloating, diarrhea, and brain fog. Research suggests that a low-FODMAP diet can be effective for individuals with irritable bowel syndrome (IBS).
- Paleo Diet: The Paleo diet removes common foods that may cause food sensitivity or intolerance. It is less restrictive than other diets, making it easier to adhere to.
- Few Foods Elimination Diet: This involves eating a combination of foods not regularly consumed. An example is the lamb and pears diet, where lamb and pears are not commonly eaten.
- Rare Foods Elimination Diet: Similar to the few foods diet, this diet involves eating foods that are rarely consumed, making them less likely to trigger symptoms. Common foods include yams, buckwheat, and starfruit.
- Fasting Elimination Diet: This diet involves strictly drinking water for up to five days, followed by the reintroduction of food groups. It should only be done with a doctor's permission, as it can be dangerous.
- Other Elimination Diets: These include lactose-free, sugar-free, gluten-free, and wheat-free diets.
Foods to Eat and Avoid
Foods to Avoid
Several foods are commonly removed during the elimination phase because they often cause allergic reactions or sensitivities. These foods include:
- Dairy Products: Milk, cheese, yogurt, and ice cream are common allergens and can cause digestive symptoms like gas, bloating, stomach pain, diarrhea, or constipation.
- Nuts and Seeds: Tree nuts, nuts, seeds, and nut butter can be allergenic due to their protein content.
- Legumes: Black beans, kidney beans, and lentils contain FODMAPs and should be avoided during the elimination phase.
- Eggs: Eggs are among the top eight common food allergens and are often eliminated.
- Wheat: Wheat contains gluten, which can cause negative symptoms in some people. Avoid wheat, barley, corn, spelt, rye, oats, and bread.
- Nightshade Vegetables: Tomatoes, peppers, eggplant, white potatoes, cayenne pepper, and paprika can cause side effects like gas, bloating, diarrhea, heartburn, nausea, and joint pain.
- Soy: Soy is a common allergen or irritant and should be eliminated.
- Shellfish: Shellfish is another of the eight common allergens and can cause symptoms ranging from mild to severe.
- Fats: Butter, margarine, hydrogenated oils, mayonnaise, and spreads can be difficult to digest for some people.
- Certain Spices and Condiments: Garlic and onion, in particular, 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 often contain artificial sweeteners that should be avoided.
Foods to Eat
Despite the restrictions, an elimination diet can still include a variety of healthy and delicious foods. These include:
- Fruits: Most fruits, except citrus fruits, can be eaten and provide essential vitamins and minerals.
- Vegetables: Most vegetables, except nightshades, are a good source of vitamins and minerals.
- Grains: Gluten-free grains like rice, buckwheat, and quinoa can be included.
- Meat and Fish: Turkey, chicken, lamb, wild game, and cold-water fish like salmon provide necessary protein.
- Dairy Substitutes: Dairy-free alternatives like coconut milk and unsweetened rice milk can be used.
- Fats: Healthy fats like cold-pressed olive oil, flaxseed oil, or coconut oil can be used for cooking.
- Beverages: Water and herbal teas without caffeine or additives are ideal for staying hydrated.
Health Benefits of an Elimination Diet
Elimination diets offer several potential health benefits:
- Identify Trigger Foods: They help identify specific foods that may be causing an immune system response and contributing to symptoms.
- Reduce IBS Symptoms: They can improve irritable bowel syndrome (IBS) symptoms like bloating, abdominal cramps, and gas.
- Reveal Gut Microbiome Interactions: They can help reveal which foods may be causing an imbalance in the gut microbiome.
- Determine Underlying Medical Conditions: They can help identify underlying medical conditions affecting digestion and absorption, such as enzyme deficiencies or celiac disease.
Sample Elimination Diet Meal Plan (One Week)
This sample meal plan provides five days of elimination diet recipes and suggestions:
Elimination Diet Breakfasts
- Day 1: 1 cup hot rice cereal, 1 cup strawberries, 1 cup herbal tea
- Day 2: Berry coconut smoothie
- Day 3: Sweet potato breakfast hash with ground bison, 1 cup herbal tea
- Day 4: 1 cup puffed rice cereal, 1 cup rice milk, ½ cup blueberries, 1 cup herbal tea
- Day 5: 1 cup hot rice cereal, 1 cup strawberries, 1 cup herbal tea
Berry Coconut Smoothie Recipe:
- 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
Blend all ingredients together.
Read also: Understanding the AIP Diet
Elimination Diet Lunches
- Day 1: 4-6 oz. chicken breast, Apple Fennel Watercress Salad, 1 cup herbal tea
- Day 2: 4-6 oz. chicken breast, 1 cup lightly sauteed green beans in olive oil, ½ cup cooked rice, 8 oz. water
- Day 3: Chicken salad with strawberries, cucumber, avocado, and olive oil, 8 oz. water
- Day 4: Shredded chicken burrito bowl, brown rice, roasted veggies, greens, olive oil, and sea salt, 8 oz. water
- Day 5: 4-6 oz. chicken breast, 1 cup lightly sauteed green beans in olive oil, ½ cup cooked rice, 8 oz. water
Apple Fennel Watercress Salad Recipe:
- 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
Combine all ingredients in a salad bowl.
Elimination Diet Dinners
- Day 1: 4-6 oz. baked salmon, 1 cup steamed broccoli, ½ cup cooked rice, 8 oz. water
- Day 2: 4-6 oz. chicken breast, 1 cup cauliflower rice, 1 cup cooked asparagus, 8 oz. water
- Day 3: Chicken and ginger âfriedâ cauliflower rice, 8 oz. water
- Day 4: Zucchini noodles with meatballs, 8 oz. water
- Day 5: Chicken burger, avocado mash, oven-roasted sweet potato âfries,â 8 oz. water
Elimination Diet Snacks
- Day 1: 1 cup raspberries, 1 cup vegetable broth, 1 cup herbal tea
- Day 2: 1 pear, 1 cup herbal tea
- Day 3: Fresh melon with a honey drizzle, 1 cup herbal tea
- Day 4: Beetroot hummus with carrots and celery, 1 cup herbal tea
- Day 5: 1 clementine or kiwi
Additional Meal Plan Ideas (30-Day)
This 30-day elimination meal plan addresses common food intolerances. It is nutritionally balanced but limited and should not be followed long-term. Consult a 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, and shredded sweet potato; cold cereal (puffed rice) with diced apple and cinnamon; hot oatmeal with strawberries and nut butter; smoothie with coconut milk, banana, spinach, and nut butter; four-ingredient pancakes with egg, mashed banana, and chickpea flour; savory porridge with cooked oats, bamboo shoots, and bok choy.
- Lunches: Sandwich with sourdough bread, smashed chickpeas, shredded lettuce, and mint; quinoa bowl with black beans, shredded lettuce, and tomato; lettuce wraps with shrimp, diced cucumber, and julienned turnip; lentil soup with carrots, celery, and spinach; grilled chicken sandwich with whole wheat bread, cucumber, and lettuce; tofu bowl with cooked quinoa, zucchini, red bell pepper, and tomato; tuna dressed with olive oil, fresh basil, and diced bell pepper.
- Dinners: Baked salmon and roasted sweet potato; extra-lean ground beef tacos with corn tortillas, diced tomato, and shredded lettuce; grilled cod with brown rice and roasted vegetables; air-fryer tempeh with cooked millet and sautéed spinach; roasted pork loin with apples, herbed quinoa, and a green leafy salad; five-bean chili with tomato, green bell pepper, and fresh corn; 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; cold cereal (Cheerios) with diced banana and cinnamon; hot oatmeal with kiwifruit and nut butter; smoothie with lactose-free milk, blueberries, lemon zest, and spinach; four-ingredient pancakes with egg, mashed banana, and shredded sweet potato; savory porridge with cooked oats, bell pepper, and shredded carrots.
- Lunches: Open-faced sandwich with rye bread, air-fried lentil cakes, and shredded lettuce; wheatberry bowl with chickpeas, shredded lettuce, and tomato; lettuce wraps with extra firm tofu, diced cucumber, and julienned carrot; lemon chicken soup with carrots, celery, and Swiss chard; grilled eggplant sandwich with sourdough bread, tempeh, cucumber, and lettuce; tofu bowl with cooked buckwheat, kale, red bell pepper, and carrot; canned salmon mixed with olive oil, fresh oregano, and cucumber.
- Dinners: Baked trout and roasted squash; ground turkey tacos with corn tortillas, diced tomato, and shredded lettuce; grilled chicken thighs with brown rice and roasted vegetables; air-fried tofu on wheatberries and sautéed Swiss chard; spinach salad with roasted chickpeas, orange slices, fresh bell pepper, and cucumber; baked cod with fresh pineapple and green bell pepper salsa; 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; cold cereal (quinoa flakes) with diced orange and ground clove; hot oatmeal with passionfruit and nut butter; smoothie with silky tofu, strawberries, lime zest, and nut butter; four-ingredient pancakes with egg, mashed banana, and almond flour; savory porridge with cooked oats, eggplant, and bok choy.
- Lunches: Sandwich with sourdough bread, sliced turkey, shredded lettuce, and tomato; buckwheat bowl with roasted kidney beans, fresh baby spinach, and tomato; lettuce wraps with chicken, diced tomato, cucumber, and bell pepper; black bean soup with carrots, sweet potato, celery, and kale; grilled sirloin steak rice wraps with rice noodles, cilantro, and cucumber; hard-boiled egg over cooked sorghum, eggplant, and zucchini; tuna cakes made with mayonnaise, lactose-free plain Greek yogurt, and red bell pepper.
- Dinners: Baked cod and roasted sweet potato and eggplant; tofu tacos with corn tortillas, diced tomato, and shredded lettuce; grilled chicken skewer with brown rice and roasted vegetables; air-fried tofu on quinoa and sautéed spinach; shredded kale salad with roasted lentils, blueberries, cucumber, and carrots; turkey meatballs served on spaghetti squash; 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 your preferred lactose-free milk; hot oatmeal with pineapple and fresh coconut; smoothie with silky tofu, blueberries, cocoa powder, and nut butter; four-ingredient pancakes with egg, mashed banana, and oat flour; savory porridge with cooked oats, pumpkin, and Swiss chard.
- Lunches: Sandwich with rye bread, egg salad, and shredded lettuce; brown rice bowl with white beans, fresh arugula, and green beans; lettuce wraps with pineapple salmon ceviche (skip the onion), diced tomato, and cucumber; turkey soup with carrots, sweet potato, spinach, and dried rosemary; sandwich with almond butter, fresh blueberries, and sunflower seeds; ground turkey patties on a wheat free bun with mayonnaise, tomato, and lettuce; crab salad with mayonnaise, lactose-free plain Greek yogurt, and diced.
- Dinners: Baked herring stuffed with fresh basil, parsley, rosemary and lemon; shrimp tacos with corn tortillas, diced tomato, green chili pepper, fresh corn, and lactose-free sour cream; grilled chicken breasts with quinoa and roasted seasoned vegetables; air-fried salmon on wheatberies with sautéed collard greens and carrots; stir-fry vegetables (bok choy, carrot, green bean) with tofu and peanuts; baked lentil balls served on spaghetti squash; grilled squid with lemon and herb brown rice.
Snacks
- Mix up your snacks throughout the week: Fresh fruit with sliced cheese. Fresh fruit with nut butter. Fresh-cut vegetables with avocado dip. Rice crackers with hummus. Trail mix with your favorite nuts. Lactose-free yogurt with fruits and nuts.
Tips for Reintroducing Eliminated Foods
An elimination diet is designed to be temporary, and reintroducing eliminated foods is a crucial step. It is important to be methodical and slowly reintroduce items back into your diet. Eating everything at once can make it difficult to identify which foods might be contributing to your symptoms. A dietitian can help you build a plan to reintroduce these foods safely and effectively.
The Whole30 Diet: An Alternative Elimination Approach
The Whole30 program is an elimination diet designed to help participants identify potential food sensitivities. The plan aims to reduce cravings, restore a healthy metabolism and blood sugar regulation, improve gut health, and calm the immune system. It involves eliminating commonly problematic food groups for 30 days and then reintroducing them one at a time to observe their impact on the body.
How the Whole30 Diet Works
The Whole30 diet requires eliminating the following foods for 30 days:
- Added sugar (real or artificial)
- Alcohol
- Grains
- Legumes
- Dairy
- Processed foods
During the elimination phase, participants avoid weighing themselves or taking measurements. After 30 days, they spend 10 or more days reintroducing food groups one at a time.
Potential Benefits and Risks of Whole30
The Whole30 diet cuts out highly processed foods and added sugars, which is generally a healthy approach. It may reduce inflammation due to the inclusion of flavonoid-rich foods like fruits and vegetables. Additionally, it may help reduce the risk of diabetes by promoting weight loss. However, it also carries risks, such as potential nutrient deficiencies due to the elimination of entire food groups and the possibility of disordered eating due to its restrictive nature.
Final Tips for Starting Your Elimination Diet Journey
- Rethink Your Meals: Don't feel confined to traditional breakfast foods. Leftovers from dinner can make a perfectly acceptable breakfast.
- Meal Prep Staples: Prepare basic food items at the beginning of the week that can be repurposed for different meals.
- Cook Enough for Leftovers: Make larger batches of dishes and freeze the leftovers for backup when you're too busy to cook.
Who Should Follow an Elimination Diet?
An elimination diet is suitable for individuals who suspect that certain foods or drinks may be causing discomfort or health issues. Itâs important to undertake this diet under the guidance of a registered dietitian to ensure nutritional balance and proper monitoring of symptoms.