If you're grappling with persistent, unexplained symptoms, an elimination diet could be the key to unlocking the root cause. This article provides a comprehensive overview of exclusion diet recipes, guiding you through the process of identifying food sensitivities, understanding the different phases of the diet, and offering practical meal plan ideas.
What is an Elimination Diet?
An elimination diet serves as a reset button for your gut and overall health. 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. By temporarily cutting out trigger foods, healing your gut, and then carefully reintroducing those foods, you’ll discover which ones actually support your body and which ones hold you back. Once symptoms resolve, the foods are reintroduced one at a time to assess for any negative symptoms associated with food.
The diet involves removing certain foods that are commonly known to cause adverse reactions and then gradually reintroducing them to monitor your body's response. This process helps pinpoint specific food sensitivities or intolerances that may be contributing to your symptoms.
How it Works
The premise behind an elimination diet is that certain foods can trigger inflammation, digestive issues, or other adverse reactions in susceptible individuals. By removing these potential trigger foods, the body has a chance to heal and recover. Subsequently, reintroducing these foods one at a time allows you to observe any returning symptoms and identify the culprits.
An elimination diet effectively determines what foods may negatively impact your gut and overall health.
Read also: The Hoxsey Diet
The Three Phases of an Elimination Diet
An elimination diet has three phases: elimination, reintroduction, and maintenance.
Elimination: This initial phase involves removing potentially problematic foods from your diet for a specific period, typically two to three weeks. This includes common triggers like dairy, gluten, soy, alcohol, ultra-processed foods, and other known allergens.
Reintroduction: After the elimination phase, you gradually reintroduce the eliminated foods one at a time, every three days or so, while carefully monitoring yourself for any changes in symptoms.
Maintenance: After identifying food sensitivities, your goal is to build a sustainable, nutrient-dense diet that supports your health while avoiding trigger foods.
Types of Elimination Diets
Different types of elimination diets are aimed at helping different conditions and symptoms. There are various approaches to elimination diets, each with its own set of guidelines and restrictions. Some common types include:
Read also: Walnut Keto Guide
- Paleo Diet: This diet removes common foods that may cause food sensitivity or intolerance, but it is not as restrictive as other diets, so it can be easier to adhere to.
- Low-FODMAP Diet: This diet focuses on removing fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), which are short-chain carbohydrates that can cause digestive distress in some individuals.
- AIP (Autoimmune Protocol) Paleo Diet: This is a more restrictive version of the Paleo diet that also removes eggs and nightshades (such as tomatoes, peppers, eggplants, and potatoes).
- Few Foods Elimination Diet: Eating a combination of foods you don’t eat regularly. One example is the lamb and pears diet, popular in the US, where lamb and pears are not commonly eaten.
- Rare Foods Elimination Diet: Similar to a few foods diet, you can only eat foods that you rarely ever eat, as they are less likely to trigger your symptoms. Common foods on a rare food diet include yams, buckwheat, and starfruit.
- Fasting Elimination Diet: Involves strictly drinking water for up to five days, then reintroducing food groups. This type of diet should only be done with permission from your doctor, as it can be dangerous to your health.
- Other Elimination Diets: These include lactose-free, sugar-free, gluten-free, and wheat-free diets.
At our clinic, we start most people out on a Paleo diet because it removes the most common foods that cause food sensitivity or food intolerance, but it is not as restrictive as many other diets, so it is a bit easier to start with.
How to Do an Elimination Diet
Before starting an elimination diet, it’s important to be aware that this diet should not be followed long-term. Instead, it should be used to determine which foods are causing your symptoms so you can avoid them in the future. You should also seek professional advice from a physician or registered dietitian before starting an elimination diet to ensure it is safe. An elimination diet is usually followed for about four to six weeks and can be used to help identify which foods are contributing to symptoms, such as which foods may be causing an imbalance in your gut microbiome.
1. Elimination Phase
During the elimination phase, you eliminate suspected trigger foods for a short period, typically two to three weeks. You should start by eliminating the foods that you suspect your body can’t tolerate, as well as foods that are commonly known to cause symptoms.
Common trigger foods include nuts, corn, soy, dairy, citrus fruits, nightshade vegetables, wheat, and foods containing gluten, pork, eggs, and seafood. During this first phase of the elimination diet, you should be able to determine if your symptoms are caused by food or another trigger. However, if your symptoms persist after removing trigger foods for two to three weeks, it is best to consult your doctor.
2. Reintroduction Phase
The next phase of the diet is the reintroduction phase, in which you gradually reintroduce eliminated foods back into your diet. Each food group should be introduced individually over two to three days while observing for any possible symptoms. Before starting the elimination diet, you should look for any symptoms you previously experienced.
Read also: Weight Loss with Low-FODMAP
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
If you experience no symptoms after introducing a food or food group, you can assume that the item is fine to eat and move on to the next food group. However, if you notice negative symptoms like the ones listed above, you have successfully identified a trigger food and should remove it from your diet. The entire process, including elimination, takes roughly five to six weeks.
If you plan to follow a more restrictive type of elimination diet, such as the fasting elimination diet or rare foods elimination diet, you should first consult your doctor or a registered dietitian. Following a diet that is too restrictive may cause nutritional deficiencies.
3. Maintenance Phase
The maintenance phase is the last phase of the elimination diet. It involves simply continuing to follow an eating style that does not include any foods you found to trigger symptoms during the reintroduction period. You should include a variety of foods from different food groups and only avoid the foods that cause symptoms.
Foods to Avoid During the Elimination Phase
Several foods are commonly removed during the elimination phase. These foods often include:
- Dairy Products: If you are sensitive to dairy, you may have digestive symptoms such as gas, bloating, stomach pain, diarrhea, or constipation. This could be due to lactose intolerance, milk allergy, or other sensitivity. Eliminate all dairy, including milk, cheese, yogurt, and ice cream.
- Nuts and Seeds: Nuts contain many proteins that can act as allergens. Eliminate all tree nuts, nuts, seeds, nut butter, or foods that contain these products.
- Legumes: Legumes (black beans, kidney beans, lentils) contain FODMAPs and should be avoided during the elimination phase.
- Eggs: Eggs are commonly eliminated during the elimination phase as they are one of the top eight common food allergens.
- Wheat: Wheat may cause negative symptoms in some people due to its gluten content. Avoid wheat, barley, corn, spelt, rye, oats, and bread. Avoid any other gluten-containing foods.
- Nightshade vegetables: People sensitive to nightshade vegetables may experience negative side effects, including gas, bloating, diarrhea, heartburn, nausea, and joint pain due to inflammation. Avoid nightshades, including tomatoes, peppers, eggplant, white potatoes, cayenne pepper, and paprika.
- Soy: Soy is a common allergen or irritant, so you may want to eliminate this ingredient during the elimination phase.
- Shellfish: Another of the eight common allergens, shellfish may cause a range of symptoms from mild to severe, depending on whether there is an allergy or sensitivity.
- Fats: Some people may have difficulty digesting and absorbing fats properly. Avoid butter, margarine, hydrogenated oils, mayonnaise, and spreads.
- Certain spices and condiments: Some spices and condiments can contain irritants that cause uncomfortable symptoms. Garlic and onion, particularly, are eliminated in a low FODMAP diet.
- Caffeine-rich beverages: Caffeine has been shown to cause frequent contractions in the digestive tract. It can also increase stomach acidity by triggering the production of more gastric acid.
- Artificial sweeteners: Aspartame, diet drinks, and sugar-free products are often full of artificial sweeteners that should be avoided during an elimination diet.
If you suspect that other foods not on this list make you feel uncomfortable, you should consider eliminating them as well.
What You Can Eat on an Elimination Diet
Elimination diets can be extremely restrictive, but there is still enough variety to make healthy and delicious meals. Some foods you can eat include:
- Fruits: Most fruits, with the exception of citrus fruits, can be eaten. Fruits provide vitamins and minerals to help prevent deficiencies during a restrictive diet.
- Vegetables: A good source of vitamins and minerals, most vegetables can be eaten with the exception of nightshades.
- Grains: Gluten-free grains like rice, buckwheat, and quinoa can be included in an elimination diet.
- Meat and Fish: Including turkey, chicken, lamb, wild game, and cold-water fish like salmon can help you reach your protein needs while following the elimination diet. Opt for lean cuts or grass-fed options.
- Dairy Substitutes: When eliminating dairy, you may use dairy-free alternatives like coconut milk and unsweetened rice milk.
- Fats: Be sure to include healthy fats like cold-pressed olive oil, flaxseed oil, or coconut oil. You can utilize these oils to cook proteins or vegetables.
- Beverages: When it comes to beverages, stick to water and herbal teas that do not contain caffeine or additives. This can help you stay hydrated without consuming any potential irritants.
The simplest way to think of a Paleo diet is that you eat whole foods, including meat, vegetables, and some fruits, nuts, and seeds.
Here is a list of a few things you can keep on hand, which can be made into many Paleo-friendly meal options:
- Shredded chicken thighs or chicken breast. Cook up 1-2 pounds of boneless skinless (because that is easiest to shred) chicken in an instant pot or slow cooker with some bone broth, salt, and pepper, and then shred it with a fork. If cooking is not your thing, pick up a roast chicken from the grocery store, but check the ingredients to be sure it is Paleo.
- Remember-rethink what a meal is. Make BBQ chicken and coleslaw by adding a Paleo barbecue sauce to some shredded chicken and mixing the shredded coleslaw mix with some mayonnaise and a dash of apple cider vinegar.
- Pesto chicken and faux rice can be made by reheating frozen cauliflower rice in a pan with olive oil, garlic, sea salt, and pepper. Remember not to overcook cauliflower rice because that’s when it gets watery.
- Plate ground meat with cauliflower and broccoli. Reheat the ground meat while you steam the cauliflower and broccoli.
- Make un-deviled eggs by cutting hard-boiled eggs in half and topping them with a little mayo and salt.
- Order steak or chicken that is not made with an extra coating or sauce.
Benefits of Following an Elimination Diet
There are several potential benefits of following an elimination diet. Some benefits include:
- Helps You Identify What Foods Are Negatively Impacting Your Health: Elimination diets can help you figure out what specific foods may be causing an immune system response.
- Reducing Unpleasant IBS Symptoms: An elimination diet may improve irritable bowel syndrome (IBS) symptoms like bloating, abdominal cramps, and gas. People who followed an elimination diet decreased their IBS symptoms by 10%, and those who best stuck to the diet improved symptoms by as much as 26%.
- Reveals Foods That May Interact With Gut Microbiome: Elimination diets can help you learn which foods may be causing an imbalance in your gut microbiome.
- Determine if There is Any Underlying Medical Condition: Several medical conditions can affect the digestion and absorption of food, including enzyme deficiencies, celiac disease, chronic pancreatitis, and cystic fibrosis. If symptoms are not improved with the elimination diet, seek help from a medical professional to rule out a more serious health condition.
Exclusion Diet Recipes: Sample Meal Plan
Here's a sample week-long elimination diet meal plan to get you started.
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
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
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
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
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 “fried” cauliflower rice, 8 oz. water
- Day 4: Zucchini noodles with meatballs, 8 oz. water
- Day 5: Chicken burger, avocado mash, oven-roasted sweet potato “fries,” 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
Tips for Starting Your Elimination Diet Journey
- Rethink your meals: You don’t have to eat breakfast foods at breakfast. Having leftovers from last night’s dinner for breakfast the next day is perfectly fine.
- Meal prep staples you can cook in multiple ways: At the beginning of the week, prepare a few basic food items that can be repurposed for different meals throughout the week.
- Cook enough for leftovers: Instead of making yourself a single serving of a dish, make a larger batch and freeze the leftovers so you have a backup plan if you are too tired or busy to shop and cook throughout the week.