What Is an Elimination Diet?
If you're experiencing digestive upset or troubling skin issues, an elimination diet may be the right choice for you.
Elimination diets are used to determine allergies, intolerances, and sensitivities to certain foods that result in uncomfortable symptoms. This type of eating method requires eliminating suspected culprits for a period of time (when symptoms subside) and then slowly re-introducing the foods—one at a time—to determine if they cause a reaction, says Leah Shainhouse MSc, RD, a consulting dietitian. Ultimately, the more foods you eliminate, the more likely you are to discover the one causing trouble. Ahead, everything you need to know about elimination diet and how to successfully identify any food-driven digestive issues.
How does an elimination diet work and who benefits from trying one?
Patients experiencing painful symptoms, such as bloating and abdominal pain, gas, diarrhea, constipation, and nausea, often attempt an elimination diet, explains Shainhouse. "It's also sometimes used for a patient that has skin issues, such as rashes or hives, which could indicate an allergy," she says, adding that these types of diets can be especially beneficial for people suffering from conditions such as irritable bowel syndrome (IBS), eosinophilic esophagitis (allergic inflammation of the esophagus), chronic migraines, ADHD, eczema, or other chronic skin ailments. "If you are experience any of these symptoms, you might want to consider an elimination diet," she suggests. "However, it's best to consult your doctor first."
Just remember that every person is unique—we react differently to common foods, which is why treatment plans must be individualized. "The same can be said about anyone with a sensitivity. Some people may need to eliminate the food entirely from their diet, whereas others may be able to tolerate small amounts or foods prepared in different ways," Shainhouse explains, adding that some people may react when eating certain foods raw, but feel just fine when those items are cooked. An elimination diet is often the first step in creating that individualized plan, since it helps determine a person's triggers.
How long does an elimination diet last?
An elimination diet has two phases: The first is elimination, and the second is reintroduction. According to Shainhouse, the former period normally lasts between two to three weeks. "Because of its complexity and the risk of nutrient deficiency, it's highly recommended to find a registered dietitian that specializes in elimination diets," she cautions. "Their expert advice can help you navigate the elimination phase."
The second phase involves slowly reintroducing the foods you cut out back into your diet. Typically, you introduce one food or food group at a time, waiting two to three days before adding the next one in. "It can take up to 48 hours to notice any symptoms, such as changes in bowel movements, abdominal discomfort, bloating, difficulty sleeping, fatigue, headaches, skin changes, or changes in breathing," notes Shainhouse. If you don't experience any symptoms within that window, you can assume that those foods do not cause a reaction and are fine to consume long-term. "Since elimination diets can be quite restrictive, this whole process can take up to six to eight weeks total," she adds.
What is a common elimination diet?
IBS suffers often begin treatment with one of the most popular elimination diets around today; the method requires eliminating FODMAPS (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), which are short-chain carbohydrates that can cause trouble in the small intestine, notes Shainhouse. Things like bread, pasta, milk, and broccoli all fall into this category. "It is a lengthy and challenging list of foods and food particles that are eliminated for up to eight weeks and slowly reintroduced," she notes.