Do you ever get the feeling that troubles with your health may be related to your diet? You’re consistently bothered by a skin rash, eczema or acne; you have bloating, diarrhea, or heartburn; your stuffy nose, asthma, migraines, joint pains, irritability or fatigue are a constant irk. Suspicious that your symptoms are linked to what you’re eating or drinking? You could be right.
Food sensitivities and intolerances are commonplace with more than half of us suffering from lactose intolerance alone. Learn what’s troubling you and how to get better with the help of an elimination diet.
The Elimination Diet
One of the most powerful, yet under-utilized, tools in medicine is the elimination diet. It can help you determine if your health complaints are diet-related, identify your triggers, and discover what foods you can continue to eat (or not) to quell symptoms. I’ve seen patients who are able to treat multiple symptoms, and even stop medications, through simple changes to their diet.
So, suffer no longer. Dedicate yourself to the elimination diet and reap the benefits. Undertake a little prep, muster a healthy dose of willpower and read on!
Note: do NOT undertake food challenges if you have a history of anaphylaxis (allergic symptoms presenting as breathing difficulties, throat swelling, vomiting or fainting, or requiring epinephrine (Epi-pen) injections). See an allergist. Pregnant women, children and people with a history of eating disorder should likewise seek the supervision of a medical practitioner.
Avoid the “Sinister Seven”
The “sinister seven” are foods that are implicated in most food intolerances and sensitivities. To undertake a classic elimination diet, you eliminate all of these foods at once:
- Cow’s milk
- Refined sugar
You’ll also eliminate food additives like artificial colours, flavours, preservatives and artificial sweeteners. Many experts also advocate for eliminating or reducing coffee, tea and alcohol during this process. I’ll leave this to your discretion (and self-assessment of willpower). Caffeine should be weaned slowly to avoid withdrawal headaches.
Note: If you drink a significant amount of alcohol, or notice withdrawal symptoms if you go without, talk to your doctor about detoxing safely.
Ready, Set, Eliminate!
Here’s a worksheet to help guide you through the process: Elimination Diet Worksheet
1) Make your game plan. Set yourself up for success by planning your elimination diet during a time when it will be easiest for you to stick with it (eg. not during travel). Stock your fridge and pantry, and let your family know how that they can support you. Make, and keep on hand, large batches of “safe” foods such as salad, sweet potatoes, homemade soup, and rice. Plan to eat at regular intervals and drink plenty of water.
2) Eliminate. Avoid the “sinister seven” and any other triggers you suspect may be a culprit. Sadly, foods we crave often or eat daily can be the worst offenders. Try to eliminate these as well. Pay attention to food labels and “hidden ingredients” (listed below). For now, avoiding eating out. Finally, keep in mind that your symptoms may worsen during the first two to three days — only to improve dramatically! So don’t give up.
Stay in this elimination phase for two weeks. If your health improves and you’ve been relatively symptom-free for at least five days, it’s time to reintroduce. And celebrate! You probably feel amazing! If not, give yourself one further week to see if you feel better, and visit your MD or ND if you’re still having trouble to see if there’s something you’re overlooking.
3) Challenge. Time to re-introduce your first food group. Choose one group, and eat a small amount for breakfast. Symptom-free by lunch? Have a larger serving of the same food group for lunch and dinner. Monitor your symptoms. Then go back to the basic elimination diet. Over the course of the next two days, continue to watch for a flare-up of your symptoms. Also keep tabs on your stress levels and be on the lookout for emotional triggers as these can muddy the waters during your challenge.
Here’s where we’re at so far:
Day 1-14: Eliminate
Day 15: Challenge food group 1 and monitor for symptoms
Day 16-17: Eliminate and continue to monitor for symptoms
4) Keep it up. Repeat step three for the remaining sinister seven. Important: once you’ve challenged a food group, go back to eliminating it until you’ve challenged all seven categories. And, if you have a lot of symptoms, loiter a few more days in the elimination phase before introducing the next group.
Day 18: Challenge food group 2 and monitor for symptoms
Day 19-20: Eliminate and continue to monitor for symptoms
Tip: Not sure if a food triggered you? Eliminate until you’re feeling better, then re-challenge.
5) Celebrate! You’ve completed your elimination challenge and hopefully identified your trigger(s). Kudos to you and your healthiest self! Now’s a good time to check in with your dietitian to ensure you’re on track to get adequate nutrients over the long-term, especially if you’ve eliminated a substantial food group from your diet.
6) Re-challenge once your gut heals. Maintain strict avoidance of any foods that you identified as intolerances or sensitivities for six months to a year. This gives your gut time to heal and restore its balance. Many people find that re-introducing their trigger foods at this time don’t cause a flare-up of symptoms, and their previous triggers can be eaten every few days without concern. Yes, please!
Congratulations on undertaking this process. I hope that you’ve found new health, and new hope that food can be an enjoyable and nutritious part of your everyday! I’m honoured to be one of your humble guides.
An aside on hidden ingredients
Many processed foods and condiments/sauces have “hidden” ingredients. Watch out for these common/hidden ingredients, read food labels carefully and when in doubt, steer clear! (or phone a friend/doctor/dietitian).
|Common trigger||Avoid/watch for||Try instead|
|Cow’s milk||Milk, yogurt, cheese, cottage cheese, cream cheese, ice cream, butter, whey, casein||Almond, coconut and rice milks and non-dairy alternatives|
|Wheat/gluten||Breads, crackers, cereals, and pastas made from wheat, barley, rye, oats, spelt, kamut; couscous||Any made from rice, quinoa, gluten-free oats, buckwheat, amaranth, teff, millet, potato flour, arrowroot|
|Soy||Tofu, tempeh, miso, soy sauce, hydrolyzed plant protein, vegetable gum, vegetable starch, textured vegetable protein||Beans, lentils
If you’re not a vegetarian: fish, chicken, turkey, lamb
|Corn||Tortillas, corn chips, popcorn, cornstarch, corn syrup, high fructose corn syrup (these latter few are in many processed foods and sauces), corn oil, vegetable oil from unnamed source||Other vegetables!
If you have arthritis, avoid nightshades: tomatoes, potatoes, eggplants, peppers, paprika, salsa, chili peppers, cayenne, chili powder
|Refined sugar||White/brown sugars, sodas, candy, sweets (many processed foods!), sucrose, cane juice, glucose, dextrose, maltose, maltodextrin, and levulose||Small amounts of maple syrup, honey, brown rice syrup, fruit sweeteners|
|Eggs||Eggs, egg whites, albumin, hollandaise sauce||Flaxseed mixed with water makes a mean egg substitute in baking!|
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