What Is An Elimination Diet?
Updated: Sep 21
According to Oxford Languages, an elimination diet is a diagnostic procedure used to identify foods that may be causing an adverse effect on a person. All suspected foods are excluded from the diet and then reintroduced one at a time.
Some people hear the phrase “elimination diet” and instantly cringe. I get it; who wants to stop eating the foods they love? Unfortunately, sometimes, an elimination diet is the key to understanding why you’re struggling with your health. Whether it’s gut issues, headaches, migraines, eczema, constipation, or even diarrhea, these symptoms can result from the foods you eat daily.
No one wants to live life uncomfortably. I know I didn’t, which is precisely why, in 2022, I embarked on a 66-food elimination diet. You read that right, SIXTY-SIX! That wasn’t even counting my already strict plant-based lifestyle. To say I was a bit overwhelmed is an understatement. But, hopefully, by the end of this post, you’ll see elimination diets aren’t too bad, especially if you plan them right.
Understanding Elimination Diets
Preparing for an Elimination Diet
Understanding Elimination Diets
Elimination diets are a diagnostic method allergists and registered dietitians have used for decades. Elimination diets usually last five to six weeks and are recommended to help identify food intolerances or allergies (1). Sometimes, elimination diets are performed to narrow down which foods contribute to gut sensitivities and even headaches or migraines.
There are three types of elimination diets, with different intensities, including:
Simple elimination diets avoid one or, sometimes, the two most common food triggers, such as gluten and dairy. In its place, it’s usually recommended to eat gluten-free alternatives like brown rice, millet, buckwheat, or quinoa (2).
Moderate elimination diets avoid several groups of food. During this diet, one may stop eating or drinking alcohol, animal products, chocolate, coffee, tea, soft drinks, legumes, nuts, wheat, etc. (2).
Strict elimination diets avoid most foods and are usually done when someone has done a food sensitivity test (2).
Benefits of Elimination Diets
Elimination diets are typically performed after a suspected food allergy or sensitivity. One may suspect a suspected food allergy or sensitivity when symptoms occur after consuming certain foods. Sometimes, food sensitivities can be narrowed down with food sensitivity tests through companies like Check My Body Health or EverlyWell.
Without an elimination diet, you can only speculate what foods are causing unwanted symptoms. An elimination diet can narrow it down and verify these assumptions, especially when symptoms occur outside the gut (such as headaches or migraines). Of course, when dealing with headache or migraine triggers, sometimes, no symptoms are present or are delayed by a few days. According to Precise Nutrition:
“Elimination diets help you to collect and analyze empirical evidence, using experimentation and observation based on what happens in your body as you change what you eat. If your headaches disappear after you’ve removed certain foods only to suddenly resurface when you reintroduce chocolate, that’s a powerful clue (3).”
How Elimination Diets Work
Elimination diets are typically done in three phases. The three phases involve removing all potential food sensitivities and reintroducing them individually. The key to an elimination diet is waiting enough time to notice potential symptoms between each food reintroduction.
Phase 1: Planning
Phase 1 typically lasts one to two weeks, depending on your elimination diet's intensity. This phase is dedicated to determining which foods you plan to eliminate. You will want to create a list of foods/ingredients you can eat and foods/ingredients you cannot. It’s important to figure out meal ideas and plan ahead, ensuring you stay on track. You don’t want to start your elimination diet feeling overwhelmingly restricted or like you can’t eat anything.
Phase 2: Avoiding
Phase 2 typically lasts between two and four weeks. This phase is dedicated to avoiding the foods you’re eliminating. Avoiding the foods allows your body time to recover and reset from the toxins and symptoms caused by your potential triggers. During this time, you must remain strict with the foods you consume.
Phase 3: Reintroducing
Phase 3 can take quite a while, depending on how many foods you initially eliminated and have to reintroduce. When reintroducing foods, you must introduce one new food every four days to ensure your body has enough time to show symptoms. Believe it or not, unwanted symptoms can take up to three days to appear. Fours days – one day to consume and three days for symptoms to appear.
It is important to remain strict with the foods you consume. Ensure you track everything from moods, headaches, bowel movements, beverage intake, food intake, and anything else you can think of. A great way to keep track of this information is by purchasing a food sensitivity journal. Once you’ve confirmed that a food is safe, write it down and reintroduce another food, but only after the three days of symptom-waiting is up.
Allergies Vs. Sensitivities
Food allergies, sometimes called food hypersensitivities, are severe and potentially life-threatening medical conditions affecting approximately 32 million Americans. This reaction is typically caused by an immune response when your immune system overreacts to a normally harmless food protein (allergen) or an IgE immune response with a nearly immediate reaction time (4). The eight major food allergens include (5):
Milk
Eggs
Fish
Shellfish
Tree nuts
Peanuts
Wheat
Soybean
Typically, food allergies cause one or more of the following symptoms: (6):
Tingling or itching in the mouth
Hives, itching, or eczema
Swelling of the lips, face, tongue, throat, or other parts of the body
Wheezing, nasal congestion, or trouble breathing
Abdominal pain, diarrhea, nausea, or vomiting
Dizziness, lightheadedness, or fainting
Constriction and tightening of the airways
A swollen throat or the sensation of a lump in your throat that makes it difficult to breathe
Shock with a severe drop in blood pressure
Rapid pulse
Dizziness, lightheadedness, or loss of consciousness
On the contrary, food sensitivities, sometimes called food intolerances, typically aren’t life-threatening but more uncomfortable, affecting approximately 20 percent of the world’s population (7). Food sensitivities occur when a person has difficulty digesting a particular food. Food sensitivities usually result in increased levels of specific IgG class antibodies and can have a delayed response time up to a few days after consumption (8). The eight major food sensitivities or intolerances are (9):
Dairy
Gluten
Caffeine
Salicylates
Amines
FODMAPs
Sulfites
Fructose
Typically, food sensitivities cause one or more of the following symptoms (10):
Abdominal pain
Diarrhea
Gas
Bloating
Headaches or migraines
Heartburn
Nausea
Upset stomach
If this sounds like something you experience, you may want to consider an elimination diet. No worries, I know elimination diets can be overwhelming, so I’ll share what I did to prepare for my elimination diet.
Preparing for an Elimination Diet
When planning my 66-food elimination diet, alongside my already strict, plant-based lifestyle, I admit I was a bit overwhelmed. My elimination diet took approximately eight months, but I couldn’t have done it without extensive planning. So, without further ado, here are the steps I took to ensure I had a successful elimination diet:
Step 1: I took two food sensitivity tests (one from EverlyWell and another from Check My Body Health. If you want to see my results, you can view my Everylwell results here and Check My Body Health results here.
Step 2: Upon receiving my detailed analysis reports, I printed them out and created a 1-inch binder with sheet protectors to quickly reference my potential food sensitivities.
Step 3: I bought a food sensitivity journal that allowed me plenty of space to track all the food I would consume during my elimination diet. The journal also had room to record my mood, symptoms, bowel movements, water intake, and sleep. I really enjoyed the information about food sensitivities, allergies, and intolerances in the front of the journal.
Step 4: I cross-referenced my printed lists of potential food sensitivities from both companies and typed up a list of all the foods since my list was very long. I then printed this list and stapled it to the inner front cover of my journal to ensure easy access at all times. I also saved this list on my phone for access on the go.
Step 5: I started working on a meal plan. Due to the extensivity of my results, I decided to go from plant-based to whole-food plant-based for the duration of my elimination diet. I then carefully strategized my meal plan to ensure each meal had the nutrients my body needed to function while avoiding deficiencies and remaining full throughout the day.
The results of my elimination diet weren’t what I expected. Of the 66 foods I eliminated, all but about 10 were successfully reintroduced. Since completing my elimination diet, I have read (and co-wrote) Earthley’s Gut Health Support Guide, focused on my gut health and successfully reintroduced two of my confirmed food sensitivities. Long story short, with hard work and dedication, you may be able to heal your gut and successfully reintroduce your food sensitivities.
⚠️ Warning: The Holistic Hipppie is not a functional medicine practitioner. These statements have not been evaluated by the FDA. This content is not medical advice and should not be used to diagnose, treat, cure, or replace medical guidance. The Holistic Hipppie assumes no liability for the application of the information discussed.
Have you ever done an elimination diet? If so, how did it go for you?
