An elimination diet can be a useful tool in managing the unpleasant symptoms of gastrointestinal conditions, such as irritable bowel syndrome (IBS) and Gastroesophageal reflux disease (GERD). Symptoms can often be intense, painful, and even confusing when you’re not sure what’s causing it.
First things first, you shouldn’t go on an elimination diet without talking to your doctor, who may refer you to a dietitian to help you through the process. There is a risk of developing nutritional deficiencies with any major dietary change and it is important to ensure that you follow the diet effectively for best results. Many foods contain ingredients you wouldn’t necessarily expect, which could derail your elimination diet, so keeping a food diary and working with a dietitian can make this process easier.
Find more about gut health Y how to improve your digestion here in Living Science.
What is an elimination diet?
There are multiple reasons someone might try an elimination diet. If you are experiencing bothersome gastrointestinal symptoms, you may want to eliminate certain foods to help pinpoint the cause of your problems.
Common elimination diets include low FODMAP diet, or the Six Food Elimination Diet, which is usually carried out over several weeks or months. the Journal of Gastroenterology and Hepatology (opens in a new tab)recommends not exceeding six weeks in the elimination stage, particularly for the low-FODMAP (fermentable oligo-, di-, mono-saccharides and polyols) diet, as it can negatively affect your gut microbiome.
“An elimination diet is a method of identifying foods to which a person is intolerant or sensitive,” explains Rachel Clarkson, a Doctify (opens in a new tab)-reviewed dietitian and nutritionist, and the founder of The DNA Dietitian (opens in a new tab). “An individual may begin an elimination diet to help identify problem foods in their diet that are causing symptoms.
Rachel Clarkson, RD, Master of Science, PGDIP, Bachelor of Science
Rachel Clarkson is a registered dietitian and nutrition specialist with HCPC. She trained at King’s College London in the UK and did additional clinical training at The Royal Marsden, St Thomas’s Hospital and Imperial College Trust. She recently published her epigenetic research from King’s College London in a peer-reviewed medical journal and continues her professional development with courses on topics such as the low FODMAP diet for the management of IBS.
“The length of an elimination diet can vary depending on the type and amount of food that is eliminated and then reintroduced or challenged. One of the most widely used and scientifically supported elimination diets is the low FODMAP diet. This diet excludes foods that contain compounds called FODMAPS that cause digestive symptoms in people with IBS. This elimination diet can take anywhere from 10 to 16 weeks for all three phases: elimination, reintroduction, and customization.”
High-FODMAP foods include some vegetables like onions and garlic, some fruits (especially stone fruits), beans, and lentils.
“Reviewing trigger foods or ingredients that can aggravate symptoms will be helpful, so completing a food and symptom diary can be a sensible approach,” adds Kim Plaza, nutritionist at Bio-Kult.
How to follow an elimination diet
If you suspect you have a particular trigger food (like dairy or gluten), it’s worth cutting it out for a few weeks to see if your symptoms improve. However, if you are unsure what your trigger foods may be, or have been diagnosed with a particular condition that may benefit from a broad-spectrum elimination diet, you should follow the steps below under the supervision of a physician.
Elimination
“This phase is typically 2-6 weeks where all potentially problematic foods are removed from the diet,” explains Clarkson. “By the end of this phase, the symptoms should have completely subsided.”
A nutrients (opens in a new tab) The journal review indicates that the low-FODMAP diet, in particular, significantly reduced swelling and pain in the subjects. A clinical trial published in the Journal of Allergy and Clinical Immunology (opens in a new tab) also found that an elimination diet achieved remission in 43% of study participants with eosinophilic esophagitis, regardless of age.
reintroduction
The reintroduction phase involves systematic testing of each food group that has been removed.
“This phase can take anywhere from 4 to 8 weeks, depending on how much food is being challenged,” says Clarkson. “During this phase, people should continue to eliminate all problem foods, with the addition of the food that is being challenged to assess if it is causing the problem symptoms. Each potentially problematic food is tested individually and the amount is gradually increased to understand if the person is intolerant to this food and at what amount the symptoms start to appear.”
Integration/Customization
The final phase of an elimination diet is where the results of dietary challenges are reviewed and discussed, says Clarkson.
“In addition, other challenges may be prescribed where more than one problem food is introduced at the same time. Finally, the use of supplements, digestive enzymes or probiotics can be discussed.”
What can you eat on an elimination diet?
It is advisable to cook your meals with raw ingredients at this stage, so you know exactly what you are consuming. Processed foods often contain flavorings, such as onion or garlic powder, which can trigger symptoms even in small amounts.
- Unprocessed meats and fish (not shellfish)
- rice-based foods
- Non-dairy fats, such as vegetable oils
- Low-FODMAP fruits and vegetables
What can’t you eat on an elimination diet?
The most common dietary triggers are often the first to be eliminated to test symptom response:
- Dairy products
- wheat and rye
- Nightshade vegetables (eg, potatoes, tomatoes, and bell peppers)
- Seafood
- Nuts and seeds
- Alliums (onions and garlic are high in FODMAPs and cause irritation in many people)
- legumes
- Citrus fruits (can be triggers for people with acid reflux and GERD)
Plaza also says that highly processed foods can be problematic. “Processed foods that are high in hidden sugars, sweeteners, additives, and emulsifiers are likely to have a negative impact on the bacteria that live in the gut, leading to increased inflammation and worsening of IBS symptoms.” , He says. “Many people notice a rapid improvement in their digestion simply by cutting out processed foods and switching to homemade whole foods instead.”
What are the benefits of an elimination diet?
According to Clarkson, identifying your trigger foods can help you make the best choices for your body. “The main benefit of an elimination diet is being able to identify the foods that cause the symptoms and in what quantity these foods cause the symptoms,” she says. “This is a huge benefit because it allows you to make the best decisions for your body and helps you understand your body on a deeper level.”
Are there risks of an elimination diet?
On an elimination diet, you must take care to ensure that you continue to receive the recommended daily amount of each nutrient, and as such, you must do so under professional supervision.
“There may be risks to cutting out food groups for an extended period of time,” says Clarkson. “Working with a healthcare professional can ensure that you carry out the elimination diet correctly and in the safest way.”
This article is for informational purposes only and is not intended to offer medical advice.
