Using the Elimination Diet to Hone in on Food Sensitivities

Have you ever wondered if the foods you’re consuming could be the cause of your health issues? According to the Cleveland Clinic, nearly 1 percent of adults in the U.S. are affected by food allergies (more than 3 million people), while food intolerances run much higher. The clinic reports that lactose, the most common specific food intolerance, affects 10 percent of Americans.

An elimination diet may be the best way to identify which food(s) might be triggering the body’s adverse reactions. “It’s the gold standard if a food sensitivity is suspected after fully evaluating a patient’s case,” said Dr. Joseph Radawi, MD, ABFM, medical director of Tri-Cities Functional Medicine in Bristol, Tennessee. “Blood sensitivity test results are lab-dependent, meaning that separate labs frequently return different results from the same blood test samples.”

The diet consists of removing specific foods or food groups from the diet suspected of causing a negative effect on a person. After a specified length of time, the foods are reintroduced one at a time to gauge their impact on the symptoms.

The most common food offenders are:

  • corn
  • dairy
  • eggs
  • gluten grains (barley, rye, spelt, wheat)
  • white sugar
  • shellfish
  • soy
  • beef
  • pork
  • processed meat
  • coffee and tea
  • chocolate

An elimination diet generally runs for three to six weeks. Three weeks is the absolute minimum to provide the body enough time to deplete the antibodies built up from its adverse reaction to the food.

How to safely start an elimination diet

As beneficial as an elimination diet can be in revealing the cause(s) of health issues, it could also be detrimental if not performed correctly. Because eliminating several food groups may cause a nutritional deficiency, it’s essential to work with a qualified practitioner. Lab tests may reveal imbalances in the body that can be addressed by a practitioner through nutraceuticals and other treatments alongside an elimination diet to support and heal the body.

Tambri Radawi, a certified functional medicine health coach and Dr. Radawi’s wife, individualizes the rate at which foods are eliminated from the patients’ diets. “I allow our patients to remove the foods over two weeks if it is overwhelming for them to remove them all at once,” Radawi said. “We remove two food groups every few days, making sure all the food groups are eliminated by the third week. It can be done in a variety of ways according to practitioner preference.”

Radawi teaches patients how to prepare and enjoy foods that may be new to them. “Helping our patients remain positive is vital to their success. We focus on the variety of wonderful foods they can enjoy rather than on what is being eliminated and create a plan from there.” Radawi meets with patients every two weeks, either individually or in a group. Keeping in close contact manages challenges and prevents setbacks. “Ingesting an eliminated food within the six-week elimination period returns the patient to day one for that food,” Radawi cautioned.

Benefits of the elimination diet

Frank and Kathleen Brown went through the elimination diet together and said they would gladly do it again if needed. After a winter season of experiencing multiple illnesses and generally feeling lethargic, they decided it was time to analyze their bodily functions and systems professionally. Their most important discovery was how “sugar zapped our energy,” Kathleen Brown said. “We’re now eating more vegetables than before, less beef and pork, and more chicken and fish. We gained energy and lost weight.”

The Browns found that by monitoring how full they felt during meals, they ate smaller portions and were satiated. Their challenges included sugar cravings, which they overcame by increasing exercise time and purchasing a vegetable chopper that made for quick meal preparation.

The elimination diet can have the following benefits: 

  • increased energy
  • reduced inflammation and pain
  • fewer digestive issues
  • lifting of brain fog
  • improved skin conditions
  • weight loss

It can be helpful for this with irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, anxiety and depression.

Rachel Dawson’s results concur. She experienced increased energy within the first two weeks of her elimination diet. The first six weeks of her program focused on removing all forms of sugar from her diet; the second six weeks continued eliminating sugar while adding the removal of grains, starches, dairy products, eggs and caffeine.

Dawson was sleeping more soundly, and her mental acuity shot up, which she described as, “clearing from a fogginess that I hadn’t before noticed.” Dawson said she was pleased with the 2 to 3 pounds per week weight loss. “Nothing dramatic,” she said, “but it has remained consistent for the past six months, totaling 50 pounds so far.”

Dawson had previously viewed following an elimination diet as an exercise in asceticism.

“I had never thought about how certain foods affect the body and how long it takes those foods to work their way out of your system,” Dawson said.

Food reintroduction 

The crucial time for the elimination diet is the food reintroduction phase. Eliminated foods are added back to the diet one at a time. The reintroduced food is eaten for one day and then removed again for three days. This waiting period is critical because the body can have a delayed reaction to the food. If reintroducing another food too soon, any reaction would be unclear as to which food caused it.

Noting which foods produced symptoms and which ones didn’t, you’ll have a clear understanding of the food to continue avoiding. After letting your body continue healing for six months or so, you can try reintroducing the symptomatic food again to test your body’s reaction to it.   

Avoid these 7 common elimination diet mistakes

1. Not seeking professional guidance. Remember that eliminating several food groups at the same time can lead to nutritional imbalances, which a practitioner will test for and address with the appropriate treatments.

2. Restricting caloric intake. Eat plenty of allowed foods for nutrients and satiety, including healthy fats such as extra-virgin olive oil, unrefined cold-pressed coconut oil, unsweetened coconut milk and coconut cream, and avocados.

3. Too many changes too fast. If needed, ease into the elimination diet. Preferably, get a head start by weaning off of caffeine and alcohol, and replace one take-out meal per day with a home-cooked, non-processed meal for a week or two before starting the full elimination process.

4. Not enough preparation. Explore recipes for the food groups you’ll be eating in place of the ones you’re eliminating. Test-run a few recipes ahead of time, so you’re set up for success with meals you can count on enjoying throughout the diet. Consider freezing several portions for busier-than-usual days and lunches to go.

5. Eating away from home. Realize that eating out is risky; you can’t honestly know what’s in the sauce, seasonings, dressings and marinades. When going to someone’s home, bring a dish to share that you know you can eat in case there aren’t clear options there for you.

6. Poor attitude. Jot down all your health issues before starting the diet, and review the list frequently. You’ll be bolstered during challenging moments by noting improvements, big and small, along the way. And remember why you’re completing the program. Post your “why” on your bathroom mirror, kitchen cabinet door, car dashboard, computer and television screens, where you work and play, and anywhere you need inspiration.

7. Expecting too much too soon. You may feel worse before feeling better, or changes will vary each day, so set your expectation to complete the diet and not rate it day to day. Your daily job is to follow the diet and not to analyze it. Maintain a diary and be honest about how you’re feeling, emotionally and physically. You may need to rest more, exercise more, eat more or drink more water.


Susan Ojanen is a freelance food and travel writer and a Certified Integrative Nutrition and Intrinsic Health Coach in private practice at smallstepswellness.com in Bristol, Tennessee. She educates and supports clients in building healthy new habits for maintainable lifestyle changes.

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