Elimination Diet: What You Should Know

source – cleveland clinic

An elimination diet is a meal plan that eliminates or restricts specific meals or components to determine which foods or ingredients you may be sensitive to or allergic to.

Medically Reviewed by Dr. K on 14th February 2022.

Elimination Diet: What You Should Know

An elimination diet is a meal plan that eliminates or restricts specific meals or components to determine which foods or ingredients you may be sensitive to or allergic to.

It’s not about losing weight. You aren’t trying to burn off some extra calories or lose weight.

An exclusion diet is most often used when you and your doctor suspect that specific foods are causing your allergy symptoms. You’ll need to work with your doctor to ensure you’re getting all of the nutrients you need.

Don’t do it if you have a severe food allergy or have experienced an extreme allergic response known as anaphylaxis. If this is the case, you must identify your trigger meal as soon as possible to avoid it. That is something you should discuss with your doctor. Some food allergies may be detected via blood and skin testing. Before you can safely attempt an elimination diet on your own, you may need them.

How Does an Elimination Diet Work?

An elimination diet consists of two parts:

  • The phase of elimination (avoidance)
  • The period of reintroduction (challenge)

Elimination phase

The first step is to quit consuming questionable items. You’ll need to check food labels carefully and inquire about restaurant preparation methods. Keep a food journal and track everything you consume, as well as how you feel afterwards. While you do this, your doctor will keep an eye on you for a few weeks.

Foods to avoid when on an elimination diet include:

  • Citrus
  • Milk
  • Eggs
  • Wheat and gluten, rye, barley, and malt vinegar, are all sources of gluten.
  • Shellfish
  • Soy

Always keep food additives in mind. Certain have been reported to cause allergic reactions in some people:

  • Things with the suffix -amine (histamine, tyramine, octopamine, and phenylethylamine)
  • Colours added to meals artificially (tartrazine and dyes derived from coal tar)
  • Aspartame (artificial sweetener)
  • Butylated hydroxyanisole and butylated hydroxytoluene (preservatives)
  • Disaccharides such as lactose and other disaccharides
  • Glutamate monosodium (flavour enhancer)
  • Nitrates and nitrites are two types of nitrates (preservatives)
  • Sulfites, benzoates, and sorbates (preservatives)
  • Tragacanth or agar-agar (thickeners or stabilisers)

It’s possible that you won’t need to avoid all of these meals simultaneously. If you think that consuming dairy products makes you feel terrible, you should start by avoiding them.

Make sure you’re eating foods with the same nutrients as those you’re avoiding. For example, if you’re advised to cut off dairy products for a while, you’ll want to search for calcium-fortified meals. (Soy is an excellent source, but check your plan to see whether it’s permitted.) A nutritionist can assist you in creating a shopping list. ​​​​​​​

Reintroduction (challenge) phase

After you’ve removed potential food allergy triggers, gradually reintroduce questionable items one by one. This procedure assists you in determining which foods are problematic.

As you reintroduce each item, keep track of any symptoms in your food diary.

If you return a meal and have any of the following symptoms, get immediate medical attention and discontinue the elimination diet until your doctor advises it’s safe to resume:

  • Swelling of the throat
  • Hives or a rash that appears suddenly
  • Breathing problem

The last stage is to quit consuming the problematic foods one by one. This time, the list should be shorter. The aim is to see whether your symptoms go away permanently.

It’s important to remember that you may be sensitive to food without being allergic to it. Even so, the elimination diet may help you figure out which foods you should avoid.

If your symptoms go away after you stop eating a particular food or component, your doctor should conduct blood or skin testing to confirm your food allergy diagnosis. This method may be used to identify some, but not all, food allergies.

Types of Elimination Diets

There are several types of elimination diets. Your doctor can design one that’s right for you. 

Some common types are: 

Simple (modified) diet. This simple elimination diet consists of eliminating just one food or, in some instances, the two most frequent food allergy triggers: wheat (including gluten-containing foods) and dairy. Consume gluten-free meals such as brown rice, millet, buckwheat, or quinoa instead.

Moderate intensity diet. You’ll avoid a variety of food categories all at once. You don’t eat or drink anything on this diet:

  • Alcohol
  • All fats, both animal and vegetable
  • Several fruits and vegetables
  • Chocolate
  • Coffee, tea, and soft beverages are all available.
  • Dairy
  • Eggs
  • Legumes
  • Nuts
  • Wheat
  • Yeast extracts

Inquire with your doctor about the meals you need to maintain your health. If you don’t want to avoid animal protein altogether, try lamb or chicken, both of which are considered low-allergy.

Strict, few foods diet. This is the most strict elimination diet. You are only allowed to consume a limited number of things. You won’t want to stick to this diet for very long since it isn’t very healthy. On this level 3 rigorous exclusion diet, only the following items are permitted:

  • Apples or juice made from apples
  • Apricots
  • Asparagus
  • Beets
  • Sugar made from cane or beets
  • Carrots
  • Chicken
  • Cranberries
  • Honey
  • Lamb
  • Lettuce
  • Olive oil
  • Peaches
  • Pears
  • Pineapple
  • Rice is a grain of rice that is (including rice cakes and cereal)
  • Oil from safflower
  • Salt
  • Sweet potatoes
  • Vinegar (white)

Try to remain hydrated by drinking plenty of water, whatever method you pick.

Benefits of an Elimination Diet

An elimination diet may help you discover particular food allergens (ingredients to which you are allergic) and pinpoint a specific food allergy.

Elimination diets may aid in the discovery of the source of symptoms such as dry, itchy skin (dermatitis) and stomach discomfort.

The best approach to treat a food intolerance or allergy is to understand your food triggers and avoid them. With your doctor’s assistance, you may carefully design a healthy, safe, and customised food plan following an elimination diet.

Risks of an Elimination Diet

If you are allergic to certain foods, reintroducing them to your diet may be dangerous. Small amounts of a meal may be OK, but bigger servings can be problematic. You may be experiencing a severe food allergy response. If you consume a certain kind of food and get a rash, throat swelling, or difficulty breathing, seek medical attention straight once.

Sources

  1. https://www.webmd.com/allergies/allergies-elimination-diet 
  2. American Academy of Family Physicians: “Summary of the NIAID-Sponsored Food Allergy Guidelines." 
  3. Asthma and Allergy Foundation of America: “Food Allergies."
  4. Cleveland Clinic: “Food Challenge Test."
  5. National Jewish Health: “Food Allergy: Diagnosis."
  6. University of Wisconsin School Integrative Medicine Department of Family Medicine: “Elimination Diet."
  7. Academy of Nutrition and Dietetics: “What is an Elimination Diet?”
  8. National Institute of Allergy and Infectious Disease: “Guidelines for the Diagnosis and Management of Food Allergy in the United States.”
  9. UW Integrative Health: “The Elimination Diet.”
  10. Environmental Working Group: “EWG’S Dirty Dozen Guide To Food Additives.”
  11. Mayo Clinic: “What is MSG? Is it bad for you?”

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