How to Do a Food Elimination Diet (Step-by-Step Guide)

How would you like to have more energy, sleep more easily, crave less junk food, and feel better? An elimination diet could be the best place to start. While there is of course no guarantee that cutting out common allergens such as gluten or dairy works for everyone, if you suspect you aren’t feeling yourself, eating clean could be the answer.

If you want to cure a health condition, or even just have more energy and feel better every day, an elimination diet is a good place to begin.

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My Story…

In September 2014, I embarked on a four-week modified elimination diet with the help of a nutritionist. Being told not to eat gluten, dairy or eggs was scary at first – it’s hard to imagine life without pizza, birthday cake or ice cream, especially when there is junk food everywhere we go.

But I had suffered through six months of chronic cold and sinus issues, with no answers from countless doctors. It turned out these foods were causing my health issues, and removing them made me feel a million times better. I still crave the pizza that I can’t eat, but I also actually crave kale too!

Avoiding gluten and dairy can sometimes feel like a full-time job that involves careful reading of product labels and restaurant menus, and you will probably start seeing food as “gluten” and “dairy” instead of, say, a loaf of bread or piece of cheese.

Why Try An Elimination Diet?

If you suspect that you have food allergies, an elimination diet is the best way to figure that out because you start to tune in to how you feel.

Some common symptoms that prompt an elimination diet:

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Digestive issues
Sinusitis, chronic cold and flu
Chronic fatigue
Autoimmune disease
Sinus and ear congestion
Asthma
Chronic migraines
Anxiety, depression, insomnia
Fibromyalgia

There are many famous cases of people who healed themselves with food after doctors were unable to treat their health conditions; and many have made food blog careers out of it, such as Ella Woodward (http://deliciouslyella.com) and Shauna Ahern (www.glutenfreegirl.com).

Food Allergies Vs. Food Intolerances

While these terms are used interchangeably (and really, if you don’t feel good when you eat something, the technical term for it doesn’t really matter), there are some key differences to keep in mind.

A food allergy affects the immune system and sets off IGE (immunoglobulin E) antibodies and histamines (which are chemicals). Food allergies range from serious to even deadly.

A food intolerance, on the other hand, is not quite as serious and means that your body is having trouble properly absorbing the food, which is why it often shows itself through digestive problems. It is easy to develop food intolerances if you eat the same food every single day. Symptoms can take anywhere from 12 to 48 hours to appear. A food sensitivity is even harder to diagnose and can show itself by making you feel foggy, crampy or exhausted.

While food allergies can be diagnosed through a blood test by your doctor, food intolerances and sensitivities are even harder to diagnose. Focusing on a whole foods, healthy diet by starting with an elimination diet (and cutting out all processed foods is always a good idea, too) is the quickest road to health.

Types of Elimination Diets

The kind of elimination diet you go on will depend on whether you are working with a dietitian or nutritionist, or embark on this new journey yourself. It can be helpful to receive a plan tailored to your specific symptoms and goals.

It is best to do a full elimination diet – as we are often sensitive to multiple foods – rather than simply removing one food.

A modified elimination diet will remove the following:

Gluten (including wheat, rye, barley)
Dairy (including milk, yogurt, cheese, ice cream, butter)
Eggs

A full elimination diet will remove the above, as well as:

Soy, corn
Alcohol, caffeine, chocolate, sugar
Nuts and fish (in some cases)

Thanks to celebrities like Gwyneth Paltrow, the most popular elimination diet is the one that removes gluten, a protein that forms when wheat flour and water mix.

If you suffer from celiac disease (an autoimmune disease that means gluten damages the small intestine’s lining), then you definitely need to avoid gluten. Some feel that just going gluten-free isn’t enough, and find full relief when they remove dairy and/or grains from their diet.

You may also be sensitive to amines (found in wine, cheese, chocolate, bananas, avocados, tomatoes) and/or salicylates (plant chemicals found in coffee, tea, honey, spices and wine). If so, you should also avoid all food additives.

A Step-by-Step Elimination Diet Plan

It can be easy to focus on the foods that you must avoid. The first week of my own elimination diet, I mourned the loss of pizza and started craving all the things I couldn’t eat. But even though a full elimination diet that also excludes chocolate, sugar, alcohol and caffeine seems scary, and it may feel that there is nothing for you to eat, it is helpful to focus on what you can eat.

Here are some foods that are allowed:

Carbohydrates/Whole Grains:

Brown rice, brown rice crackers, quinoa, millet
Sweet potatoes
Gluten-free pasta (quinoa, brown rice)
Gluten-free products are okay if low in sugar (brown rice bread, gluten-free waffles)

Dairy Alternatives:

Almond milk
Coconut milk
Rice milk
Coconut yogurt

It’s important to get enough calcium when not consuming dairy products. For a list of non-dairy ways to get enough calcium, go here: www.womenshealthmag.com/nutrition/foods-high-in-calcium

Protein: lean beef, chicken, fish (if not avoiding), beans, chickpeas, lentils

Fruit and vegetables: the more the better. Try to get lots of variety: grapes, apples, dark berries, leafy greens (kale, lettuce, swiss chard), citrus fruits.

Good fats:

Olive oil
Coconut oil
Avocados
Nut butters (sunflower seed butter is a good alternative for a nut allergy).

You will keep a food journal recording what you eat and any corresponding symptoms, which helps you work out how to proceed once the diet is over.

A Sample Daily Meal Plan

It’s a good idea to have a balance of protein, carbs, good fats and fruits/vegetables at each meal, and to make sure that you drink enough water throughout the day.

Here is a sample daily menu:

Breakfast

– A smoothie with ½ banana (can substitute 1/8 avocado, or if allergic to both then can substitute a piece of cooked sweet potato or pumpkin puree), ½ cup blueberries, 1 cup almond milk, 1 scoop protein powder

– 2 slices toasted gluten-free brown rice bread with 1 tbsp peanut or almond butter

– Some good protein powder brands: Sun Warrior (http://www.sunwarrior.com/), Vega (http://myvega.com/)

Morning Snack

– 10 cashews with a handful of grapes/an apple/an orange

Lunch

– A salad with chicken/fish/black beans/chickpeas, 1/8 avocado, homemade olive oil based dressing, 8 gluten-free crackers such as Mary’s brown rice crackers (http://www.marysgonecrackers.com)

Afternoon Snack Ideas

– 1 apple with 1 tbsp almond butter, 1 cup raw veggies with ¼ hummus, 1 apple with a handful of cashews

Dinner

– 5 oz chicken/salmon with salad/sautéed kale, ½ cup quinoa or brown rice

More lunch and dinner recipe ideas:

http://elanaspantry.com/agave-lime-chicken/
http://againstallgrain.com/2012/04/12/moroccan-chicken-salad/
http://www.thekitchn.com/recipe-red-lentil-soup-recipes-from-the-kitchn-212392

How Long Will the Elimination Diet Last?

The typical length of time is 3 to 4 weeks.

What Happens Now?

You can start to reintroduce the foods that you removed to see if you have any symptoms. The typical advice is to only reintroduce one food at a time, and then wait a day or two to try another one.

Sometimes you can eat some of the stuff you removed if you have no adverse reactions. Sometimes you will love how much better you feel and stick with the diet (which then becomes more of a lifestyle).

Common Problems

There are some common things to watch out for as you embark on this change:

Feeling worse before you feel better

My first week of my elimination diet, I was exhausted, low energy, and had headaches. After some research, I learned that for as little as one week and as many as three weeks, your body suffers from withdrawal symptoms. This is believed to be a sign that you are in fact allergic or intolerant of the food you are avoiding (gluten and dairy being the most common).

Social situations involving junk food

Let’s face it: socializing often involves food. It can be tough to go to a bar with friends and not be able to eat the cheese quesadillas everyone has ordered. It can help to remember why you are on the elimination diet in the first place: to feel better.

Replacing bread and other gluten-filled grain products with unhealthy gluten-free products

Gluten-free baked goods in particular are processed foods that are loaded with sugar, salt and fat. And they can be more caloric, too: a gluten-free muffin has 370 calories compared to the 170 calories of a regular muffin. Some products are okay: Nature’s Path offers many low-sugar, gluten-free cereals.

Not getting enough nutrients or eating enough

That’s one reason why it can be helpful to work with a nutritionist, who can advise you to eat enough fat at meals, for example (such as part of an avocado or a handful of nuts), or can prescribe supplements like vitamin C. A probiotic pill is also helpful for gut health.

FAQs

If I’m avoiding gluten, is avoiding bread enough?

Gluten is sneaky and hides in places you wouldn’t expect. You will have to avoid soy sauce, candy, beer, most condiments, and most processed foods. The best idea is to always read labels.

I have a sweet tooth. Do I have to avoid dessert on the elimination diet?

We all get cravings, and that’s okay. Try making your own baked goods and using better sweeteners, such as honey and maple syrup or even coconut sugar, instead of white or brown sugar. Gluten-free baking often involves almond and coconut flours. You can even replace an egg in a recipe by mixing together one tablespoon of flax seeds and 3 tablespoons of water.

Can I eat oats?

Oats are a gray area. Some say you can eat them if they are labeled gluten-free. Others have digestive issues. The problem with oats is not that they themselves contain gluten but that they can be cross-contaminated with gluten. Listening to your body is best.