Do you find yourself eyeing down the restroom the second you get to a restaurant? Or maybe you’re regularly avoiding social outings to deal with another upset stomach? Whether you’re plagued by bloating, fatigue or uninvited diarrhea that frequently interrupts your day, getting to the bottom of it may start with what’s on your plate.
Enter elimination diets — a dietary approach that involves identifying and removing problematic foods that trigger your uncomfortable symptoms.
People use elimination diets to help identify food allergies and intolerances in the strictest definition. They involve eliminating foods and reintroducing them one at a time to determine which foods or ingredients may be problematic. Health experts consider the Whole30 diet, gluten-free diet and low FODMAP diet elimination diets. More broadly, however, people use the term elimination diet to cover all programs that remove food groups or specific foods. Under this broader definition, the following diets qualify as elimination diets.
[READ: Stomach Bloating: How to Relieve Your Tight, Round Belly.]
What Are Elimination Diets?
An elimination diet gives the body a break in order to identify which foods may be causing gastrointestinal symptoms and other issues, like skin rashes and difficulty sleeping. There are an array of elimination diets, and not all registered dietitians agree on which eating regimens belong in that category.
In the strictest sense, an elimination diet is a structured dietary approach in which an individual temporarily removes specific foods or food groups from their diet and reintroduces them one at a time to identify and address adverse reactions, including food allergies, sensitivities and/or intolerances. The goal of following an elimination diet is to narrow and pinpoint the root cause of any symptoms or discomfort that could be associated with consuming certain foods.
More broadly, people use the term elimination diet to cover any regimen that involves removing entire food groups or specific foods.
[READ: Everything You Need to Know About Common Food Allergies]
How Elimination Diets Work
Elimination diets generally follow a similar approach: Someone experiencing unexplained symptoms stops eating certain foods for several weeks, then slowly resumes consuming them again. If your symptoms return when you start eating certain foods again, those foods may be the cause of your issues.
“Elimination diets work best when they are simple, straightforward and singular, meaning one category of food is eliminated completely for a two- to three-week period,” says Kate Cohen, a clinical nutritionist at the Hospital for Special Surgery Lifestyle Medicine Program in New York.
“If someone tries to eliminate multiple categories at once and sees an improvement, that person will have to further eliminate or carefully reintroduce in order to identify the problematic food item or category,” she says.
With all elimination diets, it’s important to keep in mind that even though a food may cause you distress, it doesn’t mean you have to completely eliminate it from your diet, says Lisa Jones, a registered dietitian based in Philadelphia. “You may be able to limit your consumption of gluten products, for example, and enjoy smaller amounts to avoid experiencing symptoms.”
Ultimately, “elimination diets are not designed to be your forever diet,” Cohen adds. “You might discover that a specific food doesn’t work for you, then you can thoughtfully figure out how to make sure you are still getting what you need. But don’t restrict forever.”
Working with a registered dietitian or other health care professional can help you find the right balance of foods.
[SEE Best Foods to Eat for Gut Health]
Reasons for Trying Elimination Diets
Elimination diets are recommended for a number of reasons. Your health care provider may recommend trying an elimination diet to pinpoint the cause of certain symptoms, such as:
— Heartburn.
— Bloating.
— Stomach pain.
— Constipation.
— Diarrhea.
— Fatigue.
— Difficulty sleeping.
— Skin rashes.
Benefits of Elimination Diets
Following an elimination diet protocol comes with a range of potential benefits, including:
— Manage or reduce symptoms.
— Identify food sensitivities or allergies.
— Reduce overall inflammation.
— Inexpensive and easy to follow.
1. May help manage or reduce symptoms.
Elimination diets can help pinpoint foods causing your discomfort. The benefit? Using your findings can serve as a preventive health measure, allowing you to manage or reduce symptoms. In some cases, this may even reduce the risk of long-term health complications associated with chronic inflammatory conditions or allergic reactions.
For example, one study evaluated the potential effect of an immunoglobulin G-based elimination diet among individuals who experience both migraines and irritable bowel syndrome. IgG is a type of antibody produced by the immune system in response to the presence of antigens, and an elimination diet involves temporarily reducing foods identified as having IgG antibody levels — which commonly includes foods such as dairy products, wheat, eggs, legumes, artificial sweeteners — based on blood test results. Researchers found that food elimination based on IgG antibodies may effectively reduce migraine and IBS symptoms.
Another study looked at 50 adults with eosinophilic esophagitis, a chronic allergic condition of the esophagus, who underwent a six-food elimination diet over a six-week period. The research suggests that an elimination diet significantly improves symptoms of EoE — reported most commonly as dysphagia (difficulty swallowing), food impaction and heartburn; and that reintroduction pointed to wheat and milk as foods most frequently associated with the condition.
2. Helps identify food sensitivities or allergies.
Removing and reintroducing specific foods can help you identify food sensitivities or food allergies, such as a gluten sensitivity. Not only can this help provide relief from uncomfortable symptoms, but avoiding food triggers can help improve your overall quality of life and prevent serious health complications or reactions, like anaphylaxis, that could arise.
Knowing what foods trigger your symptoms will help you create a customized and sustainable dietary approach.
3. May reduce inflammation.
Most studies looking at inflammation and the diet tend to focus on broader dietary patterns rather than elimination diets specifically. However, with an elimination diet, you’re often eliminating foods that can exacerbate inflammation in the body, such as:
— Refined sugars.
— Dairy.
— Gluten-containing foods.
Consuming a diet low in processed foods and refined sugar tends to mimic patterns of anti-inflammatory diets like the Mediterranean diet. The low consumption of sodium, saturated fat and sugar in the Mediterranean diet combined with an emphasis on whole grains, fatty fish, fruits and vegetables are thought to positively impact inflammation levels in the body.
4. Relatively inexpensive and easy to follow.
“Elimination diets are a simple, inexpensive and relatively easy way of testing different types of foods to see if they are giving you GI or other symptoms,” Cohen says.
Though it’s recommended to consult with your doctor, elimination diets can be followed at home on their own. They are particularly useful if you plan to see a health provider, such as your internist, a GI doctor or a registered dietitian, Cohen adds, “as it gives you information to share with that person — data that is just about you.”
Collecting this information is especially useful given that those professionals are generally not around when you’re experiencing your symptoms.
Risks of Elimination Diets
Elimination diets can be beneficial for identifying food triggers, especially under the guidance of a health care professional. However, some potential risks associated with elimination diets include:
— Nutrient deficiencies associated with eliminating entire foods or food groups.
— Disordered eating patterns due to excessive restriction or focus on healthy eating.
— Food sensitivity misdiagnosis.
— Social and psychological impacts, affecting overall quality of life.
— Unintended weight loss or weight gain.
6 Types of Elimination Diets
There’s no hard-and-fast rule as to what constitutes an elimination diet. It would be to your advantage to meet with a registered dietitian nutrition (RDN) before starting an elimination diet, especially if you on prescribed medication. A RDN can help you with your dietary and health needs.
These six widely used and well-known elimination diets aim to alleviate varying health issues, though not all of these diets have strong scientific evidence to support their purported benefits:
— Low FODMAP diet.
— Whole30 program.
— GAPS diet.
— AIP diet.
— Gluten-free diet.
— Low-residue diet.
1. Low FODMAP diet
The low FODMAP diet is recommended for people with irritable bowel syndrome or small intestine bacterial overgrowth, known as SIBO, who experience frequent cramping, diarrhea, constipation and other uncomfortable digestive symptoms. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, representing a group of short-chain carbs or sugars that are poorly absorbed in the small intestine.
The goal of a low FODMAP diet is to help individuals identify and manage foods that may trigger intestinal distress. Dieters do this by eliminating foods high in FODMAPs, such as:
— Wheat and rye.
— Lactose, found in dairy-based milk, yogurt or soft cheeses.
— Legumes.
— Fructose.
A low FODMAP diet is most easily followed with the help of a registered dietitian, Cohen says. “It is very restrictive, requires a lot of discipline to follow and is not designed to be followed long term, so it’s essential to have someone who can help interpret the results.”
2. Whole30 program
The Whole30 diet is a short-term elimination period followed by a reintroduction phase. Over the 30-day elimination period, the program eliminates food groups commonly associated with inflammation, digestive issues and hormonal imbalances.
Foods to avoid in the Whole 30 diet elimination phase include:
— Added sugar of any kind, real or artificial.
— Grains.
— Dairy.
— Legumes, including all forms of soy.
— Alcohol, except for wine vinegars.
— Carrageenan or sulfites.
3. GAPS diet
The GAPS diet, which stands for gut and psychology syndrome diet, is a restrictive elimination diet that targets individuals with a “leaky gut,” which is when the lining of the intestines becomes more permeable and allows substances like toxins or bacteria to pass through the gut to the bloodstream. The GAPS diet claims to detoxify the body and heal the gut lining.
The GAPS diet is divided into two parts: an introduction diet and a full GAPS regimen. Once you’ve completed the six-phase introductory diet, you can then move to the full GAPS regimen which lasts upwards of two years.
The GAPS introduction phase involves eliminating certain foods, such as:
— Grains.
— Pasteurized dairy.
— Sugars.
— Starchy vegetables.
The GAPS diet is implemented in stages, with the gradual reintroduction of certain foods to assess individual tolerance and identify potential triggers.
4. AIP diet
The AIP diet, short for autoimmune protocol diet, and sometimes referred to as the autoimmune paleo diet, was developed to reduce inflammation in the body and ease autoimmune disease symptoms. Followers of the AIP diet eliminate foods that commonly cause inflammation or irritation to the gut for 30 to 90 days, and carefully reintroduce foods one at a time to see how your body reacts.
Inflammatory foods to avoid during the elimination phase include:
— Nightshade vegetables, such as tomatoes, peppers, eggplants and potatoes.
— Grains.
— Nuts and seeds.
— Dairy and eggs.
— Added sugar and food additives.
— Caffeine, alcohol and tobacco.
If you have autoimmune conditions like rheumatoid arthritis, psoriasis, lupus or inflammatory bowel disease, discuss with your doctor if an AIP diet protocol might be a good option for you.
5. Gluten-free diet.
Some people associate gluten with processed and refined foods, so they may opt for a gluten-free lifestyle as part of a broader commitment to a diet filled with whole, unprocessed foods. However, for some people, a gluten-free diet is not just a choice but a necessary and lifelong treatment.
Gluten is a protein found in wheat, rye and barley. Eliminating gluten is essential for individuals with celiac disease, a chronic autoimmune disorder in which consuming gluten leads to diarrhea, abdominal pain and ultimately, damage in the small intestine. Additionally, those with gluten sensitivities who experience similar gastrointestinal symptoms may find relief from a gluten-free diet.
If you’re following this diet, keep these gluten-free staples on hand:
— Chicken, beef or fish.
— Dairy products, like cheese and yogurt.
— Gluten-free pastas made with black beans or chickpeas.
— Oats.
— Brown rice and potatoes.
— Fruits and vegetables.
When picking up gluten-free foods at the grocery store, make sure to check food labels to ensure gluten hasn’t been added as an ingredient.
6. Low-residue diet.
Following a low-residue diet means restricting any foods that contribute to the build-up of intestinal residue and leads to uncomfortable symptoms like cramps and gas.
A low-residue diet is intended for individuals with certain GI conditions, including:
— Diverticulitis.
— Ulcerative colitis or Crohn’s disease.
— Irritable bowel syndrome.
— GI tract infections.
— Cancer, either of the GI tract or experiencing GI discomfort due to cancer treatments.
— Following GI surgery.
To follow the diet, stock up on low-fiber, easily digestible foods, such as lean proteins like chicken, fish and eggs.
How to Start an Elimination Diet
Elimination diets can be restrictive and challenging to follow, even for just a few weeks. Experts recommend these strategies to help you start and sustain such a regimen:
— Work with a health care professional.
— Set specific goals.
— Be prepared.
— Stick with the plan.
1. Work with a health care professional.
For any individuals considering an elimination diet, especially if you’re experiencing gastrointestinal distress or other symptoms that could be related to your diet, it’s essential to consult with a registered dietitian and/or health care provider. Health care professionals can help you figure out what’s causing your symptoms and can guide you through an elimination diet, says Audra Wilson, a registered dietitian at Northwestern Metabolic Health and Surgical Weight Loss Center at Delnor Hospital in Geneva, Illinois.
Getting professional help is crucial because you’ll be cutting out a lot of nutrients with any elimination diet. A registered dietitian can help you find food options to replace those nutrients. And if you have a chronic condition — like diabetes — a registered dietitian can help you maintain a healthy regimen as you’re abstaining from certain foods.
2. Set specific goals.
Cohen says it’s important to have a specific goal in mind before getting started. “Make a plan — what do you want to test? What symptoms are you having that you’re trying to improve?”
That means setting a time period and sticking to it. Without a clear goal, it’s easy to forget why you started this whole process to begin with and taper off as the days go on.
3. Be prepared.
Before starting an elimination diet, you should also record what you eat and how your body responds, either on paper or with a nutrition tracking app. Continue to record your consumption and your body’s response during the elimination diet and when you resume eating foods you’ve abstained from.
Prepare for an elimination diet by creating a meal plan and stocking up on foods that are allowed for your specific eating regimen. If you’re going to eat out, check out the restaurant menu online ahead of time to see if they offer dishes you can eat, or call ahead and ask for specific details.
4. Stick with the plan.
“Be observant of how you feel,” Cohen says. “Keep your overall goal in mind and reevaluate along the way, but stick with it until the end of the period you set.”
It’s not uncommon for your symptoms to worsen during your first week on an elimination diet, says Elizabeth A. Smith, a registered dietitian in Murfreesboro, Tennessee, and an assistant professor of nutrition and food science at Middle Tennessee State University.
Those worsened symptoms are probably not a cause for alarm, but you should contact your health care provider to discuss your concerns. Worsening symptoms could be a sign that food is not the culprit and further testing is needed to diagnose the problem.
Elimination diets can be effective but they aren’t perfect, Smith says. “Other factors — like a stressful day — can interfere with results,” she says. “Discussing your concerns and symptoms with your health care provider is always prudent.”
Bottom Line
Elimination diets involve removing foods or entire food groups that are suspected of causing adverse reactions and gradually reintroducing them to pinpoint specific culprits. They can be a useful tool for identifying and managing food sensitivities or food allergies and reducing uncomfortable symptoms.
While elimination diets may be associated with potential benefits and can be followed at home, make sure to work together with a registered dietitian and/or health care provider to ensure you’re following a protocol safely and effectively.
More from U.S. News
Best Low-Carb Breakfast Ideas With High Protein
10 Bedtime Foods & Drinks for Deep Sleep
7 Easy Keto Desserts Everyone Will Love
How to Do an Elimination Diet and Why originally appeared on usnews.com
Update 02/21/24: This story was published at an earlier date and has been updated with new information.
