DH: Elimination Diet
Certain foods or groups of foods cause gastrointestinal (GI) and other body system symptoms. You may have bloating, gas, or diarrhea, headaches, congestion, or a skin rash. The symptoms are a result of the body’s reaction to the food/foods. For example, GI symptoms are from inflammation in the lining of the intestines.
Question: How do you know if there’s a relationship between your diet and certain symptoms?
Answer: An elimination diet.
An elimination diet excludes certain foods/types of foods from your diet for a period of time. The foods are then slowly reintroduced, watching for possible symptoms. This helps identify food intolerances and sensitivities. Important! - Elimination diets can be complicated. It is recommended that you work with your Goodpath coach throughout the process.
How Does an Elimination Diet Work?
You or your Goodpath coach may suspect you have an egg sensitivity/intolerance because you seem to have worsening digestive symptoms when you eat eggs. In order to test this, all foods with eggs are removed from your diet, then small amounts of eggs are slowly added back. You monitor any change in symptoms both during the time without eggs and when they are added back into your diet.
It is helpful to keep a food diary when you eliminate and reintroduce foods - it helps you to identify clues and trends, which are critical steps in improving symptoms.
How Long Does an Elimination Diet Last?
An elimination diet usually lasts anywhere from 3 to 8 weeks (including reintroduction) - this allows time for the intestinal lining to heal or other bodily reactions to subside. You should work with your Goodpath coach to determine the appropriate time period for your elimination diet. The time for your elimination diet is also dependent on the food(s) you're eliminating.
Typically, your body requires at least 1 to 2 weeks in the Elimination phase to recover from the effects of potentially triggering foods.
Don’t Stop Early! - You may actually start to feel better early in the process and be tempted to quit. If you do, you may eliminate certain foods unnecessarily. You need to slowly reintroduce foods and monitor for symptoms.
Which Foods Should I Eliminate?
Food sensitivities or intolerances occur when the body (e.g. the intestinal lining) reacts to specific foods and ingredients. The cause is not entirely understood. The most common ones are:
Other food components may also cause a reaction. Examples include amines, salicylates, sulfites, fructose, artificial sweeteners, and certain vegetables.
Your Goodpath coach can help you identify triggering foods and ingredients by reviewing your dietary intake (dietary recall) and your food and symptoms.
You may also have an allergy - when your body’s immune system reacts, to some of the same foods or ingredients. Although the causes are different, they can have similar symptoms.
What Are The Steps Of An Elimination Diet?
This typically involves a two-step process. The elimination (avoidance) phase and the reintroduction (challenge) phase. These two steps are individualized to you, your diet, and your symptoms.
Take Time To Prepare
Keep a food and symptom diary for the week before starting your elimination diet. It will help you and your Goodpath coach identify patterns between your diet and symptoms and determine which foods to remove from your diet.
Your coach will help you with safe food options and substitutions.
You and your coach can work together on grocery shopping and meal planning.
Elimination (Avoidance) Phase
You’ll omit one or more foods that you suspect are triggers.
At first, you may notice some symptoms, as you remove certain foods from your diet. It’s similar to withdrawing from caffeine or from sugary foods.
It may help to make a list of safe and substitute food options categorized by proteins, vegetables, carbohydrates, and healthy fats. You can pick something from each category to assemble a quick meal.
Reintroduction (Challenge) Phase
After the Elimination (Avoidance) phase of your diet, you will reintroduce different groups of foods. Every three days, reintroduce one particular food group. The order doesn’t matter.
For three days, watch for symptoms as you reintroduce the group of foods. Try a small amount on day 1, have twice the amount on day 2, and have a larger portion on day 3. If symptoms don’t flare up, then you’ll be able to have this food in your diet later on.
Challenge #1 (e.g. corn)
Day 1: Introduce one small portion of food (e.g. 1/2 cup [120 g] of corn)
Day 2: If no symptoms occur, eat twice the amount as day 1 (e.g. 1 cup [240 g] of corn)
Day 3: If no symptoms occur, eat a larger portion than day 2 (e.g. 1.5 cups [360 g] of corn)
Challenge #2 (e.g. nuts)
Day 1: Introduce one small portion of food (e.g. small handful of nuts)
Day 2: If no symptoms occur, eat twice the amount as day 1 (e.g. 1/4 cup [60 g] of nuts)
Day 3: If no symptoms occur, eat a larger portion than day 2 (e.g. 1/2 cup [120 g] of nuts)
Note: Only have a “challenge” food for one to three days. Do not add it back into your meal plan until the elimination diet is over. If a food causes symptoms, remove it immediately. Wait until your symptoms completely disappear before challenging with the next food.
Tips for the Reintroduction Phase:
Write down what foods you eat and how much! Quantity matters - you may be able to tolerate a particular food, but in a smaller quantity (e.g., ½ cup versus 1 cup).
Note how you feel after eating foods you reintroduce. Any changes to your digestion or energy levels?
The elimination diet may seem overwhelming, but having a plan and paying attention to foods and symptoms are really all you need to do.
Consider the diet as an experience to learn more about your body, eating choices, and habits. Your Goodpath coach can help support you, answer your questions, and help you through challenges while you complete an Elimination diet.