If you’ve been exploring an elimination diet for your persistent symptoms, you may be overwhelmed with all the conflicting advice. Some advocate for removing the top 6 allergens. Others say you should give up grains, legumes, and the big six. Some say it’s certain kinds of starches that are the problem.

I’ve heard from many of you who ask, “Which one is the right one?”, or “What do you think about the carnivore diet, is that a good one to try?”

It’s wonderful that so many people are becoming aware that their food choices have a huge impact on how they’re feeling. But many of you are falling into one of the traps I see a lot: the magic pill trap. It seems like if you can just figure out which elimination diet is the RIGHT one, then all your health problems will magically fade away.

The truth is, an elimination diet is only only ONE tool in a large box of many needed to resolve your symptoms. To get the best benefit from elimination diets, you have to choose the right one, AND use it properly to see the benefits.

 

What is an Elimination Diet, and Why Should You Use One?

 

An elimination diet is simply a diet where you remove certain foods to evaluate their effect on your body. If your symptoms improve while you have removed those foods, you can now tell that you have a sensitivity to them, and you can choose to remove them for a longer term while you work on finding your upstream causes of your sensitivity.

So often, your chronic symptoms are partly a result of eating foods you may not realize you are sensitive to. Trying a methodical elimination diet can help make sense out of all those symptoms, and help show you what is a problem for you.

But I so often see people make mistakes when they try to do elimination diets. And one of the frequent mistakes I see is choosing the wrong elimination diet for the situation.

Not only that, but diet templates are always a starting place, and must be customized. Because in Functional Nutrition and Medicine, what matters is not what has worked for everyone else, but what works for YOU.

 

How to Choose the Right Elimination Diet and How to Use It

 

The best way to choose the right elimination diet for you and your body is to begin with considering what kinds of symptoms you are experiencing. Are your symptoms primarily digestive in nature, are they more related to your immune health, or maybe you have a lot of hormone or neurotransmitter symptoms. (If you need help mapping these symptoms out, please read How to Use These 2 Functional Medicine Tools to Clarify Your Path to Healing).

There are literally hundreds of diets and dietary theories out there, but many of them fall into 6 main categories of elimination diets. Choosing the right one is important, because you don’t want to introduce too many drastic changes to your diet at once, or become deficient in important nutrients.

So choosing partly depends on symptoms. What follows is a summary of the different types of elimination diets, and when you might use them.

The basic elimination diet method is to remove (or reduce in some cases) the suspected foods for 3-4 weeks. During this time, your body has a chance to take a rest from these foods, and calm down and heal any inflammation that might be related to them.

Once the elimination period is over, you introduce the foods you removed (if desired) to test whether they have an affect, and what those affects are. This is the part that many people don’t take advantage of, but it’s one of the most important benefits of the elimination they just went through. The key is to ONLY introduce ONE food at a time and carefully observe any change in symptoms by using a tracking method. Next, you wait for 3-4 days until the next test.

If there is no change at all, then that food is not a problem. If symptoms show up, then that food may need to be eliminated for a while longer, while you work to resolve the sensitivity.

As a general rule, if you are someone struggling with persistent symptoms, I recommend removing gluten, dairy, and sugar. (You can read 6 Reasons to Quit Gluten if you Have a Chronic Illness here). These three foods are highly likely to be involved in your symptoms.

And also as a general rule, you will want to eat a real-food diet, full of fruits, vegetables, whole grains, legumes, and pastured, organic meat, free of hydrogenated fats, industrial seed oils (canola, soy, cottonseed, and safflower oils), and artificial ingredients you can’t pronounce. Avoid conventional produce to reduce your exposure to pesticides and herbicides.

 

The Basic Elimination Diet:

 

The basic elimination diet, recommended widely by Functional and Integrative practitioners everywhere, is to remove gluten, dairy, sugar (including alcohol). These three foods are the top triggers of food-related symptoms. The three right behind are corn, soy, and eggs. So the basic elimination diet involves removing these potential food allergens, to assess their affects.

The basic elimination diet is best used if your symptoms are mild but persistent. Symptoms like fatigue, sleep problems, mild digestive trouble, mild anxiety or depression, or skin symptoms would be a good indicator to try removing these 3-6 basic foods.

You should of course also continue to avoid any foods that you KNOW are a problem for you.

If you are struggling with arthritis, you may want to include nightshades in your basic elimination program. These include:

• tomatoes
• potatoes
• peppers
• eggplant
• okra
• tomatillos
• cayenne pepper
• paprika

If your symptoms or health condition is more specific, for example, to the digestive system, or you have an autoimmune diagnosis, you may need a more specific elimination diet.

 

Specific Carbohydrate Diets (SCD)

 

A Specific Carbohydrate elimination diet is primarily useful if you seem to react to lots of vegetables and fruits, or have a lot of digestive symptoms or diagnoses such as Small Intestinal Bacterial Overgrowth (SIBO), IBS, or IBD. There are 5 types of starches in plant-based foods, and some people are sensitive to some or all of them. They are collectively referred to as FODMAPs, which stands for Fructo-, Oligo-, Di-, Mono-Saccharides, and Polyols.

If you experience a lot of bloating, pain, distention, gas, and discomfort from eating what you might think are “healthy” foods, high FODMAP foods may be the culprits.

There are two different variations on specific carbohydrate diets. One is a low-FODMAP diet, and another is the Specific Carbohydrate Diet (SCD). They are similar, but they differ by which specific carbohydrates they eliminate. A low-FODMAP diet is designed to help IBS-sufferers identify trigger foods, while SCD is a more long-term strategy of avoidance of certain kinds of carbs.

As elimination diets go, low FODMAP is probably the way to help you distinguish which types of carbohydrates trigger your symptoms. You can find resources about how to give this elimination diet a try here.

 

Paleo and Ancestral Elimination Diet

 

You have probably been living under a rock if you haven’t heard of the Paleo diet. The concept of the Paleo elimination diet is to only eat foods that were available to humans before the advent of grain and dairy farming.

The Paleo diet relies heavily on animal protein, healthy fats, and lots of fresh vegetables. It eliminates not only grains, and dairy products, but sugar, industrial seed oils, alcohol, and legumes as well. Because of these omissions, this diet is also much lower in simple carbohydrates than most Americans eat.

The Paleo diet has been popularized by Chris Kresser, in his book The Paleo Cure, and the Melissa Hartwig’s Whole 30.

Many people have found significant relief from their symptoms by adopting a Paleo diet, especially those with heart disease, diabetes, metabolic syndrome, and autoimmune conditions. Because it combines the basic elimination diet with elimination of grains, it’s a good template to try if you don’t have drastic health problems, but know aren’t in your best shape.

There are some caveats for the Paleo diet. Many people worry about the high fat advocated in the Paleo diet. The science is in on this topic, and it clearly shows that there isn’t an association between cardiovascular events and dietary fat intake. But if you increase your fat intake without making sure that your gall bladder and bowel can tolerate it, you may make digestive or other symptoms worse.

Also, the Paleo diet includes many high-oxalate foods (see Specialty Elimination Diets below), such as spinach, chard, sweet potatoes, almonds (especially as almond flour), chia, peanuts, and chocolate. Some people react to oxalates with increased body pain, or urinary tract problems, such as kidney stones.

If you’re a lot sicker, with one or more autoimmune diagnoses, you may want to consider the more specific autoimmune paleo template. (See below).

 

Autoimmune Paleo Elimination Diet (AIP)

 

The Autoimmune Paleo elimination has a lot of the same basic template factors as regular Paleo, but it removes many more potential autoimmune and symptom triggers in the initial removal phase. It is one of the most strict elimination diets. In addition to removing foods on the Paleo diet, foods to remove includes:

• eggs
• legumes
• grains
• many spices and herbs
• nuts and seeds
• nightshades

The AIP should generally only be considered for serious, autoimmune health problems, and ideally should be taken on with at least some guidance. And though it can take some time to work through the elimination and reintroductions, AIP isn’t meant to be a long-term diet solution, because the lack of diversity can lead to nutrient deficiencies of zinc, selenium, B vitamins, and the omega 3:6 balance. Not only this, but it can be very hard to adhere to, because eating outside of your home becomes very difficult.

But if you have food sensitivities or autoimmune issues that have been unresolved with a basic elimination diet, AIP may be the way to go for you.

If you want more support with the Autoimmune Paleo protocol, I recommend checking out Mickey Trescott and Angie Alt’s website Autoimmune Wellness.

 

Ketogenic Elimination Diet

 

A ketogenic diet is an very low carb, moderate protein, and high fat diet designed to bring the body into nutritional ketosis. This means that your body relies on burning fats for fuel, instead of the usual carbs and sugars.

The ketogenic elimination diet is similar to the Paleo template, but it also removes or reduces starchy vegetables, like potatoes, beets, carrots, and winter squash, and most fruit.

A ketogenic diet is most beneficial for people with metabolic problems like obesity, syndrome X, and diabetes, who are wanting to reset their metabolism for weight loss and maintenance. It’s also valuable for people who have severe brain issues, like epilepsy, brain injuries, certain types of cancer, autism, or neurological disorders like Alzheimer’s, Multiple sclerosis, Parkinsons, and ALS. This is because sugar is inflammatory for the brain and cancer cells, and the high fat, low sugar template can help reduce inflammation.

People on a ketogenic diet may become deficient in potassium, and will need to adjust the carbohydrate content of their diet to their unique tolerance.

Because keto diets are very high in fat, it’s important to assess the strength of your fat digestion before diving in. You aren’t necessarily what you eat, but what you can do with what you eat. Especially exercise caution if you have had your gall bladder removed, or already know that your fat digestion is compromised.

 

Specialty Elimination Diets: Glutamates, Oxalates, Salicylates, and Amines, Oh My!

 

Sometimes, the problem is a category of foods. These include foods high in glutamates, oxalates, salicylates, and amines, like histamine.

These eliminations typically are something to look into if you haven’t gotten relief with the more basic elimination trials. For some of you, certain chemical elements of different kinds of foods may overwhelm your body’s ability to break them down.

You’ve likely heard of people reacting to MSG (monosodium glutamate). MSG is a high-glutamate food. Glutamate is a brain-stimulating chemical that naturally occurs in cured meats and cheeses, MSG, soy sauce, fish sauce, corn starch, corn syrup, seaweed, bone broths, L-glutamine supplements, gelatin, and protein isolates.

Glutamate is broken down in the liver. If you happen to be deficient in nutrients your liver uses to break down glutamates, or if you have a genetic variation that inhibits your ability to successfully break them down, you may experience symptoms when you ingest too much of them. If you eat more than your body can handle in one meal, hello symptoms.

With Specialty eliminations diets, it’s generally not possible to completely remove them from your diet. The food chemicals are often present in many common plant foods. The goal is to identify which ones are the worst offenders for YOU, and then work to eliminate those ones in particular, or to find your level of tolerance. But don’t throw the baby out with the bathwater.

Specialty eliminations are best done with the support of a nutrition professional who can help you determine where to look, and how to track the eliminations and trials.

A Food-Symptom tracking diary or app can help.

 

Conclusion

 

Food is such an important piece of how we feel, but we need to be smart about how we work to understand what we need to change to feel our best. We don’t want to open up our bodies to nutrient deficiencies, or take on undue hardship with restrictions.

Getting to the heart of YOUR unique sensitivities, so you can remove that stress from your body’s energy field is important, but you want to do it right, with the least amount of upheaval for the greatest benefit.

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When you’re ready for some support in digging through the weeds, I would be happy to sit down with you and map out an elimination diet plan in the context of all your signs and symptoms. Schedule your Free Assessment Session right here, and I’ll let you know where I think you might best focus your efforts.

With any complex health issue, food is only one part of the strategy that will bring you relief. To find out more about the strategy I use to help my clients find remission or a successful long-term management plan for their symptoms, download your copy of Roadmap to Recovery: How to Move Beyond Your Symptoms and Create a Personalized Plan to Restore Your Health.