It seems like everyone today is aware of food intolerances. It’s likely that you have tried at least one elimination diet in an attempt to improve your digestive or other symptoms. And with good reason: our daily food intake has a lot of effect on how we feel. Food is the main foundation of our health and how we feel—along with our habits around self-care, exercise, stress reduction, and sleep.
But along with the widespread use of special diets and restrictions I see being used by those with food intolerances, I also see a lot of very confused people. The Facebook Groups I frequent, related to autoimmune disease, digestive disorders like SIBO or IBS, and chronic fatigue, are full of people asking questions like:
“I have been eating a Paleo diet for a while, but I recently read about the low histamine diet, and I think histamine might be part of my problem. But half of what I eat on the paleo diet is high histamine, I’m so confused. What should I do?”
“I have been told to go AIP, Keto, low histamine, no dairy, no Eggs by my Functional Medicine Practitioner following the results of my elimination diet. I know I can do it, but I’m getting cold feet. Any tips and tricks to make this a little easier?”
“I’ve read about several diets that are “good” for SIBO—low FODMAP, SCD, GAPS, Cedars Sinai diet. But there are foods that some diets restrict that other diets say you can eat. Does anyone have an explanation for these discrepancies?
Or: “Diet. Do I need a dietician? I’ll stick to one diet, then hear of another and veer that way. Then I find myself cheating, feeling guilty, and picking another diet. My Naturopathic Doctor just said to do the SIBO-specific [diet] 80% of the time. It’s hard when you are surrounded by family who can eat whatever, whenever.”
Sound familiar?
As a bonafide do-it-yourself-er, if I want to do something like a specialized diet, I spend time online, or buy a book or two about it, and dive in. But even with a very detailed book as a guide, many of our health situations are very nuanced and complex, and need a more nuanced approach.
Though a handout or a book is a great starting place, successfully applying a specialized, therapeutic diet requires a methodical approach. To use this approach makes sure that you are appropriately using the diet as a tool to learn more about your unique body, so you can continue to make better and better choices.
The alternative is blindly grabbing for the next right thing, anxiety about whether you’re doing it right, and hopping from one diet to the next , without really understanding what you’re seeing and what’s best. For example, how do you know if the diet is really working for you? Should you be concerned about deficiencies? How restrictive is too much?
So I’m going to spell out the method and approach I use to help my clients with digestive symptoms and food intolerances adapt the principles of using therapeutic diets so they can be successful with their food-as-medicine approach. You can use these tips to improve your success, too.
Food Intolerances Key #1: A Basic Elimination Diet, to Remove the Most Common Inflammatory Foods, Should Be Completed First.
The thing most therapeutic diets have in common is that they typically eliminate the top 3 most common inflammatory foods and focus on whole, real food. In my practice, I consider this to be gluten, dairy, sugar, and alcohol at a basic level, followed by the next top three, corn, soy, and eggs. A significant number of symptoms improve with this approach alone.
So, if you haven’t already gone down the elimination-diet rabbit hole, I recommend starting with a basic elimination diet that removes these top 3‑6 foods, and focuses on removing anything processed and eating nothing but real food for 30 days.
Many people find that this basic level of clean up provides a lot of relief from food-sensitivity symptoms. Most of us can benefit from this template at least once or twice a year.
A friend and colleague of mine, who doesn’t have any significant health issues, has recently decided to do this cleanse, using the Whole 30 template, twice a year for a month at a time, and always notices that his sleep and stress management improves, digestion improves, and he generally feels great.
When my clients use this approach, they usually find they sleep better, have less digestive upset, better skin, more balanced mood, and they often lose unwanted weight as a side benefit.
A significant number of problems clear up when you eliminate gluten, dairy, sugar, alcohol, and focus on eating whole, unprocessed food. This is the food our bodies were designed to eat, and is a valuable investment in our health, no matter your health issues.
Food Intolerances Key #2: Choose the Right Template and Customize
OK, so you did the 30-day elimination diet, but you are still seeing food intolerances and symptoms, and are confused about what foods are contributing to the problem. Now what?
The next step is to choose another elimination-diet template to work with, to see if you can isolate the food-related causes of your symptoms.
Diet templates like the Autoimmune Paleo, Keto-Adapted diet, or Low FODMAP diet are examples of templates that might help you figure out what is causing trouble. They are important and essential tools, and should absolutely be used. But as tools, they are really just the place for you to start.
The most important step here is to choose the right template for your situation. Imagine that your best, personalized diet is a small apartment in the middle of a huge city—you want to begin your search by looking in the right neighborhood to start.
So for example, if you have been diagnosed with IBS, or have symptoms that suggest IBS, you probably shouldn’t give the keto-adapted diet a try. (See my video Is Keto Good or Bad? Keto for IBS). It’s generally acknowledged that the Low FODMAP or Specific Carbohydrate Diet is a useful place to start thinking about which foods might be triggering your IBS symptoms.
In contrast, if you are have Type II Diabetes and Metabolic syndrome, the Low FODMAP diet probably isn’t a useful template, whereas the Keto diet might be right for you. For more about how to choose the right diet template, check out my earlier blog post Choose the Right Elimination Diet for your Persistent Symptoms.
Next, to get the best mileage out of diet template, you must take it and make it truly your own. The way to do this is to:
- Work with the suggested elimination lists to choose small groups of foods to eliminate for a few weeks. The most likely culprits are the ones you eat frequently, especially daily.
- After your elimination period, test them one at a time to see if they really do cause symptoms. You can use a Food-Symptom Diary (like this one) to track your results.
- Remove the foods that truly cause a change in your symptoms or mental state while you work on healing the underlying causes of food intolerances (usually things like gut dysbiosis or leaky gut).
Food Intolerances Key #3: Only Test Specialty Elimination Diets for a Set Amount of Time, and Customize, Customize, Customize:
Specialty elimination diets, like Autoimmune Paleo, Low FODMAP, low histamine, low oxalate, low salicylate diets, should be a) trialed for about a month, and re-evaluated at the end of the period; and b) should be customized.
One thing I’ve found personally, with my food intolerances, and more widely with clients is that they are rarely sensitive to everything on that list. Our bodies are complex systems, with many overlapping influences, and our food tolerances are as unique as our fingerprints.
The key here is that the template tells you where to look. You have to look at that list and identify the likely culprits, but the wider goal that we shouldn’t lose sight of is that we want to have the widest-variety diet we can have.
We don’t want to eliminate foods that are actually working for us, and we don’t want to inadvertently create nutrient deficiencies by quitting foods that are actually OK for us. Eliminating foods that we DO tolerate for long enough can lead to reduced oral tolerance and actually increase food intolerances!
Specialty eliminations, with lengthy lists of things to exclude, should be taken on for a trial period, about a month, and then evaluated.
If you haven’t seen any improvement in that time, then that diet is likely not the right template for you, or there are bigger issues that need addressing. A supportive diet is always an important piece of the healing puzzle, but it sometimes isn’t enough.
Food Intolerances Key #4: If Symptoms Persist Beyond an Elimination Diet, You Need to Start Thinking About WHY Those Symptoms are Persisting.
The problem is likely bigger than just food. And regardless, I always want you to be thinking about why the sensitivities are there in the first place.
Some top possibilities include:
- Gut dysbiosis or SIBO
- Leaky gut
- Adrenal or thyroid problems
- Gut adhesions/scars
- Environmental illness from mold, pollen, dust, household toxins, workplace toxins, etc.
At this stage in your game, it’s important to find a qualified Functional Medicine or Functional Nutrition Practitioner, or Naturopathic Doctor, or similar holistic health care provider to help you investigate your root causes.
Each of these providers has a methodical way of figuring out where to support your body in your quest to regain function and quality of life.
Food Intolerances Key #5: It’s Vitally Important to Work Methodically.
It’s easy to skip around, get confused, and just get no clarity while diet hopping. But the true value of the elimination diet work is to test a series of theories about what is causing your problem, and to slowly cross off the ones that have nothing to do it.
In this way, you build on your experience and create a highly personalized diet template. And not only this, but this work empowers YOU to intimately understand what your body is doing why.
If we return to a question from the top of this article, I can now answer it:
“I’ve read about several diets that are “good” for SIBO—low FODMAP, SCD, GAPS, Cedars Sinai diet. But there are foods that some diets restrict that other diets say you can eat. Does anyone have an explanation for these discrepancies?”
The reason for these discrepancies is because there is no one, right diet for everyone. Food intolerances are caused by many different possible causes, and without doing some methodical investigation, it will be difficult to tell why this template helps and this other one hurts.
There is a right template to begin with, and this will depend on the specific symptoms or problems you are trying to address. Once you’ve chosen that diet template, it must be customized specifically for YOU! You may not need to remove everything or even a lot of the foods on the list.
This person asked specifically about SIBO, and why all these diets are supposed to work for SIBO. The answer is because each person’s SIBO is unique, and has unique causes. For many SIBO patients, the low FODMAP diet is very helpful. But “FODMAPs” are five different types of fermentable starches. The particular bacteria causing your SIBO bloating, diarrhea, or constipation may only be interested in one or two of them. But to figure this out, you must do the methodical work of getting clear about which specific foods are triggering your symptoms.
Doing this work is definitely a little bit time consuming, compared to popping a pill, or using a “stock” diet template, but it provides drastically better results in the end.
Conclusion:
Cutting through the confusion of which diet to eat for your health can be easy: simply choose the right place to start, and do your homework about which foods are specifically a problem for you. Working through this method will provide you with the most useful food information you could imagine: a perfect, tailor-made diet, uniquely suited to your personality and circumstances.
If after reading through all this, you’re still confused, or not sure how to move your situation forward, please reach out to me to get some support. This is the exact method I use to help my clients, who struggle with everything from anxiety to SIBO, figure out what to eat to thrive, while minimizing symptoms.
When you’re ready for that kind of support, you can start the process of becoming my client by scheduling a Free, 30-minute Assessement Session here.
