How to do a Simple Elimination Diet

Elimination diets are often recommended to determine the cause of gastrointestinal issues and food intolerances. An intolerance being where you have trouble digesting a particular food and experience some manageable symptoms, as opposed to an allergy which is a lot more serious. The point of the diet is to temporarily remove all potential causes of the symptoms and to reintroduce them slowly to test how you react. While the approach sounds simple in theory, it can in reality be rather challenging to do as we are so used to the foods we eat every day. Radically changing our eating habits, even temporarily takes some planning, preparation, and determination. There is however a simple version that can prove to be helpful for many.

The most restrictive of elimination diets removes every possible cause of any symptom all at once. This would include alcohol, caffeine, sugar, gluten, dairy, soy, nuts, nightshades, corn, eggs, processed meats, shellfish and more. If many of these foods are part of your every day life, then removing them all at once will of course be incredibly challenging. This type of elimination diet requires a couple of months’ commitment and would ideally be supported and recommended by a health coach, nutritionist or functional medicine doctor who can guide the process, and may be necessary for more serious symptoms.

For milder but ongoing symptoms such as bloating, gas, indigestion, occasional constipation or diarrhea, headaches, rashes or fatigue, then a simpler approach of temporarily removing just a few food types at a time can still be helpful. To keep it simple focus first on foods that are most likely to be causing issues, which for many would be gluten from wheat and cow’s milk protein, the two most common culprits for intolerances. Of course many of us can benefit from reducing or eliminating sugar, alcohol and caffeine so feel free to remove any of these also especially if they feature highly in your diet. The simple approach takes a commitment of around one month including preparation, two weeks of elimination and the reintroduction period.

Preparation Stage

First, determine what food types you will remove for a simple elimination diet. To do this consider the typical food groups that cause issues which, apart from wheat and milk, would be all gluten, all dairy, eggs, soy and corn.

From these foods groups then consider what you eat every day or the most often, the foods that you crave the most, and those that you’re most attached to. Often it can be the foods we eat all the time that cause us issues. So if you rarely eat soy this may not be necessary to eliminate, but if you have a daily soy latte habit and have skin breakouts, for example, then it’s worth considering. This is the tricky part as it’s much harder to give up a favorite food or drink, but think of it as simply an experiment for a month. Select two to four initial foods groups that you will eliminate based on your list of favorite foods and whether they fall into the common culprit list.

Next, plan how you will replace these foods over a two-week period which means thinking about alternatives for each meal. If you are eliminating all dairy then you will need to avoid milk, cream, cheese, yogurt, butter and ice cream. Nut milks and cheeses can be good replacements. If you are eliminating all gluten then avoid any foods that contain wheat, spelt, oats (unless certified gluten-free), rye, barley, and malt. Replace with rice, quinoa or millet unless eliminating all grains.

Finally, get organized, go food shopping, and make sure you have enough supplies at home for a full two-week period at the very least.

Elimination Stage

The elimination stage requires a minimum of two weeks. Eliminate your specific food groups completely for this period – no cheat days! It’s important to read food labels if you are buying anything packaged, as many of the culprits such as gluten, sugar and corn, sneak into processed foods. A longer elimination of up to a month can be good if you have the stamina, especially if you are only starting to feel the benefits at the end of two weeks. But start with two weeks and see how you feel.

Make note of how you feel every day during this stage. Symptoms may initially get a little worse before they get better so don’t panic if that happens. If your symptoms disappear then that’s a good indication that one of food groups was causing issues. Not everyone will feel better as food may not be the culprit, but this is a great experiment for testing it out.

Sample Elimination Stage (Week 1 & 2):

Remove all gluten, dairy, soy and eggs.

Drink plenty of water during this phase and ensure to eat enough fats and protein to keep blood sugars stable.

Reintroduction Stage

During this stage we want test each food group individually by adding them back in one at a time and allowing at least two days to check if they cause any adverse reactions. Take note in particular of how your digestion is working during this phase.

When adding back in a food type, only add it in for one reintroduction day then eliminate it again for the rest of this stage. Start slowly, adding in the food in it’s purest form rather than in processed food, into one meal. If there is no issue add it again in other meals that day. Then eliminate it again for the next two days.

Sample Reintroduction Stage (Week 3 & 4):

Day 1: add back in dairy only
Days 2 & 3: eliminate dairy again; monitor symptoms
Day 4: add back in wheat only
Days 5 & 6: eliminate wheat again; monitor symptoms
Day 7: add back in eggs only
Days 8 & 9: eliminate eggs again; monitor symptoms
Day 10: add back in soy only
Days 11 & 12: eliminate soy again; monitor symptoms

New Food Plan

Having tested each of the food types and noted your symptoms and reactions you should be able to determine if any of the eliminated foods were causing you adverse reactions. Now it’s time to decide if you wish to permanently change your way of eating following this experiment. If any of your symptoms improved during elimination but came back after the reintroduction of one particular food type, you might consider keeping that food out of your diet for a longer period of at least another month to see if improvements continue. If you remain symptom-free you can always try adding that food back in later to see if your body still reacts. It may just be that your body needed a break or can only handle smaller amounts of that particular food type. Or, you may immediately notice your symptoms returning and decide this food is not for you. At least now you have the information on what works for you and what doesn’t.

When adding back in all foods that have no adverse effect go slowly and try to avoid binging on all the foods you missed! And if you wish to continue experimenting with other foods you can repeat the cycle with another group of two to four food types.

Multiple times a day, every single day we make food choices. With this simple elimination diet with a commitment of just a month, you can arm yourself with some powerful information about what works for you and therefore make better choices for your own body, every single day.

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