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Can an Elimination Diet Help You Lose Weight?

Why do people assume elimination diets promote weight loss?

Rothberg: People read about some new fad or craze — and they’ve usually tried something else and haven’t succeeded. I think some of it may have arisen just from the popularity of the gluten-free diet. That probably translated into many other things.

People with allergies or sensitivities who have felt better by consequence may have had some weight loss. So other people then say, “If that worked for you, it’ll work for me.”

There have always been elimination diets, we just haven’t called them that. Certainly, vegetarian diets are a type of elimination diet.

How might such diets backfire or pose a risk?

Rothberg: People on gluten-free diets often gain weight. Many of the foods are actually calorie-dense.

SEE ALSO: What Happens to Your Body When You Stop Exercising?

People on vegetarian diets with the hopes of losing weight often replace what they have eliminated with high-calorie foods. In a way, there’s some psychology there: If I’ve taken away something high in fat and calories , I can replace it with this.

Vegan diets are, frankly, very restrictive. The worry about vitamin B12 deficiency in vegans, for example, is well-known. They do have to have supplementation.

Should people consult a doctor before trying one?

Rothberg: It depends how comfortable your primary care physician is talking about nutrition. There are physicians interested and have expertise, but they also can refer you to a registered dietitian who can provide supervision and counseling.

If someone cuts a food from his or her diet, is reintroduction dangerous?

Rothberg: I’m not sure we know the answer whether that will cause harm. People stop eating something — pizza, for instance. You might feel ill (after eating it again), but the truth is that people do this all the time. I don’t think it’s analogous to, say, discontinuing medications.

What diet do you most often recommend?

Rothberg: There is no magic to weight loss. It really is calorie restriction and eating things that are less calorie-dense — lean proteins, whole grains and vegetables.

Cut out the processed and packaged foods and refined sugars. I say this over and over, like a broken record.

40 Tips Nutritionists Say You Must Follow to Lose Weight

Just like a pair of jeans, there’s no one size that fits all when it comes to losing LBs. So rather than compiling a list of exactly what you should eat and avoid or sharing when to eat to lose weight, we tapped dietitians to share how to lose weight with their most practical, effective, and easy-to-implement advice.

Each weight-loss tip on this list is more about a lifestyle change and building a long-term habit rather than a crazy detox trick or diet “hack.” (P.S.: If any diet “promises weight loss of more than three pounds per week, restricts food groups, or requires that you purchase specific foods or supplements,” abandon ship, says Julie Upton, MS, RD, a registered dietitian in San Francisco, and the co-founder of the nutrition news company Appetite for Health.)

Here, 40 timeless, tried-and-true tips from dietitians for how to lose weight that will help you end your battle with the scale once and for all.

1

Focus more on well-being than weight.

Rather than focusing on a number on a scale, select a feeling or a wellness outcome—for example, to lower LDL cholesterol or be able to bike around your local park—as your goal, suggests Suzanne Dixon, MPH, MS, RD, a dietitian and epidemiologist with Cambia Health Solutions.

“In our vanity-obsessed world, it’s tough to let go of using the number on the scale as a guide around ‘optimal’ body size and health. However, research is pretty clear that people who focus on health-related goals when aiming to improve dietary habits are much happier and more likely to lose weight than people who obsess over reaching a very specific number on the scale,” she says.

2

Evaluate your reasons.

Then write them down. “It’s best to have concrete, long-term motives that relate to how you see yourself as a person for losing weight, rather than focusing on short-term events,” Dixon says. “Missions like ‘I want to lose weight for my 10-year class reunion,’ or ‘I need to drop inches to go on that cruise,’ are short-term and will never give your new, ‘healthy you’ behavior changes a chance of sticking.”

Instead, try: “I see myself as a healthy, fit and engaged person who wants to live a long, high-quality life for my family and friends,” she says.

3

Stay well-fueled.

Eat consistently throughout the day to avoid a dangerous and unhealthy starve-binge cycle, suggests Rachel Fine, MS, RD, a registered dietitian nutritionist and owner of the nutrition counseling firm To The Pointe Nutrition. “Long stretches between meals can leave you hangry! In that case, you’re less likely to mindfully eat and thus more to eat past fullness,” Fine says.

Upton adds that a normalized meal pattern, with three meals and two snacks, puts you on a path to better maintain a healthy calorie balance because you won’t get ravenous or graze all day.

4

Set a schedule.

To stick to that five-a-day eating pattern, “build an eating schedule and stick to it,” says Ashley Reaver, RD, a registered dietitian at Ashley Reaver Nutrition LLC. “Aim to eat every three to four hours and stick to the schedule. This way, food does not happen to you, but rather you have some control over your food choices. Not every meal will be perfect, and that’s more than okay, but creating ‘guardrails’ on your diet can help to make those less-than-ideal meals way less frequent.” (Steal weight-loss-friendly meal ideas from this flat-belly meal plan.)

5

Keep a food journal.

Track your drinks, too, so nothing you savor or sip is done mindlessly. Check out our expert guide to food journaling for weight loss for a comprehensive how-to.

“Write down everything you eat and drink. Studies show that those who log what they eat lose more weight and are more likely to keep it off,” Upton says.

6

Aim to balance each meal and snack.

Perhaps you’ve heard of the IIFYM (If It Fits Your Macros) diet? Fine recommends that all macros can fit, and you should aim for a flexible blend of carbohydrates, fat, and protein.

“In every meal and snack, seek a balance of the three macronutrients: complex carbs, healthy unsaturated fats, and lean protein. Yes, that means you might need to break your fear of carbs or fat. Both have important roles in the body and when restricted, hormonal changes result in increased cravings. Carbs are critical for the body, providing the most efficient form of fuel, especially for exercise. Fat regulates hormones and helps us to feel satisfied,” Fine says.

7

Make choices, not rules.

There is no “good” food or “bad” food. Take note and opt for foods that support your weight-loss goals and make your body feel good as often as possible.

“Many studies have proven that food restrictions drive overeating. For example, with sugar, we feel intense cravings are a symptom of addiction. However, these cravings result from the moral value placed on sweets in our society. When sweets are placed on the ‘forbidden’ list, we subconsciously want them since we think we can’t have them,” Fine says.

8

Get rid of the restrictive mindset.

Similarly, focusing too much on what you’re skipping rather than what you have the opportunity to enjoy can make a healthy lifestyle feel a bit too much like punishment. “Consider an inclusive approach, rather than a restrictive approach,” Fine says. “An ‘eat less’ frame of mind can set you up for a cycle of guilt when unfair expectations are not met due to the biological consequences of food restrictions, such as those increased cravings we talked about earlier.”

9

Step up your walking routine.

Physical activity doesn’t have to be done at the gym to “count” or be beneficial. Exercise need not be torture, Reaver says. Find easy activities and time frames that you can commit to. “Seek out two or three 15-minute breaks throughout the day to walk,” Reaver says. “Moving your body is a very important way to lose and maintain weight. Not only does it burn calories, but it also helps develop lean muscle mass, benefits cardiovascular health and mobility, and is important for mood.”

10

Increase the amount of water you’re drinking.

Add one glass of water right after you wake up, one glass before lunch, and another glass before dinner, Brooking suggests. “Staying hydrated can help you manage your appetite. Plus, if you’ve fallen short on your hydration needs through the day, having a plan to get these three glasses of water into your daily routine will help you make up any short falls on your fluid needs,” she says. If you need some extra motivation, here’s what happens to your body when you don’t drink enough water.

11

Get enough sleep.

How much you snooze plays a big role in how easily it is to slim down. “Nearly everyone needs at least seven to eight hours of sleep each night. Consistently getting less than seven hours of sleep results in low energy. Our body responds to low energy by producing cannabinoids, the same compounds that produce the munchies. Scoring enough sleep is one easy way to cut down on snacking throughout the day,” Reaver says.

12

Avoid crash diets.

Cutting calories to extremes on a crash diet equals a recipe for a rebound. “For long-term health, avoid losing weight too rapidly. A recent study in the Journal of the American Medical Association found that severe caloric restriction resulting in rapid weight loss also led to more loss of bone and muscle in postmenopausal women compared with women following a more reasonable calorie-restriction approach and slower weight loss,” Dixon says.

13

Opt for a sustainable diet plan.

If you can’t imagine doing some version of this diet plan for the rest of your life, it’s not going to be healthy or sustainable. “This doesn’t mean you need to follow the plan to the letter for the rest of your life, it just means the overall framework of the diet must be an enjoyable and sustainable way for you to eat to yield lasting results,” Dixon says.

For example, you might follow a very strict low-carbohydrate diet to lose weight, then add back in small amounts of carbs during the weight maintenance phase. You’ll make the diet a bit more flexible over time, but you still need to be comfortable with keeping total carb intake low forever more. If you’re on Team Ciabatta and can’t imagine being low-carb for the rest of your life, this isn’t the plan for you.

“The comprehensive eating pattern has to be acceptable and manageable for you for a lifestyle. Don’t think of it as a quick fix,” she says.

14

When it’s time to eat, focus on eating.

It’s tempting to scroll through Instagram or watch the news while eating breakfast, but try to make mealtime a focused affair, recommends Katherine Brooking, MS, RD, a registered dietitian in San Francisco, and the co-founder of the nutrition news company Appetite for Health.

“When you eat, eat. Don’t read, watch TV or do anything else. Being mindful of what you’re eating and how full you fill will help teach you better hunger-management skills,” she says.

15

Don’t ban your favorite foods.

Allow for space for your favorites; sweet or savory. Just adjust the remainder of your day accordingly. “Diets won’t work for the long-run if you deprive yourself of your favorite foods. You can enjoy indulgences if they’re planned for and accounted for as part of your diet,” Brooking says. “If I know I’m going to have my mom’s Chocolate Buttercream Cake for dessert, I will make sure I eat a balanced but light breakfast, lunch, and dinner to allow for a 500-calorie-a-slice cake afterwards. Remember the ‘Ps’ of weight loss: Plan, Prepare and Practice.”

The same holds true if you have a reservation at the best Italian restaurant in town for date night. Go ahead and split the gnocchi if you love it, just fuel up with oatmeal and a couple eggs for breakfast and a grilled salmon-topped salad for lunch, for example.

16

Focus on addition, not subtraction.

Instead of zeroing in on all the things you can’t have on a healthy eating plan, focus on adding in all the great foods that are part of the plan.

“A deprivation-based model causes our brains to crave the very things we are trying to eliminate. Instead, a model that focuses on adding in the healthy components can help you feel empowered,” Dixon says. “For example, maybe your new eating plan includes eating seven servings of different fruits and vegetables every day. All the effort you put into incorporating more healthy things—blueberries or mangoes, fresh or frozen—can keep your brain on a positive track. That way, you end up not missing the things you want to limit when you’re preoccupied with adding new foods into the diet.”

Plus, when you load up on these nutrition-rich foods, you have less room for the not-so-nutritious things. “Many people find when they include the legumes, vegetables, fruit, nuts and whole grains that make up a healthful diet, they really are full and don’t feel as much urge to visit the candy dish,” Dixon says.

17

Fill up on real fiber, not the fake stuff.

Plant-based eating not only lessens your load on the environment, but it also makes it easier to eat healthier and stick to a reasonable calorie count for the day.

“Add more plant-based, minimally-processed, carbohydrate-containing foods to your meal plan. Examples include vegetables, fruit, legumes, beans, nuts, seeds, and grains. Options like farro, barley, oats, wheat berries, buckwheat are high in naturally-occurring fibers and offer significantly more nutrition per bite,” Fine says.

Unlike fiber-boosted foods like ice cream, protein bars, and powders, which have little research behind their effectiveness and health-improving qualities. “Processed fibers lack additional nutrients and bioactive substances found in naturally-occurring high-fiber foods,” Fine adds.

18

Eat when you’re active.

By that, we mean fuel up when your body needs the gas. “Eat during your busy hours of the day,” says Lauren Harris-Pincus, MS, RDN, founder of Nutrition Starring YOU and author of The Protein-Packed Breakfast Club. “Just like a car needs gas on the road, not in the garage, our bodies need more energy during daylight hours and slow down to prepare for sleep when the sun goes down. When eating on the couch late at night, those calories will not be used as efficiently as those consumed earlier in the day. Try to stop eating at least about three hours before bed.”

19

Plan meals when you’re not hungry.

Chow down on breakfast, then set your game plan for the day. “Research shows that people who ordered their lunch a few hours early ordered less food than those who chose right before lunch when they were already hungry. It’s way easier to eat a balanced diet when you plan ahead, especially during those hectic dinner hours,” says Harris-Pincus.

20

Cook more meals at home.

Cooking at home is one of the best things you can do to control your fat and calorie intake. Restaurants want you to come back, so chefs often pile on more butter, oil, and salt than you would at home.

“Making meals at home is the best way for you to know what you’re eating,” Reaver says.

Upton continues: “Reams of research show that the more meals you eat away from home, the more overweight you’re likely to be. And, it doesn’t matter if you frequent five-star or fast food restaurants.”

21

Eat dessert.

Go ahead, eat that cookie, says Rania Batayneh, MPH, owner of Essential Nutrition For You and author of The One One One Diet: The Simple 1:1:1 Formula for Fast and Sustained Weight Loss. That way you won’t become a cookie monster.
“Structure is different than restriction. You don’t need to deprive yourself of any food. Just keep it in balance. Deprivation is depressing. By incorporating your favorite foods and knowing that you can eat the cookie today or swap it out for a piece of fruit as your carbohydrate in your meal or snack you feel less deprived,” she says. “If all that restriction worked, would we have such high rates of obesity in this country?”

22

Evaluate any diet trends using common sense.

Don’t eat produce grown under the ground? Bypass beans? That doesn’t seem quite right… “If a diet tells you to eliminate foods that are very important to you culturally, that’s another ‘rule’ that common sense suggests you should ignore. Fortunately, most foods with deep cultural importance can fit into a healthy diet. For example, I am not aware of any cultural or ethnic food patterns supportive of eating cream-filled processed cupcakes and candy bars, and that’s good,” Dixon says. “On the flip side, many cuisines from around the world include legumes and any diet that says, ‘no legumes’ to a person of Greek, Mediterranean, Asian, Latin American, or Middle Eastern descent just may not be feasible.”

23

Eat a balanced breakfast with at least 20 grams of protein.

Go ahead, #putaneggonit. “Most of us eat enough total protein in a day but we don’t distribute it properly,” Harris-Pincus says. “Consuming adequate protein in the morning can help to prevent muscle loss that comes with aging, plus it keeps you full longer and helps to prevent snacking later in the day.”

Upton adds is a strong proponent of protein, too, and believes, “This is the most satisfying nutrient. It’s a great idea to start your day with a protein-rich first meal to ward off cravings. Studies show that people who eat egg-based breakfasts are less likely to overeat during the day compared to those who start their day with bagels or other carb-rich first meals.”

24

Give yourself permission to enjoy indulgences.

It’s okay to crave both Brussels sprouts and brownies! “Once we grant ourselves unconditional permission to eat our favorite foods, we relieve the weight of responsibility that these foods hold over us,” Fine says.

25

Make your own breakfast.

Kick off the day with a homemade dish. “Of all three meals, breakfast is the one we can most easily control. Start your day with a balanced meal where you control the ingredients,” Reaver says.

26

Pack emergency snacks.

Remember those two snacks we suggested above? Be sure to bring ’em along so you don’t have to resort to whatever is within arm’s reach come 3 p.m. “Snacking is helpful to curb hunger and control portion sizes when you finally get to your next meal. Pack a banana or apple and pair with an individual packet of nut butter for a filling mid-afternoon snack,” Fine says.

27

Don’t drink your calories.

Skip soda, juice, lemonade, and other beverages with added sugar.

“You want to eat your calories not drink them because beverages are not as filling as solid foods. The sensory experience associated with chewing and the rate of digestion is slower and more satisfying with solid foods compared to liquids,” Upton says.

28

Ease up on the alcohol.

When you do wine about it, do so in moderation. “Alcohol packs in a lot of calories, stimulates appetite, and triggers areas of the brain that make you crave junk food. It’s extremely hard for people to maintain a healthy weight if they indulge more than a couple days a week,” Upton says.

29

Introduce a new change once or twice a month, max.

Make just one positive, health-related change to your routine every two to four weeks.
“Making small, manageable changes one at a time, then building on each success going forward, enhances self-efficacy,” Dixon says. “Self-efficacy is the feeling you can accomplish your goals. It’s something you need to increase if you want to reach any goal, including weight loss. Building on each small change so you end up stringing together an entire suite of healthy behavior changes. This is especially important if, in the past, you’ve tried to drastically overhaul your diet all at once, only to find it’s just too much to manage. That type of event decreases self-efficacy. Building on small successes to reach a goal increases self-efficacy.”

30

Combat cravings by distraction.

Use the power of time to manage that internal voice that says, “I must have a pepperoni pizza!” “For most people, cravings wax and wane throughout the day. They can feel really intense for 10 minutes, but then, you get distracted by answering an important email or finishing a work memo. Before you know it, the craving is gone,” Dixon says.

You can use this ebb and flow to your advantage. “If a craving hits, I recommend that people ‘surf the urge’ to eat that junk food. Get a glass of water, take a quick walk, watch a funny, short video clip—anything that will help you get past the desire to eat that bag of cookies or chips right this minute. Some people find it helpful to set a timer for 15 or 20 minutes. Then they busy themselves during that time and when the timer goes off, they check back in. On many occasions, they find the overwhelming desire to eat a particular food has passed,” she says.

31

Say “ciao” to cleanses.

If you do happen to overdo it on a third or fourth slice of that pizza or a cocktail beyond what you had planned ahead for, don’t feel like you need to deprive yourself the next day. “Skip the day-after cleanse. Our body is naturally designed to manage its own ‘detoxing.’ From the liver and skin to our intestines, we are metabolically wired to naturally excrete waste that builds from both natural metabolism and from our environment,” Fine says. “Plus, crazy cleanses place havoc on your metabolism with the constant cycle of under-eating and overeating.”

32

Try swapping instead of skipping.

Always snack on a handful of candy at 10 a.m.? “Set yourself up for success by replacing it with a healthier food rather than trying to skip it all together,” Dixon says. “Pack a handful of nuts in your bag. Set them on your desk in the morning, in plain sight. When ‘chocolate-o-clock’ hits, grab your healthy snack instead.” Other swaps to consider would be a chocolate chip protein bar instead of a chocolate chip cookie, an open-faced sandwich instead of a sub, and some cheese and healthy crackers instead of a slice of pizza.

33

Fill up on fiber.

Building on our previous fiber tip, aim to consume at least 25 grams of fiber per day. “More is usually better if you can sneak it in. As Americans, we barely reach half of our fiber goals on a daily basis. Fiber is found is all the plant-based foods that fill us up like fruit, veggies, nuts, beans, seeds and whole grains. In the right portions, these foods should make up most of your daily intake with a few ounces of protein per meal as an accent,” Harris-Pincus says.

34

Find a supportive ‘weight loss buddy.’

It’s true what they say: There’s power in numbers. “Have someone to whom you can be accountable and who will cheer you on and help you get back on track after a setback,” Brooking says. This can be in real life or through social media; both have been proven to be beneficial.

35

Try new recipes every once in a while.

Variety is the spice of life. “The fastest way to burn out is to only eat chicken breast, brown rice, and broccoli,” Reaver says. “Find one new recipe per week that you look forward to cooking and eating. Boredom with our options is what drives us to takeout, not lack of food.”

36

Make smart substitutions when baking.

When it’s not a family heirloom recipe or your favorite-ever treat, try a savvy swap. “To cut sugar, use applesauce or prune puree to replace half the fat in baked goods. I’ve experimented and found that you can replace 100 percent of the fat with applesauce in brownies or a moist cake and they’ll still come out great,” Brooking says.

37

Carve out time for self-care.

Stress can seriously trip up your efforts on the scale—and beyond. Both sleep and stress are often overlooked when it comes to how to lose weight because they are the more “intangible” aspects of health, but they are oh-so vital to keep tabs on, Reaver believes. “Stress eating is another trap that we can often fall into when trying to lose weight. Make sure your mental health is also a priority,” she says.

38

Think of the brain benefits.

Mental health FTW. “Regular physical activity and a healthy diet improve mood and lessen anxiety, according to research published in the journal PLOS One,” Dixon says. “So another great reason for your goal of adopting healthier eating habits might be, ‘I want to feel good about myself and my life.'”

39

Give yourself some grace.

Contrary to what you may have seen on The Biggest Loser, 10 pounds are not going to fall off in one week. “Be easy on yourself,” Fine says. “Dieting standards are unfair because we are not biologically equipped to under-fuel our body. In diet culture, we are conditioned to think that this failure to resist is solely a sign of weakness or a loss of willpower. However, food restrictions are what drive overeating, not your loss of—or lack of—willpower.”

40

Above all else, remember that it’s not a race.

Remember the tortoise and the hare? “It doesn’t matter how slow you go. Dieters are always looking for the fastest and easiest way to lose weight. Slow and steady is more effective and results in sustainable weight loss. Don’t compare yourself to others and find out what works for you,” Batayneh says.

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Top 10 Elimination Diet Mistakes

3. Lacking Nutrient-Dense Foods

Nutrient deficiencies contribute to, in my opinion, almost every chronic health problem. So, if you’re not careful in planning an elimination diet, you may become deficient in a variety of nutrients.

Classically, I’ve seen severe imbalances in macronutrients (carbs, fat, protein) that can contribute to all manner of hormone issues, blood sugar problems, or even trigger new digestive symptoms to develop.

Equally concerning are the micronutrient deficiencies that can develop. For example, if you eliminate eggs, you can easily become deficient in choline (unless you’re up-to-speed on the few other foods that contain it in any meaningful amount).

This becomes a major problem for women trying to conceive, those that are pregnant, and breastfeeding moms given choline’s crucial role in preventing neural tube defects and promoting normal brain and vision development. (Of course, choline is also uber important for children and adults of both sexes for proper liver function, cardiovascular health, and brain health, to name just a few).

That example is just focused on one food and one nutrient, but the possible nutrient deficiencies are virtually endless if you’re not well-versed in this area.

4. Focusing on Elimination, Not Inclusion

An elimination diet is a bit of a misnomer.

Yes, it involves eliminating certain foods. However, if you’re not eating those foods, what are you going to eat?

It’s far too easy to get stuck in the whole “I can’t eat that” negative mental chatter. I know because I’ve been there.

If, instead, you change the focus to what you are including in your diet, you’ll be able to see all the variety you can have. That helps you plan which foods will fill in any nutritional gaps left by the foods you are avoiding.

You’ll also avoid the trap of swapping one problem food for another. For example, if you decide to go gluten-free, buying processed, gluten-free products is likely not going to solve your problems. (And actually, quite a few of my clients have been gluten-free for years before seeking my help, but they haven’t gotten better. Sometimes the additive-filled, gluten-free products they’ve been using are the culprit.)

5. Failure to Plan Ahead

Elimination diets take planning – a lot of it!

I’m pretty free-spirited around food, since I like to embrace mindful eating and eat what I’m in the mood for, what’s in season, or what I can forage for. But undertaking an elimination diet doesn’t allow that kind of laissez faire attitude (at least, not in the beginning).

By all means, mindful eating does NOT go out the window (at least in my practice it doesn’t), but it does pay to work through which food combinations, meals, and recipes will incorporate the foods you are including (and will meet your nutritional needs).

If you haven’t thought through what you are going to eat, I suggest coming up with at least 3-5 options for breakfasts, lunches, dinners, snacks, and beverages to carry you through the time you’ll be on the elimination diet.

If you frequently eat out, travel, or go to events where you don’t have control over what you’re eating, you might want to choose to start an elimination diet at a time where you have the fewest interruptions (or maybe have a heart-to-heart with yourself about what’s most important – your health or your lifestyle?).

Remember, there’s no half-assing an elimination diet. It’s a HUGE commitment. You have either eliminated certain foods or you have not.

And given that some food sensitivities cause a delayed hypersensitivity reaction that can appear days after consumption, that margarita you had on Friday night could be triggering your brain fog Tuesday afternoon. Pretty tricky to make the connection if you don’t know what you’re looking for and virtually impossible if you’re cheating – even just once a week.

Some of my clients seek my help after having tried half a dozen elimination diets, but when we really dig into the details, sometimes they have never truly eliminated anything for long enough to experience a shift.

6. Ignoring Dose-Tolerance

Let’s say you eat a large salad for lunch and feel bloated and gassy afterwards. Your first suspicion is that you’re reacting to something in the salad. You might choose to avoid some (or all) ingredients in that salad moving forward.

However, that’s not necessarily the wisest choice. You may, in fact, not be highly reactive to any of the ingredients in the salad if eaten in moderate quantities, but when eaten in large amounts (especially all at once), you may experience symptoms.
This is called a dose-response reaction. A little bit of something is fine. A lot of it puts you over the edge.

Keep in mind that some food sensitivities have a cumulative effect, meaning eating a lot of a certain food (or combination of certain foods) over a relatively short period of time (a few days, maybe) can trigger symptoms. This again points to the importance of a well-planned elimination diet, so you remove as many of these variables as possible.

To play devil’s advocate, dose tolerance also means that you may be able to handle an occasional serving of a reactive food without experiencing symptoms.

7. Skipping the Reintroduction Phase

If you’ve been on an elimination diet and are feeling fantastic, you may be tempted to continue eating that way. Depending on how restricted your diet is, that may be fine.

For example, if you’re following a Paleo template and feel great without including grains, dairy, and legumes in your diet, but you have plenty of animal foods, a selection of fruits, vegetables, nuts, etc., you’re likely ok.

However, if your elimination diet started with a small list of foods, like the dreaded Rice-Lamb-Pear elimination diet, or even a more inclusive list of 20 or so foods, you’ll want to add in variety before you burn out (or develop new food sensitivities – see #8).

A common mistake I see on elimination diets is staying on a restrictive plan for too long, hitting a breaking point of monotony, and then throwing in the towel entirely and returning to your previous way of eating.

Technically that’s not a full elimination diet, because as I mentioned above, the goal of an elimination diet is not only to identify trigger foods, but to identify the broad list of foods that your body thrives on.

If you’ve done the careful work of eliminating foods and felt improvement, this is precisely the time you want to reintroduce foods and test for tolerance. A big part of this is body awareness (hence my focus on mindful eating), and when you’ve removed all variables by initially limiting your diet, you can accurately test for one food at a time.

Let me repeat: ONE food at a time.

(If you don’t have food sensitivity testing to guide a reintroduction schedule, you will likely need to space out foods more and spend a few extra months in a careful reintroduction phase).

8. Staying on an Elimination Diet Too Long

There’s a good reason the most common food sensitivities are to foods that are staples in most households.

Not to beat a dead horse, but part of a well-planned elimination diet involves building in enough variety so you don’t over-consume any given food, at least until you have a working knowledge of your body’s individual tolerance.

Once you’ve worked through the reintroduction period, you want to be sure you are rotating your food choices regularly to prevent new food sensitivities from developing.

Before modern agriculture, food rotation was naturally built into our lives.

Certain vegetables were only harvestable during a certain month.

Some trees only bear fruit for a 2-week window.

There was a season when some animals would have migrated through your region that you could hunt, whereas others would migrate a different time of year.

Dairy was only available, in appreciable quantities, when baby mammals were weaning.

Simply put, we weren’t eating the same thing every day for a lifetime.

So if you’ve noticed that some food have become a staple in your diet, make it a priority to find some alternatives so you don’t rely too heavily on any given food.

That might mean varying your salad greens, protein options, snacks, alternative flours, and even your spices. It might mean occasionally taking a break from an entire food group if you suspect it’s flaring up any issues.

9. Assuming All Problematic Foods are Forever Unsafe

Just because eliminating a food at one time helped you heal doesn’t mean it’ll stay that way forever. Our bodies are constantly changing, life is constantly changing, our stress levels are constantly changing, so to assume that a food may be off limits forever is nonsensical.

Yes, there may be certain foods that you choose to avoid long-term. For example, if you have an autoimmune disease, you’ll likely want to stay gluten-free. (And yes, there’s no point in adding back in processed junk food. Sorry to burst your bubble.)

But as your gut heals and inflammation subsides, some people will regain the ability to digest and assimilate a wider variety of foods. So don’t throw out that possibility and feel doomed to a life of limited food options. Keep your focus on including (and enjoying) as much nutrient-dense real food in your diet as possible.

(More than a year after my own food sensitivity journey, that’s what I’ve determined is true for me and almonds. Success!)

10. Not Looking Beyond Food

It may seem like changing your diet will be the key to solving your health problems, but that’s not always the case. You can be diligently follow a strict food plan and not get better.

Why?

Sometimes there’s more to it than what you’re eating.

For example, I had one client who was experiencing horrible bloating, but it wasn’t always after eating and there wasn’t an obvious pattern to her symptoms – that is – until we took a close look at her routine. She was consistently getting bloated during and after her showers. Luckily, since we had the results of food AND chemical sensitivity testing, we were able to identify the problematic chemical in both her shampoo and body wash. Once we switched those out for a cleaner product, her bloating disappeared.

Remember, the purpose of an elimination diet is to remove ALL potential triggers for a period of time.

Some key things to look out for: strange chemicals or dyes in personal care products (toothpaste, mouthwash, lotions, make up, etc), medications, supplements, and cleaning products. (Follow my “guilty until proven innocent” rule.)

Also, the foods and chemicals you are avoiding may be hiding under different names. Wheat, corn, MSG, and many others are found in countless products under an array of benign-sounding names.

Then there’s the tricky part, which is that certain foods can be a natural source of chemicals. For example, almonds are high in salicylic acid, tea is high in benzoic acid, and celery is naturally high in nitrate. If you’re reactive to chemicals, you need a pretty strong working knowledge of food chemistry to know all those little details and fine-tune your elimination diet.

Now that you’ve had a primer on the top 10 elimination diet mistakes, I’d love to hear from you!

  • Have you ever tried an elimination diet? What was your experience?
  • If you could do it again, would you do anything different?

Until next week,
Lily

PS – If you suspect food is making you sick and would rather do it right the first time than waste time, energy, and money making these elimination diet mistakes, I’m happy to help. Go here to learn more.

The Ultimate Elimination Diet Meal Plan Guide

Do you feel more tired than ever before? Do you have persistent gastrointestinal issues such as bloating, gas, or reflux that seem to get worse with time? Do you ever experience chronic symptoms such as headaches, joint pain or skin issues that don’t necessarily go away with medication?

If so, you’ve come to the right place.

Unfortunately, in today’s day and age, our bodies are so overly burdened (processed foods, environmental exposures, toxic chemicals, etc.) that it’s becoming incredibly difficult for our immune systems to keep up. Throw a little genetics into the mix, and suddenly you may find yourself with unwanted symptoms and or disease.

Wondering how food can relate to your chronic health issues? As crazy as it sounds, foods that you are eating on a consistent, perhaps even daily basis can be the biggest triggers for your chronic symptoms.

Trust me when I say this: Most people living with food-related health issues do not realize how poorly they honestly feel until the offending food agent(s) is completely removed for several weeks.

I have been a witness to such incredible success with this approach. Consequently, today I am going to review the benefits of an elimination diet and I will also provide you with an elimination diet meal plan. After all, aren’t you ready to feel great again?

Why Should I follow an Elimination Diet Meal Plan?

Sad but true: so many of us have been feeling crummy for so long that we forget what our “normal” feels. I am writing this article with the hope that I can help change that for you or at the very least, get the ball rolling in a more positive direction.

No one deserves to feel poorly for years on end without answers.

No one deserves to have medication after medication thrown at them without their healthcare provider digging deeper to find the root cause.

A significant reason why so many of us feel this way is because food is often the culprit, yet it is the most overlooked component of our personal health puzzle when we go to see our doctor.

The first part of the issue stems from the fact that most health care professionals (other than registered dietitians) do not receive extensive or high-level nutrition education. How could your provider educate you on something so foreign? You don’t know what you don’t know, and I don’t blame them one bit!

The second part of the issue is that a food allergy, food intolerance, and food sensitivity are three different issues, thus making it very hard to detect in certain situations. (If this is a new concept to you, please check out my article that explains the difference between an allergy, sensitivity, and intolerance.)

While a food allergy reaction is often immediate and severe, a food intolerance reaction can be delayed for hours and a food sensitivity reaction can be delayed for up to four days! It’s no wonder that so many of us struggle to find our food “villain(s)”.

The elimination diet is hands down the best method for diagnosing adverse food reactions.

While there are many excellent food sensitivity tests on the market, none are perfect regarding accuracy. This is why I say the elimination diet is the best first line of defense or “gold standard” when one feels that certain foods may be contributing to their current state of health.

If you do not have a functional nutrition expert in your area or perhaps funds are a little tight at the moment, a basic elimination diet such as the one we are discussing today is the perfect place to start.

Who Might Benefit from an Elimination Diet?

I’ve said this before and I will say it again and again…

Anyone who is experiencing aggravating and chronic health symptoms, whether they are associated with a specific disease state or not, and these symptoms are NOT responding well to conventional medical therapy, will almost always experience relief by removing offending food agents.

Even if you think that there is no possible way under the sun that your health concerns could be related to food, I challenge you to think otherwise. The immune system is like a bucket and when it finally overflows, we start to experience aggravating health symptoms. Following a properly designed elimination diet meal plan can help you “empty your bucket” to the point where you begin to feel much better.

By the way, this is why you will often see three different people with three completely different health issues experience relief following the same elimination diet.

After walking thousands of individuals through some form of an elimination diet protocol, I can honestly say that the vast majority of these individuals experienced partial and often complete symptom relief after 3-6 weeks.

Alright, now let’s get to it!

What Foods Can I Eat on an Elimination Diet?

Please understand that there are hundreds of different variations of an elimination diet- from ketogenic to, low salicylate, low histamine, to Gluten Free, Low FODMAP, Paleo and beyond. However, since I do not know you or your past medical history, we are going to begin with a general yet comprehensive and anti-inflammatory approach: the removal of the top 8 allergens.

Wheat, egg, dairy, corn, soy, peanuts, pork, shellfish.

Now you might say to yourself, “Well, I never eat soy, I don’t even like it” just like my new client said to me in my office yesterday. The thought of tofu and tempeh completely grossed him out; HOWEVER when I dove deep enough into his food journal, I discovered that he was eating soy EVERY. SINGLE. DAY! Everything from his morning protein bar to his salad dressing and packaged mashed potatoes at dinner all contained some form of processed soy.

Moral of the story? Just because you are not eating a particular food in it’s truest form does not mean that you are not consuming it in other ways.

Posts related to our Ultimate Elimination Diet Meal Plan Guide:

  • Food Sensitivity Symptoms & Testing Explained- The Ultimate Guide
  • 7 Essential Tips to Detoxify Naturally
  • The Low FODMAP Diet for Athletes: Destroy Gut Issues with Food
  • What is Functional Nutrition and How Can it Change Your Life?
  • Is Gluten Free Healthier? Here are the Facts
  • Gluten Free Diet Benefits – Is this Lifestyle for Everyone?
  • Feeling Better on a Gluten Free Meal Plan? Here’s Why

Foods to Eat on an Elimination Diet Meal Plan:

  • Fresh or Frozen Veggies

Eating a rainbow a day keeps the doctor away! The more color you eat, the greater your ability to repair DNA and reverse cellular damage. Remember, a serving of veggies is 1 cup raw or ½ cup cooked. Try to aim for at least 5-6 servings a day.

If you can eat two different colors of produce at each meal, you have done an outstanding job. As mentioned, focus on non-starchy veggies such as your dark leafy greens vs. starchy such as squash, potatoes, and parsnips. Also, the cruciferous family (broccoli, kale, cabbage, cauliflower, etc.) is the most potent when it comes to supporting your body’s natural ability to detoxify!

  • Fresh or Frozen Fruit

Fresh or frozen fruit is another excellent way to add color, variety, and flavor to your plan. Just remember, fruit is comprised of natural sugar and it is certainly possible to overdo it, especially for those of you trying to manage your weight and blood sugar.

A great rule of thumb is to aim for 2-3 servings (or medium sized pieces) of fruit a day. Ideally, you will want to learn more toward lower glycemic fruits such as fresh berries, cherries, kiwi, green apple, grapefruit, and pomegranate.

Pro Tip: try not to eat fruit alone but instead pair it with a slower digesting macronutrient family such as protein and fat. For example, try dipping your green apple in almond butter or blend your frozen berries into a smoothie that contains protein and quality plant-based fat (see elimination diet meal plan ideas below).

  • Gluten-Free Whole Grains

We are going to assume at this point that you tolerate gluten-free grains fairly well. But as always, please be sure to monitor symptoms as this can be a big trigger family for many individuals. The best examples include rice, quinoa, teff, oats, millet, sorghum, buckwheat, and amaranth.

Pro Tip: If your immune system is already on high alert, you may experience a negative reaction to a grain that you have never tried before. Again, take notes!

  • Healthy Oils

Plant-based oils are the best way to add rich flavor to your food while keeping hunger at bay. For optimal quality, make it a goal to choose organic, cold pressed oil that is stored in a dark container. Light and oxygen can cause a perfectly good oil to go rancid.

The best options include olive oil, coconut oil, and avocado oil for cooking. Other great options include canned coconut milk (add to soups or shakes) and pecan oil or flaxseed oil (awesome on salads). Olives (check out OLOVES great snack packs which my husband loves) and avocados also fall under this delicious category of plant-based fat.

  • Lean Meats (Avoid pork and shellfish)

Be sure to include quality protein with most meals in order to help control hunger, stabilize blood sugar, and maintain lean muscle mass. Great examples include chicken, turkey, venison, Cornish hen, cod, herring, tuna, salmon, sardines, halibut, mackerel, and plant friendly options such as spirulina or plant-based protein powder.

  • Legumes (Avoid peanuts)

For those who feel that they tolerate legumes (beans) well, this is a great source of protein as well as a complex carbohydrate. Incorporating ½-1 cup of legumes each day is a great way to increase fiber in your diet. It is also a great way to experience more variety when it comes to protein. Try dipping fresh veggies in hummus, enjoy a black bean and rice bowl, or add lentils and kidney beans to your chili.

  • Nuts and Seeds/ Nut and Seed Butter

This is by far and away the most convenient way to achieve your daily servings of plant-based fat Remember, fat helps to control our hunger and is also critical for optimal brain health and hormone production. Enjoy a handful of cashews or spicy pumpkin seeds for a snack. Spread sunflower butter on a rice cracker, add chia or flaxseed to your oats or add a scoop of almond butter to your smoothie.

Foods to Avoid on an Elimination Diet Meal Plan:

MUST Avoid

  • Corn
  • Egg
  • Wheat
  • Soy
  • Dairy
  • Pork
  • Shellfish
  • Peanuts

Strongly Encouraged to Avoid

  • Alcohol
  • Caffeine
  • Added sugar
  • Processed meats
  • Beef in addition to pork

Pro Tip: Make sure to wean off caffeine before beginning this plan. Removing caffeine “cold turkey” can make this an extremely difficult process. Eliminating foods that you have likely eaten daily for years on top of the removal of caffeine can make the elimination process even more difficult.

Now, let’s put everything together. Here is a sample elimination diet meal plan:

Feeling a little overwhelmed yet? If so, you may want to check out the following articles for additional guidance: The Best Substitutions for the Top 8 Allergens, as well as 7 Crucial Strategies for Following an Elimination Diet and Dining out with Food Allergies.

How Soon Will I Feel Better?

Great question.

Something I want to make very loud and clear is that there is a chance you will feel worse before you feel better when you strictly follow an elimination diet. Now don’t get me wrong, some feel better immediately but for those of us who were eating poorly to begin with AND our body had a lot of “funk” A.K.A. toxins to clear out, the “die off” reaction can be very real, similar to that of a Herxheimer reaction. Luckily, this does not typically last for more than 7-10 days for most people.

The key to minimizing the intensity of this reaction? Stay hydrated, eat every 3-4 hours in order to stabilize blood sugar and balance your meals. You must, I repeat MUST plan ahead and possibly even cook in bulk/purchase snacks in bulk in advance if you truly would like to experience success following this approach. A hungry human is not always a rational human and when your options are more limited than usual, you may find yourself in a tough spot.

In my years of clinical experience, I can easily say the vast majority of individuals who follow an elimination diet start to feel relief after the first 10-14 days and report marked improvement somewhere between the 3-6 week mark. In rare occasions, I will have a patient or two who do not feel well until they reach 12 weeks of elimination but that is not the standard. Relief often depends on how long someone has been feeling poorly and to what extreme.

Remember, the whole purpose of this approach is to give the immune system enough time to relax and heal. By removing offensive food agents, we are helping to repair our intestinal lining and we are reducing our toxic burden all while identifying food triggers. As you can imagine, that specific point of relief is different for each person. You have nothing to lose by trying a basic elimination diet, so let’s get rolling!

If you enjoyed this article and would like to improve the health of a friend or family member, don’t forget to share this article with them. Also, if you’d like to get a closer glimpse of what we’re up to, learn some amazing recipes with 5 ingredients and less, or discover fun facts on how to improve your health, check us out on Instagram under the name FWDfuel.

Have you successfully resolved your chronic health symptoms by following an elimination diet? What did you find was your biggest nutrition obstacle?

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“Food is fuel.” On the surface, that’s a statement you can get behind. After all, food does fuel your workouts and your daily life. But for some people, certain foods may drag them down rather than pump them up.

In cases of food allergies, intolerances, or sensitivities, they may provoke unpleasant symptoms such as bloating, gas, severe diarrhea, constipation, unexplained changes in weight, or nutritional deficiencies, says registered dietitian Maxine Yeung, MS, RD, CPT, founder of The Wellness Whisk. And sometimes, they may also cause non-GI woes such as headaches, migraines, skin rashes, acne, joint pains, mood changes, low energy levels, runny noses, hives, and itchy eyes, says registered dietitian Kerry Clifford, MS, RD, LDN, with Fresh Thyme Farmers Market.

“Everybody’s body responds to foods differently,” Clifford says. “Sometimes, our body doesn’t necessarily love every food we eat or our immune system might recognize something as a ‘foreign invader.'” While it’s possible to have a food allergy, sensitivity, or intolerance to any given food, the most common culprits include alcohol, coffee, corn, dairy, eggs, peanuts and tree nuts, shellfish, soy, and wheat. (Yes, even incredibly healthy foods can cause issues for some people!)

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Since there are so many possibilities that could be to blame for your body’s distress, figuring out which food (or foods) that are actually at fault can be a little tricky. One common way to ID the problem? Performing an elimination diet, which, yes, involves eliminating certain foods from your diet only to gradually reintroduce them to identify the specific trouble makers. But those are just the nuts and bolts.

If you’ve been suffering from any, if not many, of the above symptoms (bloating and gas and diarrhea, oh my!) an elimination diet probably sounds like a total saving grace. But walk, don’t run. Unfortunately, it’s not as simple as ditching ice cream for a few days and, if you feel less bloated, assuming you’re lactose intolerant. Instead, done right, an elimination diet requires precise planning and monitoring (and the help of a professional).

Before you start slashing food from your repertoire on your won, there’s quite a bit of info you should know. So, pull up a chair and get comfortable—elimination diet 101 is in session.

What is an elimination diet?

Despite being called a “diet,” it has nothing to do with weight loss or dieting in the traditional sense. Rather, an elimination diet is a two-part process lasting anywhere from three to eight weeks.

First you remove potential food triggers and then carefully add them back into your diet to determine whether they’re to blame for your reactions, says WH advisor Samantha Nazareth, MD, a gastroenterologist who practices in New York City. “Sometimes symptoms, which range from belly pain to nasal congestion, can be delayed, therefore reintroduction of each food group has to be for at least three days.”

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Yeung adds, “Once foods are identified, we can modify an individual’s diet to help improve their symptoms and other body functions such as digestion, absorption, microbial balance, and inflammation.”

In addition to just a general elimination diet that Dr. Nazareth and Yeung describe, there are also specific types of elimination diets such as a low FODMAP diet, which is used for patients suffering from irritable bowel syndrome (IBS).

“The low FODMAP diet eliminates certain short chain carbohydrates—gluten, lactose, fructose, and sugar alcohols—that ferment in our gut and can cause bloating, abdominal pain, diarrhea and/or constipation,” says Liz McMahon, MPH, RDN, a gut health-focused dietitian in Philadelphia.

According to studies, patients with IBS don’t absorb short-chain carbs, which can be a reason why they experience gas, severe bloating, and altered bowel habits (think: diarrhea, constipation, or both). “Eliminating the FODMAPs allows them to first of all, feel better, but then add them back in slowly to figure out what specific carbs/foods are causing their issue,” McMahon adds.

Can I do an elimination alone or do I need help from a pro?

Before undertaking an elimination diet, consult a professional so they can ensure that you’re conducting the diet effectively and that you’re still able to meet your nutritional needs, Clifford says. After all, if you decide to try cutting out gluten, it’s easy to not get the fiber you need. And if you eliminate dairy, you could be putting yourself at risk of too-low vitamin D and calcium levels. Your RD won’t let those issues happen.

And the same goes for more specific elimination diets such as a low FODMAP diet—best to do so under the care of a physician and/or nutritionist.

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It’s also important to talk to your doctor about any issues that you’ve had in the past (or currently have!) with disordered eating or anxiety, Yeung says. Especially in those with a tendency to control their eating, an elimination diet may trigger food restriction or a hype-focus on “good” and “bad” foods, and your health professional can help you to ensure that you follow your elimination diet in the healthiest way possible, both physically and emotionally.

How should I begin an elimination diet?

“Before starting an elimination diet, keep a food and symptom diary to help identify patterns between eating habits and symptoms,” says Yeung. This will help you and your healthcare professional figure out which food or foods you should try to eliminate.

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For example, if you notice that you regularly get itchy after eating walnuts and almonds, you might decide that you want to try eliminating tree nuts. It’s totally possible that you will decide to eliminate multiple foods or types of foods.

The important thing is to eat normally and thoroughly document both everything you eat and how you feel after eating it. Track for at least a couple of weeks before making any decisions about what you’ll try cutting.

The second you spot a potential link in your log, it can be tempting to jump right into your elimination diet. Don’t. Instead, keep eating normally, track your symptoms, and start planning. On day one of your diet, you should feel knowledgeable about the exact foods you’ll need to avoid, prepared with lots of well-rounded recipes, and ready to read food labels with confidence, says Meghan Sedivy, RD, LDN, a registered dietitian with Fresh Thyme Farmers Market.

Okay, so I’ve kept a food journal for a few weeks—now what?

When it comes to picking an actual day to start, choose a time when you know that you will easily have complete control over what you do (and don’t) eat. So, no, vacation isn’t the best time to try out something like this.

Once you do choose a time to press play on this program, make sure to avoid making simultaneous lifestyle changes. “I’ve often seen people make many other lifestyle and medication changes ,” says Yeung. “This makes it much more challenging to determine dietary sources of the symptoms.”

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For example, if you start taking probiotics at the same time you eliminate soy, it will be hard to know if you’re feeling differently because of the supplement or because of the elimination, she says. During your elimination diet, it should be your only lifestyle change in progress.

And when this kick-off day finally arrives, go ahead and eliminate all food and food groups at once. Again, it’s important to do this with a doctor or RD’s supervision. After all, if you’re cutting dairy, gluten, shellfish, and nuts…getting the nutrients you need is going to require some help, says Sedivy.

Umm, how can I make sure to get all my nutrients if I’m not eating so many things?

Hey, you—breathe! It’s a lot. But keeping up your intake of essential nutrients while on an elimination diet really isn’t as hard as it might seem.

In addition to working with a pro like a dietitian or doc, start (if not continue!) taking a standard multivitamin that doesn’t have an added “‘superfoods’ or food powders,” as they may actually have the ingredients you’re trying to avoid, McMahon says. Depending on what food(s) you’re eliminating, it’s not a bad idea to go for a vitamin that has calcium with vitamin D if you’re ditching dairy or one with B-vitamins if you’re eliminating wheat and gluten.

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McMahon also encourages elimination dieters to keep it as simple as possible, to helps de-stress the whole process by making sure each meal has three basic components: protein—lean options like chicken or fish—healthy fats—avocado or EVOO—and carbohydrates—veggies like spinach or broccoli or grains like brown rice or quinoa. Together, these components will keep you energized and feeling satisfied, which is a must especially when you’re eliminating foods.

How long does an elimination diet last?

There’s no hard-and-fast rule as to the exact length of an elimination diet. It can technically last anywhere from three to eight weeks, which “gives the body time to adjust to a new diet and also allows the gut lining—the barrier from what we put into our mouths and the rest of the body—to regenerate,” Dr. Nazareth says.

Irritants like food allergens can damage the lining, weakening the “security system” so that things that shouldn’t enter the body (think: bugs) can now do just that and cause inflammation, bloating, gas, diarrhea, Dr. Nazareth explains.

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That being said, your doctor or dietitian can help you determine the appropriate time period for your elimination diet, which will largely depend on the food(s) you’re cutting out. However, your body requires a good week or two to recoup from any potentially triggering foods.

It will be tempting to quit the process early, but Yeung says it’s important to stick it out. “Many people stop the elimination diet early because they are feeling better shortly after starting, but by doing this, you risk eliminating foods that you do not necessarily need to because you didn’t go through the reintroduction phase,” she says. “This could cause imbalanced diets and stop you from eating foods that you may really enjoy and can tolerate.”

When can I start reintroducing foods—and how?

After eliminating everything that’s a potential trigger for you, begin the challenge phase of reintroducing one food group at a time. I repeat: one. at. a. time. You do this with the intention of provoking symptoms, Yeung says. But if you find that the food that you reintroduced has caused issues, then best to hold off eating it and seek medical advice.

While you’re at it (read: throughout the entire process of elimination and reintroduction), remember to log everything.

Hey, hey, I know what you’re thinking: again with the logging?! But take it from the pros like Clifford who emphasizes the importance of tracking, tracking, tracking. “Write down what foods you ate, how much, and where you got it,” she says.

Also take time to reflect on how you feel after eating, whether there are any changes to your digestion or energy levels, and whether you can tolerate certain serving sizes, but not others. You could keep this record in a journal or on your phone or download a food tracking app.

What about the foods that still bother me? Should I keep eating them?

It’s important to know if you have a food allergy, intolerance, or sensitivity—but it’s even more important to know how to respond to that information.

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For example, she says, if you’re lactose intolerant you won’t cause harm to yourself if you eat lactose. (Although you might experience some uncomfortable side effects like gas or diarrhea.) But if you have celiac disease (confirmed by a intestinal biopsy) and eat gluten, you could harm your gut’s ability to properly take in the nutrients your body needs, thereby putting you at risk for thereby putting you at risk for vitamin deficiencies, Dr. Nazareth explains. Your MD or RD can help you fully understand your condition so that you can keep your body safe and healthy.

Laura Newcomer Laura Newcomer is a professional copywriter and content strategy consultant who specializes in the health and wellness space. Elizabeth Bacharach Elizabeth Bacharach is the Assistant Editor at Women’s Health where she writes and edits content about mental and physical health, food and nutrition, sexual health, and lifestyle trends across WomensHealthMag.com and the print magazine.

Food sensitivities and intolerances: How and why to do an elimination diet

If you’re suffering from food intolerances or sensitivities, an elimination diet could be the most profound dietary experiment you’ll ever try.

  • Want to listen instead of read?
  • We also created a cool visual guide. Check out the infographic here…

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Contrary to popular belief, food isn’t just fuel. That’s why we hate those “would you use cheap gas in your Ferrari?” arguments for eating better.

You see, food is also information. Every bite of food you eat sends some sort of message to your body. And your body responds accordingly.

So, how are these messages transmitted?

Well, our gastrointestinal (GI) tract is the interface between food and body. And this huge organ system – the size of a tennis court when stretched end to end – is responsible for converting our food into chemical messages through the processes of digestion and absorption.

However, the GI tract doesn’t just digest and absorb food.

Surprisingly, the GI tract also has its own independently working nervous system (aka the enteric nervous system). Therefore, the GI tract is rich in neurotransmitters, hormones, chemical messengers, enzymes, and bacteria. Indeed, it’s even home to 70 percent of your body’s entire immune system!

When things go wrong & how to go about fixing them

Given the amount of resources devoted to the proper function of the GI tract, it seems obvious that a healthy body starts with a healthy GI system. Want to lose fat? Gain muscle? Improve sports performance? Shine with good health and vitality? If so, better get that GI system working properly.

But a whole lot can go wrong in the gut. The following can wreak havoc on our GI health:

  • enzyme deficiency
  • microbial imbalance
  • motility issues
  • detoxification abnormalities
  • intestinal permeability
  • inflammation

Interestingly, food intolerance or sensitivities can contribute to every single one of these problems, either directly or indirectly. Indeed, a growing body of evidence shows that food allergies, or more accurately food sensitivities, can harm numerous other body systems and cause a wide range of unwanted symptoms.

For example, food sensitivities/reactions and other gastrointestinal disturbances have been linked to:

  • asthma and allergies
  • autoimmune disorders
  • skin conditions
  • arthritis
  • atherosclerosis and other cardiovascular diseases
  • neurodegenerative diseases such as dementia
  • mood disorders
  • ADD/ADHD
  • narcolepsy
  • addiction
  • migraines
  • kidney problems

Wow, that’s a huge list! And, with more research, the list grows. In fact, because of the number of conditions now correlated to either gut dysfunction or food sensitivities, anyone who feels like their GI system is working sub-optimally should at least consider trying a dietary approach known as an elimination diet.

Honestly, there are many ways to treat GI-related health conditions. But the first, easiest, and most effective place to start is by eliminating or removing foods that might be causing a problem.

The elimination diet

Obviously there’s no such thing as a perfect diet. Biochemically, we’re all unique and have individual needs for how much to eat, what to eat, and when to eat. Not to mention the fact that there are social and psychological components to eating well. So we also have to do our best to find the best nutrition/lifestyle match.

However, when suffering from GI-related complaints, the elimination diet is one approach that’s extremely useful. It addresses many of our individual needs, and benefits nearly everyone who tries it. Plus, it’s sorta fun. It’s like planning your own research project – on yourself.

Again, if you don’t have any gut-related complaints, there’s probably no need to experiment with an elimination diet. Nevertheless, if you’re suffering from food sensitivities, following an elimination diet for a few weeks could be the most profound dietary change you’ll ever make. For some people, the results can feel nothing short of miraculous.

So what is an elimination diet? Well, it’s all in the title: you eliminate certain foods for a period of time, usually three or four weeks, then slowly reintroduce specific foods and monitor your symptoms for possible reactions.

Why not just get food allergy testing done? Well, it’s often expensive and unreliable. Seriously, despite the multitude of currently available food allergy tests, the elimination diet still remains the gold standard for identifying food sensitivities.

As with all allergy tests, it too has its flaws. But it’s inexpensive, easy to do, empowering (you do it, not a lab) and you experience the results first-hand, which can be a more powerful stimulus for dietary changes than a lab test.

Elimination diet philosophy and practice

Four principles guide the elimination diet plans we assign to our patients.

  1. Science: We look to the published research for data on how certain foods impact digestion and health.
  2. Experience: Although not based on published research, we use our experience to guide other recommendations.
  3. Theory: Based on both science and our experience, we come up with explanatory models for what we’re doing.
  4. Practicality: In the end, it all comes down to what people can actually stick to.

All in all, it’s easy to get very rigid, dogmatic, or restrictive with the concept of elimination diets. And many practitioners do. But we prefer to be guided by what actually works — as demonstrated by clinical experience and the available evidence. So that’s what we’re going to cover today.

How to do an elimination diet

What to remove

The best elimination diets remove the largest number of foods. Generally speaking, the more restrictive the better. Yes, it’s more work. But, as with most things, the more work, the greater the payoff.

To begin with, a good elimination diet will remove gluten, dairy, soy, eggs, corn, pork, beef, chicken, beans/lentils, coffee, citrus fruits, nuts, and nightshade vegetables. That might sound like a lot, but it leaves plenty of options for a relatively satisfying diet comprised primarily of rice, meat (i.e. turkey, fish, lamb), most fruit, and most types of vegetables.

The following table gives an example of what to include and exclude during an elimination diet.

Foods to include Foods to exclude
Fruits Almost all fresh fruit Citrus fruits
Vegetables Almost all fresh raw, steamed, sautéed, or roasted vegetables Tomatoes, eggplant, potatoes (sweet potato and yams are okay)
Starch Rice*, buckwheat* Wheat, corn, barley, spelt, kamut, rye, oats, all gluten-containing products
Legumes Soybeans, tofu, tempeh, soy milk, all beans, peas, lentils
Nuts and seeds All nuts and seeds
Meat and fish Fish, turkey, lamb, wild game Beef, chicken, pork, eggs, cold cuts, bacon, hotdogs, canned meat, sausage, shellfish, meat substitutes made from soy
Dairy products and milk substitutes Unsweetened rice milk*, coconut milk Milk, cheese, cottage cheese, cream, yogurt, butter, ice cream, non-dairy creamers
Fats Cold-expeller pressed olive oil, flaxseed oil, coconut oil Margarine, butter, processed and hydrogenated oils, mayonnaise, spreads
Beverages Drink plenty of fresh water, herbal teas (e.g. rooibos, peppermint, etc.) Alcohol, caffeine (coffee, black tea, green tea, soda)
Spices and condiments Sea salt, fresh pepper, fresh herbs and spices (i.e. garlic, cumin, dill, ginger, oregano, parsley, rosemary, thyme, turmeric) Chocolate, ketchup, mustard, relish, chutney, soy sauce, barbecue sauce, vinegar
Sweeteners Stevia (if needed) White or brown sugar, honey, maple syrup, corn syrup, high fructose corn syrup, desserts

*May also be removed if you suspect specific sensitivities to grains.

As mentioned, this is a fairly restrictive elimination diet. There are lists available on the Internet allowing more, and sometimes fewer, foods in the diet. The key here is to not get too dogmatic. Self-experimentation rules the day. So try different things and see what works for you.

The only caveat here is that the more you remove, the more likely you are to discover foods you’re intolerant to, which is a good thing for your health.

And here’s another tip: consider removing any other foods you eat frequently. For example, eat turkey or asparagus every day? If so, try replacing them during the elimination experiment. You may find that you’ve become intolerant to one of your daily staples because you’re eating it so frequently.

How long should the diet be?

The length of an elimination diet can vary depending on your age and the severity of symptoms. Children can usually see benefit from a 7-10 day elimination diet, while most adults seem to do well following the program for around three to four weeks.

Just don’t make things too complicated on yourself. Macronutrient ratios, calorie intake, etc. aren’t very important during an elimination diet. The only really important thing is to completely avoid the foods discussed above.

Also, during the elimination diet, be sure you consume adequate amounts of water. Anywhere from 2 to 4 liters daily should do the trick.

Reintroduction

Of course, it’s not the purpose of the elimination diet to get rid of all the foods above forever. That would be awful. Rather, the point is to eliminate the foods and then slowly reintroduce them, one at a time, so you can monitor yourself for symptoms.

So, at the end of the three weeks of elimination, reintroduce a single food group for one day only. And then monitor your symptoms for two days. For example, you might decide to reintroduce dairy on a Monday. That day you could eat some cheese, ice cream, and drink a glass of milk. While getting right back to your elimination diet, monitor for any abnormal reactions on Tuesday and Wednesday.

If you have no observable symptoms, you may try reintroducing another food (i.e. eggs) on Thursday. You can continue this process for a couple more weeks, reintroducing one new food every few days, until you’ve determined what foods may cause you an issue (if any).

The whole process will take approximately 5-6 weeks and, at the end of the experiment, you’ll know a heck of a lot about how your body responds to different foods.

What to look for

The key to the approach is this: pay attention to how you’re feeling. For example, you’ll want to monitor your sleep, mood, energy, digestion, bowel habits, etc.

In fact, we recommend keeping a journal during the elimination phase and tracking any physical, mental, or emotional signs and symptoms. If you feel better during the elimination period (i.e. more energy, better sleep), it may indicate that a food you commonly eat is causing you a problem.

The second thing to watch for is symptoms – negative or positive – during the reintroduction. Negative reactions can include:

  • insomnia
  • fatigue
  • joint pain and/or inflammation
  • skin breakouts or rashes
  • headaches
  • bowel changes or GI pain
  • bloating
  • brain fog
  • sinus or other respiratory issues

Because you’ll be introducing eliminated foods one at a time, you can be very observant of food-related changes. And virtually anything that is different than you felt during the previous three weeks could be a symptom, negative or positive.

Interestingly, some people actually report increased energy when a given food is reintroduced. Unfortunately this may be created by a stress response to the particular food. And that’s actually a negative thing. So it’s important to keep a log of all reactions – positive or negative.

Tips for success

By now you should realize that the elimination diet isn’t necessarily easy. But it’s not that hard either. It just requires that you have a plan and you pay attention. Of course, the more you put into the elimination diet, the more you get out of it. So here are some tips for having success with this plan.

  • Prepare. People who spend the week prior to starting the program looking up recipes that are elimination-diet friendly do far better than people that jump right into it.
  • Have the foods that you will need on hand. Know how to cook them, and prep as much as possible in advance. For example, making a large pot of rice, complete with vegetables, protein and seasonings ahead of time can help increase compliance during those times when you get hungry and have few options nearby.
  • Clean out your kitchen. People aren’t particularly good with willpower. Get rid of the foods that aren’t part of your elimination phase (or hide them really well).
  • Keep a journal. Record symptoms, energy and mood throughout the day to help identify any patterns with food intake. Remember, this is a self-experiment. And every good scientist needs a lab book in which they can keep their notes and experimental details.

Summary

If you think you might be suffering from food intolerances, you might want to try an elimination diet.

Food has the power to promote health or create disease, and following an elimination diet can be a rewarding and eye-opening experience.

So, give it a try if you think your gut health needs a check-up. What you give up temporarily in creature comforts you’ll gain in lasting and unequivocal knowledge about your own health and wellbeing.

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Google elimination diet and more than 53 million results pop up. So what exactly are elimination diets and do you need to go on one?

Elimination diets are used to help identify foods that may be related to symptoms such as diarrhea, bloating, gas, and other problems. They are meant to be followed for a relatively short period of time, ranging from four to eight weeks.

Different health care providers administer elimination diets, including gastroenterologists, allergists, and registered dietitian nutritionists (RDNs). Before an elimination diet is used, a health care provider will typically rule out other conditions. For example:

  • If celiac disease is suspected, the physician might perform an endoscopic biopsy and test tissues in your intestine for signs of this condition.
  • Or, a breath test might be done to rule out lactose or fructose intolerance. Breath tests measure for the amounts of certain gases that may indicate that your body did not digest certain compounds, for example, lactose, found in the food recently consumed.

Elimination diets require motivation. It can be tough to make the needed dietary changes even though it is only on a short-term basis. Also, if you’re taking any medicines, discuss them with your physician before making changes to your diet and consult with an RDN. RDNs have the ability to analyze your diet and identify any nutrients that may be lacking and make recommendations for healthy substitutions based on your individual preferences. They can also offer tips on meal planning and reading food labels.

How Elimination Diets Work

Most elimination diets have two phases:

  • Elimination phase
  • Reintroduction phase

Elimination Phase

During the elimination phase, you stop eating all foods that are thought to be bothersome. The goal is to see if by restricting these foods your symptoms go away. Often individuals are aware of which foods appear to cause their symptoms. However, the healthcare provider can also help you to figure out which foods might troublesome for you.

You might be instructed to eliminate one food at a time, groups of similar foods such as a food group, or multiple food items. For example, if lactose intolerance is suspected, a health care provider might recommend you avoid all dairy foods, including milk, yogurt, and cheese. If gluten intolerance is suspected, you will be given a list of foods to restrict that contain gluten. These may include wheat, rye, barley, and processed foods that may contain gluten such as malt vinegar, pre-seasoned meat, and some lunch meats.

Working with an RDN can be helpful during this phase. The RDN can review your typical eating habits and give you a list of food items to eat in place of the foods you need to eliminate. In addition, the RDN can help to design an elimination diet that considers your individual food preferences

Reintroduction Phase

If your symptoms have improved, the next step is to reintroduce the foods that were restricted. The goal is to see if by eating these foods your symptoms return. During this phase, the patient tracks which foods are tolerated. Usually, starting with a small amount, one food item at a time is added back into your eating plan. If the symptoms do not return, a larger portion of the food is tested for tolerance. The patient records the amount of the food tolerated. The reintroduction phase continues until all of the potentially bothersome foods are tested.

Sometimes, food intolerances may relate to an ingredient used in a specific product or food brand. This is common with sulfite sensitivities. Some dried foods, for example, contain sulfites. But one brand of dried apricots may contain sulfites, while another may not, so label reading and detailed food records can be very helpful.

Three Things to Remember about Elimination Diets

  1. Elimination diets are not meant to be followed for long periods of time and should only be done so under the supervision of a health care provider.
  2. An RDN can help you follow an elimination diet that also meets your nutrition needs.
  3. The outcome of an elimination diet is an individualized eating plan, which may include a list of foods to restrict, eat occasionally, or consume in smaller amounts.

Finding an RDN

Ask your health care provider for a referral to a dietitian. Or, search the Academy of Nutrition and Dietetics’ “Find an Expert” list to locate an RDN in your area.

Why an Elimination Diet Won’t Help You Lose Weight

“The one thing XYZ celebrity stopped eating to look this good.” “Cut out carbs to drop 10 pounds fast!” “Get summer-body ready by eliminating dairy.” You’ve seen the headlines. You’ve read the ads, and, hey, maybe you’ve even considered or tried one of these too-good-to-be-true tactics yourself. I completely understand why. We live in a diet-obsessed culture, where images of women with killer abs and the “quick fixes” that make them possible help sell magazines, products, and aspirations. It’s actually one of the reasons I changed careers to become a registered dietitian. Not to help with the quick fixes, but quite the opposite. I became a dietitian to help people learn what it really takes to get healthy. And eliminating foods or going on a severe diet to drop pounds quickly is a method that will fail time and time again. (Here are the other outdated diet mistakes you need to stop making once and for all.)

First, let’s get on thing out in the open. I’m a vegetarian.

You may be thinking it’s a bit hypocritical of me to speak out against elimination diets when I’m cutting an entire food group. And you may have a point. But my decision to not eat meat has nothing to do with weight loss. As a matter of fact, as someone who knows what it’s like to eliminate a food group, I know that it doesn’t magically melt away pounds. I also recognize that elimination diets are medically necessary for a large group of people. For instance, those with irritable bowel diseases follow a low-FODMAP diet to help ease symptoms. (See what happened when one editor tried the diet in an attempt to solve her tummy troubles.) Those with celiac disease can’t eat gluten. Diabetics have to watch their added sugar intake. Some people with a history of high blood pressure need to be mindful of the salt in their diet. And let’s not forget about the dreaded-and sometimes deadly-food allergies. For people with these conditions, elimination diets are necessary. They don’t eliminate food groups with the goal of losing weight, but with the goal of staying alive and feeling well.

I’m talking about using a short- or long-term elimination diet as a means to lose weight.

Now if you’re thinking, “Well my bestie stopped eating gluten and lost 25 pounds,” I will admit that there are the people out there that eliminated gluten/sugar/dairy/etc. from their diet and they lost weight. (Remember when Khloé Kardashian credited dairy with helping her lose 35 pounds?) To those people, I salute you. But I bet it wasn’t easy. You are the exception, not the rule. And let me tell you why.

While we all want the quick fix to lose 10 pounds and look great in our jeans, that unicorn just doesn’t exist. If it did, we would all look like Jessica Alba and Kate Upton. Instead, losing weight requires hard work and “behavior modification.” This jargony term appears a lot within the nutrition world. It’s one that dietitians and other health professionals use to explain how they help people lose weight and keep it off-and it’s been a proven method of weight loss dating way back to the 1970s.

Quite simply, the term means a change in your behavior, and not just something simple, like cutting out a food group. Research has found that these behavioral modifications should focus on psychological interventions. As a matter of fact, a recently published review claims that cognitive-behavioral therapy is the most preferred intervention for treating obesity. In other words, the modified behavior has nothing to do with cutting out one food from your life. Instead, behavioral interventions help people recognize why they always opt for that food in the first place.

So what does this actually look like in practice? Have you ever made a grand pronouncement like “I’m never eating a brownie again”? Behavioral modification is about thinking why you chose the brownie. Were you emotional at the time and eating out of stress? Do brownies help you cope with other circumstances that don’t involve food? Once you recognize those behaviors, it’s easier to make changes to avoid those actions.

Behavioral modification may also entail long-term nutrition education. Rather than cutting out one food because it’s high in calories, it’s better to learn about the nutrients that come from that food and figure out how to make all foods fit within a healthy diet and lifestyle. Not only will this approach help you feel less deprived, but it will help you make better choices in the long run. It may sound like a cliché, but weight loss is a journey. It’s not a switch you can flip one day to easily drop 20 pounds. I know that you “know” this, but it’s so easy to believe what sounds easier and faster than something that looks like hard work. Losing weight or getting fit doesn’t happen by arbitrarily cutting out red foods, starches, milk products, gluten or anything else that’s part of a balanced, healthy diet. It happens with time, energy, and hard work. (Related: What People Don’t Realize When They Talk About Weight and Health)

So, now what? Here are some success-proven ways to start a weight loss journey:

Meet with a registered dietitian. Dietitians take classes in nutrition counseling to help you make behavioral modifications. Because nutrition is so different for everyone, a nutritionist will help you create a plan that will work for you and your lifestyle.

Start with small changes. If you meet with a healthy eating pro, he or she will likely help you create a plan that introduces small diet and lifestyle changes. Instead of cutting all sugar from your diet, focus on reducing dessert one or two nights a week. Don’t eat enough veggies? Try adding one to your morning smoothie a couple days a week. Small changes add up to big habits over time.

Create a support group. The foundation of tried-and-true “diet” programs, such as Weight Watchers is moderation, not elimination, and, with WW specifically, it creates a sense of camaraderie and accountability with in-person check-ins. There’s no reason you can’t create the same thing with any of your own friends who are trying to lose weight. How about a “dessert one night a week” club or a “fill half your plate with veggies” group pledge? Doing it together can make it easier to commit and more fun.

  • By Natalie Rizzo, MS, RD

What You Should Know Before Trying an Elimination Diet

If you’ve been feeling unwell and none of the treatments you’ve tried have worked, look to your diet. Systematically cutting items from your diet and seeing how you feel can be one way to see if food is making you feel crummy. And if so, which foods, says Heidi Turner, M.S., R.D.N., a medical nutrition therapist at The Seattle Arthritis Clinic.

Elimination diets are used to pinpoint the underlying cause of a wide range of health problems, from digestive issues and heartburn to joint paint, allergies, migraines, insomnia, anxiety, depression, and skin issues, she says.

“If you’re saying, ‘Oh my gosh, I have these hives every day and these medications and supplements aren’t working,’ then you want to be looking at the foods you’re eating,” says Turner. “Food has the ability to impact our immune system so significantly.”

Has a healthcare provider suggested you try an elimination diet, or did you Google your symptoms and now you’re wondering if you should try one yourself? Maybe your best friend keeps telling you how the Whole30 diet changed her life? This is what you should know before cleaning out your fridge.

Typically completed under the guidance of a registered dietitian or a primary care provider who specializes in integrative medicine, an elimination diet removes antigenic foods, which are those found to create an immune response in some people, says Turner.

Wheat, dairy, gluten, eggs, soy, sugar, alcohol, caffeine, corn, citrus fruits and nightshade plants are typical culprits, she says. In people who are sensitive to them, gluten and dairy consumption may cause digestive issues or lead to mood issues, for example. And nightshades—tomatoes, eggplant, white potatoes, pepper, paprika and tobacco—may aggravate arthritis in some people, Turner says.

Elimination diet weight loss

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