How To Start An Elimination Diet

If you’ve ever looked up remedies for digestive issues, you’ve likely come across the term “elimination diet.” It has nothing to do with weight loss, but rather is a way to identify problematic foods that could be causing symptoms such as bloating, stomach pain, constipation, diarrhea, hives and rashes.

“In an elimination diet, you remove specific foods from your diet for a period of time to see if it impacts or alleviates your symptoms,” says Maria Conley, RDN, a dietitian nutritionist at the Henry Ford Center for Integrative Medicine. “An elimination diet can help pinpoint certain foods you’re sensitive, intolerant or allergic to. And, for people with irritable bowel syndrome (IBS), an elimination diet can help manage symptoms.”

The foods you eliminate can vary depending upon your specific issue. But whatever type of elimination diet you’re starting, it’s always best to get guidance from a registered dietitian nutritionist, who can ensure you’re maintaining proper nutrition.

Here, Conley shares how to get started.

Phase 1 Of An Elimination Diet

In the first phase, you’ll avoid foods that you may be reacting poorly to for four to eight weeks. (The end date depends upon how you’re feeling and how well you’re progressing through the diet.)

If you have IBS, you’ll want to stick to a low FODMAP diet. Certain fermentable carbohydrates, known as high FODMAP foods, can cause bloating, gas, diarrhea and constipation. While there is a huge range of high FODMAP foods, a few examples include onions, garlic, apples, avocado, cashews, beans and milk products. A few low FODMAP options include strawberries, oranges, rice, eggs and quinoa. Read more about a low FODMAP diet here.

For those who are trying to diagnose a specific food allergy or sensitivity, an elimination diet will be much more tailored to foods you suspect are the culprits. If you’re not sure, you can start with common allergens like dairy, gluten, eggs and soy.

Phase 2 Of An Elimination Diet

In the second phase, you’ll slowly reintroduce eliminated foods into your diet. “Start with a small portion size of one food at a time,” says Conley. “Gradually work your way up to larger portions if you’re able to tolerate them and keep a food journal to monitor your symptoms.”

If a food isn’t tolerated well, wait three to four days to allow your symptoms to subside before trying a new food.

Phase 3 Of An Elimination Diet

The last phase, Conley says, is continued maintenance. By this phase, you should be able to identify foods that do and do not trigger your symptoms and modify your diet accordingly.

“Three to six months later, you can retest foods that upset you to see if you can better tolerate them,” says Conley. “Sometimes, when a problematic food is taken out of your diet, the burden on your immune system declines and your gut has the opportunity to heal. So a problematic food could be reintroduced later on and become tolerable.”

Tips For A Successful Elimination Diet

Significantly modifying your diet can feel overwhelming—especially if you’re a creature of habit. The key is to plan ahead. Here are a few tips:

• Do your research. Have a good understanding of which foods you can have and which you can’t. Find substitutes for your favorites. (For example, if you love yogurt but can’t have it, research a good dairy-free alternative.)
• Create a grocery list of approved foods from each food group. Make sure you have as much variety as possible to ensure maximum nutrition. “A good question to ask is, ‘if a food gets taken out of my diet, what can be added into my diet?’” says Conley.
• Take time to meal prep. Don’t wait until you’re hangry to scarf something down—you’ll be more likely to break the diet. Instead, make meals and snacks before hunger strikes.

It’s also important to note that you shouldn’t be on an elimination diet for an extended period of time, unless under the supervision of a dietitian. Not only could it lead to nutrient deficiencies, but “for some people, there’s a risk that adhering to a strict elimination diet in the long-term could lead to disordered eating,” says Conley. “It’s always best to get guidance from an expert and check in with them along the way.”

To find a functional medicine doctor or registered dietitian nutritionist at Henry Ford, visit henryford.com or call 1-800-436-7936.

Maria Conley, RDN, works with functional medicine patients as part of the Center for Integrative Medicine.