Elimination Diet

Digestive health is a big focus of naturopathic medicine since digestion is the foundation of health. It is where we absorb vitamins and nutrients to help support a healthy body overall. Digestive symptoms are also a common complaint in patients. One area ND’s can look into to evaluate and treat digestive symptoms is with elimination diets. 

When it’s suspected a body is not tolerating certain foods well, an ND may recommend an elimination diet. This is where you cut out suspected foods for several weeks and then challenge your symptoms by reintroducing those foods and see how your body feels. Elimination diets are useful for identifying food intolerances and sensitivities, and can be used to help heal the gut.

Some digestive symptoms of food intolerance are heartburn, nausea, bloating, gas, diarrhea and constipation. Going back to the importance of the digestive system to overall health, many people experience more systemic symptoms throughout their body as well. Some of these symptoms include joint pain, acne, eczema and rashes, headaches and migraines, fatigue, behavioural problems, food induced bronchitis, and weight gain.

There are many different variations of elimination diets. The general idea is to strategically limit your diet to identify food sensitivities. The length of time food is eliminated from your diet is typically between 2-12 weeks. The length of time for a food elimination diet will usually depend on how restrictive the diet is, how severe the symptoms are to start, and how symptoms are progressing during the diet. While following an elimination diet, we will also focus on gut healing and digestive support. Once the elimination diet is complete, we will start reintroducing and challenging food. 

Elimination diets: 

The traditional elimination diet involves pairing back the diet substantially and focusing on lean meats, basic vegetables and fruit, with rice. This is typically done for about 2 weeks and then food reintroduction begins. This can be really helpful when it either seems like you are reacting to a lot of foods, or digestion is a big issue but you just don’t know what you are reacting to.

Main food allergens: Where you cut out some or all of the 8 main common food allergens – dairy, wheat/gluten, soy, corn, peanuts, tree nuts, crustacean shellfish, and fish. This works well if you know you react to one or more of these foods.

Select elimination based on suspected foods: If you have suspicions about foods that seem to trigger symptoms then we would focus on cutting these foods out. 

Food sensitivity testing:

This is an alternative way to identify food sensitivities. It involves a blood sample which is tested for food antigens, and then an elimination diet is designed around the specific foods identified. This takes some of the guesswork out of elimination diets. 

When making significant diet changes it is important to make sure you are working with a health professional who can monitor caloric intake as well as vitamin and nutrient status to prevent deficiencies. 

Tips for success and gut healing: 

The goal of an elimination diet is to remove foods that are irritating to the gut and causing inflammation and to promote gut healing and health. By eliminating these irritating foods and focusing on anti-inflammatory foods we can promote gut healing.

Some tips for success with the elimination diet and ways to promote healing are:

Plan ahead, and prep meals and snacks to make the elimination diet easier, and resist the temptation to deter from the elimination diet.

If you do have a food that is not a part of the elimination diet, note how you feel and move on. Get back to the diet as soon as you can.

Focus on reducing pre packaged and processed foods and instead focus on fruits, vegetable, grains, and protein.

Try to rotate the foods you eat, keeping in a lot of variety. Sometimes when we eliminate one food item, we switch the focus entirely to a new food item and can develop new food sensitivities. A great example is if you have eliminated dairy, try to have a variety of the alternatives, like coconut, almond, soy, and cashew, instead of solely focusing on one alternative.

Choose prebiotic and probiotic foods when possible (like fibre rich foods and fermented foods).

Removing the offending foods will decrease irritation and inflammation and allow your gut a chance to heal. You can promote gut healing even more by discussing supplement support with your ND.

Some of the types of supplements we might use are:

Herbs to help soothe the digestive track and promote healing like aloe vera, slippery elm, and marshmallow. 

Nutrients like L-glutamine and butyrate to nourish the cells of the intestine and decrease inflammation.

Probiotics to help balance the good bacteria in your gut.

A digestive enzyme to help break down food.

Depending on your diet restrictions your ND may also recommend a multivitamin or specific vitamin and nutrient support to prevent deficiencies.

Food reintroduction:

Ideally by the end of the elimination diet you will have noticed a significant reduction or elimination of your symptoms. This means it is time to reintroduce foods! 

Food reintroduction is done in a very systematic way so we can assess how your body will handle these foods. Often many or all of the eliminated foods can come back into your diet. Sometimes people will find they still have an issue with some foods and they may need to eliminate the foods for a bit longer, or in some cases they may need to limit their consumption more long term. 

Plan out which order you are going to reintroduce the foods in. Start with foods that are less irritating and then move onto the foods that are known to be more irritating. For example we often recommend leaving dairy and wheat to be some of the last foods introduced.

When doing the food re-introduction, keep a symptom journal to track how you feel.

Take your time and try not to overindulge in these foods until you know how your body will respond.

How to introduce a food:

Try one new food every three days. Consume a little bit of that food several times over those three days and track how you feel and any symptoms you might experience. 

If you notice a flare in your symptoms, like digestive upset, headaches, skin irritation, etc. then you will want to pull that food out of your diet again for another month and then try again. 

Wait until your symptoms clear and then try the next food.

If you don’t have any reaction to the introduced food then you can bring it back into rotation in your diet, and move onto the next food.

One of the main take-aways of the elimination diet is that variety and rotation of foods is important! Try not to eat the same thing all the time, instead try to have a wide variety of foods.

An elimination diet can be a useful way to identify food intolerances and sensitivities, as well as promote not only digestive health but overall health and wellness! If you would like more information on elimination diets and digestive health, please contact us and we would be happy to support you!

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