An elimination diet can be a useful tool for controlling bothersome symptoms of gastrointestinal conditions, such as irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD). Oftentimes, symptoms can be severe, distressing, and even confusing when you’re not sure what triggers you.
First things first: You shouldn’t go on an elimination diet without consulting your doctor, who may refer you to a dietitian to help support you through the process. There is a risk of developing nutritional deficiencies with any major dietary change and it is important to ensure that you are following the diet effectively for best results. Many foods contain ingredients you wouldn’t necessarily expect, which can derail your diet for elimination, so keeping a food diary and working with a nutritionist can make this process easier.
Find out more about gut health and how to improve digestion here at Live Science.
What is an elimination diet?
There are many reasons why someone might try an elimination diet. If you are experiencing bothersome gastrointestinal symptoms, you may want to stop certain foods to help you identify the cause of your problems.
Common elimination diets include the low-FODMAP diet, or the six-food elimination diet, which is generally done over several weeks or months. The Journal of Gastroenterology and Hepatology (Opens in a new tab)It is advised not to exceed six weeks in the exclusion phase, especially for a low-FODMAP diet (Oligo-, Di-, Mono-saccharides and Polyols), as this can negatively affect the gut microbiome.
Rachel Clarkson explains, path (Opens in a new tab)– Dietitian, Nutritionist, Reference and Founder DNA Nutrition Specialist (Opens in a new tab). An individual can start an elimination diet to help identify symptom-causing foods in their diet.
Rachel Clarkson is a registered dietitian and nutritionist with HCPC. She trained at King’s College London in the UK and underwent further clinical training at Royal Marsden, St Thomas’ Hospital and Imperial College Trust. She recently published her epigenetic research from King’s College London in a peer-reviewed medical journal and continues to develop professionally with courses on topics such as the low FODMAP diet for the management of IBS.
“The duration of an elimination diet can vary depending on the type and number of foods that are eliminated and then reintroduced or objected to. One of the most widely used and scientifically supported elimination diets is the low FODMAP diet. This diet excludes foods containing compounds called FODMAPS which It causes gastrointestinal symptoms in individuals with IBS. This exclusion regimen can take anywhere from 10 to 16 weeks for all three phases: exclusion, reintroduction, and allotment.”
Foods that are high in FODMAPs include some vegetables such as onions and garlic, some fruits (especially crushed ones), beans and lentils.
“Reviewing foods or ingredients that may aggravate symptoms would be helpful, so completing a food and symptoms diary may be a reasonable approach,” adds Kim Plaza, a nutritionist at Bio-Kult.
How to follow the elimination diet
If you suspect you have a certain type of trigger food (such as dairy or gluten), it’s worth stopping for a few weeks to see if your symptoms improve. However, if you are unsure of your trigger foods, or have been diagnosed with a specific condition that may benefit from a broad-based food elimination diet, you should take the following steps under your doctor’s supervision.
“This stage is usually 2 to 6 weeks in which all potentially problematic foods are eliminated from the diet,” Clarkson explains. “By the end of this stage the symptoms should have completely subsided.”
a Nutrients (Opens in a new tab) The journal review notes that the low-FODMAP diet in particular significantly reduced bloating and pain in subjects. A clinical trial reported in Journal of Allergy and Clinical Immunology (Opens in a new tab) It also found that the elimination diet achieved remission in 43% of study participants with eosinophilic esophagitis, regardless of age.
The reintroduction phase involves systematic testing of each food group that has been eliminated.
“This stage can take anywhere between 4-8 weeks, depending on the number of foods being challenged,” Clarkson says. “During this stage, individuals should continue eliminating all problem foods, adding the food being challenged to assess whether it is causing the problematic symptoms. Each potentially problematic food is individually challenged and the quantity is gradually increased to understand if The person was intolerant to this food and in what quantity does the symptoms begin to appear.”
Integration / customization
The final stage of the elimination diet is where the results of food challenges are reviewed and discussed, Clarkson says.
In addition, other challenges may be described in which more than one type of problem food is presented at the same time. Finally, the use of nutritional supplements, digestive enzymes, or probiotics can be discussed. ”
What can you eat on the elimination diet?
It is advisable to cook your meals using raw ingredients at this point, so you know exactly what you are eating. Processed foods often contain flavorings, such as onion or garlic powder, which can trigger symptoms even in small amounts.
- Unprocessed meat and fish (not shellfish)
- Rice-based foods
- Fat-free dairy products, such as vegetable oils
- Low FODMAP fruits and vegetables
What can’t you eat on an elimination diet?
The most common food triggers are often the first to be eliminated to test for symptom response:
- wheat and rye
- Eggplant vegetables (such as potatoes, tomatoes, and peppers)
- Nuts and seeds
- Allium (onions and garlic are high in FODMAPs and are irritating to many people)
- Citrus fruits (can be stimulating for those with acid reflux and gastroesophageal reflux disease)
Plaza also says highly processed foods can be a problem. “Processed foods that contain many hidden sugars, sweeteners, additives, and emulsifiers are likely to have a negative effect on the bacteria that live in the gut — increasing inflammation and exacerbating IBS symptoms,” she says. “Many people notice a rapid improvement in their digestion simply by cutting out processed foods and instead switching to whole, home-cooked foods.”
What are the benefits of an elimination diet?
According to ClarksonAnd the Identifying trigger foods can help you make the best decisions for your body. “The main benefit of an elimination diet is to be able to identify which foods are causing symptoms and how much of those foods are causing symptoms,” she says. “This is a great benefit because it allows you to make the best choices for your body and helps you understand your body on a deeper level.”
Are there any risks of following an elimination diet?
In an elimination diet, you must be careful to ensure that you are still receiving the recommended daily amount of each nutrient, and as such you must do it under professional supervision.
“There can be risks of eliminating food groups for an extended period of time,” Clarkson says. “Working with a healthcare professional can ensure that the elimination diet is followed correctly and in the safest manner possible.”
This article is for informational purposes only and is not intended to provide medical advice.
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