The Elimination Diet

I’ve been using the Elimination Diet a lot in my practice lately. It’s such a useful diagnostic and therapeutic tool, helping to identify food intolerances at the same time as reducing inflammation, healing the gut and improving mood.

I find it especially useful in patients who come to me having ‘tried everything’, been to every specialist, had all the tests, and still can’t find the answer.

It also provides a good foundation from which to treat almost any chronic condition, from skin problems to hormonal imbalance to autoimmune disease.

So, what is the Elimination Diet?
First of all, it’s not a diet – there is no calorie restriction and you are encouraged to eat plenty of the healthful foods on the list.

Instead, it’s a process of elimination of the 14 most common dietary allergens and then, after a period of 3-4 weeks, a careful reintroduction of these foods to see if they provoke a reaction.

The result is a type of ‘paleo’ diet – plenty of fruits and veggies, good-quality fish and poultry, non-gluten containing grains and dairy alternatives like almond milk and coconut yoghurt. Nuts, seeds and legumes are also on the ‘green’ list.

So, what can’t you eat? Well – gluten, dairy, sugar, alcohol and caffeine are the big ones. Then there are other common dietary allergens like eggs, peanuts, shellfish, corn, beef, pork, soy and processed meats.

All processed foods are best avoided, as well as deep fried and fried food – this gives the liver a break and further reduces the inflammatory ‘load’ on the body.

Why the Elimination Diet?
Food allergies are easily detectable by blood tests, but intolerances are less so – sometimes these only become apparent when we remove the food for a time and then reintroduce.

Problems associated with food intolerances can also be very wide-ranging – including digestive problems, headaches, chronic sinusitis, fatigue, depression, mood swings, eczema, skin irritations, joint aches, asthma, and weight gain.

The other benefit of cutting out all allergens from the diet is that it reduces the overall burden on the immune system and allows the body to heal.

Food reactions of any type trigger low-grade inflammatory reactions in the gut, making the intestinal wall more porous and exposed to the influx of undigested food particles into the blood (a condition referred to as “leaky gut”).

This breakdown of the intestinal barrier can allow other substances like bacteria and chemicals to leak into the bloodstream, further stimulating the immune system and causing more inflammation.

Just as food reactions can lead to leaky gut, the reverse is also true; leaky gut can significantly increase the development of food sensitivities.

The intestinal lining is made of cells that replace themselves approximately every two to four days; in the span of a single week, every cell in the intestinal lining is replaced.

Removing from the diet potentially harmful foods and those that cause inflammation, while at the same time supplying the body with healthy, anti-inflammatory whole foods makes this newly-formed gut tissue stronger and healthier.

And as 70% of our immune tissue is clustered around the digestive tract, a healthier gut means a more well-regulated immune system.

Many of the chronic symptoms above will dramatically reduce or completely disappear following the initial period of elimination. The next hurdle is to reintroduce foods properly and mindfully.

Reintroducing foods
This is the most important part of the diet, and often the most challenging! You should carefully reintroduce foods one at a time, every two days.

So, on Day 1, eat a couple of good-sized portions of e.g. eggs. Then observe, continuing with the Elimination Diet until Day 3. If no reactions have occurred, start with another food (e.g. bread) on Day 3.

Record any reactions that occur – I give my patients a Food Reintroduction Symptoms Tracker chart, but you can record on a piece of paper or spreadsheet.

If you have a reaction from a food, eliminate that food and don’t reintroduce any more foods until the reaction has passed. Then eliminate this food for a further three to six months before you reintroduce it again.

There are many types of Elimination Diets, but I find this one especially useful in my clinical practice. For more information, handouts and recipes, come and see me in Luz or Aljezur.

By Poppy Burr
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Poppy is a degree-qualified medical herbalist practicing from Aljezur and Praia da Luz. She offers holistic consultations and personalised treatment plans using plant-based medicine.
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