How To Complete An Elimination Diet Suited To You

What is an elimination diet?

Elimination diets are commonly used tools in functional medicine. The food we eat is the foundation of our wellness yet, some foods, even seemingly healthy ones, may triggers unwanted symptoms in some people. It is estimated that between 2–20% of people worldwide may suffer from some form of a food intolerance. An elimination diet is the process of removing a food or group of foods from a person’s diet for a set period of time. The absence of the food(s) and then careful reintroduction of the item(s) helps determine whether specific foods or ingredients in foods contribute to unwanted symptoms. Elimination diets are individualized based on each patient’s history, eating patterns, and overall symptom picture.

Why complete an elimination diet?

Food sensitivities can be responsible for a variety of symptoms. You may benefit from completing an elimination diet if you struggled with any of the following symptoms:

Bloating
Heartburn
Distention
Constipation
Diarrhea

Fatigue
Difficulty sleeping
Skin rashes
Headaches
Low mood

Common types of elimination diets:

• FODMAP Diet: This diet eliminates foods high in certain carbohydrates (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) that can be difficult to digest and may cause digestive symptoms such as bloating, gas, and diarrhea. It is often used to manage irritable bowel syndrome (IBS) or other functional gastrointestinal disorders.

• Gluten-Free Diet: This diet eliminates all sources of gluten, a protein found in wheat, barley, rye, and some other grains. It is necessary for individuals with celiac disease, an autoimmune disorder triggered by gluten, and may also be followed by those with non-celiac gluten sensitivity.

• Dairy-Free Diet: This diet eliminates all dairy products, including milk, cheese, yogurt, and butter. It is commonly followed by individuals with lactose intolerance, a condition in which the body has difficulty digesting lactose, the sugar found in dairy products. It may also be followed by individuals with milk protein allergies.

• Specific Carbohydrate Diet (SCD): This diet eliminates complex carbohydrates, disaccharides, and certain grains. It is often used to manage digestive disorders such as Crohn's disease, ulcerative colitis, and celiac disease.

• Low-Histamine Diet: This diet restricts foods that are high in histamine or release histamine in the body. It is followed by individuals with histamine intolerance, a condition characterized by an inability to properly break down histamine, leading to symptoms such as headaches, flushing, hives, nasal congestion and digestive issues.

• Whole30: Whole30 is a 30-day elimination diet that removes grains, legumes, dairy, added sugars, processed foods, and certain food additives. It is designed to reset eating habits, identify food sensitivities, and promote overall health and well-being. It is not specifically designed for a particular health condition.

• Autoimmune Protocol (AIP) Diet: The AIP diet eliminates foods that may trigger inflammation and exacerbate autoimmune conditions. It eliminates grains, legumes, dairy, eggs, nightshade vegetables, nuts, seeds, refined sugars, and processed foods. The AIP diet is often recommended for individuals with autoimmune diseases who are looking to manage their symptoms and reduce inflammation. It eliminates potential trigger foods to support immune system regulation.

• Six Food Elimination Diet: This diet is often used in the diagnosis of food allergies in children. It helps identify specific allergenic foods that may be causing symptoms such as skin rashes, digestive issues, or respiratory problems. It eliminates the most common allergenic foods, including milk, eggs, peanuts/tree nuts, soy, and wheat.

These are just a few examples of elimination diets, and there may be variations or combinations of these diets based on individual needs and specific health conditions. It's important to consult with a healthcare professional or registered dietitian before starting an elimination diet to ensure proper guidance and monitoring throughout the process.

What to expect on an elimination diet:

• Duration of the Diet: During the elimination phase, you will remove certain foods from your diet based on the specific type of elimination diet you are following. This phase typically lasts for a few weeks to several months, depending on the diet and your individual needs.

• Potential Withdrawal Symptoms: Some people may experience withdrawal symptoms when cutting out certain foods, particularly those containing caffeine or sugar. These symptoms can include headaches, irritability, and fatigue. These effects should subside after a few days as your body adjusts.

• Improved Symptoms: If you have food sensitivities or intolerances, you may notice a reduction in symptoms during the elimination phase. For example, digestive issues, skin problems, or respiratory symptoms may improve as you remove trigger foods.

• Food Reintroduction: After the elimination phase, you will start reintroducing the eliminated foods one at a time in a systematic manner. This is usually done over several weeks, and each food is reintroduced individually, allowing you to observe any reactions.

• Identification of Food Sensitivities: The primary goal of an elimination diet is to identify any food sensitivities or intolerances. By reintroducing foods one by one, you can pinpoint which ones are causing adverse reactions.

• Increased Awareness of Eating Habits: Elimination diets often require careful reading of food labels and increased awareness of ingredients. This can lead to improved knowledge about the foods you consume and better eating habits.

• Emotional Challenges: Elimination diets can be challenging, especially if you have to give up favorite foods or make significant dietary changes. This might cause some emotional ups and downs during the process.

• Support and Guidance: Having a healthcare professional or registered dietitian guide you through the elimination diet can be highly beneficial. They can help you plan your meals, monitor your progress, and provide support throughout the process.

• Reintroduction Reactions: Some individuals may experience reactions when reintroducing certain foods. These reactions could be mild or more severe, depending on the level of sensitivity. If you experience severe reactions, it's essential to stop consuming the food and consult with a healthcare professional.

Is there a blood test to use instead of completing an elimination diet?

There are many lab tests availalve that measure certain antibodies or biomarkers in the blood that are associated with an immune response to specific foods. They claim to identify which foods might be triggering adverse reactions in individuals. However, food sensitivity tests have many challenges including lack of standardization, difficulty interpreting the significance of IgG antibodies and potential cross-reactions between foods. Food sensitivities are complex and can involve various immune mechanisms. Blood tests often oversimplify the process by focusing on just a few markers, potentially missing other important factors.

Due to these limitations, many healthcare professionals and experts still consider elimination diets as the gold standard for identifying food sensitivities or intolerances. Elimination diets allow for a more comprehensive and personalized approach, and they are more likely to provide accurate results in identifying specific trigger foods.

If you are considering food sensitivity testing, it's crucial to consult with a qualified healthcare professional who can help you understand the limitations and implications of the test results. They can also guide you on the most appropriate approach to identifying and managing potential food sensitivities based on your unique health needs and history.

Relish Health offers a Whole30-style, physician-guided elimination diet. The 50-day program guides you through removal of specific foods from your diet for 30 days. This 30-day period is proceeded by 10-days of preparation and followed by 10 days of careful food reintroduction. The course provides step-by-step instructions, meal plans, and resource guides. During the months of January and September, Dr. Leazenby is available to answer questions and provide encouragement through facebook and live zoom classes.

A PRIMER ON HISTAMINE INTOLERANCE

IS A LOW FODMAP DIET RIGHT FOR YOU?

Natural Allergy Relief

Spring has finally arrived in the Midwest. Seasonal allergies are a common complaint that affects an estimated 50 million people in the US. Symptoms can vary, but runny nose, itchy, watery eyes, sneezing, headaches and fatigue are commonly described and can impact your quality of life. 

Conventional treatment for allergies includes antihistamine medication and nasal sprays. These medications can offer symptomatic relief, but they do not solve the problem. They can can also come with unpleasant side effects like drowsiness and nausea; or in the case of nasal sprays, dependence. 

Allergic reactions occur when your immune system identifies a normally harmless substance as dangerous. In sensitized individuals, allergens in our environment such as pollen, trigger the production of IgE antibodies. These immune molecules cause release histamine and other allergy-mediating molecules, which lead to inflammation of the nasal airways and eyes, itching, swelling and mucus production. 

Common allergy symptoms include:

• Congestion

• Excess mucus production

• Sneezing

• Runny nose

• Itchy, watery eyes

• Scratchy throat

• Irritation in the ears

• Difficulty sleeping

• Irritability

• Hives

At Relish Health I approach allergies from a holistic perspective. There are a number of natural solutions to quiet symptoms and support your immune system through lifestyle, diet, gut health and inflammation control. Consider these strategies:

1. Get your diet on point

• Diet has a direct effect on immune system function. Nearly 2/3rd of our immune cells reside in our gut. Diet can directly affect the level of inflammation and histamine in our body. Oftentimes, allergic responses are exacerbated when our body is overloaded with triggers. Diet is an obvious place to start decreasing that burden.

• Eat as clean as possible. This means removing foods that are refined, processed or high in sugar. Choose organic where you can to reduce pesticide exposure.

• Based your diet on anti-inflammatory foods. This means eating a diet rich in fruits and veggies that provide fiber and antioxidants. These foods benefits our gut and immune function. Find dietary sources of omega-3 fatty acids such as wild-caught salmon, flaxseed, or chia seed. Use herbs and spices liberally, since their content of anti-inflammatory compounds is especially dense.

• Add fermented foods like sauerkraut or kimchi to your diet for a natural dose of probiotic.

• Try an elimination diet. Dairy foods are mucus-producing for many people and can make allergy season that much worse. To decrease congestion, consider a full elimination of all dairy foods (including milk, cream, cheese, yogurt, etc.) for 30 days. Notice if any of your symptoms improve over that elimination period. After the 30 days, you can reintroduce it to see how dairy affects you.

• Stay hydrated. You should aim to consume about half your body weight (lbs) in fluid ounces, spread throughout the day. Proper hydration reduces the histamine response.

• Address potential food sensitivities.

• Familiarize yourself with foods that trigger oral allergy symptoms due to cross-reactivity with pollen from birch, ragweed, or grasses.

Need help with addressing your diet and gut health, schedule an appointment with Relish Health. 

2. Reduce your exposure to allergens

• You may have an urge to limit your time outdoors in order to find relief from your season allergies, but this is not a realistic, long-term solution.

• Use a neti pot: By flushing the nasal cavity with a gently warmed saline solution, you clear out allergens and loosen mucus. You can use a neti pot two to three times a week.

• Create a safe space: During periods of peak symptoms, keep the doors and windows of your home closed. Use an air conditioner and/or high-quality air filter to help reduce allergens in your home.

• Wash off: Showering before bed to remove allergens from your hair and skin can help reduce contamination of the bedding.

3. Have your vitamin D level checked

• Low vitamin D levels are associated with an increase in allergies. Consider taking a high-quality vitamin D supplement and increasing your exposure to sunlight to help decrease symptoms such as sneezing and nasal congestion. Vitamin D3 has been shown to naturally support immune system function, and strengthen respiratory health.

4. Add natural support

• There are a number of natural compounds in foods and herbs that can provide seasonal allergy symptom relief, including nettles, quercetin, bee pollen and honey.

• Nettles: The stinging nettle plant has been used for centuries to treat allergy symptoms. Nettle’s may reduce the amount of histamine that is produced by the body in response to an allergen. You can consume nettle as a tea or take it as a tincture.

• Quercetin: Quercetin is a flavonoid found in foods such as apples, broccoli, citrus, fennel and red onion. It’s also a natural antihistamine that works without the side effects of many medications. Start using quercetin regularly as soon as seasonal allergies hits in order to build up levels in the body and then continuing throughout the allergy season.

• Local bee pollen and raw honey: You can find bee pollen and raw honey at your local farmers market or health food store. Bee pollen has been shown to decrease the IgE mediated activation of mast cells, thereby dampening the allergic response. Local, raw honey acts similarly to a vaccine. By giving yourself a little dose of the local pollen through the honey, you allow your body to begin building a tolerance to the pollen and have a less severe allergic response. It’s best to start taking either honey or bee pollen daily at least six weeks before allergy season begins.

(Access to high quality nettle and quercetin products is available through the Relish Health online pharmacy.)

If your symptoms do not resolve with these strategies, there be more underlying factors at work. Schedule time with Relish Health, an allergist or your PCP for assistance. Targeted evaluation of nutritional and metabolic status through lab work and desensitization techniques can provide further options. 

FOODS TO AVOID IN ALLERGY SEASON