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?

A Primer on Histamine Intolerance

What is Histamine?

Histamine is a compound which is released by some types of immune cells in response to injury, allergic triggers and inflammatory reactions. Histamine is an important chemical that has a role in a number of different bodily processes. It stimulates gastric acid secretion, plays a role in inflammation, dilates blood vessels, affects muscle contractions in the intestines and lungs, and affects your heart rate. It also helps transmit messages between nerve cells and helps fluids move through blood vessel walls. Histamine is also released if your body encounters a threat from an allergen. During an allergic reaction, histamine causes vessels to swell and dilate, leading to symptoms like congestion, hives or anaphylaxis.

Histamine occurs naturally in some foods. Bacteria are also capable of producing histamine. Fermented foods and beverages (and left-overs) naturally contain small quantities of histamine due to fermenting bacteria or yeasts.

What is Histamine Intolerance?

Histamine intolerance is a disorder associated with an impaired ability to metabolize ingested histamine. In a healthy person, ingested histamine is broken down by two enzymes: DAO and HNMT. When one of these enzymes is not working correctly, histamine intolerance can occur. Histamine intolerance is not a sensitivity to histamine, but an indication that you have developed too much of it.

Symptoms of Histamine Intolerance:

When histamine build-up occurs, a variety of symptoms may be present:

• Skin: redness, rash, hives, itching, swelling and local inflammation

• Respiratory System: runny nose, congestion, shortness of breath and sneezing

• Gastrointestinal Tract: nausea, vomiting, cramping, bloating and diarrhea

• Circulatory System: low blood pressure and heart racing

• Neurological System: headache, palpitations and tingling

Main symptoms of histamine intolerance and possibly corresponding histamine receptors. Biomolecules. 2020 Aug; 10(8): 1181.

Causes of Histamine Intolerance:

Low levels of the DAO enzyme may be due to genetic predisposition or illness. DAO activity can also be blocked by certain medications and alcohol consumption.

DAO is made in the intestines. If the intestines are not healthy, there may not be enough DAO to break down histamine normally. Low DAO levels may explain why histamine intolerance symptoms are more common in people with gastrointestinal disorders such as inflammatory bowel disease, IBS, celiac disease, and small intestinal bacterial overgrowth (SIBO).

How to Diagnosis Histamine Intolerance:

Currently there are no tests that can confirm a diagnosis of histamine intolerance. Blood work, review of your medication use and allergy testing is recommended to rule out other causes of histamine symptoms. After a thorough evaluation, a trial of a low histamine diet is recommended. If typical symptoms of histamine intolerance improve after following of a low-histamine diet, a diagnosis of histamine intolerance is confirmed.

Treatment of Histamine Intolerance:

Histamine intolerance requires a whole-body approach to healing. Addressing underlying health issues and optimizing gut health are necessary.

• Diet: A low histamine diet is the treatment of choice. The tolerance to dietary histamine varies from person to person and the foods tolerated must be deduced by trial and error. Some people can only tolerate very small amounts of histamine rich foods, while others can be more liberal. An elimination diet for 3-4 weeks followed by careful reintroduction of foods is helpful. Following a low histamine diet can be challenging if you already have a restrictive diet. It is recommend that you work with a knowledgable health care provider to minimize your risk of nutritional deficiencies.

• Medications: Antihistamines or oral/topical steroids may be helpful for severe systemic symptoms.

• Supplements: There is little to no data on these, but the following are sometimes used: Vit C, probiotics, quercetin, N-acetyl cysteine, and DAO enzymes. Please use any supplement under the guidance of a practitioner.

• The basics: Sleep, stress management, and regular exercise are important parts of healing.

High Histamine Foods:

There are many lists available online to identify high histamine foods. The “Food Intolerance” app may also helpful.

Foods that may trigger the release of histamine:

• Most citrus fruits

• Cocoa and chocolate

• Tomatoes

• Egg whites

• Fish

• Peanuts

Foods that may interfere with DAO levels:

• Alcohol

• Energy drinks

• Green, black or maté tea

Some foods and drinks that are rich in histamine:

• Alcohol

• Aged cheeses

• Canned, pickled, and fermented foods, such as sauerkraut

• Smoked products, such as sausage, ham, bacon, or salami

• Spinach

• Eggplant

• Ketchup

• Vinegar

• Canned fish, such as mackerel and tuna

Curious whether you may have a histamine intolerance?

References:

Comas-Basté O, Sánchez-Pérez S, Veciana-Nogués MT, Latorre-Moratalla M, Vidal-Carou MDC. Histamine Intolerance: The Current State of the Art. Biomolecules. 2020 Aug 14;10(8):1181. doi: 10.3390/biom10081181. PMID: 32824107; PMCID: PMC7463562.

Which foods are high in histamine? Medical News Today. Accessed 11/9/2022.

Foods in allergy season

Seasonal allergies season is in full swing in the Midwest right now. In addition to typical symptoms of congestion, sneezing and watery eyes, a smaller group of allergy suffers also complain about itchy mouth. This mild, localized reaction from fresh produce items is actually caused by oral allergy syndrome (OAS), also known as pollen-food syndrome. As many as 15% of seasonal allergy sufferers may experience some amount of crosse-reactive symptoms with fresh foods. 

In OAS, the proteins in the foods look similar enough to the pollen proteins that your immune system causes a mild localized allergic reaction . Usually the symptoms quickly dissipate, but they can understandably make you want to avoid the otherwise healthy, triggering food.

The most common pollens that cause this cross-reactivity are from birch, ragweed, or grasses. Since the pollen production of these plants is seasonal, OAS symptoms can often increase or decrease with the seasons as well. These are some of the most common foods that can cause OAS:

• Birch pollen: Apples, Almonds, Carrots, Celery, Cherries, Hazelnuts, Kiwi, Peaches, Pears, Plums

• Grass pollen: Celery, Melons, Oranges, Peaches, Tomatoes

• Ragweed pollen: Bananas, Cucumbers, Melons, Sunflower seeds, Zucchini

If you experience OAS, there are several ways you can minimize symptoms.

• Remove the triggers for your reactions: During allergy season, avoid foods that cause discomfort. Keeping a food diary can be helpful for identifying problem foods.

• Cook foods: Since OAS occurs in raw foods, usually cooking the food will change the protein structure enough that your body will not react.

• Peel foods: Sometimes pollen proteins concentrate on the skin of the produce and peeling can minimize symptoms.

• Address your overall allergies symptoms through these strategies.

Need help determining if your symptoms are related to OAS? Schedule an appointment with Relish Health today. 

TIPS FOR NATURAL ALLERGY RELIEF