The Elimination Diet: Is It Worth The Hype?

An elimination diet is a dietary approach designed to identify and eliminate specific foods that could potentially be causing symptoms or adverse reactions in the body. While it can be an effective tool for identifying food sensitivities and intolerances, it's essential to understand the ‘why’ behind the diet and the pros and cons before beginning such a restrictive eating plan.

The Difference Between a Food Sensitivity, Intolerance, and Allergy:

Food Sensitivity

A food sensitivity is a poor reaction to certain foods in the body. While symptoms are not life threatening, they can be quite disruptive and include things like joint pain, digestive complaints (bloating, gas, constipation or loose stools, acid reflux), chronic fatigue and brain fog, rashes and skin irritation (hives, aggravation of eczema or psoriasis, worsening acne), headaches and migraines, and even mood disruption. One of the most common food sensitivities today is gluten, although there is debate as to whether gluten itself is the problem, or if our harmful farming practices and use of heavy pesticides like glyphosate are to be blamed.

Food Intolerance

A food intolerance refers to the inability to process or digest certain foods. The most common food intolerance is lactose intolerance. Intolerances often involve the lack of certain enzymes to break down certain parts of foods which then sit in our digestive tracts and cause digestive symptoms. Specifically in lactose intolerance, the body lacks the enzyme lactase to break down the sugar lactose, which then accumulates in the gut and causes symptoms like bloating, gas, inflammation, and diarrhea.

Food Allergy

A food allergy is a true allergic reaction where the body’s immune system responds to a specific food - think peanut or shellfish allergies. These symptoms can range from itching or tingling reactions, facial swelling, and hives, to full blown anaphylaxis that can be life threatening.

How to Test for Food Sensitivities:

Two of the main ways to test for food sensitivities are via the Elimination Diet or an IgG Food Sensitivity Test via blood work. Before we get into the pros and cons of an elimination diet, let’s note that neither of these tests are perfect. Food Sensitivity Panels are often quite expensive and unreliable. They can cause problems in creating false positives which means that certain foods show up as reactive when they might not be, causing unnecessary elimination of foods and a restrictive diet which can potentially end up creating more harm than good. Elimination diets on the other hand have their own pros and cons which we’ll dive into below.

Pros & Cons of an Elimination Diet

Pros of an Elimination Diet:

1. Identifying Food Sensitivities: One of the primary benefits of an elimination diet is its ability to pinpoint specific food sensitivities or intolerances. By systematically eliminating certain foods and then reintroducing them one at a time, we can observe any adverse reactions or symptoms that we might have missed from desensitized repeated exposure. This process can help identify trigger foods that may be causing digestive issues, skin problems, headaches, or other uncomfortable symptoms.

2. Personalized Approach: An elimination diet offers a personalized approach to nutrition and health. It allows individuals to understand how their bodies respond to different foods, empowering them to make informed choices that support their overall well-being. By identifying and eliminating irritating foods, individuals can adopt a diet that is tailored to their unique needs, promoting better digestion, energy levels, and overall health.

3. Increased Awareness of Eating Habits: Engaging in an elimination diet requires careful attention towards food labels and ingredients. This increased awareness encourages individuals to become more mindful of their eating habits. They may discover hidden additives, preservatives, or processed ingredients in their usual diet that they were not aware of before, encouraging them to make healthier choices and opt for whole, unprocessed foods.

4. Potential for Symptom Relief: For individuals experiencing chronic health issues, an elimination diet can be a helpful tool in finding relief. If certain foods are contributing to symptoms such as bloating, inflammation, joint pain, or skin conditions, eliminating them from the diet temporarily can lead to significant improvements in overall well-being. This can provide individuals with a sense of control over their health and an opportunity to find relief from persistent discomfort.

Cons of an Elimination Diet:

1. Nutritional Imbalance: Eliminating entire food groups or multiple foods from your diet can potentially lead to nutritional imbalances if not carefully managed. Certain food groups offer essential nutrients that contribute to overall health. Removing them without proper substitutes or guidance from a qualified healthcare professional can result in deficiencies, particularly if the diet is followed for an extended period.

2. Social Limitations: Following an elimination diet can present challenges in social settings. It may be difficult to navigate meals with friends and family or find suitable options when dining out. Restrictive diets can also create feelings of isolation or frustration when food choices become limited. It's important to consider the potential impact on social interactions and find ways to manage these challenges while sticking to the diet.

3. Psychological Impact: The restrictive nature of an elimination diet can potentially lead to psychological and emotional challenges. Constantly monitoring and eliminating foods from the diet may trigger feelings of deprivation or anxiety around food. Additionally, the process of reintroducing eliminated foods can be emotionally overwhelming if adverse reactions occur. It's important to approach an elimination diet from a grounded and pragmatic space and seek support from healthcare professionals to ensure a healthy relationship with food is maintained. If an individual has a history of eating disorders, restrictive eating, or a poor relationship to food, elimination diets are not recommended.

4. Complex and Time-Consuming: Successfully implementing an elimination diet requires careful planning, organization, and dedication. It involves researching food ingredients, reading labels, and preparing meals from scratch to ensure compliance with the diet's restrictions. This can be time-consuming and demanding. The complexity of the diet may also deter some individuals from maintaining the diet long-term, leading to inconsistency or discontinuation.

5. Lack of Clear Diagnostic Value: While an elimination diet can provide valuable insights into individual food sensitivities or intolerances, it is important to note that it is not a diagnostic tool for diagnosing medical conditions such as allergies or autoimmune conditions like celiac disease. The elimination and reintroduction process may help identify triggers for symptoms, but a definitive diagnosis should be made by a qualified healthcare provider who can conduct appropriate tests and evaluations.

6. Potential for Over-Restriction: There is a risk of over-restriction when following an elimination diet without proper guidance. While it is necessary to eliminate certain foods for a period to observe reactions, it is equally important to reintroduce them systematically to determine true triggers accurately. Without professional support, individuals may unnecessarily restrict their diets, leading to a limited variety of foods and potential nutrient deficiencies.

Elimination Diets can be complicated and rigid. Oftentimes if there is a suspected food sensitivity, it may be suggested to follow a modified elimination diet (i.e. removing only a couple common offenders like wheat and dairy for 4-6 weeks). It’s crucial that the elimination diet is seen as a trial and not a long-term solution. The whole purpose of this trial is to gain more information about the body. Elimination trials should be done with the guidance of a qualified healthcare provider, and should be done in a holistic fashion. Other factors and contributors to health should always be considered including overall nutrition, lifestyle habits, digestive function and capacity, and sleep and stress management.

Remember, an elimination diet should be approached with caution and should not replace proper medical advice or diagnostic testing when necessary. If you are curious about the potential role of food sensitivities and your symptoms, seek out guidance from a healthcare provider that can assist you in decoding your symptoms and helping you make an informed decision on whether or not an elimination diet is right for you.