The Elimination-Challenge Diet: How Do I Know if I Am Sensitive to a Food?
Could the food you eat be actually harming you?
One of the most frustrating challenges we face as we begin to wade in the ocean of ?Let Me Figure Out My Health Issues? is to determine: could something I?m eating be contributing to my symptoms?
Because the truth is, hidden (or at least as-yet undiscovered) food sensitivity is a major contributing factor to digestive distress and a roadblock to achieving optimal health.
If you eat a food that your body is sensitive to – especially on a regular basis – the consequences can be far reaching.
A wide variety of gastrointestinal related symptoms can be traced back to food sensitivity, including gas, bloating, loose stool, constipation, spasm, indigestion, intestinal pain, reflux, heartburn, colitis and so on.
Additionally, there is a rather large list of seemingly unrelated issues that can be pinned back to the gut and food intolerances: acne, fatigue, headache, joint pain, feeling ?blah?, eczema, hives, other skin rashes, chronic yeast infection, bladder infections, blood sugar problems, dizziness, itching and even heart palpitations.
Basically, if you have any chronic issue that you can?t quite get to the bottom of and wrap your arms around, it is worth considering a food sensitivity – most particularly if these issues are digestive-related.
The task can seem daunting for sure. There are hundreds of foods out there, you like what you like, and may feel a little lost in both where to start and then what to do with what you find out!
I get it. I really do. It took me many years to uncover my gluten sensitivity, with much kicking and screaming and gnashing of teeth. Luckily, it won?t take you that long because you will learn from my mistakes and I will give you the tools you need.
What is the elimination-challenge diet?
The gold standard for figuring out food sensitivity is the elimination-challenge diet. There are blood tests that can check for food sensitivity, and we will talk about those later, but I have to say in the majority of cases the elimination challenge diet is more accurate.
During an elimination-challenge diet, one or more foods are removed from the diet for a specified amount of time and then strategically reintroduced to the body so you can assess your body?s reaction to the food. Your body will let you know :)
One of the great things about the elimination challenge diet is that it can be tailored to YOU. You can eliminate as many or as few foods as you want to make it work for your lifestyle.
How to do it
I?m going to break down the steps for an elimination-challenge diet, and then we?ll talk about tweaking it for you:
1. First, eliminate the food(s) for four weeks. This should be a fairly strict elimination. Read labels. For example, if you are eliminating gluten, check all of your sauces, marinades and even lotions, shampoos and conditioners. Look at all of the ingredients of anything with a label. The more obvious things like bread, pasta, crackers and baked goods are easy, check it all however. This goes for all foods, not just gluten.
2. Get on the Internet and find some awesome recipes. There is SO much free info out there. You can easily Google recipes that will deliver tasty tidbits while excluding the foods you want to challenge.
After the four-week elimination period, you are able to challenge the food against your body and see how your body responds.
3. To do this, choose ONE food (ie- gluten, milk, tomato, etc) and have 2-3 servings of this food in a pure form (ie – pasta, cream of wheat, bread) in ONE day.
4. Then, re-eliminate the food again for another THREE days. This is because the type of food sensitivity we are talking about (IgG and not IgE) can take up to 72 hours to generate symptoms. This is a huge part why teasing out foods we are sensitive to is so tricksy!
5. During those three days (and obviously the day of the challenge), watch for symptoms. Watch for a worsening of your current symptoms or new symptoms cropping up. It could be anything – feeling more bloated, getting symptoms of heartburn, headache, rashes, irritability, fatigue, mood swings, congestion, watery eyes, racing heart, and so on and so forth. PS – If you get any of these symptoms after your very first serving of the food you are challenging, you don?t have to continue on with subsequent servings. That is enough.
6. If you DO get symptoms, chances are good that you are sensitive to that food. In cases like this, I typically recommend cutting the food back out for 2-4 weeks and re-challenging. Based on the severity of your symptoms, you may not want to re-challenge, and that is totally fine too! The great thing about this is you can make it work for you.
7. If you DON?T get symptoms after the challenge and the subsequent three days, chances are good that you can tolerate that food just fine, and you can rotate it back into your diet. Have the food twice to three times weekly for the first two weeks and then as desired thereafter
(PS – use common sense. This is not carte-blanche permission to eat cookie dough as often as you?d like ;) )
8. After that three day period, move on to the next food and repeat the process. In this way, you will be challenging a new food every 4 days. Depending on how many foods you eliminated, this could take a few weeks but I assure you the data and insight you gain into yourself and your body during this process is invaluable! And very much worth your time.
Lots of people have questions about where to start: which foods to tackle first? Are you going to be able to eat ANYTHING? Of course you are.
Here is the neat thing: you can eliminate as many or as few foods as you want. Some people want to do one thing at a time to not feel overwhelmed, yet others cleave to a more comprehensive elimination to figure out what is what once and for all.
Generally speaking, when I am working with people with long-standing digestive issues, I have them eliminate the following foods, which are common allergens: gluten-containing grains and their products, milk and milk products (including yogurt), sugar, artificial sweeteners, legumes (including soy), beans and nightshade veggies (white potato, bell pepper, eggplant and tomatoes). Depending on alcohol intake, we may trim that back to weekends or kick it to the curb too. I don?t often target eggs and tree nuts right out of the gate but keep in mind they could be problematic for some, so keep those in your back pocket.
If the above list makes your head spin, GO SLOWER. Evaluate your current diet and see what types of foods you eat the most of. Do you do a lot of sandwiches? Are you always reaching for the candy bowl after lunch? Start there. Sadly enough, it?s often the foods we love and crave the most that can do us the most harm (and here I?m thinking of pizza and mac and cheese, two delectable perfect storms of inflammation and gastrointestinal mayhem).
It is totally fine to do one elimination at a time, or only choose a couple of foods to eliminate, or the whole shebang in one go. If you have a suspicion you might be sensitive to a particular food, follow your intuition about it.
Bottom line: there is no wrong way to go. Eliminate the food or foods for a month, systematically challenge your body with them 2-3 times in one day, cut them back out for three days, watch and wait – and repeat with the next food. This protocol can be used with any food, beverage or product. You now know how to do it.
Why not just get a food sensitivity test?
You may be wondering why go through all of this time, trial and error if it?s possible to just take a blood test and see what your sensitivities are? For a couple of reasons. One, as I have blogged about before, I use food sensitivity testing like ELISA and ALCAT as a tool and not as a live-and-die-by-the-lab deal. When I use these tests, I am looking for either 1-2 foods to come up strongly, a whole bunch to come up mild to moderate, or a combination of the two. In the latter two scenarios, this speaks more to functional conditions like leaky gut and immune dysfunction than it does to someone having 25 food intolerances.
Next, like any other tests, this one isn?t perfect, either. It can have false negatives and positives. If you have already been eliminating a food item for a while that you suspect you may be sensitive to, it won?t show up on the test because you haven?t been exposing your immune system to the potentially problematic foods.
So, the ELISA and ALCAT tests have limitations with accuracy and application. The limits in the elimination-challenge diet rest solely with your desire to execute it. The strength of the elimination-challenge diet is in the accuracy of it. Your body will absolutely let you know what foods it can tolerate and which ones it cannot.
Does it take time? Sure. Will you have to be diligent, read labels, and plan accordingly? Definitely. But all good things – like the knowledge you will gain from this self exploration – are worth your time, diligence and patience. The alternative is to continue on as you have been. And I know this doesn?t sit well with you, because you are reading this post.
Next steps…
There is another limit to the elimination-challenge diet. Not so much in the process itself but what it means to digestive distress and optimal health. Many times, figuring out food intolerances alone is not enough to completely stop gastrointestinal complaints. It is a major puzzle piece, but the buck does not stop there. It?s not the ONLY piece.
Restoration of gastrointestinal bliss is often a multifaceted process that includes not only identifying and removing food sensitivities, but ensuring:
- that your beneficial bacteria are happy and thriving,
- that you have enough digestive fire to break down your food appropriately,
- that you don?t have an undiscovered pathogen on board like yeast, harmful bacteria or a parasite
- that any medications or environmental exposures aren?t harming your gut
- and that the lining of the digestive tract is intact and healthy
If you?d like more info on that, you can check it out here.
Elimination-challenge diets are quite trendy right now, with many popular books based on them – including my own (blush), and also the work of JJ Virgin (best selling author of The Virgin Diet) and others. Trendy sure, but they are effective at identifying problem foods for you that are preventing you from feeling – and even looking – your best.
