Elimination diets to identify food sensitivities have been shown to provide relief for a range of symptoms, health problems and chronic illnesses. This post details the elimination diet phase 1 I performed, including what an elimination diet is, the benefits, food lists (what to eat and what to exclude), recipe ideas and example daily meal plans.
Disclaimer: This post is intended for informational purposes only. I’m not a qualified practitioner and I’m not encouraging anyone else to do an elimination diet. Elimination diets should only be performed under the supervision of a qualified medical practitioner. Please consult a qualified practitioner before considering and undertaking an elimination diet or making any changes to your current diet or treatment plan. This post contains affiliate links, meaning at no additional cost to you I earn commission if you click on a link and make a purchase. As an Amazon Associate, I earn from qualifying purchases. See my full disclaimer here.
Functional Medicine Elimination Diet – first port of call for any symptom & condition?
Nutritionist Tom Malterre recommends an elimination diet to identify food sensitivities as the first port of call when dealing with any symptoms or chronic illness. Consuming foods we’re sensitive to causes inflammation, which can contribute to symptoms and prevent you knowing whether other factors such as infections or mold, are also responsible for symptoms (1).
What is an Elimination Diet?
An elimination diet, in functional medicine, is the most effective way of determining food sensitivities that may be increasing inflammation, causing a leaky gut, suppressing the immune system and contributing to symptoms, such as dizziness, chronic fatigue, skin rashes and headaches etc (2; 3). There are 2 phases involved.
Phase 1 – Elimination
- Removing common food allergens/sensitivities for at least a few weeks until symptoms and health improve.
- Replacing them with nutritious unprocessed foods, which reduce inflammation, heal the gut lining and support the immune system.
Phase 2 – Reintroduction
- Slowly reintroduce one food at a time and observe how you feel.
- This allows you to identify which foods you can enjoy and which ones are aggravating symptoms and need to continue to be eliminated or limited.
Benefits of an Elimination Diet
1). Identifies Food Sensitivities, which reduces inflammation and eases symptoms
With food allergies/sensitivities, the immune system overreacts and perceives the specific food to be a toxin or threat. In response, the immune system creates inflammation to attempt to destroy and remove the threat from the body (2). Whereas food allergies produce symptoms immediately, like hives, swollen lips and difficulty breathing, food sensitivities are difficult to identify as they can produce a delayed immune response that can take up to 3 days to appear (2; 3). Continued consumption of foods you are sensitive to causes prolonged inflammation, which damages healthy cells and tissues, causing symptoms (2; 3).
An elimination diet allows you to identify which foods you react to. Removing them from your diet allows the immune system to calm down, which reduces inflammation and allows the body to heal and regenerate and function optimally.
Elimination diets have been shown to improve symptoms for those with:-
- Eosinophilic esophagitis (4),
- Irritable bowel syndrome (5),
- Migraines (6),
- Autoimmune conditions (7) and
- Skin conditions (8).
2). Heals leaky gut
80% of your immune system is in your gut. Therefore, a healthy gut is vital not only for physical health, including digestive, cardiovascular, metabolic, skin and hormonal health, but also mental health (2).
A healthy gut has small gaps in its lining which allows water and nutrients to flow through, whilst also blocking toxins and bacteria. If the gut lining becomes weaker, holes can develop, causing a leaky gut (2). This means the toxins, bacteria and undigested food can now pass through the gut lining into the bloodstream and spread throughout the body, which:-
- Causes inflammation,
- Impairs the absorption of vital nutrients like vitamins and minerals,
- Increases the risk of infections and,
- Can result in the immune system producing an auto-immune response (2).
Removing foods which damage the gut heals the gut lining and consequently strengthens the immune system, relieving symptoms of any inflammatory and auto-immune disease and preventing the development of any further conditions (2; 3).
3). Gives you more energy, both physically and mentally
Chronic inflammation from the continued consumption of foods you are sensitive to increases the energy demands of the immune system, limiting the energy available for rest of the body (9). Eliminating foods from your diet you’re sensitive to increases the energy available for the rest of the body, benefitting you both physical and mentally.
total elimination diet
There are lots of different versions of elimination diets but below is the one I followed that improved my health by easing my dizziness, pain and fatigue.
Phase 1). Elimination Phase
Foods To Eliminate
I first removed the following foods, which are either common food allergens/sensitivities, increase inflammation, feed the bad bacteria in the gut or damage the gut lining:-
- Common allergen/food sensitivity,
- Can cause leaky gut and inflammation,
- Causes the protein zonulin to be released, which widens the holes in the gut lining (2).
Butter, buttermilk, cheese, cream, curds, ghee, ice cream, kefir, margarine, milk, sour cream, whey, yoghurt
- Common food allergen/sensitivity,
- Highly inflammatory,
- Conventional dairy contains artificial hormones and antibiotics, which kills the good bacteria in your gut (2).
- Common allergen and food sensitivity,
- Egg whites contain lysozyme which cannot be digested, so easily passes through the gut lining and enters the bloodstream, causing inflammation (2).
Edamame, miso, soy lecithin, soy milk, soy mince, soy protein powder, soy sauce, tamari, tempeh, tofu
- Top allergen and food sensitivity,
- Contains lectins, which can bind to the gut wall and damage it,
- Contains a large amount of various anti-nutrients, which limits the absorption of vital vitamins and minerals from the food we consume,
- Can disrupt your hormones, which negatively impacts your health,
- The majority of soy is genetically modified, which is lower in nutrients and higher in toxins (10).
REFINED SUGAR AND ARTIFICIAL SUGAR SUBSTITUTES
Cane sugar, white sugar, demerara sugar, brown sugar, saccharin, sweetex, sorbitol, xylitol, erythritol, corn syrup, high fructose corn syrup, dextrose, sucrose, aspartame, neotame, sucralose
- One of the most inflammatory foods,
- Increases free radical production, which damages healthy body cells,
- Causes vitamin and mineral deficiencies,
- Feeds the bad bacteria in the gut,
- Suppresses the immune system for a few hours after consumption, reducing the body’s ability to fight viruses, bacteria and other pathogens (10; 11),
- Causes a rapid rise in blood sugar levels, which increases symptoms for those with conditions like dysautonomia and POTS.
Sweetcorn, corn on the cob, high-fructose corn syrup, cornstarch/corn flour
The majority of corn is genetically modified, which is lower in nutrients and higher in toxins (12).
GRAINS AND PSEUDOGRAINS
Amaranth, barley, buckwheat, corn, millet, oats, quinoa, rice, sorghum, teff, rye, wheat, spelt
BEANS AND LEGUMES
Aduki/adzuki beans, baked beans, black beans, borlotti beans, broad beans, butter beans, cannellini beans, chickpeas, edamame beans, fava beans, flagelot beans, garbanzo beans, great northern beans, haricot beans, kidney beans, lentils, lima beans, lupin beans, navy beans, peanuts, pinto beans, runner beans, snap peas, soy bean, split peas
NUTS AND SEEDS, INCLUDING NUT/SEED BUTTERS, FLOURS, MILKS AND OILS
Acorns, almonds, brazil nuts, cashews, chestnuts, chia seeds, filberts, flaxseeds, hazelnuts, hemp seeds, hickory nuts, macadamia nuts, peanuts, pecans, pine nuts, pistachios, poppy seeds, pumpkin seeds, sesame seeds, sunflower seeds, walnuts
Aubergine/eggplant, ashwagandha, cayenne pepper, chilli powder, curry powder, garden huckleberries, golden berries, goji berries, ground cherries, mixed spice (some contain pimento), paprika, peppers, pimento, potatoes (except sweet), tobacco, tomatoes, tomatillos.
Grains/pseudograins, beans/legumes, nuts and seeds and nightshades all:-
- Contain antinutrients (lectins, phytates, saponins), which bind to the gut wall lining and damage it by causing large holes to develop,
- Binds to vital vitamins and minerals from our food, preventing our bodies from absorbing them,
- Over time this can potentially lead to deficiencies (2).
MEAT, INCLUDING ORGAN MEAT AND PROCESSED MEAT
Beef, lamb, pork, turkey, chicken, liver, kidney, heart, bacon, hot dogs, jerky, luncheon meats, deli meats, sausages, salami
- All meat has an omega 3:6 fat ratio that falls outside of the ideal 1:1-1:4 ratio.
- Red meat and organ meat is high in saturated fat, which when consumed in excess feeds the bad bacteria in the gut, and simultaneously reduces the number of good bacteria, which suppresses the immune system (13).
- Processed meat contains inflammatory added sugar, artificial additives and preservatives (14).
- Higher amount of toxic chemicals, pesticides and antibiotics,
- Higher amount of saturated fat,
- Higher amount of inflammatory omega 6 fats,
- Lower amount of anti-inflammatory omega 3 fats and vitamin D.
Clams, crab, crayfish, krill, lobster, mussels, oysters, prawns, scallops, scampi, shrimp
- Contains tropomyosinommon, which is a major allergen (18).
Canola, corn, cottonseed, grapeseed, palm kernel, peanut, rapeseed, safflower, sesame, soybean, sunflower, vegetable
- High in inflammatory omega 6 fatty acids,
- Low in anti-inflammatory omega 3 fatty acids (19).
Store bought ready made biscuits, cereals, cakes, cookies, dips, flapjacks, muffins, ready meals, pancakes, pasta sauces, pastries, pies, pizza, popcorn, pretzels, sausage rolls, scones, shortbread, waffles
- Contain high amounts of added refined sugar, salt, fat and artificial preservatives, additives, colourings and flavourings, which create inflammation and increase the bad bacteria in the gut (20).
Coffee, tea, matcha tea, green tea, energy drinks
- Increases the level of the stress hormone cortisol, which weakens the immune system,
- Stimulates the nervous system, which can increase symptoms for those with conditions like dysautonomia and POTS,
- Stresses the adrenal glands, which can reduce energy levels,
- Interferes with sleep, which is critical for optimal function and healing (10).
- Causes holes to develop in the gut lining,
- Feeds the harmful bacteria in the gut,
- Increases free radical production, which damages healthy body cells (21).
All chocolate products and powders (cacao/cocoa powder)
- Contains caffeine,
- Very high in the anti-nutrient phytic acid, which can damage the gut and reduce nutrient absorption,
- Often contains refined sugar, dairy and soy, which can increase inflammation (22).
Aioli, barbecue sauce, chutney, coleslaw, compotes, conserves, gravy, guacamole, hollandaise sauce, hummus, jams, ketchup, marmalade, mayonnaise, mustard, pesto, pickles, relish, salsa, soy sauce, stocks, tahini, teriyaki, tzatziki, vinegars (except apple cider vinegar)
- These contain added sugar, wheat, dairy, soy, eggs, vegetable oils and additives and preservatives.
FOODS TO EAT
I replaced the above foods with nutritious anti-inflammatory, anti-viral and anti-bacterial foods, which are rich in vitamins and minerals to help reduce inflammation, increase the number of good bacteria in the gut, strengthen and heal the gut lining, rebuild other damaged tissues and support the immune system. I aimed to eat at least 30 plants a week as recommended to optimise gut health and ate in season foods where possible to maximise nutrients (this Eat The Seasons post has a full list of the fruits, vegetables, herbs and spices in season for each month of the year).
FRUITS AND VEGETABLES (all, except nightshades)
- Rich in fibre, antioxidants and various vitamins and minerals, which helps support the immune system, cleanse the body and reduce inflammation,
- High in polyphenols and fibre, which feeds the good bacteria in your gut and binds to toxins to eliminate them from the body,
- To get maximum benefit, I ate a range of different coloured fruit and veg from the rainbow, each of which supports different functions in the body (23).
SUSTAINABLE WILD CAUGHT FISH/SEAFOOD (WITH AT LEAST 2 PORTIONS OF OILY FISH PER WEEK)
- Oily fish (salmon, mackerel, herring, trout, whitebait, sardines, pilchards) is the best source of anti-inflammatory omega 3 fatty acids as well as vitamin B12 and D, which reduces inflammation and supports the immune system (24, 25).
- However, fish contains mercury, which is toxic to the nervous system in large amounts, so it is recommended to avoid high mercury fish (bigeye tuna, king mackerel, marlin, orange roughy, shark, swordfish and tilefish) (26).
- Help absorb fat soluble vitamins (A, D, E & K) from the food we consume,
- Important for hormonal health,
- Help produce bile, which helps eliminate toxins from our body (27).
HERBS, SPICES & CONDIMENTS
Apple cider vinegar, basil, black pepper, bone broth, cardamom, Ceylon cinnamon, chives, cloves, coconut aminos, coriander, cumin, dill, fennel, garlic, ginger, lemongrass, mace, marjoram, mint, nutmeg, parsley, rosemary, sage, samphire, tarragon, thyme, turmeric, white pepper
- These have anti-inflammatory, anti-viral and anti-bacterial properties and help add lots of flavour to foods.
- Contains amino acids, which heals and strengthens the gut lining (28).
- It can be found in the following foods:-
- Bone Broth (Australian Bone Broth Company or Trader Joe’s). Can be drunk on its own, used as a replacement for stock, gravy and sauces or added to soups, stews and casseroles.
- Gelatin (UK Link/US Link),
- Collagen powder (UK Link/US Link). This can be dissolved in cold or hot water or added to coffees and smoothies.
Fermented foods increase the number of good bacteria in the gut, which supports the immune system (3). You can easily make your own fermented foods at home like this Fermented Red Cabbage Sauerkraut, or alternatively buy the following foods ready to eat:–
- Water kefir
- Coconut milk kefir (I consumed this in moderation due to the higher saturated fat content)
Ensure these products are raw, organic and unpasteurised. Store bought products can be pasteurised to prolong shelf life, which kills the good bacteria and minimises the health benefits.
These are a rich source of fibre, omega 3 fatty acids, vitamins and minerals (29). They can be used to make sushi, sprinkled over salads and added to sauces and dips and are a great alternative to salt to add a salty flavour to meals:-
- Sea moss, most commonly consumed in sea moss gel form, which is believed to contain 92 of the 102 minerals our body needs (UK Link/US Link).
- Herbal Teas:-
- Burdock root (UK Link/US Link)
- Great for liver health and removing harmful toxins (30).
- Chamomile (UK Link/US Link)
- Improves sleep and digestion (31).
- Dandelion root (UK Link/US Link)
- Improves liver health and digestion (32).
- Hibiscus (UK Link/US Link)
- Rich in antioxidants and vitamin C to support the immune system (33).
- Lemon and ginger (UK Link/US Link)
- Eases nausea and improves digestion (34).
- Lemon balm (UK Link/US Link)
- Promotes relaxation and improves sleep (35).
- Lemon verbena (UK Link/US Link)
- Promotes relaxation and ease anxiety and stress to improve sleep (36).
- Peppermint (UK Link/US Link)
- Improves digestion and eases nausea (37).
- Rooibos (UK Link/US Link)
- Rich in antioxidants to support the immune system (38).
- Rosehips (UK Link/US Link)
- Rich in antioxidants and vitamin C, which helps support the immune system (39).
- Burdock root (UK Link/US Link)
- Green vegetable juices, like this Fennel Juice Recipe.
- Tiger nut milk or coconut milk. These are allergy friendly plant based milk alternatives, free from dairy, soy, grains, nuts, seeds and gluten. If buying store bought, ensure no additives, preservatives or grains like rice flour are included in the ingredients. I prefer to make my own from scratch at home.
Eliminating a large number of foods can feel restrictive. However, with some simple substitutions you can still easily enjoy versions of your favourite everyday meals and foods:-
- Use carob powder, a caffeine and stimulant free chocolate alternative, instead of cacao and cocoa powder (UK Link/US Link).
- Use lettuce or cabbage leaves in place of tortilla and taco wraps.
- Use baked sweet potato or butternut squash slices in place of toast.
- Use pumpkin puree instead of tinned tomatoes when making chilli, curry, bolognese, stews and casseroles (UK Link/US Link).
- Finely dice celeriac, parsnip, carrot or cauliflower in a food processor to use in place of rice like in this Pumpkin and Mushroom Risotto.
- Spiralise butternut squash, carrot, beetroot or courgette to use instead of spaghetti and grain, soy and bean pasta and spaghetti alternatives.
- Use tiger nut flakes instead of oats to make overnight oats, flapjacks and crumbles (UK Link/US Link).
- Swap white potatoes for sweet potatoes.
- Sweet freedom syrup, a natural sweetener made from 100% fruit extracts, is a great replacement for refined sugar (UK Link/US Link).
You may also find my other post, 20 Healthy Food & Drink Swaps helpful, where I list simple substitutions for the eliminated foods and drinks to make the transition easier.
Related Post: 20 Simple Healthy Food & Drink Swaps
Elimination Diet Recipes
Main Meals & Side Dishes
Broths & Stocks
Desserts & Snacks
- Dairy Free Christmas Chocolate (just use different chocolate moulds when outside of the festive season!)
Example Daily Meal Plan
Day One Example
Breakfast – Immune Boosting Chaga Berry Thick Smoothie Bowl
Snack – Apple
Lunch – Salmon Rainbow Salad (select 4-5 different approved coloured vegetables) with avocado
Snack – Bliss Ball
Dinner – Pumpkin, Mushroom & Spinach Risotto
Dessert – Panna Cotta
Day Two Example
Breakfast – Grain Free Porridge
Snack – Vegetable Crudités/Sticks with Mashed Avocado
Lunch – Root Vegetable Soup
Snack – Handful of Tiger Nuts
Dinner – Tomato Free Bolognese With Tuna
Dessert – Oven Baked Chocolate Pancake
DETOX & WITHDRAWAL SYMPTOMS
It’s common to feel worse for the initial few days to couple of weeks of an elimination diet. When eliminating foods that are causing inflammation and damaging the gut, the body goes through withdrawal, the same feeling you get if you stop drinking caffeine, for example (2; 3).
Consuming inflammatory foods, and foods I am intolerant/sensitive to, impairs the body’s ability to detox and remove toxins efficiently, which may cause them to accumulate and build up in the body (2; 3). Removing these foods from my diet improves my bodies ability to cleanse and remove toxins, which may result in detox symptoms like:-
- Dizziness/light headedness,
- Brain fog,
- Itchy skin,
- Sleep problems,
- Flu like feelings.
I experienced flu-like symptoms, nausea, headaches, fatigue and worsening of my shakiness and dizziness for the initial couple of weeks. After this my withdrawal reactions eased and I noticed improvements in my health.
10 Tips For Success
I found the following tips helpful when planning and performing my elimination diet.
1). Plan well
Spend at least a week before starting phase one researching food swaps, planning recipes and putting together a weekly meal plan and grocery list to prevent you wondering what you can eat or running out of the allowed foods.
Related Post: 11 Tips To Make Cooking Easier
2). Work with a medical practitioner
It’s important an elimination diet is performed under the guidance of a qualified medical practitioner to ensure you have a balanced diet and don’t develop any deficiencies. They can also help conduct other tests and assessments to identify other potential causes of health problems and medical concerns.
3). Keep a journal
I tracked the following each day to help measure my progress and guide when the best time to start reintroducing foods was:-
- The meals you ate,
- How you felt after each meal,
- How well you slept,
- Pain, fatigue and any other symptoms out of 10.
4). Eat a wide variety of foods and eat the rainbow each day
Consuming a range of different foods ensures you don’t get bored of eating the same foods each day. Eating seasonally is one way to increase the variety of foods consumed – this Eat The Seasons post has a full list of the foods in season, able to be grown locally, during each month of the year. Also, the number one predictor of the number of good bacteria in our gut and overall gut health, where 80% of our immune system is located, is the number of plant foods we consume, so I ate at least 30 plants a week as recommended (40, 41).
5). Avoid eating out and takeaways
As hard as this is, restaurants and takeaways often prepare foods with inflammatory vegetable oils and cross contamination with off limit foods like gluten and dairy is a potential concern. To avoid progress being hindered, I avoided eating at restaurants and ordering takeaways during the elimination phase.
If travelling, bring lots of fruit, vegetable sticks and tiger nuts with you. These travel well, are portable and don’t require any preparation.
6). Choose low temperature cooking methods and avoid using oils with a low smoke point
High temperature cooking methods (toasting, grilling, barbecuing, microwaving, deep frying) result in inflammatory compounds and harmful toxins being released (42, 43). Lower temperature cooking methods (steaming, poaching, stewing and slow cooking) produce a lower amount of these harmful chemicals while also preserving a greater amount of nutrients in foods (44, 45, 46).
An oil’s smoke point is the temperature that it starts producing smoke and releasing harmful inflammatory free radicals, which damage healthy tissues (47). Unrefined, cold pressed coconut, avocado and olive oil have a lower smoke point of 160-190°C/325-375°F. To eliminate the potential smoke point issue when roasting, baking and sautéing, use vegetable broth instead, or unsweetened apple sauce, mashed banana or pumpkin puree when baking.
7). Keep hydrated
Dehydration can produce similar symptoms to food sensitivities, including headaches, fatigue and dizziness (48). Staying hydrated can also help ease any detox and withdrawn symptoms experienced. It is typically recommended to drink 2-3 litres/8-12 cups of fluid each day (49).
8). Focus on digestion
Even if we eat the above gut healing foods, our body needs to be able to digest and absorb the nutrients from them for us to reap the benefits and heal. Taking a few slow deep breaths before meals, eating without distractions and chewing each mouthful thoroughly are a few natural ways to improve digestion, help ease stomach and digestive complaints, like nausea and bloating, and maximise the nutrients our body absorbs and utilises.
Related Post: 10 Tips To Improve Digestion Naturally
9). Prioritise rest and sleep
Rest and sleeping well is important to allow our body to heal, especially if you experience withdrawal symptoms.
10). Check your body care products
Skin and body care products, like moisturisers, creams and shampoos, can contain eliminated ingredients like green tea, caffeine, gluten and vegetable oils. Everything we put on our skin is absorbed into our body (50). Therefore, using these products may hinder progress. Switch to natural low toxin products free from these ingredients.
Elimination Diet Variations
Other types of elimination diet also exclude other foods:-
Citrus fruit – clementine, grapefruit, kumquats, lemons, limes, mandarin, oranges, pomelo, tangerines.
High histamine foods – also excludes fermented foods, dried fruit, avocados and spinach (51).
Autoimmune protocol (AIP) – a more strict elimination diet, which also excludes fruit, berry and seed based spices (caraway, cardamom, coriander, cumin, fennel, fenugreek, mustard, nutmeg, star anise etc.) but allows all meat, organ meat and shellfish (52).
Low FODMAP diet – excluding high FODMAP foods, which contain short-chain carbohydrates that some people can’t digest, which can lead to digestive problems. It’s commonly used for those with irritable bowel syndrome (53).
GAPS diet – commonly used to treat those with conditions affecting the brain like autism, ADHD and dyslexia. It eliminates processed foods, refined carbohydrates, grains, starchy vegetables, pasteurised dairy and soy and includes all meats, fish and shellfish, eggs, fruits, vegetables and fermented foods (54).
6 food elimination diet – commonly used for those with eosinophilic esophagitis (EOE). It eliminates 6 food groups (milk, wheat, eggs, all seafood (fish & shellfish), nuts and soy) (55).
PHASE 2). REINTRODUCTION
After there has been a noticeable improvement in symptoms, you progress to elimination diet phase 2, which involves slowly adding foods back into your diet, one at a time. In my following blog post, I detail how to reintroduce foods after elimination diet to identify any food intolerances and sensitivities.
Related Post: How To Reintroduce Foods After Elimination Diet
- Tom Malterre – The Elimination Diet: Discover the Foods That Are Making You Sick and Tired and Feel Better Fast (UK Link/US Link)
Other Health & Chronic Illness Blog Posts
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