Food Elimination Diet: Three Steps to Get You Started
Embarking on a food-elimination diet can effectively identify food allergies, food intolerances, or food sensitivities and alleviate related symptoms. It's important to approach this process systematically and with guidance.
Food-related adverse reactions can encompass a range of conditions, including food allergies, food intolerances, and food sensitivities. While they may share some common symptoms, these conditions have distinct underlying mechanisms. Let's explore the differences between food allergies, food intolerances, and food sensitivities, delve into their causes and symptoms, and discuss how a dietitian can assist in managing food allergies through a food-elimination diet.
In this article, you will learn three essential steps to help you get started on a food-elimination diet, but first let’s take a look at the differences in food allergies, intolerances, and sensitivities.
Food allergies
Food allergies affect a significant portion of the population, causing adverse reactions when certain foods are consumed. These allergic responses can range from mild discomfort to severe, life-threatening reactions.
Common Food Allergies:
Peanuts: Peanut allergies are one of the most common and potentially severe food allergies. Even trace amounts of peanuts can trigger an allergic reaction.
Tree Nuts: Tree nuts, including almonds, walnuts, cashews, and others, can cause allergic reactions. These allergies tend to be lifelong and can cause severe symptoms.
Milk: Milk allergies occur when the immune system reacts to proteins found in cow's milk. Lactose intolerance, on the other hand, is a different condition caused by an inability to digest lactose, the sugar in milk.
Eggs: Allergic reactions to eggs are common, especially in children. The proteins in egg whites or yolks can trigger allergic responses.
Wheat: Wheat allergies are often confused with gluten intolerance or celiac disease. Allergic reactions to wheat involve an immune response to proteins found in wheat, while gluten intolerance is an inability to digest gluten.
Soy: Soy allergies can cause various symptoms, including hives, itching, and gastrointestinal issues. Soy is a common ingredient in many processed foods, making it challenging to avoid.
Fish and Shellfish: Fish and shellfish allergies can develop at any age. Reactions can be triggered by both raw and cooked forms of these seafood items.
Causes and Symptoms:
Food allergies occur when the immune system mistakenly identifies specific proteins in food as harmful substances. Upon exposure to the allergen, the body releases histamines and other chemicals, leading to various symptoms. Common symptoms of food allergies include:
Skin reactions such as hives, itching, and eczema.
Digestive problems like nausea, vomiting, abdominal pain, and diarrhea.
Respiratory issues include coughing, wheezing, nasal congestion, and difficulty breathing.
Swelling of the lips, tongue, throat, or face.
Anaphylaxis, a severe and potentially life-threatening reaction characterized by a sudden drop in blood pressure, constriction of airways, and swelling of the throat.
Food intolerance
Food intolerances refer to difficulties in digesting or processing certain foods or food components. Unlike food allergies, which involve an immune system response, food intolerances are typically caused by deficiencies in enzymes or other digestive factors required for proper digestion. Here are some common types of food intolerances:
Lactose Intolerance: Lactose intolerance is the inability to fully digest lactose, a sugar found in milk and dairy products. It occurs due to a deficiency of lactase, the enzyme responsible for breaking down lactose. When lactose remains undigested, it can cause symptoms such as bloating, gas, diarrhea, and abdominal discomfort.
Gluten Intolerance: Gluten intolerance, also known as non-celiac gluten sensitivity, refers to a negative reaction to gluten, a protein found in wheat, barley, and rye. Unlike celiac disease, gluten intolerance does not involve an autoimmune response or damage to the small intestine. Symptoms may include digestive issues, fatigue, headaches, and brain fog.
Fructose Malabsorption: Fructose malabsorption is the inability to effectively absorb fructose, a sugar found in fruits, honey, and some sweeteners. When fructose is not properly absorbed in the small intestine, it can ferment in the large intestine, leading to symptoms such as bloating, gas, abdominal pain, and diarrhea.
Histamine Intolerance: Histamine intolerance is characterized by an inability to properly metabolize histamine, a compound found in various foods, particularly aged or fermented foods. When histamine levels accumulate in the body, symptoms such as headaches, flushing, hives, digestive disturbances, and nasal congestion can occur.
FODMAP Intolerance: FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are a group of carbohydrates that can be poorly absorbed in the small intestine. Some individuals may have difficulty digesting and absorbing FODMAPs, leading to symptoms such as bloating, gas, abdominal pain, diarrhea, and constipation. Common sources of FODMAPs include certain fruits, vegetables, grains, and dairy products.
The symptoms of food intolerances can vary widely among individuals and may overlap with other gastrointestinal conditions. Common symptoms include:
Bloating
Gas
Abdominal pain or cramps
Diarrhea or loose stools
Nausea
Headaches
Fatigue
Skin rashes or itching
It's important to note that the symptoms of food intolerances are typically delayed and can occur hours or even days after consuming the problematic food. Identifying specific food intolerances may require keeping a food diary and working with a healthcare professional or registered dietitian to conduct an elimination diet or other diagnostic methods.
Food Sensitivity
Food sensitivity also referred to as non-allergic food hypersensitivity or non-celiac gluten sensitivity, is a broad term that encompasses adverse reactions to certain foods without involving the immune system (as in food allergies) or specific digestive deficiencies (as in food intolerances). The exact mechanisms underlying food sensitivities are not well understood and can vary between individuals.
Food sensitivity symptoms can manifest in various ways, such as:
Digestive issues (abdominal discomfort, bloating, diarrhea)
Headaches or migraines
Joint pain
Fatigue or lethargy
Skin problems (eczema, rashes)
It is worth noting that food sensitivities can be challenging to diagnose due to the lack of standardized tests and clear diagnostic criteria.
Managing Food Allergies, Intolerances, and Sensitivities with a Dietitian:
A registered dietitian plays a crucial role in managing food allergies, intolerances, and sensitivities, helping individuals navigate the complexities of their dietary needs. One effective approach is the implementation of a food-elimination diet. An elimination diet is a systematic approach to identifying and managing adverse reactions to certain foods. It involves temporarily removing potential trigger foods from the diet and then gradually reintroducing them to observe any symptoms that may arise. The primary goals of an elimination diet are to identify specific food allergies or sensitivities, alleviate symptoms, and promote overall well-being.
Here are three essential steps to help you get started on a food-elimination diet:
Step 1: Consult with a dietitian.
Before starting a food-elimination diet, it is crucial to consult with a registered dietitian. They can provide personalized guidance and ensure the diet is appropriate for your specific needs. They will consider your medical history, symptoms, and potential allergens to determine the foods to eliminate.
Step 2: Identify and Eliminate Potential Trigger Foods.
Based on the guidance of your dietitian, you will need to identify and eliminate potential trigger foods from your diet. These foods will be specific to your situation and may include common allergens or triggers such as dairy, gluten, eggs, soy, or others. It's essential to strictly avoid these foods for a predetermined period, typically around 2 to 4 weeks, to allow your body to clear any reactions and symptoms.
During this elimination phase, it is vital to carefully read food labels, as many allergenic ingredients may be hidden in processed foods. Your dietitian can provide resources and tips for identifying potential hidden allergens and finding suitable alternatives.
Step 3: Monitor Symptoms and Reintroduce Foods.
After the elimination period, you will gradually reintroduce the eliminated foods back into your diet, one at a time. This is done to observe any adverse reactions or symptoms that may occur. Start with small portions of the eliminated food and monitor your body's response over a period of 2 to 3 days.
Keep a detailed food and symptom diary during the reintroduction phase to track any changes or reactions. If symptoms reappear after reintroducing a specific food, it may indicate an allergy or sensitivity to that particular food. Consult with your healthcare professional or dietitian to discuss the results and determine appropriate dietary adjustments moving forward.
Throughout the entire process, it is crucial to maintain open communication with your dietitian. They can provide ongoing support, and guidance, and help interpret any findings to ensure you have a comprehensive understanding of your body's response to different foods.
In summary, while food allergies involve an immune system response to specific food proteins, food intolerances arise from digestive difficulties, and food sensitivities refer to adverse reactions that are not mediated by immune or digestive mechanisms. Understanding these distinctions can help individuals and dietitians identify the appropriate strategies for managing and addressing specific food-related adverse reactions. If you suspect any adverse reactions to food, it is advisable to consult a healthcare professional for proper evaluation and diagnosis.
An elimination diet can be a valuable tool in identifying and managing food allergies, intolerances, or sensitivities. However, proper guidance from a registered dietitian is crucial to ensure your nutritional needs are met, and to prevent unnecessary dietary restrictions or nutrient deficiencies. With their expertise and support, individuals can successfully navigate an elimination diet, leading to improved health and overall well-being.
