Elimination Diet as a Method of Determining Food Sensitivities
Your physical and mental well-being can be significantly affected by a sensitivity to a certain food. People with food sensitivities may experience abdominal pain, gassiness, chronic diarrhea, constipation, and other symptoms.
If you think you are sensitive to a particular food product, you can use an elimination diet to determine the cause of your symptoms. Along with medical tests and food diaries, elimination diets help to provide a solution to your problem.
Elimination Diets and Allergy Testing
Elimination diets are also commonly referred to as exclusion diets. They are sometimes used as an alternative treatment for various conditions, including arthritis and irritable bowel syndrome. Doctors often recommend following these diets to confirm allergy testing results.
Elimination diets have already been playing an important role in food allergy treatment, as well as treatment of food intolerance and other sensitivities. However, their effectiveness against food-related disorders hasn’t been studied well yet. Existing studies involving elimination diets have shown quite controversial results.
Thus, according to a number of studies, people with eczema didn’t improve their symptoms by following an elimination diet alone, without being getting an allergy test first. On the other hand, another research, that studied eczema in infants tested positive for an egg allergy, did find improvements in their symptoms due to an egg-free diet.
Elimination diets have also been found to be effective in people who develop a disease known as eosinophilic esophagitis. Eosinophilic (or allergic) esophagitis is an allergic inflammatory condition affecting the esophagus, whose symptoms often include heartburn, difficulty swallowing, abdominal pain and others. Besides, people diagnosed with an allergy and suffering from irritable bowel syndrome and migraines can reduce their symptoms using an elimination diet, as well.
Can Elimination Diets Worsen Your Allergies?
Some experts believe that following an elimination diet for prolonged time periods can intensify your immune system’s response to an allergy trigger. Thus, people with mild food allergies may develop more severe allergic reactions after a long-term elimination diet.
Researchers at Johns Hopkins University conducted a study involving children who had outgrown their allergies to peanuts. The study showed that continued elimination of peanut products from the diets of these children led to a recurrence of severe allergies.
Another study has found that people completely eliminating gluten from their diets tend to have worse reactions after accidental exposure to gluten-containing foods.
Therefore, people with food allergies who develop “classic” allergy symptoms like hives, swollen lips and tongue, or anaphylaxis, should only re-introduce once eliminated foods under close monitoring of a specialist.
How Does an Elimination Diet Work?
Elimination diets help to confirm the results of allergy testing through excluding certain food products from your diet for a limited period of time. Before you start following such a diet, you should consult with your healthcare provider first.
Below, there is a detailed instruction on how to use elimination diets.
To start with, you will have to eliminate the suspected food allergen from your diet for a period of two weeks. This also applies to any food products that may contain even trace amounts of the allergen. Experts recommend that you keep your diet as simple as possible and prepare your food yourself, to prevent the risk of cross-contamination.
Thus, if you suspect an egg allergy, better stick to fresh fruits, vegetables, and meats, and avoid baked goods, complicated salad dressings and sauces, or processed meat products (such as meatloaf and meatballs). People with celiac disease should be especially cautious, as they may develop a severe reaction even to microscopic traces of gluten found on non-gluten products due to cross-contamination.
If you notice improvements in your symptoms after the two weeks of your allergen-free diet, you will need to do a so-called food challenge that involves re-introduction of the eliminated food. The challenge should be performed using the food in its basic form, rather than a product containing multiple ingredients. For example, in the case of egg sensitivity, try eating a boiled egg, instead of some pastry.
If your symptoms don’t improve after a course of elimination diet, you are most likely allergic to another food.
Sometimes, the symptoms may also get worse after re-introduction of the food. To rule out the risk of coincidence, it’s recommended to try the whole process of food elimination and challenge one more time. This will help to confirm the results.
How to Use a Food Diary?
Allergy specialists often recommend that you support your elimination diet with food diaries where you keep track of the foods you eat every day and the symptoms you experience. This can allow you to spot certain patterns concerning your condition and determine potential sources of cross-contamination or cross-reactivity.
You can use a small notebook as your personal food diary. Make sure to record each meal you have during the day, including the major ingredients. Thus, instead of writing down just a word “salad”, consider mentioning what exactly the salad was made of, for example, lettuce, tomatoes, cucumber, chicken, etc.
Apart from the foods you eat throughout the day, you should also record the symptoms you experience, including some detailed information. For instance, the idea would be to mention what exactly you feel, at what time your symptoms tend to occur, how long it takes for them to develop, and how severe they are.
Normally, a few weeks or a month of keeping a food diary is enough for you to be able to see some pattern of the foods you eat and the symptoms you have, but sometimes, it can take more time. Besides, you may have a hard time trying to spot any variation in your symptoms, if they are triggered by a food you consume every day.
Why Do You Need Medical Testing?
Some people decide not to submit themselves to medical testing, if their symptoms are not severe enough. However, this is a common mistake. In fact, medical testing is a great way to determine the cause of your symptoms, whether it is a food sensitivity or some other health condition.
Thus, intolerance to lactose can be determined using a non-invasive test performed in a lab, while celiac disease can be diagnosed based on special blood tests and an endoscopy.
Sometimes, allergy tests (e.g. skin prick test or blood test) may provide inconclusive results. For instance, some people diagnosed with a food allergy may actually tolerate eating that food. In this case, an elimination diet and following food challenge may be required to confirm the results. If you got a positive allergy test result, but had never reacted to that food, your allergist will likely suggest that you cut the food out of your diet and perform a food challenge after several weeks.
If you have unpleasant symptoms after eating certain foods, but your food sensitivity test is negative, you are likely to have something else. For example, eating greasy food may lead to diarrhea and abdominal pain caused by gall stones. In this case, a visit to a gastroenterologist can help to see what is wrong.
The Bottom Line
You can find various types of elimination diets aimed to determine food sensitivities. Some of them are limited to only a few foods or to one or two food groups (like fruits and vegetables). There are also diets made of food considered to be “non-allergenic”, even though almost any food can trigger an allergic reaction. In alternative medicine, fasting for long periods can also be used as a method of identifying food allergies and sensitivities.
When it comes to limiting your diet to certain food products, there is always a risk of poor nutrition, especially in kids. Therefore, make sure that your elimination diet remains balanced and contains sufficient amount of vital nutrients. Before eliminating a certain food from your diet or from the diet of your child, you should discuss the issue with your doctor first.