What Is the Elimination Diet?

Elimination diet

Verywell / Debbie Burkhoff

At Verywell, we believe there is no one-size-fits-all approach to a healthy lifestyle. Successful eating plans need to be individualized and take the whole person into consideration. Prior to starting a new diet plan, consult with your healthcare provider or a registered dietitian, especially if you have an underlying health condition.

An elimination diet is a diagnostic tool used to determine and relieve symptoms of food sensitivities. It does this by temporarily removing specific foods or food groups from a person's diet for a prescribed amount of time, then reintroducing them one at a time to uncover possible connections between suspected foods and undesirable symptoms, such as acne or fatigue.

The concept of elimination diets was first conceived by physicist Dr. Albert Rowe in 1921, who popularized it with his book Elimination Diets and the Patient’s Allergies in 1941. Later, the concept was used by Australian researchers who connected the consumption of food additives with chronic urticaria (hives) in a group of patients. While an elimination diet is great for that specific purpose, it’s not a great long-term solution for weight loss or other health goals.

What Experts Say

“This elimination diet is used to help identify any food allergies, intolerances, or sensitivities. The diet typically only lasts for 5 to 6 weeks and it’s recommended that you work with a dietitian to ensure you’re following it correctly and not falling short of any nutrients.”

Kelly Plowe, MS, RD

What Can You Eat?

When following an elimination diet, all aspects of your diet are flexible apart from the temporary restriction of certain foods for a specific period.

Like the Six Food Elimination Diet, multi-food elimination diets target specific foods that are suspected common allergens: milk, soy, eggs, wheat, peanuts/tree nuts, and seafood.

Other elimination diets may include processed meats, artificial colorings and flavorings, preservatives, and/or processed sugars on their list of restricted foods.

Sometimes only a single food is eliminated at a time.

During the reintroduction phase, each food on the restricted list is added back slowly, one at a time, into your diet. Physicians and dietitians usually emphasize keeping a food journal to help identify reactions and record insights.

This slow, one-by-one process helps determine the amounts of foods a person can consume before eliciting a reaction. If you are gluten-intolerant, for example, you'll supposedly be able to identify exactly how much wheat you can eat before experiencing symptoms of inflammation.

What You Need to Know

When following an elimination diet, you will eat primarily non-inflammatory foods that aren’t known irritants or allergens, such as fresh produce and lean protein. You will completely avoid foods thought to be allergens or irritants.

The following guidelines apply to the Six Food Elimination Diet. A registered dietitian or doctor can tailor an elimination diet to match your needs.

Food allergens can commonly cause anaphylaxis, swelling of the mouth, rhinitis, diarrhea or vomiting, and neurologic responses, such as headaches, nervousness, anxiety, and confusion.

Food intolerances or sensitivities can also cause gastrointestinal difficulties, mood changes, and fatigue. Some allergic reactions are a response to foods themselves, while others are due to a hypersensitivity to food additives.

Keep in mind that many factors besides nutrition can contribute to a person's symptoms, making elimination diets challenging to summarize and roll into one real “diet.”

However, being aware of sensitivities can empower you to shift your diet to eat in a way that promotes optimal health, energy, and vitality.

There is no recommended timing for the elimination diet. Eat as many meals and snacks that allow you to feel satiated and energized. Eating three meals and two to three healthy snacks is a good way to stay full and avoid fatigue.

Your healthcare provider is your best resource for beginning an elimination diet and can support the process with recipes and suggestions. It’s highly recommended to have a list of alternatives to the foods you'll be eliminating, such as almond milk in place of dairy milk.

You should also develop a plan for caloric intake before you start an elimination diet because you may be cutting out many foods you would typically eat — so have replacements at the ready.

Generally, elimination diets begin by cutting out all suspected major food allergens, including soy, dairy, gluten, and tree nuts, and re-introducing them later to confirm suspected allergens. 

However, if you have a known food allergy, you should only try an elimination diet under the supervision of a health professional to avoid potential illness or anaphylaxis.

What to Eat
  • Vegetables

  • Fruits

  • Non-wheat grains

  • Plant-based fats

  • Animal fats

  • Nuts and seeds

  • Lean protein

What Not to Eat
  • Wheat

  • Dairy

  • Tree nuts

  • Soy

  • Seafood

  • Eggs

  • Caffeine

  • Sugar

  • Alcohol

  • Corn

Vegetables

Leafy greens, cruciferous veggies like broccoli and cauliflower, and root vegetables like beets and carrots.

Fruits

Berries, citrus, apples, tropical fruits

Starches and Grains

Non-wheat grains such as amaranth, arrowroot, barley, buckwheat, cassava, chickpea, lentil, millet, oats, potato, quinoa, rice, sago, tapioca, and Teff.

Plant-Based Fats

Olive, avocado, and flax oils. Depending on your needs and goals, you may also be able to eat sunflower, safflower, and/or unrefined, light-shielded canola.

Animal Fats

The fats in animal proteins are fine to eat on an elimination diet, but an overall healthy diet includes minimal red meat.

Seeds

You can enjoy seeds and their nut butters on an elimination diet, be sure to check the label on any store-bought nut butter.

Meat

Fresh and frozen. The less processed, the better.

Wheat

Wheat and products containing gluten are usually the first to go when you begin an elimination diet. Bulgur, couscous, durum, farina, graham flour, Kamut, malt made from wheat, matzah, seitan, semolina, spelt, sprouted wheat, triticale, wheat berries, and wheat germ oil. You may also want to eliminate gelatinized starch, hydrolyzed vegetable protein, modified food starch, vegetable gum, and vegetable starch.

Dairy

Dairy is off-limits at the beginning of an elimination diet. This includes cow’s milk, goat’s milk, cheese, yogurt, casein, and whey protein powders.

Tree nuts

This includes cashew milk, macadamia nut milk, coconut milk, and almond milk, as well as all tree nuts in their unprocessed forms. Brazil nuts, hazelnuts, almonds, pistachios, walnuts, and coconuts are non-compliant.

Soy

Any soy products, including but not limited to tempeh, tofu, and soy milk.

Seafood

all fish (salmon, mackerel, herring, cod, tilapia, swordfish, etc.) and shellfish (shrimp, clams, mussels, crab, lobster, prawns, etc.). It also includes caviar, fish roe, bonito flakes, clam juice.

Eggs

Whole eggs, egg whites, and egg-derived products.

Caffeine

Say goodbye, at least temporarily, to caffeine. This includes coffee, energy drinks, pre-workout, soda, caffeinated teas, and other caffeine sources.

Sugar

Sugar, artificial sweeteners, and sugar alcohols all get the boot during an elimination diet. Some health professionals also recommend avoiding natural sweeteners, such as honey, stevia, and maple syrup.

Alcohol

Avoid all types of alcohol during your elimination diet.

Corn

Some people are sensitive to corn, and it can act as an inflammatory agent. As such, corn and corn products get cut during an elimination diet.

Pros and Cons

Pros
  • Temporary

  • Safe

Cons
  • Not appropriate for some groups

  • Energy- and time-intensive

Pros

Temporary

An elimination diet requires a lot of planning but is only meant to last for a finite amount of time. You might want to continue certain restrictions indefinitely if you determine any food sensitivities.

Safe

Generally, an elimination diet is a safe one if you want to learn more about how your body reacts to certain foods and create more awareness around your eating habits. Remember to experiment with new foods like seaweeds, organ meats, and exotic veggies, so you don't miss dairy or nuts and obtain vital minerals (like magnesium, potassium, and selenium) and vitamins (A, the Bs, and D3).

Cons

Not Recommended for Some Groups

An elimination diet may become a trigger for people who are in recovery for disordered eating, anorexia nervosa or bulimia nervosa.

Energy- and Time-intensive

For many, an elimination diet can be a vast departure from their cultural traditions or day-to-day choices. Fortunately, humans are extremely adaptable. Just be prepared for a transition period as you adjust to new foods.

Sample Meal Plan

What you eat on the elimination diet depends on whether you are reintroducing foods. This is a sample meal plan for when you are eliminating all potential allergens and food sensitivities. You will likely need a lot of produce, as well as lean meats, nuts, and seeds, to make sure you are getting enough calories when cutting out so many other foods. Keep in mind this is not an all-inclusive meal plan, and if following the diet, you may find other meals that work best for you.

Day 1

  • Breakfast: Fruit and greens smoothie made with coconut milk
  • Snack: Apple; pumpkin seeds
  • Lunch: Grilled chicken breast; mixed greens; cucumber, tomato; balsamic vinegar, and olive oil
  • Dinner: Pork stirfry with vegetables and ginger; riced cauliflower

Day 2

  • Breakfast: Turkey sausage; sauteed spinach; roasted sweet potato with coconut oil
  • Snack: Fruit and coconut milk smoothie
  • Lunch: Whitefish poached in broth with lemon juice; green beans; sesame seeds; quinoa
  • Dinner: Rice pasta with meat sauce; garden salad

Day 3

  • Breakfast: Steel-cut oatmeal; berries; coconut milk
  • Snack: Rice crackers with hummus
  • Lunch: Shredded chicken breast lettuce wraps with mandarins and bell pepper
  • Dinner: Vegetable and chickpea curry; quinoa

Is the Elimination Diet a Healthy Choice for You?

Overall, the elimination diet is healthy and helpful to determine food sensitivities.

While an elimination diet is mostly coherent with the federal dietary recommendations, the initial phase does veer from some federal suggestions. For example, the USDA recommends ample servings of dairy and grains, but on an elimination diet, you’ll need to avoid dairy products and wheat.

A bit of research and planning goes a long way to find adequate calcium and vitamin D sources outside of the dairy food group, and you can find plenty of non-wheat grain products to meet the whole grains recommendation.

The USDA also recommends eight ounces of seafood per week to prevent heart disease. You may choose to supplement with omega-3 fatty acids, EPA, and DHA or source these from plants.

Elimination diets are not focused on weight loss or gain, but knowing how much energy you need to fuel your life is important. Use our simple calorie calculator to find out how much food you need each day.

Your body burns calories through essential functions such as breathing, circulating blood, and creating and repairing cells, and physical activity burns additional energy. On average, women need 2,000 calories; men usually require more.

If you are new to tracking calories, it is strongly recommended to track at maintenance calories for a week or two without making any purposeful changes to your diet in favor of weight loss or gain.

Knowing that you are meeting your recommended caloric intake can also help rule out symptoms like fatigue or mood swings that you suspect might be caused by a food sensitivity but are actually caused by undereating.

In the elimination phase, toxins and potentially inflammatory foods are entirely removed from your diet. This phase can last anywhere from 21 days to six weeks. Since this diet can be restrictive, it might not be suitable for you. Speak to your doctor if you have any concerns or if you have potential allergies.

Health Benefits

Whole Food-based

If you are the type of person who grew up eating processed foods daily, you might feel deprived at first on an elimination diet. However, as long as you eat enough fruits, veggies, meats, and compliant grains, those feelings will eventually subside due to a satiating range of whole foods.

May Help Relieve Symptoms

Researchers have reported success in using elimination diets to treat ADHD, Celiac disease, irritable bowel syndrome, and leaky gut syndrome. Many physicians who develop elimination diet plans also suggest that avoiding certain foods may clear up brain fog and reduce joint pain. Speak to your doctor about your symptoms and whether an elimination diet might help.

Health Risks

May Cause Dietary Deficiencies

It can be easy to underestimate the energy requirements to replace dairy, wheat, and nuts. These foods often naturally contain or are enriched with essential amino acids, vitamins, and minerals needed for health. Make sure you have a plan in place before you begin eliminating entire food groups from your diet. You also might want to get a blood panel to determine any current deficiencies.

A Word from Verywell

An elimination diet can be difficult to follow, especially in the beginning, but is relatively balanced and less restrictive than some other food plans. If you suspect you may be sensitive to things like dairy, gluten or soy, connect with a registered dietitian or nutritionist to find out if an elimination diet is right for you.

Just be aware of the temptation to attribute all of your stresses and woes to your diet. There are an infinite amount of factors that influence our well-being, and it's important to address all the facets of your life with equal care.

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