Elimination Diets: The Why, What, When, and How

We are seeing an all time high in diseases brought on by inflammation. Although environmental triggers and toxins as well as genetics can play a role in this, much of the rise in cardiovascular disease, diabetes, arthritis and other common illnesses are due to the consumption of an “inflammatory diet.” 

The Why

More and more evidence and medical research further supports this —- if people remove inflammatory foods from their diet, their heart disease and diabetes reverse. That being said, not everyone is sensitive to the same inflammatory foods, which has prompted many to partake in an “elimination diet” where certain specific foods are eliminated from the diet and then, in a very systematic and stepwise way, are reintroduced. Some do an elimination diet because they want to lose weight. Although in and of itself, an elimination diet does not guarantee weight loss, removing processed foods and other triggers commonly found in the standard American diet (“SAD”) often leads to a nice side effect of weight loss.

The What

By definition, an elimination diet is an eating plan that omits a food or group of foods believed to cause an adverse food reaction, often referred to as a “food intolerance.” Many people do not know what the triggering food is for them, so there are suggested elimination diets based on suspicions or by disease presentations (links to some of them are referenced below). 

The When 

Elimination Diets can be done at any time. Most will recommend a time period of at least thirty days to really let the gut reset, with about a 2 week period of reintroduction. I usually advise against doing it around the holiday or summer months, as most people tend to have a lot of social get togethers around that time which of course brings on more temptations and in turn a lower compliance rate. January thru March tends to be a great time as many people are motivated to lose some of holiday weight and cravings and shed some pounds for summer.  

The How

There are several critical steps that, if put into place before starting the elimination diet, will lead to a much higher success rate. 

First, one needs to decide what the purpose of the elimination diet is and then decide which one aligns most with that goal. There are endless elimination diet options; in fact, one can customize it completely depending on their circumstances or food preferences. Most people go with one of the more common diets well written about in the literature. This makes it easier for the novice, who might be searching online for recipes, etc. 

Things to consider — do you want to include meat? Coffee? Dairy? Gluten? Any other preferences? All in all, elimination diets will all include lots of plants and low to no processed ingredients. Some common ones are the whole 30, FODMAPs, and vegan elimination diet.  

No matter which you choose, you will want to include lots of anti-inflammatory foods such as spices, berries and vegetables, and eat a whole foods diet. You should write down a plan — complete with start and end date, around big social events or travels. Schedule in a 2 week reintroduction as well. Clear the pantry of any temptations (the chocolate chips, the chips, the ice cream or whatever other late night fix you have been consuming), and ideally get a partner or friend on board. 

Keep it fun, host a potluck party with people who are on board with you on this cleanse. It makes it so much easier and feels less like you are missing out. Gather ahead of time and experiment with new recipes, or modify some of your family go-to’s. Keep a journal of your symptoms during the elimination diet and particularly with the stepwise reintroduction to help isolate allergens or sensitivities. It is not uncommon to have some withdrawal symptoms in the first week or even ten days of the cleanse. Hydrating well helps decrease cravings, and scheduling other activities during peak craving times (later in the evening, afterschool when the kids are snacking…), so you anticipate the challenges before they even arise. 

Keep reminding yourself of your “why” and your body will thank you for it! 

The Bottom Line 

Elimination diets are not for everybody, and someone’s elimination diet might not be the best for you. As a general rule, most elimination diets will have less processed foods and sugar and more plants and spices. Take a week or two to pre-prep and to get everything ready. Meal planning and scheduling social dates with elimination diet “recruits” can help keep it fun and less restrictive. Plan your reintroduction carefully (ideally not over the holidays) to help assess what foods or ingredients may be triggers for your symptoms. 

In the end, to borrow the words of food expert Michael Pollan in his acclaimed novel Food Rules, “Eat Food. Mostly Plants. Not too much.” 

Good luck with your challenge!!

Anti-Inflammatory Diet for Atherosclerosis and Coronary Artery Disease: Antioxidant Foods, Emi Saita, Kazuo Kondo, Yukihiko Momiyama; Clin Med Insights Cardiol. 2014; 8(Suppl #): 61-65.

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BASED IN asheville, 


veena somani md

integrative  lifestyle  coach