The Science Behind Elimination Diets

Chances are, this isn’t the first time you’ve heard the phrase “elimination diet.” This method of addressing food sensitivities and intolerances has taken the health industry by storm and become a go-to diagnostic tool for many dietitians.

For those who are experiencing symptoms that may be attributed to a food sensitivity or intolerance – including fatigue, bloating and diarrhea – adopting a temporary elimination diet can provide some guidance as to what you should and shouldn’t eat. However, it’s a good idea to understand the science behind the methodology before you jump on the bandwagon.

The Breakdown:

The term “elimination diet” was coined in 1941 by Dr. Albert H. Rowe, M.D., who discussed the concept and methodology in his book, Elimination Diets and the Patient’s Allergies. Also sometimes called “exclusion diets,” the elimination diet is generally used as a diagnostic technique for identifying food sensitivities and intolerances.

Today, it’s estimated that up to 20 percent of the global population may be dealing with food sensitivities. As research surrounding food sensitivities and intolerances has expanded, elimination diets have grown in popularity as well.

“Elimination diets aren’t meant to last forever,” says Notch Medical Advisor Dr. Chris Meletis, N.D. “They’re simply a tool to lessen the burden on your gastrointestinal system.”

How it Works:

An elimination diet is a short-term solution to addressing food sensitivities and associated symptoms by removing and incrementally re-introducing suspected trigger foods.

“By avoiding reactive foods, you’re allowing your body to quiet down its inflammatory response and regain homeostasis,” says Meletis. “Otherwise, it’s just like putting salt on a wound.”

Because IgG antibodies have a half-life of 21 days, the symptoms associated with IgG reactivity aren’t usually immediate. For this reason, the length of the elimination diet – and how often you rotate in or reintroduce potential trigger foods – is extremely important. Most people pursue elimination diets for anywhere from four to eight weeks, depending on their personal needs.

If you’ve taken a food sensitivity test, elimination diets are also a great tool to differentiate between “earned” and “fixed” scores, Meletis says. Many people have semi-permanent, or “fixed,” food sensitivities that remain stagnant throughout their life. However, it's possible to develop an “earned” sensitivity simply because you eat that food every day, which is something that can usually be addressed with a temporary elimination diet.

Common Misconceptions:

  1. "There is only one 'true' elimination diet."
    Though the original elimination diet may be considered the gold standard, it definitely isn’t for everyone. Meletis recommends what is often called a “rotation diet” – a version of the traditional method that involves completely avoiding your most reactive foods and rotating less reactive foods in every four days. However, there are many alternatives that are also worth considering, such as the low-FODMAP and six-food elimination diets.

  2. "If you’re reactive to a food, you must eliminate it."
    “There is no such thing as a normal person with normal reactivity,” Meletis says. Your specific symptomology, genetic susceptibility and medications you’re taking are just a few factors that may influence the type of elimination diet you adopt.

    Because IgG antibodies are widely prevalent in your bloodstream, you’re naturally going to have an antibody response to the foods you consume the most. For this reason, an elimination diet is a great tool to discover which foods are associated with specific symptoms.

  3. "Elimination diets help you cure existing sensitivities."
    Though you might feel better after eliminating foods you’re sensitive to, it’s important not to think of an elimination diet as a cure. Because reactivity and symptomology vary from person-to-person, the elimination diet is meant to help detect sensitivities and differentiate between fixed and earned scores. In many cases elimination diets may reduce reactivity, but you shouldn’t pursue one with the hopes that it will get rid of your sensitivities completely.

  4. "Elimination diets should only be done in lieu of food sensitivity testing."
    Even with the help of a doctor or registered dietitian, elimination diets have their limitations. Though many people pursue elimination diets without ever touching a food sensitivity test, they’re most effective when completed in coordination with one another.

    According to Meletis, the biggest issue with elimination diets is knowing where to start.

    “Since everyone is different and has different sensitivities, it doesn’t make sense for everyone to start in the same place,” he says. “By completing a food sensitivity test in advance, you’re eliminating a bunch of unnecessary steps.”

In summary, the best elimination diet is the one that works with your specific lifestyle. Your current diet, personal goals and health history are all important considerations, which is why we suggest consulting with a doctor or registered dietitian before diving in.

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