How an Elimination Diet Works
An elimination diet may be beneficial for people with a variety of health conditions that are related to food reactions.
- Bloating, gas, indigestion, or other gastrointestinal issues
- Achy joints
- Brain fog
- Frequent colds or immune system issues
- Mood swings, anxiety, or depression
What Are the Potential Health Benefits of an Elimination Diet?
An elimination diet can help you figure out which foods are causing you to feel bad. This can be a game changer for people with food allergies or intolerances.
Additionally, an elimination diet can help improve symptoms of other medical conditions that may be triggered by food reactions. Some of these include:
- Irritable Bowel Syndrome (IBS) or Other Gastrointestinal Disorders IBS is a common gut disorder that causes unpleasant issues like diarrhea, cramping, abdominal pain, gas, and constipation. Research has shown that elimination diets may help reduce these symptoms in some people with IBS.
- Eosinophilic Esophagitis (EoE) A chronic condition, eosinophilic esophagitis is characterized by inflammation in the esophagus. A review published in 2020 found that elimination diets were “highly effective treatments for eosinophilic gastrointestinal diseases.” Another study showed that more than 75 percent of patients with EoE who followed an elimination diet reported fewer symptoms and less inflammation on biopsy tests.
- Celiac Disease Symptoms of this autoimmune condition are triggered by gluten, which is a protein found in wheat. A diet that eliminates gluten is the only way to treat celiac disease.
- Attention Deficit Hyperactivity Disorder (ADHD) ADHD is a neuropsychiatric disorder that affects about 7 percent of kids and adolescents. According to a study published in 2020, an elimination diet was effective in reducing symptoms for 30 percent of children with ADHD.
- Eczema or Allergic Conditions Emerging research is showing that food sensitivities may play a role in eczema — an inflammatory skin condition that causes itching, redness, and rashes. A 2015 clinical case report found that some people with asthma reported symptom improvement and less dependence on medicines when they followed an elimination diet.
- Migraine Migraine is a neurological disease characterized by repeated episodes of symptoms, usually including debilitating headaches, that can impact a person’s quality of life. In a 2010 study, participants who followed an elimination diet reduced their average number of headaches from nine to six.
- Other Conditions Certain foods are known to worsen symptoms of other diseases, especially autoimmune or inflammatory disorders. An elimination diet may be used for various health conditions.
Weight Loss Effects
Examples of Elimination Diets
- Dairy Products This food group includes milk, yogurt, cheese, butter, and ice cream.
- Wheat Foods that contain flour, bran, or gluten may be restricted.
- Eggs Eggs and condiments that contain eggs, like mayonnaise or salad dressings, are frequent triggers.
- Soy Soy-based products include edamame, soy sauce, and tofu.
- Nuts and Seeds Peanuts and tree nuts are often culprits to eliminate.
- Fish Shellfish is an especially common food allergen.
- Citrus Foods Oranges or grapefruits may be on your list to remove.
- Certain Vegetables Tomatoes and peppers are often eliminated.
- Artificial Sweeteners Aspartame and other non-natural sweeteners might need to be removed from your diet.
- Oils Dairy-based butters and certain oils may need to be avoided.
- Legumes This category includes beans, peas, and all soy-based products.
- Sugars Candy and sweets might be restricted.
- Others Certain spices and extracts may need to be avoided, along with caffeine and alcohol.
Some other examples of elimination-style diets include:
- Low-FODMAP Diet This diet plan involves restricting certain carbohydrates that may cause intestinal problems. The low-FODMAP diet is usually recommended for people who have symptoms of IBS.
- Gluten-Free Diet With a gluten-free diet, you’ll stop eating any foods that contain gluten. This includes wheat, barley, and rye products.
- Few Foods Diet You restrict your diet to only a few foods that you don’t usually eat.
- Specific Carbohydrate Diet This plan allows for certain types of carbohydrates while restricting others.
- Lactose-Free Diet With this diet, foods that contain lactose (a sugar found in milk and milk products) are avoided by those who are lactose-intolerant.
Meal Planning for an Elimination Diet
If you decide to follow an elimination diet, you might need to plan or prepare your meals ahead of time.
A registered dietitian or food and nutrition practitioner can assist you in creating an appropriate strategy. These experts are trained to help you read food labels and incorporate the correct amount of nutrients into your diet. The Academy of Nutrition and Dietetics offers a resource to help you locate a dietitian in your area.
You might want to look online for recipes that will accommodate your eliminated foods. Some people also like to prep their meals for the week to make mealtime quick and easy.
What to Expect if You Try an Elimination Diet
- You will eliminate certain foods from your diet for a short period of time and then reintroduce them gradually.
- A medical professional will monitor your diet and progress.
- You will keep a written record of your food intake and symptoms.
- You may undergo certain medical tests before, during, or after the diet to help better identify food triggers. For example, people with EoE may need repeat biopsies to see if inflammation in their esophagus improves or worsens when foods are removed or added back.
- You and your healthcare provider will come up with an individualized eating plan based on the results you find. This may include foods to avoid or consume in smaller amounts.
Pros and Cons of an Elimination Diet
As with any eating plan, there are pros and cons of following an elimination diet.
- You’ll feel better. The goal of an elimination diet is to identify triggers that are causing your symptoms. If you can successfully avoid these foods, your quality of life may improve.
- It’s temporary. An elimination diet is intended only for a short amount of time, which makes it easier for some people to successfully complete.
- It can be restrictive and hard to follow. You may have to eliminate some of your favorite foods completely, which is difficult for some people.
- It takes time to plan. You’ll likely spend more time tracking your food intake, planning your grocery list, and preparing your meals.
- It might not work. Despite your best efforts, you may not be able to identify food triggers that are causing your unpleasant symptoms.
- It could lead to malnutrition. If you stay on the diet for a long time, you may develop a deficiency in iron, calcium, vitamin B12, vitamin D, or other nutrients.
Tips for a Successful Elimination Diet
- Work with a qualified professional. An elimination diet can be challenging. Make sure you are working with a doctor or dietitian who can help you through the process.
- Follow your plan carefully. Don’t deviate from your diet or allow yourself to cheat.
- Prepare your own food. Most restaurants can’t guarantee that certain foods aren’t contaminated with something you’re trying to avoid.
- Record your reactions. Keeping a detailed journal of your food intake and symptoms throughout the process can help you and your provider pinpoint problematic foods.
- Don’t stress. Do your best to follow the plan, but don’t worry if you can’t easily identify triggers. You may need to repeat the elimination phase or cut out different foods. Try to be patient during this process.
Resources and Other Types of Diets to Try
Here are some other types of diets you might be interested in learning more about:
- Lactose intolerance diet
- Vegan diet
- Gluten-free diet
- Paleo diet
- FODMAP diet
- Specific carbohydrate diet
- Whole30 diet
- Anti-inflammatory diet
- Autoimmune protocol diet
- Ketogenic diet
- Atkins diet
The following resources may be helpful if you decide to try an elimination diet:
Editorial Sources and Fact-Checking
- The Elimination Diet [PDF]. UW Integrative Health. November 2018.
- Food Elimination Diet. FARE.
- What Is an Elimination Diet. Academy of Nutrition and Dietetics. August 13, 2019.
- How to Do an Elimination Diet — A Complete Guide. Institute for Integrative Nutrition. April 28, 2021.
- Facts and Statistics. FARE.
- Irritable Bowel Syndrome: Symptoms and Causes. Mayo Clinic. November 2, 2022.
- Eosinophilic Esophagitis: Symptoms and Causes. Mayo Clinic. September 21, 2022.
- What Is Celiac Disease? Celiac Disease Foundation.
- Bosch A, Bierens M, de Wit AG, et al. A Two Arm Randomized Controlled Trial Comparing the Short and Long Term Effects of an Elimination Diet and a Healthy Diet in Children With ADHD (TRACE Study) Rationale, Study Design and Methods. BMC Psychiatry. May 27, 2020.
- Eczema. American College of Allergy, Asthma & Immunology.
- Can an Elimination Diet Help You Lose Weight? Michigan Medicine. January 3, 2017.
- Elimination Diet. U.S. Department of Veterans Affairs. December 4, 2020.
- 6-Food Elimination for Eosinophilic Esophagitis (EOE). The Oregon Clinic.
- FODMAP Diet: What You Need to Know. Johns Hopkins Medicine.
- Nigg JT, Holton K. Restriction and Elimination Diets in ADHD Treatment. Child and Adolescent Psychiatric Clinics of North America. October 2014.
- Choose the Right Elimination Diet for Your Persistent Symptoms. Confluence Nutrition. October 26, 2018.
- Lactose-Free Diet. UR Medicine.
- Eosinophilic Esophagitis (EoE). Asthma and Allergy Foundation of America. May 2021.
- Heal the Gut With the IFM Elimination Diet. The Institute for Functional Medicine.
- An Allergist’s Guide to Elimination Diets. ImAware. April 19, 2021.
- Atkinson W, Sheldon TA, Shaath N, Whorwell PJ. Food Elimination Based on IgG Antibodies in Irritable Bowel Syndrome: A Randomized Controlled Trial. Gut. October 2004.
- Madison JM, Bhardwaj V, Braskett M. Strategy for Food Reintroduction Following Empiric Elimination and Elemental Dietary Therapy in the Treatment of Eosinophilic Gastrointestinal Disorders. Current Gastroenterology Reports. March 28, 2020.
- Spergel JM, Andrews T, Brown-Whitehorn TF, et al. Treatment of Eosinophilic Esophagitis With Specific Food Elimination Diet Directed by a Combination of Skin Prick and Patch Tests. Annals of Allergy, Asthma & Immunology. October 2005.
- Virdee K, Musset J, Langland J. Food-Specific IgG Antibody — Guided Elimination Diets Followed by Resolution of Asthma Symptoms and Reduction in Pharmacological Interventions in Two Patients: A Case Report. Global Advances in Integrative Medicine and Health. January 1, 2015.
- Alpay K, Ertas M, Orhan EK, et al. Diet Restriction in Migraine, Based on IgG Against Foods: A Clinical Double-Blind, Randomized, Cross-Over Trial. Cephalalgia. July 2010.