How to use a food elimination diet to discover your food sensitivities

Updated April 11, 2024. Medically reviewed on Nov 3, 2020 by Rosanna Sutherby, PharmD. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Food sensitivity testing and elimination diets are a dynamic duo. A food sensitivity test can tell you how strongly your immune system reacts to different foods—based on measurements of IgG antibodies in your blood. An elimination diet, in turn, can help you use the food sensitivity test results to efficiently cut out the specific food group that give you unpleasant food sensitivity symptoms. [1]

That said, what is an elimination diet, and how does it work?

Understanding Elimination Diets

Elimination diets are utilized to identify individual food issues by removing certain foods from your diet. They help to identify and later treat food intolerances, food allergies, and other adverse reaction occurrences or related disorders, such as [1]:

  • Eosinophilic esophagitis – EoE is a chronic allergic inflammatory condition of the esophagus characterized by the presence of a type of white blood cell called eosinophils. Certain foods can trigger an immune response in individuals with EoE, leading to inflammation and damage to the esophageal tissue.
  • Irritable bowel syndrome – IBS is a gastrointestinal disorder characterized by such IBS symptoms as abdominal pain, bloating, diarrhea, and constipation. Food sensitivities are known triggers for IBS symptoms in many people.
  • Migraine headaches – Migraines are severe headaches often accompanied by symptoms like nausea, vomiting, and sensitivity to light and sound. Certain foods and beverages are known to trigger migraines, although triggers can vary widely among patients.

All that said, there are several elimination diets that healthcare providers and their patients can implement. [1]

1 Gluten-Free Diet

A gluten-free diet is usually a highly regimented lifestyle choice that excludes all foods that contain a protein called gluten. This protein is found in wheat, barley, and rye. [2] It’s a popular diet for patients who have not yet been diagnosed with a gluten-related medical condition but want to identify a possible gluten sensitivity. [2]

Those who are following this diet must adhere to a strict set of guidelines. In particular, these people must exclude [2]:

  • Wheat
  • Barley
  • Rye
  • Triticale
  • Oats

They must also avoid processed foods that may contain gluten, such as beer, breads, cookies, cereals, and salad dressings. [2]

However, they can incorporate other grains, including but not limited to [2]:

  • Amaranth
  • Arrowroot
  • Buckwheat
  • Flax
  • Quinoa
  • RIce
  • Soy

2 Low-FODMAP (Fermentable Oligo-, Di-, Monosaccharides, and Polyols) Diet

This diet eliminates FODMAPs—or harmful sugars that can distress the intestines. [3] Healthcare providers will recommend this diet to diagnose irritable bowel syndrome or small intestinal bacterial overgrowth (SIBO)—a condition that can cause malabsorption of nutrients and chronic diarrhea. [3]

Like the gluten-free diet, the low-FODMAP diet is very restrictive, but it’s usually used only in the short term. People who may be good candidates for this type of elimination diet are those who frequently experience [3]:

  • Cramping
  • Diarrhea
  • Constipation
  • Stomach bloating
  • Gas
  • Flatulence

To practice this type of elimination, low-FODMAP diet you would [3]:

  • Eliminate all FODMAP foods
  • Reintroduce FODMAP foods one by one to observe their effects on your body
  • Identify and avoid triggering FODMAP foods

High FODMAP foods include [3]:

  • Dairy-based milk, yogurt, and ice cream
  • Wheat-based cereal, bread, and crackers
  • Beans and lentils
  • Vegetables, like artichokes, asparagus, onions, and garlic
  • Fruits, like apples, cherries, pears, and peaches

All that said, before embarking on this diet, it’s important to discuss its restrictions and possible side effects with a registered dietitian or healthcare provider.

3 Six-Food Elimination Diet (6-Fed)

Within the clinical space, the 6-FED diet is most commonly used. This diet follows three steps [1]:

  • Eliminate the six foods most responsible for food allergies, which are milk, eggs, soy, wheat, nuts, and fish
  • Maintain this elimination for four to six weeks, while monitoring potential symptoms
  • Reintroduce each food type back into your diet to identify whether any trigger a food allergy or gastrointestinal symptom

Factors to Consider

Elimination diets, especially those that are highly restrictive, like the gluten-free or low-FODMAP diet, may pose challenges when it comes to meeting nutritional requirements. Thus, it's essential to maintain a balanced diet by incorporating alternative nutrient-rich foods to compensate for any potential deficiencies.

For example, if your food sensitivity test reveals that you have a high IgG reactivity to peaches, eliminate them from your diet and add in the problematic food group that has a similar nutrient profile (i.e. high in dietary fiber and vitamin C), such as yellow corn or asparagus.

Consulting with a registered dietitian or nutritionist can also provide valuable guidance in ensuring you meet each of your nutritional needs. Healthcare providers, including doctors, dietitians, and allergists, can offer personalized recommendations, monitor your progress, and address any concerns or complications that may arise along your journey.

Identify Food Sensitivities Easily With Everlywell

Elimination diets can provide patients with a clear path toward identifying and managing their food sensitivities. By systematically eliminating and re-adding certain foods, patients can gain valuable insights into how their bodies respond to certain foodstuffs and hone in on food sensitivities.

With the Everlywell Food Sensitivity Test, you can gain additional insight into your body's response to specific foods from the convenience and comfort of home. This test measures IgG reactivity levels for a wide range of foods, providing personalized information on potential sensitivities and intolerances. By combining the results of the Food Sensitivity Test with an elimination diet, you can further refine your understanding of which foods may be triggering symptoms and tailor your dietary choices accordingly.

Plus, your results are secure and retrievable through our online platform, where you can also speak with a licensed healthcare provider about whether an elimination diet coaching plan (and which one) may be right for you.

Get started today.

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References
  1. Malone J, Daley S. Elimination Diets. StatPearls. Medical Citation URL. Accessed April 11, 2024.
  2. Gluten-free diet. Mayo Clinic. Medical Citation URL. Accessed April 11, 2024.
  3. Veloso H. FODMAP Diet: What You Need to Know. Johns Hopkins Medicine. Medical Citation URL. Accessed April 11, 2024.
Rosanna Sutherby, PharmD holds a PharmD and is a retail pharmacist who has worked in the industry for roughly 20 years. Sutherby has extensive knowledge about medications, diseases, and conditions, and knows how to confidentially educate patients. Sutherby also creates content revolving around anything in the medical sphere with a focus on conditions and articles. Her published work has appeared in Managed Healthcare Executive, Formulary Watch, and PsychCentral, and spans a variety of topics, including cardiovascular health, immunology, sleep disorders, mental health, alcohol and opioid use disorders, vaccine education, and medication use and safety.
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