In part 1 and part 2 of this blog, I explained various ways you may be sensitive, allergic or intolerant to certain foods, how these can impact your health and put additional stress on your adrenals, and some ways to begin to identify problematic foods. In Part 3 below, I’ll show you how to clarify your suspicions that some foods may be bothering you and eliminate these problem foods from your diet.
The value of an elimination and challenge diet
If you are eating nutritious foods, getting sufficient rest, exercising, and creating quality time alone or with people you care about yet don’t feel as well as you think you should, hidden food allergies, sensitivities and intolerances could be at fault. They can impact your immune system, your digestive system, and your ability to tolerate stress. They are associated with and can cause or complicate chronic health problems – particularly the following:
- auto-immune conditions
- digestive issues
- joint or muscle pain
- neurological or emotional issues (like migraines, ADHD, depression, and some coordination problems)
- eczema or allergies
There are many variations on the elimination and challenge diet, but all share common characteristics. In a nutshell, the elimination portion of the diet removes potentially offending foods from your diet; the challenge portion puts the foods back into your diet one at a time and allows you to discover which ones are causing problems. Unlike an immediate allergic reaction such as hives, swelling or shortness of breath, many food sensitivities or intolerances create more subtle or chronic problems in your body – such as joint pain, fatigue, digestive disturbances, or emotional or behavioral issues. If you eat the problematic food regularly, the related reactions can be so chronic that there is no clear cause and effect between the offending food and your symptoms. By removing the food for a short period of time, you can allow your reaction to lessen. Then after a period of time, you reintroduce the food. If you then experience the same symptoms that you had been experiencing chronically, a link between the food and the symptom becomes more easily identifiable.
How to begin
Before you begin the elimination, list any symptoms that are currently problematic for you across the top of a page. Below them list today’s date, then give each symptom a numerical value from 1-5 based on average severity over the past 2 weeks (1 = extremely mild, 5 = extremely severe). These symptoms may be anything from abdominal cramping to mood swings. If you have a symptom that isn’t always present but rather comes and goes, such as a migraine or heart palpitations, record how frequently you experience it (e.g. once a month, twice a week, etc.) It can also be helpful to record your weight and body measurements at this time since food sensitivities can sometimes contribute to water retention.
NOTE: Do NOT do an elimination and challenge diet without consulting your doctor if you have ever experienced an anaphylactic reaction to a food or are already aware of food allergies which cause airway restriction.
If you believe that your food reactions are linked to only a few foods, you could choose to simply eliminate those to begin with. However, it is usually best (although more difficult) to remove as many potentially problematic foods as possible, not only to increase your odds of discovering the ones that are causing difficulties, but because sometimes it is the combination of foods, rather than a single food, that is at issue. Also, it is sometimes the foods you crave and eat regularly that are the main culprits. The primary categories of food to include in the elimination and challenge are below
Categories to Eliminate
Examples of Category (not comprehensive)
|Wheat and Gluten-containing grains||white or wheat bread, pasta, bulgur, rye crackers, barley, spelt, barley, soy sauce|
|Dairy and dairy products||milk, ice cream, cream-based soups, yogurt, cheese, casein, butter, cookies|
|Corn and corn products||popcorn, corn syrup, corn batters, dextrin, ketchup, tortillas|
|Citrus fruits||oranges, orange juice, lemons, citrus beverages|
|Eggs||mayonnaise, noodles, cakes, bread, albumin|
|Shellfish||shrimp, crab, mussels, scallops, clams|
|Processed meats||hotdogs, sausage, lunch meats|
|Soy||soy sauce, tofu, tempeh, edamame, soy ice cream|
|Artificial preservatives, colorings, sweeteners||BHA, BHT, yellow dye # 5, aspartame, saccharine, MSG|
|Sugar, caffeine, alcohol, hydrogenated oils||Dextrose, high fructose corn syrup, coffee, chocolate, colas, beer, wine, partially hydrogenated oils|
If a food is not on this list but you eat it almost every day, it may be helpful to test that food, and obviously, if you suspect a food other than those included on the list above, add it to your list. For example, some people with joint pain are especially sensitive to substances called alkaloids found in a group of plants commonly known as nightshades. If joint pain is an issue of yours, it may be helpful to eliminate and challenge nightshade vegetables as well. These include potatoes, tomatoes, eggplant, and peppers.
Supporting yourself through the process
The goal is to eliminate each of the foods on your list for a period of 1-3 weeks. Although the concept of an elimination diet is relatively simple, it is anything but easy. If you suddenly feel panicked at the thought of giving up your morning latte and scone, allow that feeling and observe it. Sometimes psychological “addictions” to foods are clues to sensitivities. Give yourself time to prepare for the elimination emotionally. It can be hard to completely alter your eating patterns, and it often involves altering your lifestyle as well. I encourage you to nurture yourself during the elimination and to use the time to take care of yourself emotionally, socially and physically, eliminating those things, people or behaviors from your life which are not healthy, and bringing in those that are. This is a good time to incorporate a yoga, meditation or gentle exercise program. It is not a good time to begin a very strenuous exercise program if you are not already used to it! As you eliminate foods, your body may experience some physical withdrawals or detoxification reactions. In fact, sometimes headaches, body aches, fatigue and irritability may actually increase the first few days. During this time, drink plenty of water and eat a variety of colorful vegetables and fruits. These foods are high in antioxidants and provide important nutrients required by the liver to carry out detoxification. Extra vitamin C (non-corn sourced) can be helpful as well. Be gentle with yourself and realize that this is not an exercise in deprivation; you have chosen to eliminate and challenge these foods to discover more about your body and experience more energy and vitality! Also remember that the elimination phase does not last forever.
If all your symptoms are completely gone after a week, you may begin the challenge phase. If not, I typically encourage people to wait 14 days. By this time, food related symptoms are usually gone or have noticeably decreased, yet you are still within the window of time in which your reactions will be relatively easy to identify. To challenge foods, reintroduce the foods you eliminated one at a time. Pick one and ingest it two times in the same day (unless you have an obvious reaction after the first ingestion). Don’t change anything else in your diet for the next 48 hours because sometimes reactions can take up to 2 days to appear. During this time, evaluate your symptoms. Record the food eaten along with the date in the left hand column of your symptoms list and rate each of your symptoms. If you have no reaction to the food after 2 days, you may then incorporate it into your diet and challenge the next food. If you do have a reaction, remove the food from your diet again and wait until your reaction has calmed down before challenging the next food. This process will help you uncover allergies, sensitivities, and reactions to foods.
Some examples of success
This is not an easy process. However, if you do discover a significant food reaction, eliminating it from your diet can make a huge impact on your life and your health. I had a 9 year old patient who was having a range of emotional and behavioral issues: difficulty concentrating in school, being disruptive in class, fighting with other children, and being unable to sit still at home. During the course of an elimination and challenge, we identified a reaction to corn. His parents removed corn and corn products from his diet, and his behavior transformed. He became attentive and well-behaved in class, stopped getting in fights and began playing well with other kids, and his mother said for the first time since she could remember, he participated with the family in the evenings watching television or talking.
I had another patient who came to me complaining of excruciating abdominal pain that sent him to the ER an average of twice a month. He had had extensive imaging done and had been given prescriptions for pain, all to no avail. I ran labs on him and discovered a marker for gluten sensitivity. Using an elimination and challenge diet, we discovered that gluten was a major issue. He eliminated gluten from his diet, and his abdominal distress disappeared completely.
Final Words of Encouragement
Knowledge is power. The more you know about the things that impact and affect your health, the more choices you have in how to deal with them. I have outlined the basic process for an elimination and challenge diet for you, but there are many resources to help you through the confusing details. Websites such as celiac.org, cornallergens.com, and godairyfree.org are just a few places that offer recipes as well as assistance in locating hidden derivatives of foods in the diet. Adrenalfatigue.org has a section that discusses the connection between adrenal function (i.e. stress) and allergies (Adrenal Function in Health Conditions – Allergies) and also lists many of the foods that contain the common allergens (Adrenal Function in Health Conditions – Allergens). Challenge yourself to try an elimination and challenge diet; you may discover that the foods you were eating regularly were adding to your stress and that without them you feel better than you ever thought you could.
About the Author
Dr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.