How To Do An Elimination Diet

In this guest post Kylene Bogden, performance dietitian for the Cleveland Cavaliers and co-founder of FWDfuel Sports Nutrition, teaches how an elimination diet can be used to help fix gut issues and chronic fatigue.

Hi guys, Kath here! You guys know I believe that I don’t believe in diets, and that all food groups can be enjoyed as part of a diverse diet (I’m looking at you gluten and dairy!) That said, every body is different. And only you know how you feel. And if you just have a gut feeling (pun intended!) that something you are eating might be throwing off your wellness, how do you go about figuring out what it is so you can continue to enjoy all the other foods you love? Registered Dietitian Kylene Bogden specializes in functional nutrition and elimination diets and is here today to share a science-based guide on how to troubleshoot your diet. Take it away Kylene!

Do you ever wake up and think “Man, there is no way I can get through today without some form of caffeinated beverage!” (or, allergy meds, reflux meds, an abundance of candy- you fill in the blank…)

How about “My joints have felt so stiff and creaky for a while now. Aren’t I a little too young for this nonsense?!

And then there’s, “ Ughh! I should not have acne as an adult.” Or  “I swear these foods never made me bloat or sent me to the bathroom before!!!”

Guess what? I have some exciting news…

Contrary to popular belief (and what your doctor might have told you), this is not “aging!” Nor is it being a “busy mom” or “marathon runner balancing a stressful job.”

Annoying symptoms are actually a result of an overburdened immune system. Stay tuned because in this post I will be discussing how to use an elimination diet as a way to reverse fatigue and chronic health conditions!

Your Immune System in a Nutshell

OK, I promise not to dive too deeply into the science here, BUT, there are four key points I want you to understand regarding the complexity of the human immune system.

  1. Approximately 77% of our immune system resides in our gut!  How crazy is that? In other words, everything we eat comes in contact with this powerful system. It’s no surprise then that junk food makes us feel so poorly and real food can literally save our lives. (Kath Younger= The Real Food Original MVP!)
  2. There are trillions of bacteria in our gut. In fact, the number of bacteria in our gut alone is exponentially MORE than the bacteria found within the rest of our entire body. Hence why it’s so important to have our gut bacteria “happy” and in balance.This bacteria is essentially the control center for our bodies. These little guys help us digest our food, produce vitamins, and protect us from outside danger. When our gut bugs are no longer balanced and living symbiotically, we may start to notice that suddenly we can no longer tolerate foods, we once ate daily. Next comes annoying symptoms like fatigue, skin rashes, sinus issues, joint pain, headaches and eventually, if left unaddressed, we may come face to face with an autoimmune diagnosis such as Hashimoto’s Thyroiditis, Celiac Disease, or Multiple Sclerosis.
  3. The immune system is like a bucket. We start to experience the nagging symptoms mentioned above when the bucket “overflows”. What causes the overflow? Things like stress, overtraining for a sport, lack of sleep, a crummy diet, and medications such as reflux medications, NSAIDS and antibiotics. Therefore, removing inflammatory foods can help unload the bucket if you will.
  4. Your genetics do NOT dictate your future! Sure, you may carry certain genes related to cancer or autoimmune conditions, but it does not mean that is your destiny. And yes, even if your mother, sister, and grandmother developed a certain condition, it does not mean that you will develop the condition as well.

When I started my career as a dietitian, I was taught that your genes are your genes and you will “just have to live with it.”

But now we know that lifestyle (mainly diet) can silence our “bad” genes or trigger and turn on those genes. 

While there are no guarantees in life, eating in a way that silences funky genes is probably worth a shot. So, let’s get rolling!

An Elimination Diet Might Save Your Life

Alright, so what if I told you that there is a good chance that modifying your diet could reverse or at least significantly decrease your chronic symptoms? What if I also told you there is a chance that if an elimination diet is implemented properly, you may be able to completely avoid certain medications, testing, procedures, and surgeries in the future?

By the way, for what it’s worth, 10 years ago, I was totally the dietitian who made fun of all the “kook science” centered on removing foods from someone’s diet.

Fast forward to my years working at the Cleveland Clinic Center for Functional Medicine and my perspective completely changed.

It was actually part of our initial protocol to walk patients through an elimination diet, no matter their condition. I was extremely hesitant at first but, lo and behold, men and women who had suffered their entire lives from issues like fatigue, hives, migraines, bowel disease, and joint pain were suddenly seeing symptoms completely reverse for the first time. Many of these patients were told they just had to “deal with it” because “nothing can be done.” It was no surprise that our waitlist was ~3,000 patients for over a year straight!

This was undoubtedly the most rewarding experience of my career and that is why I’m excited to teach you the basics of an elimination diet today.

Elimination Diet Basics

What exactly is an elimination diet you ask? Well, put simply, it’s the removal and the reintroduction challenge of a certain food or food groups for a specific period of time.

Typically the shortest amount of time you would remove a food is for 3 weeks and for those who have not felt well for quite some time, we might extend the elimination period to 12 weeks.

In a dream situation, you would be working with an experienced dietitian who seeks to learn more about your symptoms, health history, family medical history, diet, and environment. After this assessment, your dietitian would help you decide which foods may be best to remove. If you are not working with a licensed professional, it is best to keep a food AND symptom journal for two weeks to see if you can track any patterns. The goal is to draw clues to guide your removal.

Lastly, if you take this approach and you struggle to find any correlations, I would suggest that you remove the most commonly consumed allergens such as wheat, egg, dairy, corn, soy, and peanuts. When your body is chronically inflamed, the immune system often attacks what it sees most.

Tips for Success When Removing Commonly Eaten Foods

1. Plan Ahead

It is not humanly possible to succeed when removing commonly consumed foods if you do not research some of the best elimination diet recipes in advance. This means you must plan ahead, shop ahead and cook ahead!! This is especially critical if you are:

  1. A picky eater or
  2. Live with individuals who eat differently than you

Plus, planning ahead is the only way to ensure that this is a simple, and cost-effective experience. Recipes can contain 2-5 ingredients if that is your style, like these sweet potato sliders!!

Most importantly, planning ahead ensures that your daily intake is balanced. Just because you have removed a few staple foods does not mean you should be living off lint and ice cubes each day. In fact, this defeats the entire purpose. If you are not maintaining proper macronutrient balance and or you are not hydrating properly during this process, the end result will not be what you had anticipated.

2. Rank Your Symptoms

I always have my clients rank their symptoms before and after implementing an elimination protocol. I usually administer the questionnaire that I created but you can actually develop your own version within minutes.

Create a scale of 0-10 in your head. On a sheet of paper, write down which symptoms are bugging you the most to the least. For example, daily migraines would be a 10 but joint stiffness a few times a week might be a 5. Sinus congestion once a week might be a 2. Add these numbers up and total your score. Do this again the day before you end the elimination diet.

3. Reintroduce Properly

After having walked thousands of individuals through an elimination protocol, there is one thing I can say for certain. If you do not reintroduce foods properly towards the end, it almost defeats the entire purpose of the food removal in the first place!

When it comes time to reintroduce, choose ONE new food at a time in its NAKED form. For example, if you removed dairy, do not reintroduce the ice cream with 7+ ingredients. Instead, start with a glass of milk as it does not contain any other ingredients.

Please also note that it can take up to 3-4 days for you to react to a certain food. This means, if you eat something on Monday, you may not feel the aftermath until Wednesday. This is why I strongly recommend introducing one new food every 4 days.

Lastly, be sure to document the reintroduction process. What went well? What was a disaster? This will be your guiding light when it comes to the next steps and long term success.

Always Remember, Food is Medicine

It is incredibly important to understand that we are using food as medicine during an elimination diet protocol. The process is no different than taking a medication for a few weeks. If you have a past medical history of an eating disorder or disordered eating, it is best to work closely with your healthcare team as an elimination diet may not be appropriate.

Please note that a severely restricted elimination protocol is NOT meant to be implemented for the rest of your life. If you find that 6-12 weeks pass and you do not feel well upon the majority of food reintroduction, then that means we have not gotten to the root of your health issues. The root issue(s) must be addressed and the gut must be rebalanced for the body to successfully welcome back a wide array of foods!

And there you have it my friends, the 411 on elimination diets. If you have any concerns about your current state of health, please whip out that food journal and start taking notes today. You just might surprise yourself with the correlations that you make!

Do you have questions about an elimination diet? I’d love to connect with you. Please message me on Facebook or Instagram @fwdfuel!

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