Which Foods Are Your Inflammatory Triggers? The Elimination Diet in Four Steps
If there’s one thing that a person with autoimmunity should do to start the healing process, it is to first figure out what foods are acting as inflammatory triggers. For many, this can seem daunting. We have deep-rooted emotional connections to the foods and beverages that we consume, whether we realize it or not. Embark upon an elimination diet, and you will soon understand what I mean. Still, it’s a worthwhile, and I dare say, mandatory process.
Let’s say you successfully make it through a 21-day elimination diet (you can). You’re feeling much better, and you’d like to find out which foods you can safely add back from your previous life. This is where it can get tricky.
How are you going to reintroduce foods so that you gain a clear understanding of which foods are triggers and which are safe? Just as important, how long is this going to take?
Here’s a smart tip: If you do it the right way, it doesn’t have to take months upon months. The more data you gather throughout the entire process, the easier it will be to understand which foods are friends and which foods are not, in the least amount of time.
As an Integrative and Functional Medicine Nutritionist, I have guided many clients through elimination diets and have seen some miraculous results. My most successful clients, regardless of whether they got a blood test or did a standard elimination diet, are the ones who commit to using tools that help clarify symptoms and symptom severity as well as document their intake along with symptoms, in order to discover how their symptoms are related to specific foods.
Those who do not gather this data throughout both the elimination and reintroduction phases are often left confused and find themselves back at square one, which is starting the elimination process all or partially over again. This can drag the process out, taking months to years, depending on how steadfast or lackadaisical one is about using the tools and recording the data.
1. First things first
Start by taking an inventory of your symptoms with a Medical Symptoms Questionnaire (MSQ). The MSQ provides a way to quantify the severity of symptoms, system by system. This allows you to see which systems are affected the most and also gives you a total score. This is a great way to be clear about your symptoms before eliminating any foods. You may also discover that you’ve been coping with a lot more symptoms than you realize. Perhaps a nagging, low-grade headache or belching after meals has just become a part of your everyday normal. The MSQ will give you a new awareness of your symptoms and help you realize how they are affected during the elimination and reintroduction phases. After the elimination period, you can take another MSQ and see how you have improved overall as well as how each system has improved.
2. Time to eliminate foods
At the very least, you should eliminate gluten and dairy, but since you’re going through this rigorous data gathering process, it would be ideal to increase your odds of finding your food triggers by eliminating some other common culprits. These include corn, soy and eggs. And while you’re at it, go ahead and eliminate all forms of fast food and alcohol. Fast food will likely contain something you’re already eliminating, so I like to be clear about that one up front. In general, you want to go with a “clean” diet, meaning home-cooked with the highest quality ingredients, like organic produce and grass-fed/wild/pastured meats, fish and eggs. We know that alcohol causes “leaky gut” and encourages overgrowth of pathogenic gut microbes (and kills the good microbes), so it’s best to cut it out if you want to see improvement. Eliminate all of these things for a minimum of 21 days, which incidentally is the length of time it takes to form a habit. Good habit-forming is not the only reason for the 21 days, however. It takes roughly this long for the antibodies you’ve made to your trigger foods to be cleared from your system.
3. It’s all about the data
Here’s the part that many people forget to do or just flat out avoid—food and symptom journaling. That’s too bad, because it sure makes knowing how your food affects you (the point of this whole endeavor, I might add) much more obvious. Make sure to record not only what you eat and drink at each meal and snack, but how you feel both physically and emotionally before, during and after your meal. If you have any digestive symptoms after a meal, be sure to note how long afterward they occur. This can give you or better yet, your health practitioner/nutritionist, a clue as to which part of the digestive tract needs support and which nutrients may be affected (which in turn affects you). Make notes about the timing, consistency and color of your bowel movements as well.
4. Time to reintroduce
Once you’ve made it through your 21 day elimination phase and repeated your MSQ, it’s time to reintroduce–but not all at once. Pick one food or food category, such as gluten, that you’ve eliminated and start there. Have the best quality source of that food, such as organic couscous or whole-wheat sourdough bread for gluten, or organic grass-fed yogurt or kefir (a trusted raw milk source is best, although low-temperature pasteurized another option). Eat 2-3 servings over the course of only 1 day; then eat as you have been eating during the elimination phase for next 3 days, noting any symptoms that arise. It is very important to continue with your food and symptom journaling. If you have no symptoms, you are clear to have that food, although I would suggest continuing to have it in whole food, high quality form and rotating it in once every 2-3 days. If you do note symptoms with reintroduction, avoid this food for 6 months before trying again. You may find that after 6 months, your body is no longer reactive to this food, or you may find that you need to continue avoiding it for longer or indefinitely. On the fifth day, introduce the next food in the same way, and so on.
As far as alcohol reintroduction is concerned, save it for last. Have 1 serving, making sure that the drink you choose does not contain any foods or food compounds that you have decided to avoid, such as gluten in beer. Avoid drinks made with commercial mixes and use only fresh, high quality ingredients for mixed drinks. Note how you feel right away and over the next 3 days; however, remember to use alcohol sparingly if at all, due to its known negative effects on digestive health. Alcohol and autoimmune has been explored in depth via the link here, and we recommend you read the post as a companion topic.
If you are diligent with your food and symptom tracking, it should take no longer than 5-7 days to reintroduce each food. This means that you should be finished with your elimination diet in anywhere from 4-6 weeks. Piece of cake! Just make sure all of the ingredients in said cake are approved by your immune system.
Need some guidance?
I recommend this affordable and convenient, step-by-step elimination diet program from Whole Life Nutrition: http://bit.ly/W2phw8
About the Author
Angie King-Nosseir MS, RD is an Integrative and Functional Registered Dietitian, with a passion for walking with people along their path toward health transformation. Angie has a Master’s degree in Nutrition, is a Certified LEAP Therapist, corporate wellness health coach, freelance nutrition and wellness writer, and certified yoga instructor. She is trained in Functional Nutrition and Medicine through the Institute for Functional Medicine and in Food as Medicine through the Center for Mind-Body Medicine.
This blog post was originally published by AutoimmuneMom.com, written by Angie King-Nosseir, and first published on Sep 28, 2014.
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