How to (safely) Do a Food Allergy Elimination Diet with Ashley Koff
Gluten, lactose, shellfish, peanuts. No matter what the food, it seems like someone you know can’t eat it. People might roll their eyes when you explain you’re allergic to gluten, but food allergies are serious business. Luckily, public awareness of food allergies is growing rapidly, as is the need for more knowledge about them: what they are, how to diagnose them, and how to live with them. That upset stomach you get after eating a bowl of ice cream might mean you have a dairy allergy, or maybe just an intolerance. Whatever your symptoms, it’s becoming more and more important to be able to diagnose a food allergy (or intolerance!) properly.
Food allergies are a little different from food intolerances, although both can cause lots of discomfort. Generally, food allergies are associated with an immune system response, and food intolerances are associated with a digestive system response. The symptoms of both, like diarrhea, nausea and bloating, can often overlap, though, so an elimination diet might be a good way to find out which foods make you feel like crap and why.
So, if you’ve ever wondered how to safely eliminate foods you suspect are making you feel bad, we’re here to help. We’ve compiled a list of ideas to consider if you’d like to try a food allergy elimination diet. This is just a list of basic suggestions; as always, you should consult a medical professional before embarking on any kind of diet or eating plan.
1. Choose the right time. Since eliminating foods from your diet can be kind of restrictive, choose a time when you know you’ll be able to have control over your diet. It’s best to schedule one when you know you’ll be at home, not on vacation or traveling for work. You may also want to avoid doing an elimination diet close to birthdays, holidays, other family celebrations.2. Consult a doctor, dietician, or nutritionist. It’s really important that you have some sort of medical guidance if you’re going to try to do an elimination diet. Your doctor, dietician or nutritionist can run tests for specific allergies and rule them out. (Also, if you eliminate foods before your test results, the results may be invalidated.) A medical professional can look at your overall health and medical history to help decide the best way for you, as an individual, to rule out food allergies.
3. Decide how long is right for you. Food allergy elimination diets can last for a few weeks, a few months, or even years, depending on the foods you’re eliminating and your symptoms. Ashley Koff, a registered dietician who was the lead consultant for Huffington Post Living’s ‘Total Energy Makeover’ with Ashley Koff RD, says a plan should be “very individual – if its an allergy like celiacs to gluten, it’s for life. For others (ie intolerances), it could be weeks or months and then they [the patient] could possibly have small amounts of a better quality version of that ingredient.”
4. Make sure your family and friends are on board. If you’re suddenly eating only white rice and chicken breasts, the people in your life might wonder what’s up. Let your friends, roommates, significant other and family know that you’re trying to to eliminate foods you might be allergic to; that way, they can help support you. You might make an agreement not to keep certain foods in the house so you’re not tempted, or decide to eat only at home for the duration of your trial period.
5. Keep a food journal. Keep a food and symptom journal before, during and after your food elimination period. This will you help (and your care provider!) figure out what might be triggering your symptoms, which can range from intestinal upset to headaches and fatigue. Ashley Koff RD comments that, “Food/symptom journals really help me help my patients.”
6. Decide what food (or foods) to eliminate. Look carefully at your symptoms and see what foods you might try eliminating. You could try eliminating them individually (ie no eggs for a week), or eliminating all suspected allergens and adding them back in one at a time. Foods that can cause allergies are:
- Dairy products, including eggs, cheese, milk and yogurt
- Wheat products that contain gluten, including bread, pasta, and products containing other grains like barley, rye or oats
- Nightshades, which include vegetables like tomatoes and eggplant
- Corn products like cornmeal, cornstarch corn oil, grits and maize
- Citrus fruits like oranges, grapefruits and tangerines
- Legumes, like peanuts, lima beans, chickpeas, etc
- Yeast-containing foods like bread or beer
- Soy products like tofu, edamame, soy milk, etc
- Tree nuts like almonds, pecans, pistachios and hazelnuts
7. Replace nutrients. You can’t just eliminate a food and not expect to replace its nutrients somewhere else in your diet. Ashley says:
Just eliminating isn’t enough – you want to replace to make sure you get adequate nutrients in your diet. If you are trying to heal your body, [you need to] also improve the quality of your food choices (I call it being a “qualitarian”), because while a food can cause a problem, artificial substances/chemicals/pesticides/are likely to make symptoms worse or at least not help them heal.
So for example, if you’ve eliminated dairy, you may want to make sure you’re getting calcium from lots of leafy greens, or protein from tofu or other bean products (depending on your plan, of course).
8. Always read food labels. It’s helpful to do this anyway (so you avoid nasty stuff like high-fructose corn syrup), but if you’re specifically trying to avoid, say, soy products, you’d better read the labels. Processed foods can contain all kinds of ingredients you’d never expect, so be a responsible consumer and check out the ingredient list before eating.
Overall, you’ve got to be careful, attentive, and listen to your body. Each one of us is different; you may find that gluten doesn’t bother you as much if you eat sprouted wheat bread instead of processed white sandwich bread, or you might find that not eating nightshades totally eliminates your painful joint swelling. The point of doing a food elimination diet is to find out how your body can feel the best that it can–and much of that depends on what you put into it.