How to do an elimination diet: part 2
In How to do an elimination diet: part 1 I outlined how to do dietary eliminations.
In this article I’ll be discussing how to strategically reintroduce foods to help identify what is a problem for you.
Important: if you’ve experienced allergy type symptoms to food including wheezing, coughing, having an itchy throat, rashes or you’ve previously had severe digestive reactions like diarrhoea speak to your GP about these and do not trial reintroducing any foods until you’ve received medical advice.
Reintroduction phase
Once you have completed the elimination phase for a set period, you can begin to reintroduce the eliminated foods one by one.
Add one new food separately for 2-3 days and notice if it brings back any of your initial symptoms.
Keeping a symptom diary can be helpful.
It’s important to trial one type of food at a time (rather than a food item with multiple ingredients) and a small amount initially, for example, a small block of cheese rather than eating a pizza to see if cheese is a trigger.
You can also introduce foods in a specific order (known as a ladder) to help identify if certain types are an issue, you may find milk and yoghurt troublesome but cheese is ok.
Here’s a guide to introducing some food groups:
How to test dairy foods
Often reactions to dairy can be linked to proteins (e.g. whey or casein) or the sugar (lactose) so it’s helpful to test foods with the least protein and lactose first (so higher fat dairy) and build up to those with more of each.
Some individuals find goat’s and sheep’s diary is easier to digest than cow’s milk so it can help to test these separately.
A sample wholefood, dairy ladder would be
Ghee
Butter
Double cream
Fermented dairy (kefir)
Hard goat’s/sheep’s cheese
Soft goat’s/sheep’s cheese
Lactose free dairy
Cottage cheese
Hard cow’s cheese
Soft cow’s cheese
Natural yoghurt
Baked milk
Milk
Some people find raw (unpasturised) dairy works better for them digestively but this can be tricky to get hold off. Some cheeses in supermarkets are now unpasturised (Parmigiano Reggiano, Brie and Rouquefort are often unpasturised).
If you react to the proteins in dairy then even raw dairy is likely to be problematic
How to test gluten /wheat
Bread contains yeast which ferments and may cause bloating so it isn’t the best way to test gluten.
Instead trial some simple gluten grains paired with foods that don’t trigger symptoms. For example:
Yeast free rye bread
Spelt
Pasta
Cous cous
Barley
24 hour fermented sourdough (testing yeast)
What if it doesn’t work?
Causes of digestive issues and other symptoms are not always triggered by the type of food you eat but more ‘how’ you eat.
It can be helpful to try:
Stop grazing and snacking throughout the day and stick to 3 meals with micro fasts in between for 3-4 hours to avoid irritating your digestive system
Eat slowly and chew your food thoroughly, breathing deeply at the onset of a meal to support healthy digestive function.
An irritated digestive system may not be able to tolerate too much raw food or fibre so try ensuring all food is cooked in some way i.e. steamed and lowering fibre content slightly to see if this helps.
Consider lifestyle factors like stress, exercise, travelling and sleep issues as a possible cause of digestive issues and trial meditation, yoga and stress management strategies to see if they help.
If you are having issues with your digestive health and confused about what to eliminate and how you can contact me for a free 15 minute call.
