One of the most frustrating things in family medicine is when a patient comes to me with a host of symptoms, I order testing, and everything comes back normal. It’s NOT in your head, I swear! For some people, the more obvious stomach ache or change in bowel habits gives a clue to food being the culprit, but for others, it’s a change in behavior, headaches, or mood changes. Other times it can be breathing problems, joint pain, rash, weakness or just not feeling well. These latter symptoms don’t always lead people to look at their diet.
Just about everyone has heard of the saying, “You are what you eat.” And nowadays, research is clarifying a fascinating connection between your gut and your mind. I often turn people to elimination diets to help parse out the relationship between their symptoms and food. Of course, we can do food allergy testing, but these test results don’t always add up to real-life symptoms: One can test positive for egg allergy, for example, but has eaten eggs all of their life without problems. This can be because the test is looking for a true allergy (immune reaction) and what the person is experiencing is actually an intolerance (difficulty digesting). Even then, sometimes the problematic agent is not something we can easily test for. People can be affected by food additives or coloring too.
Elimination diets, while there are many, are generally made up of 2 phases: elimination and reintroduction. They are pretty straightforward, but do require commitment and planning. The majority of elimination diets, are about 6-8 weeks long for both phases.
- Elimination: Usually, by categories of food, such as grains, dairy, nightshades, rather than a specific food, like potatoes. Depending on the program and/or your symptoms, this phase can last 3-8 weeks. Most people feel better during this time, though some will feels worse for the first 1-2 weeks through the detox phase. The most common foods to eliminate are: gluten, dairy, soy, egg, corn, shellfish.
- Reintroduction: Bringing back foods is usually done in a stepwise fashion, with a new category every 3-5 days. If no symptoms or problems are triggered, this is considered a “safe” food. During this phase, you may consider introducing specific foods rather than categories because your body may be reacting to an individual food within a broader category. This phase can also last several weeks depending on your approach.
Some popular elimination diets include the Whole30 (cutting out inflammatory foods), Conscious Cleanse (changing the way you pair foods), low FODMAP diet (FODMAPs are short-chain carbohydrates that some people cannot digest), and the Feingold Diet (removing food additives and coloring). Gastroenterologists found that the Six Food Elimination diet helped reverse Eosinophilic Esophagitis, a condition of the immune system that masquerades as gastroesophageal reflux but is really allergy related. Depending on your current diet and your symptoms, one may be better for you than another and you may need to try more than one type of elimination diet (avoiding histamine provoking foods and food additives, for example).
My general approach in working up symptoms through diet is to start with an elimination diet as a way to collect more information. Keeping a diary/journal is very important during an elimination diet, I recommend it during the elimination phase as well, starting with an inventory of symptoms before you eliminate anything. Be sure to be slow and methodical about the reintroduction phase. It’s best to work with your doctor or a nutritionist especially during this phase so you can maximize learning from the sneaky delayed reactions that happen with some food groups.
At Direct Osteopathic, we also add in supportive supplements, hoping to reverse reactions by rebalancing and healing the microbiome. This fosters resilience in your gut so that minor food reactions don’t cause significant symptoms, which allows people to maintain a more balanced diet.
Getting back into the driver’s seat with food that makes you sick is very empowering. Many elimination diets are too restrictive to continue on an on-going basis (unless, of course you are affected by ALL of the foods you cut out!). Ultimately, eliminating what causes problems and keeping in what doesn’t is more sustainable and, frankly, more enjoyable. You are what you eat, but you can’t let what you eat control who you are!
Have you thought about doing an elimination diet? Need some guidance? Schedule your visit or consultation with us, we can dive right into it with you.
Dr Lisa
