Food reactions of any type can trigger low-grade inflammatory reactions in the gut, making the intestinal wall more porous and exposed to the influx of large, undigested food particles into the blood (a condition referred to as “leaky gut”). This breakdown of the intestinal barrier can allow other substances like bacteria, chemicals, and yeast to leak from the intestine into the bloodstream, further stimulating the immune system and causing more inflammation. Just as food reactions can lead to a leaky gut, the reverse is also true; leaky gut can significantly increase the development of food sensitivities. Removing problem foods decreases inflammation and helps calm the immune response. The Elimination Diet helps to reduce inflammation by promoting the ingestion of anti-inflammatory foods. Over time, these foods, combined with the elimination of common trigger foods, cause inflammation to subside and helps the gut to heal.
The intestinal lining is made of cells that replace themselves approximately every two to four days. This means that, in the span of a single week, every cell in the intestinal lining is broken down or sloughed off and a new cell grows to take its place. Removing from the diet potentially harmful foods and those that cause inflammation, while at the same time supplying the body with healthy, anti-inflammatory whole foods (especially those containing healthy fats, fiber, and an array of phytonutrients) makes this newly-formed gut tissue stronger and healthier.
Much of one’s overall health is determined by the health of the gut.
More than 70% of the immune system is clustered around the digestive tract. The gut immune system is constantly assessing things that are ingested or inhaled into the digestive tract. The way the immune system responds is impacted by the flora that inhabits the gut. The normal flora also referred to as the microbiome, helps regulate the immune response. When the gut is inflamed, the balance of beneficial versus non-beneficial microbes is thrown off. This results in improper stimulation of the immune response and can cause adverse symptoms. Providing essential nutrients for healing is a critical factor in creating a healthy microbiome as well as a healthy immune response. Eliminating certain foods decreases inflammation, which allows the gut, and ultimately the immune system, to heal. Additionally, a healthy gut microbiome can be rebuilt by eating healthy whole foods, especially those high in protein, phytonutrients, probiotics, and prebiotics. These foods are the basis of the Elimination Diet.
In order to achieve the therapeutic effects of the Elimination Diet, it is important to know which foods to avoid and which foods are okay to eat. The table below provides a summary.
Touring Through the Food Plan
- Protein: Protein is an essential cornerstone of optimal nutrition. It performs multiple functions in the body, such as helping to stabilize blood sugar levels, which in turn keeps hunger and cravings at bay. Additionally, the human body cannot effectively eliminate toxins without amino acids—the building blocks of protein—that bind transformed toxins in the liver and help the body excrete them. Thus, it is extremely important to include some protein in every meal or snack. The Elimination Diet offers different sources of animal and plant proteins from which to choose. As with the other food categories, quality is of utmost importance. High-quality proteins include lean, pasture-raised, grass-fed, organic, and non-genetically modified (GMO) sources. Options include low-mercury fish like halibut, herring, mackerel, salmon, sardines, and tuna. Wild-caught, sustainable fish choices are preferred, as some farmed fish may contain hormones and harmful chemicals. Other protein options include the wild game (buffalo, elk, lamb, venison) and poultry (chicken, Cornish hen, turkey). Vegetarian protein choices include spirulina, legumes, lentils, peas, and select protein powders (hemp, pea, and rice).
- Legumes are a perfect source of quality protein and complex carbohydrates, which give a sense of fullness and stabilize blood sugar. At least one serving of legumes on a daily basis in soup or as cooked beans, dips, or hummus is recommended.
- Dairy Alternatives Dairy products are not included in the Elimination Diet, as dairy is often a culprit in gastrointestinal symptoms. Additionally, the risk of toxin and hormone contamination is high with many commercially available dairy products. There are several dairy alternatives available in this food plan, mostly in the form of milk made from nuts. Dairy substitutes like coconut (boxed variety), almond, flaxseed, or hazelnut milk often contain added sweeteners or gums, so it is important to read food labels before purchasing. Unsweetened coconut kefir is included in the food plan because of its prebiotic and probiotic potential, which may help improve gut health and aid in toxin removal.
- Nuts & Seeds A variety of nuts and seeds are included in the Elimination Diet. They can be added to meals for a nutrient and flavor boost—perhaps sprinkled on top of salads or vegetable dishes—and make a great snack choice. Eating a handful of nuts each day has been shown to reduce the risk of chronic disease. It is recommended that at least 1 to 2 servings of nuts be eaten every day. Raw, unsalted nuts instead of nuts roasted in oil are preferred. Flaxseeds and hemp seeds can be ground and stirred into smoothies or sprinkled on salads. Additionally, nut butter like almond butter, cashew butter, and tahini (sesame seed butter) can be used as condiments, spread on fruit, or drizzled over vegetables.
- Fats & Oils A large selection of fats and oils can be used for salad dressings and cooking while following the Elimination Diet. Approved choices are minimally refined, cold-pressed, organic, non-GMO fats and liquid oils, as these will be the best quality. Consuming these high-quality fats on a daily basis is recommended for reducing inflammation, stabilizing blood sugar levels, and minimizing sugar cravings. Extra-virgin olive oil is associated with healthy cholesterol levels. Research suggests that consuming minimally processed extra-virgin olive oil provides the greatest health benefits by increasing HDL (healthy cholesterol) and decreasing oxidative damage. The health benefits of olive oil are also found in whole olives, which are included in this category. Coconut-based fats, particularly coconut oil, are rich in medium-chain fatty acids (MCFAs) that help restore gut health. MCFAs are absorbed directly into the lining of the small intestine and sent straight to the liver for energy production, or are converted into ketone bodies, an important source of energy for the brain.
- Ghee, or clarified butter, is also included in this category. While ghee is technically a dairy product, all milk proteins are removed in the process of making it. Ghee is primarily composed of short-chain fatty acids (SCFAs), which are easily digested by the body and are thought to stimulate the secretion of stomach acids to help with digestion. Ghee also has a high concentration of butyric acid, which contains antiviral properties and helps break down food for energy.
- Non-Starchy and Starchy Vegetables The Elimination Diet emphasizes eating plenty of vegetables. Ideally, it is best to get 10–12 servings of vegetables per day. (A serving is ½ cup of most vegetables or 1 cup of raw leafy greens.) Green vegetables, especially members of the cabbage family, are particularly nutritious for those on the Elimination Diet. However it is important to eat a “rainbow of colors” in addition to greens; such foods include red beets, red peppers, and radishes; orange carrots, orange pepper, yams, sweet potatoes, and winter squash; yellow summer squash and yellow peppers; and white onions and garlic. To promote good health, it is important to eat a variety of colors each day. While darker-colored plants are generally higher in phytonutrients, even vegetables from the white family have potent contributions to make.
- Fruits phytonutrient-rich fruits offer antioxidant protection, which helps reduce inflammation. Eating a piece of fruit may be helpful when the desire for something sweet arises. It’s always better to eat fruit with a little bit of protein, such as nuts or nut butter, to offset any blood sugar spikes. Fruit can be fresh or frozen but must contain no added sugars or sweeteners. The Elimination Diet includes fruits that offer a wide range of health benefits, including blackberries, blueberries, kiwi, pomegranate seeds, and raspberries. Pomegranate seeds are recommended because they support detoxification pathways. In addition to improving memory and cognition, blueberries contain one of the highest antioxidant levels of all fruits. Apples contain phytonutrients that suppress inflammation. They may be eaten raw or stewed with cinnamon for added benefits. Small amounts of dried fruit are acceptable on occasion; you can make your own dehydrated, non-sweetened fruit to eat. As with vegetables, it is important to purchase organic fruit whenever possible. While citrus fruits are included.
- Gluten-Free Grains Gluten and gluten-containing grain products (bread, cereals, crackers, pasta, etc.) are omitted from the Elimination Diet. Removing the gluten-containing grains is just the first step, however, as gluten is also commonly found in prepared sauces, dressings, seasonings, and many other foods. Gluten-free whole grains, those with an intact bran outer coat, are allowed on the Elimination Diet as they provide an excellent source of fiber and other phytonutrients to assist with detoxification. These grains include amaranth, buckwheat, kasha, millet, oats, quinoa, rice, and teff. Cross-contamination is an issue with oats and perhaps other gluten-free grains when those grains are grown near wheat, rye, or barley. It is also an issue when gluten-free and gluten-containing grains are processed using the same machinery. When purchasing oats, look for the certified gluten-free seal on the package. Patients with celiac disease need to ensure that gluten has been entirely omitted from daily eating.
- Beverages Hydration helps rid the body of toxins, builds resilience to stress, enhances metabolism, and promotes satiety. It is important to drink plenty of clean, filtered water throughout the day. Individual recommendations for fluid intake will depend upon a number of factors. To determine an individual’s baseline hydration needs, use this equation Bodyweight(KG) ÷ 30 = Fluid intake (L). So 60 Kg man required 2L of water daily to maintain normal functions. In addition to filtered water, broths (vegetable, bone), meat stocks, and other decaffeinated beverages like fresh, raw, cold-pressed vegetable juices are also good liquid choices. Decaffeinated teas are also recommended on the Elimination Diet. Omitted from the Elimination Diet are coffee, alcohol, soft drinks, and non-dairy creamer. Coffee, while not high on the list of potential allergens, can have a significant effect on blood sugar and stress hormones. Eliminating coffee might lead to having headaches for a few days. One strategy to try is to slowly lower caffeine intake over several days to minimize the headaches, fatigue, or other unpleasant withdrawal symptoms that are often associated with caffeine withdrawal.
- Alcohol is avoided because of its inflammatory effects and its interference with liver function. The liver breaks down most of the alcohol a person consumes, but the process of breaking down alcohol creates toxins that promote inflammation and weaken the immune system. Both artificially sweetened and regular soft drinks should be eliminated for the duration of the Elimination Diet. Try substituting seltzer water with lemon or lime wedges, or a splash of coconut water. It is important to avoid non-dairy creamer, as it contains refined sugars and unhealthy hydrogenated fats. Instead, use one of the non-dairy milk substitutes like almond or coconut milk in place of milk and creamer.
- Spices and Condiments All herbs and spices are included in the Elimination Diet. Some of these can reduce pain and inflammation, particularly in cases of a gastrointestinal upset: cayenne pepper, chili powder, cilantro, ginger, nutmeg, and paprika. Turmeric is also known for its anti-inflammatory and pain-relieving properties. Digestive health is further enhanced by several others, including cinnamon, cumin, and dill. Other herbs and spices selected for detoxification and for their overall antioxidant and antimicrobial effects include cloves, oregano, rosemary, and thyme. Most condiments available on store shelves are not permitted on the Elimination Diet, as they can contain added sweeteners and preservatives. However, homemade versions of many condiments—including ketchup and barbeque sauce—can be easily made using few approved ingredients. Vinegar is permitted in the diet.
Inflammatory Foods to Exclude:
Focusing on anti-inflammatory foods in the diet is just the first step. What is not eaten is as important as what is eaten. During the Elimination Diet, and even afterward, reduce or eliminate the following:
- Trans-fats: Found in processed foods like cakes, cookies, bagels, and crackers.
- Refined sugars: Added refined sugars are pervasive in processed foods. Read the labels very carefully for sugars such as HFCS, corn sugar, corn syrup, and sucrose.
- Foods with a high glycemic response: High-glycemic foods create blood sugar spikes after eating; these can stress the body to overproduce insulin, which is not healthy. Over time, the body becomes less equipped to handle high-sugar foods, and inflammation increases from the excess sugar and insulin produced. Examples of foods with a high-glycemic response are refined grains and bread, desserts, sweetened beverages, and highly processed prepared foods.
- High omega-6 oils such as corn or soy: Most people eat high amounts of refined vegetable oils in their diet if they eat lots of processed foods. These oils have high amounts of omega-6 fats and too few omega-3 fats. When the omega-6 fat level in the diet is too high compared with the omega-3 level, enzymes involved in inflammation can be activated. The goal is to balance those two types of fats.
- Gluten-containing foods (wheat, rye, barley, spelt, Kamut): More people are learning that they have gluten intolerance. While it is unknown why this is happening, one theory is that the genetic modification of these grains in the modern era of agriculture has led to changes in how most people digest them in the gut. For some people, wheat may be more of an issue; for others, all of these grains could provoke inflammatory-related symptoms. Another theory about the recent surge of gluten intolerance is that the reaction isn’t caused by the grains themselves, but rather by the pesticides and herbicides the grains are treated with. Yet another theory is that treating grains with enzymes or acid to make flour that is more easily mixed with liquids (a process called deamidation), may be affecting the body’s ability to handle them.
- Saturated animal fats from grain-fed red meats: Dietary fat has had a bad reputation for a long time. However, there are many types of fats and they are not all inflammatory; too much poor quality fat is the real problem. New research suggests that a high-fat meal of animal foods could lead to inflammation in the body. Adding vegetables to the meal can help to offset the inflammation. This finding does not mean that one should not eat animal foods, but that if they are eaten, vegetables should be included with the meal.
- Dairy-containing foods: Foods that contain dairy products such as milk, yogurt, cheeses, and butter, when eaten in large amounts, may be inflammatory in certain individuals. This effect may be due to the milk itself or to the contaminants in the milk, such as growth hormones and antibiotics that were given to the cow.
- High-temperature cooking with fats: The process of cooking can lead to the formation of inflammatory compounds in foods. Foods that take on a brown color with cooking have high levels of these compounds (e.g., fried potatoes; fried, broiled, grilled, and roasted meats, especially bacon, and fish; pastries or pizza crust). Both during and after the Elimination Diet use slow-cook methods, as well as poaching and steaming, instead of grilling, broiling, and Deep frying.