Elimination diets are the first part of a diagnostic
technique for determining what foods are causing
undesirable symptoms. Their purpose is to prepare
the patient for the second part of the diagnostic process,
the food challenge by cleansing the body of all
possible foods that could be causing the symptoms.
During the challenge phase, the patient eats the suspect
food and waits to see if symptoms reappear.
Elimination and challenge give healthcare professionals
a way to reproducibly pinpoint exactly which
foods are causing an adverse reactions so that the
patient can exclude these foods from their diet.
Benefits
People with symptoms that interfere with their
daily life benefit greatly from pinpointing which
foods are causing the symptoms so that these foods
can be eliminated from the diet. People with less severe
symptoms may find the process of elimination and
challenge too costly and disruptive to make it
worthwhile.
Precautions
Many people who suspect that certain foods are
causing their symptoms try modified elimination diets found on the Internet or elimination diets they devise
themselves. These diets have varying degrees of success.
For example, many people try eliminating all
dairy products to see if their symptoms of lactose
intolerance—bloating, cramping, diarrhea, and
gas—improve. This do-it-yourself approach may be
adequate for people with mild sensitivities to only
one food or food group, but it is risky for people
with severe intolerances. People with moderate to
severe sensitivities need professional guidance to
eliminate non-obvious sources of the potential problem
food.
Risks
One risk of all elimination diets is that they are not
nutritionally balanced. They increase the risk that
vitamin and mineral deficiencies will develop. Anyone
going on a full elimination regimen needs to consult a
dietitian or nutritionist about how to use dietary supplements
to assure adequate, balanced nutrition
A second risk is that people who self-diagnose
symptoms as food intolerances using a non-medicallysupervised
elimination diet may be ignoring symptoms
of more serious and progressive diseases such as celiac
disease, Crohn’s disease, gastroesophageal reflux disease,
irritable syndrome, and other health problems
that need medical treatment.
Finally, anyone suspected of having a moderate to
severe food allergy should be under the care of a
physician. Any food challenging must be done in a
healthcare setting, as severe reactions can cause anaphylactic
shock and death.
Research and general acceptance
The medical community accepts elimination diets
as a standard way to diagnose food sensitivities. A true
elimination diet is quite restrictive, takes a long time to
implement, and should be supervised by a healthcare
professional. Many short cut do-it-yourself elimination-
style diets are available on the Internet. Although
people who believe they have a food intolerance often
try these diets, they are not accepted by healthcare
professionals as diagnostically accurate, and they may
cause short-term vitamin and mineral deficiencies.
