Elimination Diet - Elimination Diet

Elimination Diet

The elimination diet must be comprehensive and should contain only those foods unlikely to provoke a reaction in a patient. They also need to be able to provide complete nutrition and energy for the weeks it will be conducted. Professional nutritional advice from a dietitian or nutritionist is strongly recommended. Thorough education about the elimination diet is essential to ensure patients and the parents of children with suspected food intolerance understand the importance of complete adherence to the diet, as inadvertent consumption of an offending chemical can prevent resolution of symptoms and render challenge results useless.

While on the elimination diet, records are kept of all foods eaten, medications taken, and symptoms that the patient may be experiencing. Patients are advised that withdrawal symptoms can occur in the first weeks on the elimination diet and some patients may experience symptoms that are worse initially before settling down.

While on the diet some patients become sensitive to fumes and odours, which may also cause symptoms. They are advised to avoid such exposures as this can complicate the elimination and challenge procedures. Petroleum products, paints, cleaning agents, perfumes, smoke and pressure pack sprays are particular chemicals to avoid when participating in an elimination diet. Once the procedure is complete this sensitivity becomes less of a problem.

Clinical improvement usually occurs over a 2 to 4 week period; if there is no change after a strict adherence to the elimination diet and precipitating factors, then food intolerance is unlikely to be the cause. A normal diet can then be resumed by gradually introducing suspected and eliminated foods or chemical group of foods one at a time. Gradually increasing the amount up to high doses over 3 to 7 days to see if exacerbated reactions are provoked before permanently reintroducing that food to the diet. A strict elimination diet is not usually recommended during pregnancy, although a reduction in suspected foods that reduce symptoms can be helpful.

Reasons for undertaking an elimination diet may vary from patient to patient, as some types of elimination diets are not out of medical necessity but completely by choice. Some of the most common elimination diets include

• Veganism, where an individual removes all animal products from the diet, including meat, dairy, fish, eggs, and even honey. Many will refuse to use any item that has been produced by an animal, like leather or fur clothing.
• Vegetarianism, which tends to be a less extreme version of veganism, with options ranging from an ovo-lacto vegetarian, a person who will consume no meat, but will consume dairy products and eggs, a Pescetarian that consumes no meat products except fish and shellfish, or even a flexitarian who will consume a mostly vegetarian diet, but eats meat and other animal products on occasion.
• Gluten-free, a diet where all grains that contain gluten are eliminated from the diet, including wheat, kamut, spelt, barley, rye, and potentially oats, though there is some controversy on this grain. This is the only medically accepted treatment for patients who have Celiac disease and has some inconclusive studies linked to decreasing symptoms of autism.