What is the elimination diet?

Wondering what effect food is having on you?

woman choose  from sweet cake and red apple

One of the most common topics patients ask about is food allergies or sensitivities and how to discover and sort these out.

There is actually a difference between a food allergy, intolerance, and sensitivity – check out my blog What’s the difference between food allergy, sensitivity, and intolerance? for more info on the specific differences.

You may have heard of an elimination diet before, but do you really know what it is and why it is useful?  That’s what I’m going to cover in this blog.

What is the elimination diet?

The elimination diet, also known as elimination/challenge diet or hypoallergenic diet, is considered the “gold standard” in diagnosing food sensitivities.  It consists of 3 phases:

1. Elimination phase

Remove the most common allergenic, irritating, inflammatory, reactive foods for at least 3-4 weeks (sometimes longer).  For my patients, I customize the diet by blood type and/or based on  known reactions to foods, as well as to address specific health concerns.

During the elimination phase, observe for improvement in symptoms (eg: energy, skin, sleep, digestion, pain, weight, etc).  In the vast majority of cases, some improvement in some symptoms will be observed.  Sometimes this improvement is quite dramatic – I usually find that patients feel much better and are very happy with results.

2. Reintroduction phase

Add back eliminated foods one at a time in order to assess the individual response to that food.  This allows us to isolate each food and see how it affects the patient.

Some foods may cause no immediately observable issue, while others can elicit symptoms, such as skin issues, digestive disturbance, bloating, constipation/diarrhea, headaches, mood changes, fatigue, pain, etc).

The length of the reintroduction phase will vary depending on what foods were eliminated and how they are reintroduced.

3. Maintenance phase

This is an oft forgotten phase, but very important!  During this phase, any foods that proved problematic during reintroduction are avoided, while foods that caused no issue during reintroduction are part of the diet again.

It is during this phase that I continue to work with the patient to address digestion, immune balance, and the chief concerns that brought them to my office.  While there are always some foods that will likely always be irritating for each patient, I understand that it is not realistic to avoid those foods completely for life in most cases.

The long-term goal is to change the balance of the diet to be more supportive for that individual, while balancing the digestive and immune systems so that when the patient encounters a stressor, such as a food irritant, he or she is less reactive than previously.

Because diet is such an ingrained habit (ie: you eat multiple times per day, every day, for your whole life), this is a gradual transition that goes hand in hand with other healing modalities.

What are the advantages of the elimination diet?

  • Kick start weight loss, healing, and symptom relief
  • Stimulate and reinforce habit changes
  • Provide both treatment and diagnosis
  • Create an environment that is more supportive for healing
  • During reintroduction, assess the effect of each food and determine which foods are working well or aggravating at this time
  • Diagnose what role food is playing for the individual through observation of how symptoms respond to the elimination and reintroduction phases

What are the limitations of the elimination diet?

  • It can be difficult to change dietary habits – this depends on each patient and I do my best to support my patients as much as possible, but in some situations, a full elimination diet is not the best choice
  • It is a subjective exercise and sometimes responses can be confusing or difficult to interpret – that’s what I’m here for, to help patients get the most from this experience!
  • Best for identifying more dramatic, short-term effects from foods, but does not always clarify the long-term effects of some dietary choices – to address this, I use the Blood Type Diet with many patients and often in conjunction with an elimination diet, which helps us understand both what food are currently contributing to health issues and which foods and dietary choices support that individual best over the long-term to prevent disease

What can I expect?

Nearly across the board, when I prescribe an elimination diet to a patient, he or she initially reacts with apprehension regarding eliminating certain foods.

However, just as often, patients tell me how much BETTER they feel once in the elimination phase and sometimes want to continue this phase LONGER than 3-4 weeks!

Patients tell me that initially it can be challenging to figure out what to eat, but soon they realize how much choice they really have in what to eat and it becomes much easier.

The majority of patients observe major shifts in their health concerns, including skin healing, resolution of digestive distress, more regular bowel movements, increased energy, weight loss, improved sleep, reduction of pain (headaches, body aches, joint pain), the list goes on!

Patients also tell me what a valuable experience the elimination diet was for them and how happy they are that they did it!

I had one “star patient” create a blog documenting her month on the elimination diet, including how she felt, what she ate (plus photos!), recipes, and tips.  I am so pleased with her progress and feedback and often share her blog with my patients to provide ideas and support.

What about food sensitivity testing?

My short answer is that there can be value, but it depends on the individual patient.  To get the best value from food sensitivity testing it is important that you use the right type of test, prepare correctly, and get a professional interpretation of the results.  These tests can be very expensive, so you want to do it right the first time!

For pros and cons of food sensitivity testing and my take on it, check out my blog Is there value in food sensitivity testing?

Have you done an elimination diet?  What was your experience?

Have you ever done food sensitivity testing?  Was it helpful for you, and how?


  1. Treating irritable bowel syndrome - Kate Whimster, Toronto Naturopath - May 8, 2015

    […] can improve significantly by identifying and removing the offending foods from their diet. A hypo-allergenic elimination diet is recommended with gradual re-introduction of foods to identify any specific […]

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