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The Best Way to Identify Food Sensitivities

 Far more than just fuel for the body, food is information that has the power to promote health or create disease.  The messages food molecules send can either tell the body how to heal and repair itself to function optimally or can spur inflammation that weakens the body’s systems and drives the development of chronic conditions or disease.

     People are often unaware that particular foods they regularly consume may trigger an immune system reaction that releases damaging inflammatory signals and cheFood Groupsmicals throughout their body. Such food reactions are at the root of a wide range of common health complaints and conditions, including respiratory ailments, skin conditions, mood disorders, gastrointestinal symptoms, weight and metabolic issues and more.

     Over time these food reactions compromise the immune system, give inflammation the upper hand, and slowly erode a person’s well-being.  People often do not realize how bad they feel until these “trigger” foods are removed from their diet.  Discovering which foods are the “culprits” and eliminating them long enough for the body to recover is essential to enjoying the best possible health.

How Food Reactions Damage the Body

     The main role of the immune system is to identify and rid the body of foreign invaders that may enter the bloodstream.  Many food sensitivities or intolerances start when poorly digested food molecules cross over into the bloodstream through gaps in a porous intestinal lining (a condition often referred to as “leaky gut syndrome”). While the immune system recognizes food molecules broken down into their smallest components (amino acids, fatty acids and simple sugars), it perceives larger, less fully digested food particles as a threat to defend the body against.  

     In the process of the immune system’s attack, the tissues and organs surrounding the attack location suffer collateral damage or, in some cases, immune cells may directly target tissues that are similar in structure and make-up as the protein molecule in the food.  The latter type of attack eventually leads to the development of autoimmune conditions such as Hasimoto’s thyroiditis, rheumatoid arthritis or multiple sclerosis.  In these examples, tissues of the thyroid, joint and myelin sheath (coating of nerves) fall victim to repeated immune system assaults that eventually impair their function.

     In addition to direct inflammatory damage to tissues, immune system antibodies (proteins the immune system makes in the course of a food reaction) attach to food molecules to form what is known as “immune complexes”.   As these complexes circulate in the bloodstream, they become lodged in joints and tissues where they further damage and impair the normal functions of the body.

The Importance of Detecting Reactive Foods

     It is essential to realize that once the immune system tags a particular type of food molecule as an “enemy”, it stays on high alert and will launch a new inflammatory attack each time that food is consumed.  Continuing to eat reactive foods keeps the immune system working overtime.  Moreover, the constant background inflammation that occurs as a result makes a person more susceptible to the development of all kinds of disorders and diseases down the road.                                           

     Even when a food reaction does not directly stem from an immune system attack involving antibodies, food sensitivities from other causes can still develop that stress and inflame the body as well.  People can be deficient in certain enzymes needed to break down particular foods (like lactase required to digest sugars in milk) or they may overconsume certain foods to the point of exhausting their body’s ability to digest and process them.  The latter scenario is a common occurrence due to the fact that most processed foods are loaded with ingredients derived from common food allergens like wheat, dairy, corn or soy.

     Whether or not a food reaction affects the body significantly or not can depend on a number of factors, including the amount and frequency a food is consumed. Small, infrequent amounts of the food may not have a great impact but the more some types of food proteins build up in the system, the more likely a threshold is reached that elicits a more serious reaction.

Do You Identify with these Symptoms or Conditions?

     Unlike classic food allergies (Type 1) that produce an immediate response (such as an allergy to peanuts or shellfish), symptoms produced by Type 3 delayed-onset food intolerance or sensitivities are not so obvious and can take up to three days to manifest.  Due to the delayed response of this type of food reaction, people often do not make the connection between their symptoms and the foods they eat.

     Many dozens of symptoms and conditions are linked, either directly or indirectly, with food allergies or sensitivities.  See if you identify with any of the more common ones in the table below         

Detecting Food Sensitivities with the Elimination/Challenge Diet

     Discovering whether or not a food allergy or sensitivity is contributing to your symptoms is vitally important to your future health.  It can also make a big difference in how you feel day to day.  Whether a reaction is due to a true food allergy, intolerance or sensitivity, the Elimination/Challenge Diet is the most effective and reliable way to make that determination.

     An Elimination/Challenge Diet is a short-term eating plan in which you eliminate potentially reactive foods for a period of time and systematically reintroduce them one by one, paying close attention to how your body reacts and how symptoms change throughout the process.  Along with removing some of the most common food irritants, a good elimination diet involves increasing the amount of healing and beneficial foods to allow the body to make needed repairs and regenerate healthy new cells.

     Despite the number of food sensitivity tests currently available, elimination diets are still considered by health experts as the gold standard in detecting food reactions.  While the right type of blood tests can be helpful in identifying the presence of immune system antibodies to a food at the time of the test, they are costly and usually not covered by health insurance.  Moreover, these types of tests are not always perfectly reliable as they are designed to look for specific reactions to particular isolated components in foods. The problem is that multiple chemicals in foods can produce different reactions in different individuals.  Also, a food allergy test may show negative results for an underlying food sensitivity even when the sensitivity still causes adverse symptoms. This would be the case if a food sensitivity did not occur as a result of a true immune response but instead due to a reaction to a certain chemical component in a food.  

     The fact is that elimination diets are generally quite on target in detecting food sensitivities.  Plus they are free, doable by anyone, and can be started at any time.

Health Benefits of an Elimination Diet

     In addition to identifying hidden food sensitivities, an Elimination/Challenge Diet serves to accomplish many valuable health benefits. Many chronic symptoms improve or disappear, including ones that often fail to respond to conventional medical treatment.  The most common benefits people tend to experience are greater energy, a clearer mind, less aches and pains, clearing of skin conditions, relief from digestive and intestinal distress, improved respiratory health, better sleep and weight loss. 

     Beyond relief of symptoms, an Elimination/Challenge Diet serves as the first step in actually breaking food allergies or sensitivities and enabling people to once again enjoy previously reactive foods without the return of allergic reactions.  While some food allergies are “fixed” with no prospect of eating the food again without incurring symptoms, many food sensitivities are temporary and can be reversed.  This generally involves adhering to a period of complete avoidance for a period of months, allowing the immune system to recover and restore its reserves, healing the gut and then limiting the frequency and amount the food is consumed once it can be safely added back to the diet. 

     Other important benefits gained from an Elimination/Challenge Diet include:

Strengthened immune health - eliminating reactive foods allows the immune system to calm down and frees up much of the energy the body expends on initiating and sustaining immune responses.  When the immune system is not repeatedly engaged in attacking food molecules, the body can better heal as well as protect itself against true enemies like bacterial infections or cancer.  Keeping the immune system out of overdrive also greatly reduces the opportunity for an autoimmune disease to develop or worsen.

Reduced inflammation – eating food that constantly triggers an inflammatory immune system reaction contributes to a state of chronic low-grade inflammation, the driver of all chronic diseases and conditions.  Staying clear of reactive foods greatly reduces immune system attacks and the associated release of inflammatory chemicals throughout the body.

Better digestion – symptoms of digestive distress are commonly experienced when reactive foods are consumed.  When the gastrointestinal tract is irritated and inflamed, it cannot function optimally to adequately finish the digestive process and extract from foods the nutrients the body needs for optimum function. Giving the digestive system a break from dealing with difficult-to-digest foods often relieves these symptoms plus it lessens the possibility that partially digested food molecules will gain entrance to the bloodstream to trigger an immune assault.  

Improved gut health - the first step in healing a “leaky” gut is to remove irritants since ongoing inflammatory reactions prevent the repair and replacement of intestinal cells.  An elimination diet reveals what foods are irritating your system so you can remove them from your diet long enough for your gut to heal.  Additionally, the healthy whole foods consumed on an elimination diet help rebuild the gut lining since they are high in protein and phytonutrients.

Enhanced detoxification – with a few modifications, the elimination diet can double as a detox diet.  Since an elimination diet restricts processed and other types of foods and beverages that contain various types of chemicals and synthetic additives, it lowers the toxic burden of the body and enables overburdened detoxification channels to recover and begin to function efficiently again.  This allows for better clearance of toxins that have accumulated due to environmental exposure, foods, beverages, drugs, alcohol, etc.

Elimination of food addictions and cravings – people often crave the very foods to which they are allergic or sensitive to because endorphins (“feel-good” brain chemicals that act like opiates) released in response to the bodily stress of a food reaction make them feel better for a short time after they eat them. Consequently, removing these trigger foods helps to break food addictions.  Getting off sugar, processed and other unhealthy foods also helps to reset taste buds and increase the desire for healthier whole foods.  Because cravings for simple sugars and carbohydrates can occur due to low levels of serotonin from food reactions, eliminating reactive foods also can have a marked positive impact on mood.

Weight loss – inflammatory immune system reactions from eating reactive foods results in tissue swelling, abdominal bloating and excess water weight (sometimes called “false fat”).  As previously mentioned, endorphins the brain releases in response to the stress of food reactions produces addictions to those very foods.  The eventual wearing off of that “high” makes people crave those very foods in a desire to experience again the same pleasurable feelings.  Moreover, the stress of repeated food reactions causes the adrenal glands to pump out hormones such as adrenaline and cortisol to raise blood sugar and boost energy in order to better deal with the stress.  High cortisol levels lead to increased belly fat and the rise in blood sugar triggers the release of greater amounts of insulin, the fat-storing hormone.  As these two hormones dissipate, fatigue, irritability or mental sluggishness often set in, driving a person to eat more of the same reactive food in order to feel better.  Rather than a problem of weak willpower, overweight people are often trapped by the overpowering force of what is known as the food allergy-addiction cycle.  Breaking these addictions by identifying and removing reactive foods inevitably results in weight loss.

How the Elimination Diet Works

     An Elimination/Challenge Diet is like an experiment you conduct on yourself. You start by removing test foods from your diet for three weeks to allow immune system antibodies to dissipate. This is because you will not generally feel the true effects of a food on your body upon reintroducing it unless you are first off of it for a sufficient period of time.  After an elimination diet, you will be much more in touch with your body’s responses. If your symptoms diminish within that time period and you feel worst when the food is later reintroduced, you have likely identified a food sensitivity or allergy.

     Assuming symptoms do improve within the time period, you then begin the challenge phase in which each removed food is added back to the diet in larger amounts for one day followed by two days of monitoring symptoms (the additional time is allowed since delayed food reactions can take up to 72 hours to manifest).  

     If no symptoms appear, you continue to eat that food in normal amounts and start the same process with the next challenge food.  If symptoms do appear at any point within the three days, you stop the challenge food immediately and do not introduce a new challenge food until the flare-up of symptoms disappears.  

     During this time you keep a food journal in which you note what you consume and any symptoms you experience, whether physical, mental or emotional.  The amount of time it can take to work through all of the challenge foods depends on a number of factors, the greatest of which is the type of elimination plan you select.

     If you want more detailed instructions, you can find complete step-by-step guidelines for conducting the reintroduction challenge phase of the diet after the conclusion of this article.  Information about what to do with your results going forward is also included. 

Elimination/Challenge Diet Options

     Depending on the types and severity of symptoms along with the health objectives of an individual, elimination diets can vary with regard to the number of foods restricted. The most accurate and effective elimination diets remove the largest number of foods.  The more foods you remove, the more likely you are to discover which ones are reactive.  This makes the detective work involved simpler.  If you just remove one food, you might not feel better because you are still eating another problem food.  That makes it harder to notice if you feel worse or not when you reintroduce the removed food.

     The disadvantages of removing a wider range of foods is that the diet becomes more challenging to stick to and the challenge phase will take longer since foods or food types are reintroduced one at a time.  If you find the prospect of a more complete elimination diet too overwhelming, then you may want to opt for a more limited plan.  However, taking this option may mean having to do additional elimination diets to conclusively identify the correct problem foods should you not achieve your health objectives.  If you have a lot of symptoms or severe ones that have not resolved through other means, you would really benefit from the more complete elimination diet plan.

Foods You May Need to Remove

     In addition to removing some of the most common trigger foods with high allergy potential, most health experts also recommend removing foods that fall in the following categories:

  • Foods that you already know or suspect cause symptoms
  • Foods that you tend to crave or consider “comfort foods”(the ones you think you cannot do without)
  • Foods that you tend to eat every day or eat four or more days a week (repetitious use of the same food is a likely cause of developing food allergies or sensitivities)

     If you possibly can, it is best to remove all of these foods because any favorite you hang onto may be the one that causes symptoms that will mask any improvements from discontinuing the other foods you are testing.  If you have many foods on your list and you know you will not realistically stick to the diet if you remove all of them, pick two or three to begin with that are the most repetitive in your diet and/or ones you crave the most as you will still learn some valuable information.

The next group of foods to consider excluding is common trigger foods with high allergy potential. 

The top seven according to many experts are:

  • Wheat and gluten
  • Dairy
  • Corn
  • Soy
  • Eggs (whites are more allergenic than the yolks)
  • Sugar (while not a true allergen, sugar is a highly overconsumed substance that creates similar inflammatory symptoms as other reactive foods and many people do develop sugar sensitivity)
  • Peanut (peanuts are more frequently associated with immediate-onset allergies but also commonly cause delayed-onset allergic reactions)

Modified Elimination Diet - a very basic elimination diet removes at least the top four reactive foods, wheat (and gluten), dairy, corn and soy. The reason these four are so common is that they are found so abundantly in processed foods and make up such a large portion of the standard American diet.  As an example, three out of every four grocery store items contain some form of corn.  In addition, wheat, corn and soy are such heavily genetically modified crops in this country that some experts think the immune system may especially react to them as their proteins and genes are altered and more easily perceived as “foreign”.  If you are overweight or have any type of metabolic or blood sugar-related condition, include sugar in your modified elimination diet.

Limited Elimination Diet - if eliminating all four of those foods seems too daunting for you, a recommended option is to do a limited elimination diet that at least removes gluten and dairy.  Why those two?  The proteins in wheat (gluten and gliadin) and dairy (casein and whey) are responsible for about half the cases of food intolerance and are particularly overconsumed.  It is essential to remove both at the same time because reactions to them can be very similar.  By eliminating both and then reintroducing one at a time, you get a clearer testing response in order to determine which one is the problem or whether both are problematic.  If you are overweight or have any type of metabolic or blood sugar-related condition, include sugar in your limited elimination diet.

Standard Elimination Diet – a standard elimination diet includes all of the top seven food triggers and can also include some or all of the following additional problematic foods (elimination diets do vary and not all recommendations include every one of these foods or beverages).  Some on the following list are reactive due to chemical components in the food and others because they increase inflammation in the body and contribute to food allergy-like symptoms.  Whether or not they are eliminated depends on individual factors such as the type and severity of symptoms. Working with a trained health practitioner or nutritionist can help you implement the right type of elimination diet, one tailored to suit your particular health needs.

  • Yeast
  • Tree nuts
  • Citrus - citrus contains a compound called synephrine that can trigger headaches, migraines, asthma, skin and joint issues.
  • Coffee and caffeinated teascontain chemicals that tax the liver and slow down the ability of the body to detoxify. Coffee also has a significant effect on blood sugar levels and stress hormones.
  • Alcohol some alcoholic beverages have ingredients that may contain gluten, artificial flavors and/ or colors, or preservatives. Alcohol also contains sugar that helps yeast and harmful bacteria in the gut to thrive.
  • Nightshade vegetablesthese vegetables and spices - tomatoes, white potatoes, eggplant, peppers, chilis, cayenne, paprika, and tomatillos - contain an alkaloid compound called solanine which may exacerbate joint pain, skin and digestive issues.
  • Chemical additives - artificial food coloring, flavors, preservatives (BHA and BHT), sulfites (contained in grapes, prunes, and raisins not organically grown), MSG and other glutamates, xanthum and other gums, nitrates, sorbic and benzoic acid, texturing agents, artificial sweeteners. This would include fast foods and highly processed foods that contain a variety of proinflammatory chemicals that add to the toxic burden on the liver.
  • Amines, salicyclates and sulfitesnaturally occurring chemicals in foods such as tomatoes, broccoli, olives, spinach, mushrooms, avocado, most dried fruit, smoked meats, canned fish, hard cheeses, soy sauce, miso, wine, chocolate, cocoa, beer, cola drinks, vinegars, and yeast extract.
  • Certain meats conventional beef, pork or veal as well as processed meats, like sausage, cold cuts, canned meats, and hot dogsMany of these meats are fatty and difficult to digest and some like sausage contain allergen fillers and added ingredients. The fact that most are from conventionally raised animals fed GMO omega-6 grains makes the meats inflammatory as well.
  • Shellfish and farm-raised fish - shellfish are sometimes allergenic and farm-raised fish are often fed genetically modified corn and soy.
  • Certain oils and fats –refined and hydrogenated oils - especially corn, soy, peanut or vegetable oils - or foods cooked in these oils. This would include margarine, shortening and commercial salad dressings that commonly contain soybean oil.
  • Certain spicesspice mixes may contain anticaking agents such as wheat flour. Non-organic spices sold in the in the United States are fumigated with hazardous chemicals banned in Europe and other places.  Check labels to ensure spices you purchase do not contain preservatives and additives that can cause irritation and lead to a food reaction.
  • Supplements additives – may contain wheat, soy, corn, milk, sugar, yeast, artificial colorings, or other additives.

Grain-Free Elimination diet - a grain-free elimination diet is basically the same as the standard elimination diet with the added exclusion of all grains rather than just gluten grains.  This type of elimination diet is particularly recommended for people with gastrointestinal symptoms and conditions.  For anyone with an auto-immune disease or severe digestive or intestinal issues, a further limitation would be to exclude nuts, beans, legumes and seeds.

     When removing a food on the Elimination/Challenge Diet, it is essential to avoid every form of the food as it is not always obvious by the name given to the food or the ingredient name on the label that the product contains the food you are trying to avoid.  I have included lists after the conclusion of the article with alternate names and hidden sources for some of the common potential food allergens.

Foods You Can Include

     Even when you remove all potentially problematic foods, there really is plenty left to eat.  Focusing on eating a wider variety of healthy whole foods free of chemicals can only benefit your overall health.  Most elimination diets focus on lean meats, vegetables, fruits, healthy fats, nuts, seeds, legumes and gluten-free whole grains.  The table below will give you some guidelines on what you can safely eat.      


    An elimination diet must be done correctly if it is to achieve its purpose. The following guidelines will help ensure that your elimination diet is successful and effective:

Be fully committed.   Like everything else worth working at, an elimination/challenge diet takes commitment and discipline.  For the program to be beneficial, it must be followed strictly as any cheating will invalidate the results.  You must be willing to undergo a certain amount of discomfort, deprivation and inconvenience to successfully achieve your health objectives.

Be positive and mentally prepared.   Choose to adopt an “I can do this” mentality and attitude.  Focus on positive thoughts about the experience and remind yourself how feeling better, having more energy, losing weight or whatever your personal goals are will be well worth the challenge.  Remind yourself that the hardest part starting out generally only last three to four days and that, as you feel better, you will have more energy and motivation to complete the course.

Select a start date.   Though there is never a perfect window of time to embark on an elimination diet, try to find a period of weeks you can devote to the diet that is at least relatively free of travel, special occasions or events involving food that might make strict adherence too difficult.  Since the first few days are usually the most challenging, time the start of your program with the beginning of a weekend or other period of days your workload is lighter. 

Plan and prepare for what you will eat.  Plan what you are going to eat for all meals and snacks and familiarize yourself with the ingredients for any recipes you intend to make.  You can find a wealth of elimination diet recipe ideas for smoothies, soups, fresh vegetable and fruit juice drinks, snacks and healthy entrees and sides on the internet.  Create a shopping list and purchase enough of the ingredients you will need for at least for the first week.  Be sure to read labels carefully to ensure nothing you purchase contains hidden forms of the foods you want to avoid.  Buy as much fresh and organic produce as you can. 

Do advance food preparation.  If you can possibly make ahead some soups, snacks or other recipes to have on hand, it will make things easier and measurably increase your chances of sticking with the program should you run short on time to prepare the right foods on a given day. Cook larger amounts of recipes so leftovers can be frozen to help out with the following week’s meals.  It is especially important to plan meals or snacks to take with you when you will be away from home for more than a few hours so you will not get hungry and be tempted to eat what you want to avoid.  If mornings are hectic for you, do your prep work and pack what you need for the next day the night before.

Prepare your kitchen.  Before you start the program, inventory your pantry and refrigerator and discard, freeze, donate or otherwise remove foods you are restricting or at least hide them really well so you will not be too tempted to cheat!

Prepare your body.  Eating extra clean in the days prior to starting the elimination diet will help your body more easily adjust to the diet and lessen any withdrawal symptoms.  The more you normally consume fast foods, refined and processed foods, sweets, or heavy amounts of dairy, gluten grains and red meat or pork, the more days ahead of the diet you will want to work on cutting those out and transitioning to healthier food choices.

Detox from caffeine.  If you regularly drink coffee or other caffeinated beverages, it is recommended that you start to taper the amount you drink by half for a few days until you have completely discontinued it.  For the rest of the week before starting the elimination diet, drink one cup of caffeinated green tea steeped for five minutes in boiling water as the caffeine in green tea is minimal and the health benefits are excellent.  Tapering off coffee in this fashion will help you to avoid severe headaches or fatigue when first starting the elimination diet.  Additional things you can do to ease withdrawal symptoms is to drink six to eight glasses of filtered water each day, take 1000-2000 mg. of buffered vitamin C powder or capsules twice a day and get extra rest since you will likely suffer some fatigue.  You can also drink herb teas such as chamomile or peppermint.

Adhere 100 percent to dietary exclusions for at least three weeks – when testing for food reactions, it is important to realize that even a trace amount of a food can trigger an immune reaction and make your results inaccurate.  100 percent effort equals 100 percent results whereas 99 percent effort could equal zero valid results.  Three weeks is generally the amount of time it takes for the antibodies produced by the immune system in the course of a food reaction to dissipate.  Complete immune clearance will make food sensitivities easier to detect in the reintroduction phase.

Avoid all forms of the foods you are testing.  It is important to become familiar with other names, forms and sources of common food allergens such as gluten, wheat, dairy, corn and soy. Carefully check ingredient labels as multiple names exist for these foods and some of their components hide in unlikely sources.  Familiarize yourself with the list of alternative names and hidden sources of common food allergens provided at the end of this article.

Eat a wide variety of foods.  Expand your repertoire of foods with a special focus on including a wider variety of nutrient-dense vegetables.  Try to eat a salad daily and a minimum of four servings of vegetables, especially dark leafy greens and other deep colored vegetables that contain an abundance of healing phytonutrients (a serving is only ½ cup cooked vegetable or 1 cup raw leafy greens).  Be adventurous enough to try some new recipes and ways of preparing them. You may be surprised at how good they will taste to you when you are not eating the less healthy options.  If you get in a rut with just eating a limited selection of your favorite allowed foods, you will be deficient in nutrients you need to build your health and you also risk creating reactions to the foods you are eating repeatedly.

Keep a food journal.  To help you identify patterns, write down all the foods you eat and the beverages you drink and then track any physical, mental, or mood signs and symptoms you may experience during the elimination and reintroduction phases.  Practice the art of listening to your body and make daily entries noting how you feel physically (presence or absence of symptoms such as fatigue, pain, swelling, itching, diarrhea, bloating), emotionally (mood swings, depression, anxiety, irritability, anger, fear, etc.), and mentally (cloudy or foggy thinking, dull or slow thinking processes).  If you feel better or experience a lessening of any symptoms during the elimination phase, it may indicate that a food you commonly eat is causing you problems.  This record is important to have when you begin reintroducing foods in the challenge phase.

Do not restrict calories or focus on weight loss.  While called a “diet”, the Elimination/Challenge Diet does not restrict calories nor is weight loss the main goal.  However, since most of the foods allowed on the diet are naturally low in calories, most people who need to will lose weight.  Those who find they are hungrier than usual are free to snack or eat more as their hunger dictates as long as they stick to the approved foods.  Eat enough food and do not allow yourself to get too hungry. Anyone wanting to gain weight should eat more frequently and select more calorie and nutrient-dense foods like rice, avocados, nuts, nut butters, coconut milk and cream, sweet potatoes, etc.

Be prepared for possible withdrawal symptoms.  Realize that you could feel worse in the first days of an elimination diet due to withdrawal symptoms triggered by your body’s craving food allergens that you have not had for several days.  Be assured that these symptoms are a normal part of the detoxification process and should subside by day four or five and disappear altogether by day 11 or 12.   Drinking plenty of water and keeping your blood sugar levels balanced by eating good sources of protein and healthy fats along with vegetables each meal should help as will getting extra rest if you can.  Vitamin C supplements and Epsom salt baths may also help to alleviate the discomfort of certain types of symptoms.

Take appropriate supplements.   Since some types of elimination diets can be fairly restrictive, taking a few key supplements is recommended to ensure basic nutritional needs are met.  Among these would be a potent multivitamin/mineral complex, omega-3 fatty acids (fish oil), vitamin D3, digestive enzymes and probiotics.  Be sure to invest in high quality, well-absorbed, low additive and allergen-free products.                

Get adequate rest and go easy on exercise.  Strenuous exercise is not recommended during the weeks you are on the elimination phase of the program as the body as the body needs time to rest and detoxify. Keep physicalactivity limited to lighter forms of exercise such as walking, yoga or other mild intensity exercise.  If you must do more, be sure to consume carbohydrates, proteins and fluids before and after physical activity. Coconut water can be used for a natural electrolyte replacement.

Follow the correct guidelines for reintroducing test foods.   It is essential that test foods be systematically reintroduced in the challenge phase in a particular order, amount, type and timing.  In addition, symptoms should be carefully observed and recorded throughout the process.  For more details on the exact procedures to follow, read the “Challenge Phase Reintroduction Instructions” that follows this article.

Concluding Thoughts

     Undertaking an Elimination/Challenge Diet is one of the most powerful things you can do to revolutionize your health.  While the time, effort and discipline involved in the process may seem too overwhelming or difficult to you, put it in the perspective of a lifetime of dealing with symptoms that will only get worse if you do nothing about them. Not only can you gain relief from these symptoms and feel better but the information you learn about what foods adversely affect you will also make a huge difference in your future health!


The Elimination Diet by Alissa Segersten and Tom Malterre, MS, CN
The Immune System Recovery Plan by Susan Blum, M.D., M.P.H.
Optimal Wellness by Ralph Golan, M.D.
Natural Medicine, Optimal Wellness by Jonathan Wright, M.D. and Alan Gaby, M.D.
The Complete Elimination Diet Guidebook by Heidi Turner, MS, RD
The Clean by Alejandro Junger, M.D.
Digestive Wellness by Elizabeth Lipski, Ph.D., CCN, CHN


     When you have completed three weeks of eliminating the foods you have chosen, you can begin the systematic reintroduction of your test foods.  For some individuals with extensive gastrointestinal symptoms or chronic long-lasting symptoms of any type, it may be necessary to continue this phase for two to three weeks longer.  If you experienced complete relief from all of your symptoms after only two weeks of a strict elimination protocol, you can start the challenge phase sooner.

Follow carefully the directions below:

  • Keep a record of each food that you test and all the symptoms you experience. 
  • Add foods back one at a time to see if any symptom reoccurs or worsens.  Even if you do not have a noticeable reaction, you must challenge only one food at a time to ensure accurate results.
  • Start with the foods with the least allergic potential and test foods like wheat, dairy, corn, soy, eggs, peanuts, citrus and yeast last, starting with the one that you miss the most.  You want to wait longer to reintroduce dairy, gluten, soy, and corn since these foods commonly cause the strongest reactions and take the longest to clear the system.  Wait to challenge alcohol, coffee, and black tea until all of the previous foods have been reintroduced.
  • Test foods on an empty stomach
  • Be sure to test foods in a single ingredient pure form.  For example, test milk or cheese or wheat, but not macaroni and cheese that contains milk, cheese and wheat!  If you are testing for a milk allergy, have a glass of milk at breakfast and another glass of milk or cheese with lunch.  When testing the gluten-containing grains, test first with wheat (use pasta, cream of wheat or another very plain form of wheat) because it is the grain highest in gluten and will therefore give you the clearest results.  You can test other gluten grains, such as rye, separately.
  • Eat the test food three times per day (morning, noon and night) for one day.  In case you have a strong reaction, eat a smaller amount for breakfast.  If you do not experience any reaction, consume larger amounts for lunch and dinner.
  • Be on the alert for symptoms – negative or positive as you reintroduce each food.  An offending food will usually produce symptoms within the first twelve hours though it can be delayed further.  Negative reactions to watch for include:
  • Write down any reaction you experience or changes in the way you feel in your journal and note whether the symptom was “mild”, “moderate” or “severe”.   Record both physical and emotional responses.  Also note if the food seems to make you feel unusually good or “high” or if you experienced increased energy as this can occur as part of a stress response to a particular food.
  • If you notice any return of symptoms or a new symptom on the first day of the challenge, stop eating the food right away.  If the symptoms that returned clear up over the next few days, you have confirmed that the test food was indeed a trigger.
  • Allow at least two full days with each food you test to see if symptoms occur before you move on to the next food.  Do not eat the test food the second day of the challenge but continue to monitor for symptoms.
  • Allow at least three days to see if symptoms occur when you are testing wheat or gluten as those foods tend to be more delayed in the immune response.  Note:  If you react to wheat, you will need to do the gluten challenge.  If you have no reaction to wheat, you can skip the gluten challenge.
  • Stick to the elimination diet you have been doing with the exception of the food you are challenging.
  • If you did experience symptoms, wait until your symptoms completely disappear before challenging the next food (this generally takes a few days but could take longer for all of the chemicals in the food to leave the body.  Taking buffered vitamin C can help the reaction clear your body more quickly). You must let your system return to a state of calm before testing another food, or you will risk inaccurate results.
  • If you experience no reaction to the test food for 2-3 days, it is safe to keep it in your diet for the rest of the challenge period and beyond.  If you are unsure about whether you experienced a reaction or not, take the food back out of your diet for at least one week and try it again.
  • Proceed to test the next food on your list, following the same guidelines.  Be patient – it may take you another two weeks or so to reintroduce all the foods you have eliminated.
  • Option:   test individual foods within a single food grouping after completing initial testing of all the foods to see if you are sensitive to certain forms and not others.  For example, for the dairy grouping, you can test cow’s milk cheese, sheep cheese, and goat cheese.  You may find you tolerant one and not another. Yogurt and butter may often be tolerated when milk is not.

What to Do with Your Results Going Forward

     If you discover that you have sensitivities to certain foods, it is best to avoid those foods for a minimum of three months although many experts recommend as long as six months to a year.  A longer period of time is definitely needed for gluten or dairy reactions.  The objective is to allow your body, and particularly your gut, to heal more fully and rebuild its immune system reserve. 

     It is also important to remember that food sensitivities are not food allergies.  This period of avoidance should be sufficient to “break” the sensitivity and allow you to eventually reintroduce these foods one by one into your diet without suffering adverse reactions. 

     If you have a true food allergy, the food allergen should be avoided completely.  Food sensitivities have more to do with how much and how often you eat a particular food, which can vary from one individual to another.  Depending on your particular tolerance threshold, you may be able to again eat small amounts of foods you are sensitive to and not react to them.

    Gluten, however, is the exception. If you have a genetic susceptibility to gluten, it is unwise to resume eating it even if does not seem to bother you.  The reason is that one out of four people who remove gluten from their diets, eliminate all of their symptoms, and then resume eating gluten again will develop an autoimmune disease within three years.  The recommendation is that you obtain comprehensive gluten antibody testing while you are still gluten-free to determine if you are genetically vulnerable before doing a gluten challenge.

Safe Ways to Incorporate Reactive Foods Back into Your Diet

    To find your personal threshold, you can do a mini-challenge on each of the foods to which you reacted to see if your body can handle smaller amounts.   If you still react, then you know you need to keep it out for an extended period of time (about a year) and re-test it after that time.  If you do tolerate small amounts of a reactive food, you may want to try following a rotation diet where you eat the food no more than every four days.  The idea is to keep a large amount from overwhelming the immune system so there is less of a chance that you will react to the food.

     If you have multiple food allergies and numerous symptoms, set up a rotation diversified diet where most of your foods are eaten no more than once every four to five days.  This will allow you to eat and remain relatively symptom free.  After six to twelve months or more, you should be able to relax somewhat on the rotation schedule.  Your body will let you know if you are eating the food too frequently.  If quantities are too much, your old symptoms will reoccur.  And if even a small amount of a food affects you, then discontinuing the food altogether is your best option as it may be a fixed allergy.


     The following tables will give you a good idea of the types of foods, derivatives and ingredients that may contain wheat/gluten, dairy, corn and soy – all very common food allergens widely used in processed foods.  The simplest way to avoid them is to only eat unprocessed whole foods.  However, if you do opt to use packaged foods or ingredients while testing any of these foods on the Elimination/Challenge Diet, then carefully check labels to ensure that you do not unknowingly consume any form of the food you are trying to avoid.  Bear in mind that these tables are not exhaustive lists and that you can locate more extensive lists on the internet.

WHEAT/GLUTEN     ​      









Besides the fact that soy is a common food allergen, most soy products should be avoided anyway because they are made from genetically modified soy unless the product is organic and specifically labeled “non-GMO”  

Copyright © 2008-2015 Lucinda Bedogne, CNHP, CNC

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