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Top 10 Elimination Diet Mistakes

Top 10 Elimination Diet Mistakes

If you’re reading this, I’m guessing you have tried an elimination diet (or have considered going on one) and you’re questioning if they really work.

Let me start by saying I’m a fan of elimination diets.

BUT (and this is a big BUT)…

They only work if know how to do them properly.

As a specialist in this area, I’ve personally guided many clients through an elimination diet (including myself) and on average, they experience a 60-70% drop in overall symptoms within the first 30 days.

Ironically, the vast majority of my clients have already done an elimination diet (or two.. or three…) and haven’t gotten results.

Sometimes, in fact, when they attempted an elimination diet on their own, their symptoms got worse. Not exactly the pay off you’d hope for after restricting your diet to a monotonous few foods.

So today I want to review the top 10 elimination diet mistakes so if you decide to do one yourself, you improve your chances of success.

Who Should Try an Elimination Diet?

If you suspect you have food sensitivities or other adverse reactions to foods (which often manifest as digestive issues, skin disorders, joint pain, autoimmune problems, trouble losing weight, fatigue, infertility, and more), an elimination diet is a key part of the healing process.

Elimination diets remain the gold standard in confirming food sensitivities (even when lab testing has been done) and figuring out your unique “dose tolerance” to individual foods. By removing problematic foods, at least for a period of time, and then reintroducing certain foods, you can identify your reactive (or trigger) foods and which foods your body can handle.

Top 10 Elimination Diet Mistakes

1. Quitting When You Feel Worse (at the beginning)

Many people expect that when you go on an elimination diet, you will instantly feel better. This isn’t always the case.

If you have regularly been consuming reactive foods and eliminate them cold-turkey, you can experience withdrawal symptoms. Essentially, your body has adapted to this regular onslaught of inflammation and either up-regulated or down-regulated certain pathways to help clear out problematic food antigens and other inflammatory mediators.

When you remove the trigger, it takes time for those mechanisms to find a new equilibrium. It’s somewhat akin to an alcoholic going through withdrawal when they enter rehab, though usually less severe symptom-wise. Sometimes this period of adjustment can last for two weeks, leaving you to scratch your head over why you’re fatigued, experiencing headaches, or having strange bowel movements.

Unfortunately, if you are not aware of this, you may assume that the foods included in your elimination diet are causing your symptoms to get worse. This can lead you to eliminate even more foods from your diet – and they may very well be the foods your body needs to heal.

2. Following a Cookie Cutter Plan

I can’t even begin to count how many elimination diets are out there. And I don’t recommend any of them.

Why?

Because our bodies are different and there is no such thing as a one-size-fits-all with elimination diets. There are certain foods that are generally inflammatory or that are a first-line choice to eliminate, but what if you’re the 25% of the population that has no reaction to that food?

And what if you are, instead, in the 25% of the population that reacts to seemingly benign foods, like pears? or lemons? or spinach? or turmeric? or black pepper?
I’ve seen all of these foods (and more odd-ball items) show up on food sensitivity tests.

With the help of accurate food sensitivity testing, it’s now possible to plan a fully customized elimination diet that improves your chances of success.

If you’ve tried an elimination diet and haven’t seen improvement after more than 2 weeks, there’s a good chance you’re reacting to something in your diet and it could be as bizarre as black pepper, coconut oil, or carrots.

Food sensitivity testing and the assistance of a specialist can save you months (or years) of trial and error (and debilitating symptoms).

3. Lacking Nutrient-Dense Foods

Nutrient deficiencies contribute to, in my opinion, almost every chronic health problem. So, if you’re not careful in planning an elimination diet, you may become deficient in a variety of nutrients.

Classically, I’ve seen severe imbalances in macronutrients (carbs, fat, protein) that can contribute to all manner of hormone issues, blood sugar problems, or even trigger new digestive symptoms to develop.

Equally concerning are the micronutrient deficiencies that can develop. For example, if you eliminate eggs, you can easily become deficient in choline (unless you’re up-to-speed on the few other foods that contain it in any meaningful amount).

This becomes a major problem for women trying to conceive, those that are pregnant, and breastfeeding moms given choline’s crucial role in preventing neural tube defects and promoting normal brain and vision development. (Of course, choline is also uber important for children and adults of both sexes for proper liver function, cardiovascular health, and brain health, to name just a few).

That example is just focused on one food and one nutrient, but the possible nutrient deficiencies are virtually endless if you’re not well-versed in this area.

4. Focusing on Elimination, Not Inclusion

An elimination diet is a bit of a misnomer.

Yes, it involves eliminating certain foods. However, if you’re not eating those foods, what are you going to eat?

It’s far too easy to get stuck in the whole “I can’t eat that” negative mental chatter. I know because I’ve been there.

If, instead, you change the focus to what you are including in your diet, you’ll be able to see all the variety you can have. That helps you plan which foods will fill in any nutritional gaps left by the foods you are avoiding.

You’ll also avoid the trap of swapping one problem food for another. For example, if you decide to go gluten-free, buying processed, gluten-free products is likely not going to solve your problems. (And actually, quite a few of my clients have been gluten-free for years before seeking my help, but they haven’t gotten better. Sometimes the additive-filled, gluten-free products they’ve been using are the culprit.)

5. Failure to Plan Ahead

Elimination diets take planning – a lot of it!

I’m pretty free-spirited around food, since I like to embrace mindful eating and eat what I’m in the mood for, what’s in season, or what I can forage for. But undertaking an elimination diet doesn’t allow that kind of laissez faire attitude (at least, not in the beginning).

By all means, mindful eating does NOT go out the window (at least in my practice it doesn’t), but it does pay to work through which food combinations, meals, and recipes will incorporate the foods you are including (and will meet your nutritional needs).

If you haven’t thought through what you are going to eat, I suggest coming up with at least 3-5 options for breakfasts, lunches, dinners, snacks, and beverages to carry you through the time you’ll be on the elimination diet.

If you frequently eat out, travel, or go to events where you don’t have control over what you’re eating, you might want to choose to start an elimination diet at a time where you have the fewest interruptions (or maybe have a heart-to-heart with yourself about what’s most important – your health or your lifestyle?).

Remember, there’s no half-assing an elimination diet. It’s a HUGE commitment. You have either eliminated certain foods or you have not.

And given that some food sensitivities cause a delayed hypersensitivity reaction that can appear days after consumption, that margarita you had on Friday night could be triggering your brain fog Tuesday afternoon. Pretty tricky to make the connection if you don’t know what you’re looking for and virtually impossible if you’re cheating – even just once a week.

Some of my clients seek my help after having tried half a dozen elimination diets, but when we really dig into the details, sometimes they have never truly eliminated anything for long enough to experience a shift.

6. Ignoring Dose-Tolerance

Let’s say you eat a large salad for lunch and feel bloated and gassy afterwards. Your first suspicion is that you’re reacting to something in the salad. You might choose to avoid some (or all) ingredients in that salad moving forward.

However, that’s not necessarily the wisest choice. You may, in fact, not be highly reactive to any of the ingredients in the salad if eaten in moderate quantities, but when eaten in large amounts (especially all at once), you may experience symptoms.
This is called a dose-response reaction. A little bit of something is fine. A lot of it puts you over the edge.

Keep in mind that some food sensitivities have a cumulative effect, meaning eating a lot of a certain food (or combination of certain foods) over a relatively short period of time (a few days, maybe) can trigger symptoms. This again points to the importance of a well-planned elimination diet, so you remove as many of these variables as possible.

To play devil’s advocate, dose tolerance also means that you may be able to handle an occasional serving of a reactive food without experiencing symptoms.

7. Skipping the Reintroduction Phase

If you’ve been on an elimination diet and are feeling fantastic, you may be tempted to continue eating that way. Depending on how restricted your diet is, that may be fine.

For example, if you’re following a Paleo template and feel great without including grains, dairy, and legumes in your diet, but you have plenty of animal foods, a selection of fruits, vegetables, nuts, etc., you’re likely ok.

However, if your elimination diet started with a small list of foods, like the dreaded Rice-Lamb-Pear elimination diet, or even a more inclusive list of 20 or so foods, you’ll want to add in variety before you burn out (or develop new food sensitivities – see #8).

A common mistake I see on elimination diets is staying on a restrictive plan for too long, hitting a breaking point of monotony, and then throwing in the towel entirely and returning to your previous way of eating.

Technically that’s not a full elimination diet, because as I mentioned above, the goal of an elimination diet is not only to identify trigger foods, but to identify the broad list of foods that your body thrives on.

If you’ve done the careful work of eliminating foods and felt improvement, this is precisely the time you want to reintroduce foods and test for tolerance. A big part of this is body awareness (hence my focus on mindful eating), and when you’ve removed all variables by initially limiting your diet, you can accurately test for one food at a time.

Let me repeat: ONE food at a time.

(If you don’t have food sensitivity testing to guide a reintroduction schedule, you will likely need to space out foods more and spend a few extra months in a careful reintroduction phase).

8. Staying on an Elimination Diet Too Long

There’s a good reason the most common food sensitivities are to foods that are staples in most households.

Not to beat a dead horse, but part of a well-planned elimination diet involves building in enough variety so you don’t over-consume any given food, at least until you have a working knowledge of your body’s individual tolerance.

Once you’ve worked through the reintroduction period, you want to be sure you are rotating your food choices regularly to prevent new food sensitivities from developing.

Before modern agriculture, food rotation was naturally built into our lives.

Certain vegetables were only harvestable during a certain month.

Some trees only bear fruit for a 2-week window.

There was a season when some animals would have migrated through your region that you could hunt, whereas others would migrate a different time of year.

Dairy was only available, in appreciable quantities, when baby mammals were weaning.

Simply put, we weren’t eating the same thing every day for a lifetime.

So if you’ve noticed that some food have become a staple in your diet, make it a priority to find some alternatives so you don’t rely too heavily on any given food.

That might mean varying your salad greens, protein options, snacks, alternative flours, and even your spices. It might mean occasionally taking a break from an entire food group if you suspect it’s flaring up any issues.

9. Assuming All Problematic Foods are Forever Unsafe

Just because eliminating a food at one time helped you heal doesn’t mean it’ll stay that way forever. Our bodies are constantly changing, life is constantly changing, our stress levels are constantly changing, so to assume that a food may be off limits forever is nonsensical.

Yes, there may be certain foods that you choose to avoid long-term. For example, if you have an autoimmune disease, you’ll likely want to stay gluten-free. (And yes, there’s no point in adding back in processed junk food. Sorry to burst your bubble.)

But as your gut heals and inflammation subsides, some people will regain the ability to digest and assimilate a wider variety of foods. So don’t throw out that possibility and feel doomed to a life of limited food options. Keep your focus on including (and enjoying) as much nutrient-dense real food in your diet as possible.

(More than a year after my own food sensitivity journey, that’s what I’ve determined is true for me and almonds. Success!)

10. Not Looking Beyond Food

It may seem like changing your diet will be the key to solving your health problems, but that’s not always the case. You can be diligently follow a strict food plan and not get better.

Why?

Sometimes there’s more to it than what you’re eating.

For example, I had one client who was experiencing horrible bloating, but it wasn’t always after eating and there wasn’t an obvious pattern to her symptoms – that is – until we took a close look at her routine. She was consistently getting bloated during and after her showers. Luckily, since we had the results of food AND chemical sensitivity testing, we were able to identify the problematic chemical in both her shampoo and body wash. Once we switched those out for a cleaner product, her bloating disappeared.

Remember, the purpose of an elimination diet is to remove ALL potential triggers for a period of time.

Some key things to look out for: strange chemicals or dyes in personal care products (toothpaste, mouthwash, lotions, make up, etc), medications, supplements, and cleaning products. (Follow my “guilty until proven innocent” rule.)

Also, the foods and chemicals you are avoiding may be hiding under different names. Wheat, corn, MSG, and many others are found in countless products under an array of benign-sounding names.

Then there’s the tricky part, which is that certain foods can be a natural source of chemicals. For example, almonds are high in salicylic acid, tea is high in benzoic acid, and celery is naturally high in nitrate. If you’re reactive to chemicals, you need a pretty strong working knowledge of food chemistry to know all those little details and fine-tune your elimination diet.

Now that you’ve had a primer on the top 10 elimination diet mistakes, I’d love to hear from you!

  • Have you ever tried an elimination diet? What was your experience?
  • If you could do it again, would you do anything different?

Until next week,
Lily

PS – If you suspect food is making you sick and would rather do it right the first time than waste time, energy, and money making these elimination diet mistakes, I’m happy to help. Go here to learn more.

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Category: Best of Blog, Nutrition Basics
{ 23 comments… add one }
  • Cassie Tran June 23, 2015, 9:57 am

    Great tips! I have a food intolerance to white potatoes and white rice. I found that just not eating them at all was the best for me.

    • Lily June 23, 2015, 10:52 am

      Glad you liked it, Cassie, and have figured out your specific food intolerances.

  • Lana June 23, 2015, 10:49 am

    Great post as always, Lily!!

    • Lily June 23, 2015, 10:50 am

      Thanks Lana!

  • Maya June 23, 2015, 6:26 pm

    A very timely post for me. Thank you Lily

  • Jenny June 24, 2015, 8:36 am

    Love this post. Too true. I can’t wait to share it with others!
    Xo you and your hard work.

  • Elise June 30, 2015, 2:49 pm

    Lily! Once again, you nailed it. I kept nodding my head with each suggestion. I always blame every symptom on food, so thank you for the reminder to look beyond the food!

  • Mary January 6, 2016, 3:26 am

    Hi Lily, I have been in the elimination diet now for 3 days from the order of a Dr. I have been very bloated and gassy, and having headaches, and light headed. So any advice you can give me would be nice. I would love to feel better from arthritis, insomnia, headaches,and stomach pain and constipation. The Dr thinks I have a leaky gut and has me taking GLUTAGENICS. I hope to gain relief from this holistic Dr that I just started seeing; thanks to my sweet sister paying for it, so wanting to feel better and not wasting my sister money feel motivated to do this diet to get relief. Do you think I am on the right path? I would also like to loss weight (15) lbs. Any advice would be welcomed. Thanks so much, Mary

    • Lily January 6, 2016, 9:41 am

      Hi Mary,
      Sorry to hear you’re not feeling well on your elimination diet. I’m not able to give individual nutrition advice in this format, but I hope you find some hints from my article to discuss with your doctor.

  • Danya Richter April 23, 2016, 9:42 pm

    I am going nuts trying to find out the answer if my natural shampoo and not natural makeup and lipstick with small amounts of my eliminated foods will ruin my diet and my progress. If I have an auto immune disease and I am gluten free forever but my mac lipstick has a bit in it….is that really so bad? Or is it everything?

  • Greta May 3, 2016, 1:48 pm

    If a traditional elimination diet is making you worse, you may also want to look at salicylate sensitivity. There are people who can not tolerate natural plant chemicals, designed to defend the plant from insects and fungus. I got worse and worse on my elimination diet, which eventually lead me to this sensitivity, and the trigger to my eczema.

    • Lily May 3, 2016, 6:20 pm

      Yes and few people are familiar with it. I uncovered my own salicylate sensitivity through food and chemical sensitivity testing. You can read more about my experience (and how nutrient deficiencies can make it worse) here.

  • Carissa September 13, 2016, 9:24 pm

    Hi there, this is all very helpful and insightful. Can you recommend a website, blog etc that would help me with planning what to eat through out the day while on the elimination diet?

  • Nicole September 16, 2016, 10:21 am

    Thank you so much! I just took a food sensitivity test, and it came back with twenty items, one being black pepper. I am on day 5 and going strong, and I found this article helpful and inspiring.

    • Lily September 16, 2016, 11:38 am

      Keep it up, Nicole! The payoff of a well-planned elimination diet is so worth it.

  • Christel Koranda October 10, 2016, 9:03 pm

    I am on day 37 of an elimination diet and have not cheated once! That being said, I still haven’t added back sugar, peanuts, dairy or gluten yet, but I’ve gained 4 lbs!! I am about ready to throw in the towel b/c I hate eating this way and now I’m gaining weight. Any thoughts???? I look at my journals and I feel like they are filled with veggies, etc. and maybe it’s the higher fat content I’m using?

  • Rachel Tremblay October 19, 2016, 5:22 pm

    How often do people do this test and find out they are NOT gluten sensitive?

  • Zoe November 8, 2016, 9:57 am

    Hi! I started the elimination diet to see if I have a foot intolerance that is causing my acne. Im on day 17 of the elimination phase and my skin has nEver been better. It’s so exciting. I’m wondering if it’s too soon to start reintroducing? Also if my diet calls for cutting out alcohol, what do you think the repercussions of cheating would be? I’m curious how esssential that is to the overall diet

  • Tina February 11, 2017, 7:58 pm

    Great information. Thank you. I just found out that I have minor allergies (by a blood test) to many staple foods – wheat, milk, eggs, peanuts, corn and potatoes. I’ve only been eliminating for about 2 weeks and have had horrible headaches every day. Your post helped me to understand that this may be a normal part of the process. Again, thank you.

    • Lily February 15, 2017, 1:43 pm

      Glad my post was helpful, Tina. Good luck on your elimination diet!

  • Jodi-Anne February 24, 2017, 9:34 pm

    Great article! I’ve been on the elimination diet now for over a month and was feeling so much better, now my stomach is acting up again. Read your article only to find out that I am probably sensitive to both Almonds and Celery as I have chemical allergies to both salicylic acid and nitrates…Going to try removing those and see if my stomach feels better. Then talk to my doctor. What do you think of Kombucha?

    • Lily February 27, 2017, 2:20 pm

      I share my thoughts on fermented foods, including kombucha, in this post. 😉

  • Stacey March 21, 2017, 1:26 pm

    I cut out diary, eggs, and gluten a couple days after Christmas, and more recently, I cut out beans. I feel great and I’ve lost 10 pounds effortlessly. I’m afraid to try adding foods back in! But you have given me the encouragement that I need.

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