You can gain a ton of insight into the causes of symptoms if you tune into the messages your body is sending out when you experiment with food. Symptoms manifest long before a disease does, so this is why it’s so important to pay attention to the warning signs your body is giving you rather than masking symptoms with drugs. Further, some of these foods are causing damage to different parts of your tissues, so once identified, you can potentially prevent an autoimmune attack on your body or even reverse the damage done by autoimmunity. In my first post, What is an Elimination Diet and What You Should Know Before Starting, I review the common symptoms of food sensitivities and explain how to do an elimination diet correctly so that you can get the most out of what it can offer. In this post, I’m going to explain the why behind the foods that should be eliminated, where to start based on your current health, and what foods you should add into your diet to help repair your gastrointestinal lining and to nourish you in the process.
Foods to Eliminate
To keep it simple, you can do it one of two ways: basic elimination or advanced. If you’re someone who feels overwhelmed with the idea of doing a food elimination diet, want to test the water first without diving in, or are dealing with some mild, but annoying chronic symptoms, then starting with the basic food elimination is the route I would suggest going. Most of my clients who start with this elimination notice huge gains in their health pretty quickly. Now, if you have already done a food elimination diet and have not had results, are suffering greatly with digestive issues, or have a full-blown autoimmune attack, then it’s recommended to start with the advanced elimination. There is no right or wrong way to do it; just get started somewhere and build from there if you need to.
Basic Elimination (The top offenders)
The top two foods that should be eliminated include gluten and dairy. They are by far the two foods that cause the most issues in people. I have personally seen this in practice, and just with the elimination of these two foods, my clients have had profound improvements in their health. The most common association to gluten sensitivity is with Celiac disease. However, what is thought to be more common than Celiac disease is Non-celiac gluten sensitivity (NCGS). NCGS is characterized by both intestinal and extra-intestinal symptoms related to ingesting gluten-containing foods. 1 Symptoms of NCGS includes many, but some common ones are bloating, abdominal pain, diarrhea, epigastric pain, lack of well-being, tiredness, headache, foggy mind, and anxiety. Neurological symptoms from a gluten sensitivity are also common and can include peripheral neuropathy and cerebellar ataxia. 2 A gluten sensitivity, or even Celiac disease can develop at any time in a person’s life, so just because you’re a certain age doesn't mean anything when it comes to food-related issues. Further, the range of symptoms of a gluten sensitivity is vast, so please don’t think the symptoms are limited to just the above.
Gluten has not been apart of our diet for very long as the native diet of humans consisted of mostly meat, fruits, and vegetables with very little exposure to grain. Gliadin and glutenin proteins primarily make up the structure of gluten. Gliadin is the component that is rich in prolamine and glutamine, which cannot be degraded by intestinal enzymes and triggers an immune reaction in genetically predisposed individuals. 3
The gluten-free product market has grown substantially over the years. According to Dr. Alessio Fasano, he states that the prevalence of gluten-related issues are on the rise, and based on his study, it seems that prevalence has doubled every 15 years in North America. 4 Why such an increase over the years? Well, there is no clear answer for this. However, some research and experts in the field link this rise to glyphosate. Glyphosate is the active ingredient in the herbicide, Roundup. A study done on Fish exposed to glyphosate showed that they develop digestive problems that are similar to that of celiac disease. Glyphosate has been shown to disrupt gut bacteria in animals, specifically killing beneficial forms and causing an overgrowth of pathogens. Interestingly, the use of glyphosate on wheat in the U.S. has risen sharply in the last decade, in step with the sharp rise in the incidence of Celiac disease. 5,6 My recommendations are to avoid non-organic produce, meat, and grains as much as you can. The Dirty Dozen List ranks the top twelve vegetables and fruits found to have the highest levels of pesticide residue, which is very helpful when you’re trying to make informed choices while out shopping. Having a healthy gut microbiome is essential for health as 70%- 80% of our immune system resides in our gut. 7 Protect your gut microbiome by choosing organic as much as you can.
Where is gluten found, and why do some people not fully improve once it’s eliminated?
When you hear of gluten, it is typically referring to the protein found in wheat, rye, some oats (must be labeled gluten-free as most are contaminated), barley, and triticale; thus foods containing these ingredients should be avoided on a gluten-free diet. Now, a big reason one may not improve when they eliminate gluten is that they may be consuming other foods that are cross-reacting with gluten. Cross-reactive foods are known to mimic gluten to the human immune system. 8 Casein (milk protein) is the most likely to cross-react and should also be removed at the same time that gluten is removed. This is imperative as many people with a gluten sensitivity also have a sensitivity to dairy. Another reason casein should be removed is that it is one of the top allergen foods in the U.S. In my opinion, you would be wasting your time on an elimination diet if you only eliminate gluten and not dairy along with it.
In my first post, I discussed how leaky gut is at the root of many chronic illnesses, especially in the development of an autoimmune disease, and is a cause for the development of food sensitivities. Leaky gut is triggered by many things including certain medication like NSAIDs, stress, surgeries, gut infections like small intestinal overgrowth (SIBO), yeast overgrowth, and parasites, as well as challenging foods like alcohol and food sensitivities. When the gut barrier is inflamed and more permeable, it’s not uncommon for the immune system to react to many different foods as undigested food proteins leak through the damaged gut barrier. When someone is dealing with many different symptoms, eliminating these foods can help calm down the immune response and allow them to heal.
People who have a full-blown autoimmune attack going on, meaning they’re dealing with many symptoms that are affecting their quality of life, do well when they take a comprehensive approach to a food elimination diet. This diet is well known as the Autoimmune Paleo Diet.
In the Autoimmune Paleo diet, the following foods are removed:
All of these foods are either known to cross-react with gluten, are ones that are commonly known to invoke an immune response, inflammatory, or are aggravating to the gut. This diet was designed to heal the gut in addition to helping one determine additional foods they could be causing a reaction. There is a wealth of information on this diet from books to blogs that are extremely helpful when doing an advanced elimination diet such as this. I highly encourage doing your research before eliminating all of these foods or working with a nutritionist that can help you. On average, you will follow this diet from anywhere from two to six weeks, but possibly longer depending on the severity of your symptoms.
In my non-autoimmune clients who have noticed an improvement in their symptoms on a gluten and dairy-free diet, but have not had complete resolution of their symptoms, I will consider other potentially problematic foods. This approach is not as comprehensive like that of the Autoimmune Paleo diet, but equally as effective. Other foods that people can commonly be reacting to include grains and eggs. Grains are a common staple in our diet, but we do not need them to survive. Grains are high in lectins and have been shown to degrade the intestinal barrier. 9 Grains that are gluten-free like rice, millet, corn, and gluten-free oats can also cross-react with gluten, just like casein mentioned above. I often suggest removing them to aid in the gut healing process on an elimination diet and testing for tolerance on reintroduction. One of the tests that I use in practice to help those determine other foods that cross-react with gluten that they could be reacting to is Cyrex Labs, Array 4. I will be going over more on this test in my next post, which is part 3 of the blog series.
Eggs are a common food allergen in children, but adults can develop a sensitivity to eggs later in life, especially those who have leaky gut, so this is why I often suggest eliminating them to test for tolerance. Keep in mind that when you’re ready to reintroduce eggs, you need to introduce the yolk and white separately as reactions can be to either one. Interestingly, more people tolerate the yolks more than the whites.
Now if symptoms don’t improve with the elimination of these top offending foods, I begin to look into other root causes of their symptoms that could be related to things like viruses, bacteria, parasites, small intestinal bacterial overgrowth (SIBO), toxins, etc.
Other Highlights on an Elimination Diet
To make the most gains from doing an elimination diet, you shouldn’t just focus on removal of the above foods. It’s important to also remove inflammatory foods and replace your diet with the highest quality, most nutrient-dense foods available to you. They will not only help to repair the gut in those with leaky gut, but it will also help provide a powerhouse of nutrition essential for optimal detoxification and cellular health.
Food is powerful medicine. If you need someone to help you get started on a path to improving your health? You can contact me here.
In optimal health,
I'm Meagan Reynolds- a certified functional medicine practitioner and dietitian located in Nashville, TN. I help women reverse Hashimoto's symptoms so they can regain their energy and heal their brain and body.