Elimination Diet: Definition, Benefits, & Examples​

By Charlie Huntington, M.A., Ph.D. Candidate
​Reviewed by Tchiki Davis, M.A., Ph.D.
When done carefully and methodically, elimination diets can help identify food allergies and sensitivities. Let’s see what this looks like in practice.
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I have never personally undertaken an elimination diet, but I do have experiential evidence that eliminating one food substance from my diet makes a big difference. In the last year, recognizing that sugary foods seemed (a) very difficult for me to eat in moderation and (b) to be related to mood swings in my daily life, I resolved to stop eating them. I cut out every food with added sugar I could think of. I scrutinized all the processed foods I considered eating, from pasta sauces to crackers to protein bars.
For a few days I craved sugar and felt not-so-great, but after that it seemed like a cloud had lifted from my brain. Suddenly, I could focus on work! I remembered things I needed to do, and then I did them. I found myself more interested in my friends and hobbies, more patient with unexpected challenges. Pretty soon, I was sold on the power of not eating sugar.

My elimination diet was the simplest experimental design you can think of: Make one change and see if other things change afterward. A true elimination diet is a more involved process, starting with the removal of many foods, but the general idea is the same. Let’s look at the science behind elimination diets.​
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What Is an Elimination Diet? (A Definition)​

An elimination diet involves changing the foods that a person eats to see if certain undesired symptoms are related to the consumption of those foods (Ly et al., 2017). Typically, every effort is made to remove all potentially harmful foods from one’s diet for a period of time. Then foods are reintroduced into the diet one at a time, with a period of time to observe whether the original physical or mental symptoms return. If those symptoms return in the wake of adding a food, it can be reasonably assumed that the food is partially or fully responsible for the symptoms one is experiencing. With this new knowledge, the person doing the elimination diet is able to decide whether they want to continue avoiding that food or try to eat it in amounts that will not have adverse effects on their health.

Benefits of an Elimination Diet​

The primary purpose of elimination diets, from their introduction, was to both diagnose and serve as treatment for potential food allergies (Rowe, 1944). Eventually, doctors realized that psychological and behavioral symptoms that could reflect food sensitivities, as well as food allergies, could be identified through elimination diets (Singh & Kay, 1976). (My story of how removing added sugar from my diet changed my mental health is a good example of this.)
 
There is a lot of research attesting to the benefits of using elimination diets to treat certain physical conditions. For example, it is clear that people who have atopic dermatitis (better known as eczema) show reductions in their eczema and have fewer inflammatory markers in their blood after beginning elimination diets that remove the foods they are known to be allergic to (Agata et al., 1993).
 
Other researchers (Hart, 2018) have found that elimination diets reduce the symptoms of irritable bowel syndrome as well as joint pain, respiratory problems, and migraine. In fact, even some people with depressed mood experience benefits from changing their diets (Karakula-Juchnowicz et al., 2017).
 
The benefits of elimination diets are not reserved for people with chronic medical issues or mental health disorders. Elimination diets have been applied with people such as a elite athletes as well, and the participants in those studies, after removing from their diets foods to which they might have been sensitive, have performed better at their sports and appeared healthier on several measures of physical health (Kostic-Vucicevic et al., 2016).

While there are ample benefits to elimination diets, they are not easy to undertake, requiring discipline and effort. Elimination diets are often implemented with children, and families with children who are undergoing elimination diets typically find the whole process stressful and challenging (Meyer et al., 2017). After all, many of the most common allergens, such as peanuts, wheat, dairy, and eggs, are present in many foods that children—and adults!—enjoy. (While I am now old enough to appreciate the benefits of not eating sugar, if you had told me as a ten-year-old that brownies, cookies, and ice cream were now off-limits because it was going to be “good for me,” you better believe I would have responded differently!)

Examples of an Elimination Diet

Here is an example of the procedure used in one study to determine whether children with attention-deficit/hyperactivity disorder experience fewer mental health challenges if certain foods are removed from their diets (Bosch et al., 2020):
​
First, all known common food allergens are removed from the children’s diets for five weeks. This means that they do not eat milk, eggs, wheat, fish, or peanuts and nuts, among other foods. Then, every two weeks a new food is introduced into the diet, and the parents are asked to observe whether the child’s mental health symptoms change for the better or for worse. After those fourteen days have passed, the food is removed from the diet again.

If eating the food seemed to coincide with worse mental health symptoms, the food may be kept out of the child’s diet indefinitely, but if it did not, it is decided that the food will be added back to the child’s diet after the elimination diet process is complete. For a whole week, the child’s diet is then returned to the baseline of the elimination diet. Then, another food that was eliminated is reintroduced, and the parents watch for symptom changes again. This process is followed until all foods removed have been tested in this way, which means it can take up to a year or more (Bosch et al., 2020). Since some research suggests that children who go on elimination diets experience nutritional deficiencies and changes in growth patterns because of these amended diets (Isolauri et al., 1998), it is important to also monitor the rest of a child’s well-being during an elimination diet.

Elimination Diet Meal Plan

If you would like an example of an elimination diet in action, you can think of the paleo diet (Slavin & Ailani, 2017), as it effectively removes all instances of grain and dairy consumption from one’s diet. What does the meal plan of somebody on a paleo diet look like? It focuses heavily on vegetables and meats as the staples of the diet, with things such as fruits and seeds used for snacks. A person following this kind of diet might have eggs and bacon for breakfast, salmon and a salad for lunch (no croutons, no dressing), and chicken and sweet potatoes for dinner. Along the way, they might snack on sunflower seeds or blueberries.
 
Elimination diets often include the removal of very potent sources of nutrition, such as eggs, dairy, and wheat. It is important for a person of any age following an elimination diet to think carefully about how they will continue to get all the essential nutrients they need (Meyer et al., 2016). Supplementation with a multivitamin, or changing one’s diet to prioritize foods that will make up for lost protein intake, for instance, may be necessary.
 
If you would like more advice on how to go about beginning and following an elimination diet, I recommend watching this video:

Video: How to Do an Elimination Diet

Elimination Diet for IBS​

Many, though not all, people with irritable bowel syndrome (IBS) have sensitivities to food that may cause or worsen their symptoms. For people with IBS who believe they have food sensitivities—which may not reliably show up on food allergy tests—following a specific elimination diet, the FODMAP diet, may be helpful (Smith et al., 2020).
 
The FODMAP diet, which stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols, removes from the diet a variety of carbohydrates that the body finds difficult to digest, thereby reducing the stress and effort placed on one’s digestive system. To achieve a diet that does not include any of these kinds of carbohydrates entails ceasing to eat wheat, onions and garlic, dairy, artificial sweeteners, and some fruits. Although many people find this kind of diet challenging to maintain, they also find it helps with many of their digestive problems (Bellini et al., 2020).

Elimination Diet for Eczema

As we noted above, following an elimination diet may reduce the severity of eczema in our skin. While it can be tricky to determine which foods—and it is usually multiple foods—need to be removed from one’s diet, and nutritional deficiencies may result from removing key foods, permanently removing certain foods from one’s diet does seem to be among the best solutions for treating eczema (Kim et al., 2013).

Elimination Diet for Inflammation

Several elimination diets have been studied for their potential to reduce inflammation in our bodies (Starz et al., 2021), and inflammation is related to several of the chronic medical issues, such as irritable bowel syndrome and eczema, that we have discussed so far. While diets such as the FODMAP diet can reduce inflammation by reducing the amount of contact our digestive systems have with difficult-to-digest foods or foods we are sensitive to, they also run the risk of weakening our immune systems by decreasing the diversity of foods and nutrients we ingest. Again, an effective elimination diet should take into account that key nutrients may need to be acquired elsewhere in one’s diet after the elimination of certain foods.

Elimination Diet for Migraine

Elimination diets also seem to protect some people against migraine (Kelman, 2007). Studies have found that elimination diets protect against the intensity, frequency, and number of migraine symptoms. This is something that many people with migraine have noticed for themselves—they may already know before seeing a doctor that consuming certain foods seems to increase the likelihood they will have a migraine or make the migraine worse than it would otherwise be (Bergh et al., 1987).

Elimination Diet for Gut Health

It is clear that elimination diets alter the composition of our gut microbiota (Díaz et al., 2018). As you might have noticed by now, this is a double-edged sword: While elimination diets can be very helpful for reducing allergic and inflammatory markers in our guts, they can also put us at risk of having too little diversity in our gut microbiota.

Elimination Diet for Depression

As we noted above, an elimination diet may even help people with symptoms of depression  (Karakula-Juchnowicz et al., 2017). Eating high-fat and high-sugar foods while also eating little dietary fiber seems to be associated with depression, perhaps because if we eat lots of inflammatory foods and few anti-inflammatory ones, we put our brains at risk of greater oxidative stress and inflammation (Jones et al., 2017).
 
Researchers have also been interested in the potential for elimination diets to improve symptoms in people with autism spectrum disorder (ASD) and people with ADHD (Ly et al., 2017). At this point in time, there is little research to conclusively suggest that an elimination diet will benefit children or adults with ASD. Meanwhile, the research regarding elimination diets for people with ADHD (which usually involves specifically removing food additives, or the substances added to food to make it stay fresh or look more appealing) suggests that the positive effects are small at best. All that said, these diets may be helpful for people with either diagnosis, so long as adequate nutritional intake is maintained in other ways. 

Articles Related to Elimination Diet​

​Want to learn more? Check out these articles:

Books Related to Elimination Diet​

If you’d like to keep learning more, here are a few books that you might be interested in.

Final Thoughts on Elimination Diet​

Elimination diets are not something to undertake lightly. One research study found that implementing an elimination diet where four or more foods are removed adds significant time and expense to one’s eating routines (Sheedy et al., 2022). Additionally, eliminating foods that do not need to be eliminated can actually make us more susceptible to developing an allergy or sensitivity to that food (Elizur et al., 2017).

For these reasons, I recommend moving slowly and consulting with a medical professional regarding any elimination diet you may try. There is a careful balance to strike between reducing one’s unpleasant symptoms and creating new issues through introducing nutritional deficiencies to one’s life. Elimination diets hold so much potential for helping us live healthier lives; they just have to be implemented with a lot of intentionality.

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