June cohort for the Elimination Diet, 2024

Written By Ana M. Nunes

At the beginning of June, I started coaching sessions for the first group of people whose objective is to comply with the Elimination Diet (ED) prescribed by the Institute of Functional Medicine (IFM). There are 5 of us in total. As I currently follow a slightly different diet for health reasons, I did not accompany my clients on this journey. In any case, I have experience in following various types of diets, including very strict diets, so I am fully capable of guiding them and sharing experiences in the first person.

The IFM Elimination Diet is a three-week program designed to educate the patient and the clinician about the main foods that may be causing discomfort, inflammation or other types of allergies and sensitivities in some way. By eliminating certain food groups, typically associated with allergies or gastric sensitivities, we will be supporting the gut microbiome, reducing inflammation and increasing phytonutrient intake (nutrients from plants). During this program, the patient removes specific foods and food categories from their diet for at least three weeks. After this period, careful reintroduction of foods begins with the aim of identifying previously hidden food triggers that may contribute to illness, fatigue and reducing overall vitality. For patients with IgE-mediated anaphylactic food allergies, reintroduction should only occur in the presence of trained healthcare professionals. For food reactions, including sensitivities and intolerances, reintroduction can often occur safely at home after the elimination diet has reduced inflammation and stress in the body.

For many people, the Elimination Diet has been instrumental in identifying a path to improved health. However, I must warn that the Elimination Diet is not suitable for all patients, such as constitutionally weak patients, patients with acute illness or a history of an eating disorder or active eating disorder, and pregnant women.

It is a challenging diet for the vast majority of people, because there is a total elimination of specific ingredients, commonly ingested daily or in large quantities by most people. Some examples are coffee, dairy, gluten and sugar. In some cases there must be a period of adaptation and preparation until the first day of the diet arrives. During this period, there are no days for “accidents”, however, adequate and individualized support from the coach can greatly contribute to the success and identification of symptoms associated with the reintroduction of foods. It can help in choosing alternative foods and take the experience of detoxification and cleansing of the body and mind to a deeper and more transformative level.

This is my promise, to make a great challenge a pleasurable experience of self-knowledge, discovery and connection with your own body. It is an experience that can usually have a lasting impact, and does not necessarily involve the total removal of the eliminated food.

Let it go for 3 weeks! If it is meant to be it will be yours forever.

It has been a very rewarding experience for me as a coach. Soon I hope to be able to share some of my clients' feedback with you.

Below, I share some bibliographic references with scientific evidence of the impact of the elimination diet on the management and even complete resolution of some health problems.

Warm regards,

Ana Margarida

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Supporting References

  • Jactel SN, Olson JM, Wolin KY, et al. Efficacy of a digital personalized elimination diet for the self-management of irritable bowel syndrome and comorbid irritable bowel syndrome and inflammatory bowel disease. Clin Transl Gastroenterol. 2023;14(1):e00545. doi:14309/ctg.0000000000000545

  • Zalewski A, Doerfler B, Krause A, Hirano I, Gonsalves N. Long-term outcomes of the Six-Food Elimination Diet and food reintroduction in a large cohort of adults with eosinophilic esophagitis. Am J Gastroenterol. 2022;117(12):1963-1970. doi:14309/ajg.0000000000001949

  • Wood RA. Diagnostic elimination diets and oral food provocation. Chem Immunol Allergy. 2015;101:87-95. doi:1159/000371680

  • Molina-Infante J. Nutritional and psychological considerations for dietary therapy in eosinophilic esophagitis. Nutrients. 2022;14(8):1588. doi:3390/nu14081588

  • Mayerhofer C, Kavallar AM, Aldrian D, Lindner AK, Müller T, Vogel GF. Efficacy of elimination diets in eosinophilic esophagitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2023;21(9):2197-2210.e3. doi:1016/j.cgh.2023.01.019

  • Ostrowska L, Gier D, Zysk B. The influence of reducing diets on changes in thyroid parameters in women suffering from obesity and Hashimoto’s disease. Nutrients. 2021;13(3):862. doi:3390/nu13030862

  • Aydinlar EI, Dikmen PY, Tiffikci A, et al. IgG-based elimination diet in migraine plus irritable bowel syndrome. Headache. 2013;53(3):514-525. doi:1111/j.1526-4610.2012.02296.x

  • Barmeyer C, Schumann M, Meyer T, et al. Long-term response to gluten-free diet as evidence for non-celiac wheat sensitivity in one third of patients with diarrhea-dominant and mixed-type irritable bowel syndrome. Int J Colorectal Dis. 2017;32(1):29-39. doi:1007/s00384-016-2663-x

  • Xie Y, Zhou G, Xu Y, et al. Effects of diet based on IgG elimination combined with probiotics on migraine plus irritable bowel syndrome. Pain Res Manag. 2019;2019:7890461. doi:1155/2019/7890461

  • Hui-Beckman JW, Goleva E, Berdyshev E, Leung DYM. Endotypes of atopic dermatitis and food allergy. J Allergy Clin Immunol. 2023;151(1):26-28. doi:1016/j.jaci.2022.07.021

  • Oykhman P, Dookie J, Al-Rammahy H, et al. Dietary elimination for the treatment of atopic dermatitis: a systematic review and meta-analysis. J Allergy Clin Immunol Pract. 2022;10(10):2657-2666.e8. doi:1016/j.jaip.2022.06.044

  • Papapostolou N, Xepapadaki P, Gregoriou S, Makris M. Atopic dermatitis and food allergy: a complex interplay what we know and what we would like to learn. J Clin Med. 2022;11(14):4232. doi:3390/jcm11144232

  •  Wollenberg A, Christen-Zäch S, Taieb A, et al. ETFAD/EADV Eczema Task Force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol. 2020;34(12):2717-2744. doi:1111/jdv.16892

  • Lim HS, Kim SK, Hong SJ. Food elimination diet and nutritional deficiency in patients with inflammatory bowel disease. Clin Nutr Res. 2018;7(1):48-55. doi:7762/cnr.2018.7.1.48

  • Nosrati A, Afifi L, Danesh MJ, et al. Dietary modifications in atopic dermatitis: patient-reported outcomes. J Dermatolog Treat. 2017;28(6):523-538. doi:1080/09546634.2016.1278071

Ana M. Nunes