Elimination diet

Comprehensive Elimination Diet (Adapted from the Institute of Functional Medicine)

The Comprehensive Elimination Diet is a dietary program designed to clear the body of foods and chemicals you may be allergic or sensitive to, and, at the same time, improve your body’s ability to handle and dispose of these substances.

We have called this an “Elimination Diet” because we will be asking you to remove certain foods, and food categories, from your diet. The main rationale behind the diet is that these modifications allow your body’s detoxification machinery, which may be overburdened or compromised, to recover and begin to function efficiently again. The dietary changes help the body eliminate or “clear” various toxins that may have accumulated due to environmental exposure, foods, beverages, drugs, alcohol, or cigarette smoking.

In our experience, we have found this process to be generally well tolerated and extremely beneficial. We obviously hope that you will find it useful too. There is really no “typical” or “normal” response. A person’s initial response to any new diet is highly variable, and this diet is no exception. This can be attributed to physiological, mental, and biochemical differences among individuals; the degree of exposure to, and type of “toxin;” and other lifestyle factors. Most often, individuals on the elimination diet report increased energy, mental alertness, decrease in muscle or joint pain, and a general sense of improved well-being. However, some people report some initial reactions to the diet, especially in the first week, as their bodies adjust to a different dietary program. Symptoms you may experience in the first week or so can include changes in sleep patterns, lightheadedness, headaches, joint or muscle stiffness and changes in gastrointestinal function. Such symptoms rarely last for more than a few days.

We realize that changing food habits can be a complex, difficult and sometimes confusing process. It doesn’t have to be, and we think that we have simplified the process with diet menus, recipes, snack suggestions and other information to make it a “do-able” process. Read this information carefully. If you have any questions about the diet, or any problems, please give us a call. We would be happy to help, and often we can resolve the issue quickly.

Introduction to the Menu Plan for the Comprehensive Elimination Diet

Eat only the foods listed under “Foods to Include”, and avoid those foods shown under “Foods to Exclude” in the “Comprehensive Elimination Diet Guidelines.” These Guidelines are intended as a quick overview of the dietary plan. If you have a question about a particular food, check to see if it is on the food list. You should, of course, avoid any listed foods to which you know you are intolerant or allergic. We also may change some of these guidelines based upon your personal health condition and history.

The “7-Day Menu Plan” may be used “as is” or as a “starting point.” This is a suggested menu that you might find useful while you are on the elimination diet. Feel free to modify it and to incorporate your favorite foods, provided that they are on the accepted list.

A few suggestions which may be of help:

• You may use leftovers for the next days’ meal or part of a meal, e.g., leftover broiled salmon and broccoli from dinner as part of a large salad for lunch the next day.
• It may be helpful to cook extra chicken, sweet potatoes, rice, and beans, etc. that can be reheated for snacking or another meal.
• Most foods on the menu plan freeze quite well.
• Please add extra vegetables and fruits as needed. The menu is a basic one and needs your personal touch. This is not a calorie-restricted diet. Use the suggested snacks as needed for hunger or cravings; leftovers are also handy to eat as snacks.
• If you are a vegetarian, eliminate the meats and fish and consume more beans and rice, quinoa, amaranth, teff, millet, and buckwheat.
• Breakfasts that need cooking are easiest to incorporate on your days off. Muffins can all be made ahead of time, frozen, and used as needed.
• If you are consuming coffee or other caffeine containing beverages on a regular basis, it is always wise to slowly reduce your caffeine intake rather than abruptly stop it; this will prevent caffeine-withdrawal headaches. For instance, try drinking half decaf/half regular coffee for a few days, then slowly reduce the total amount of coffee.
• Select fresh foods whenever you can. If possible, choose organically grown fruits and vegetables to eliminate pesticide and chemical residue consumption. Wash fruits and vegetables thoroughly.
• Read oil labels; use only those that are obtained by a “cold pressed” method.
• If you select animal sources of protein, look for free-range or organically raised chicken, turkey, or lamb. Trim visible fat and prepare by broiling, baking, stewing, grilling, or stir-frying. Cold-water fish (e.g., salmon, mackerel, and halibut) is another excellent source of protein and the omega-3 essential fatty acids, which are important nutrients in this diet. Fish is used extensively. If you do not tolerate fish, consult with us. We may suggest supplemental fish oils. Avoid shellfish, as it may cause allergic reaction.
• Remember to drink the recommended amount (at least two quarts) of plain, filtered water each day.
• Strenuous or prolonged exercise may be reduced during some or the entire program to allow the body to heal more effectively without the additional burden imposed by exercise. Adequate rest and stress reduction is also important to the success of this program.

Finally, anytime you change your diet significantly, you may experience such symptoms as fatigue, headache, or muscle aches for a few days. Your body needs time as it is “withdrawing” from the foods you eat on a daily basis. Your body may crave some foods it is used to consuming. Persevere. Those symptoms generally don’t last long, and most people feel much better over the next couple of weeks.

Good luck and Bon Appetit!

Comprehensive Elimination Diet Guidelines

FOODS to INCLUDE FOODS to EXCLUDE

Fruits: whole fruits, unsweetened, frozen or water-packed, canned fruits and diluted juices	Oranges and orange juice
Dairy substitutes: rice, and nut milks such as almond milk and coconut milk	Dairy and eggs: milk, cheese, eggs, cottage cheese, cream, yogurt, butter, ice cream, frozen yogurt, non-dairy creamers
Non-gluten grains and starch: brown rice, millet, quinoa, amaranth, teff, tapioca buckwheat, potato flour	Grains: wheat, corn, barley, spelt, kamut, rye, triticale, oats (although certified gluten-free oats would be OK)
Animal protein: fresh or water-packed fish, wild game, lamb, duck, organic chicken and turkey	Pork, beef/veal, sausage, cold cuts, canned meats, frankfurters, shellfish
Vegetable protein: split peas, lentils, and legumes	Soybean products (soy sauce, soybean oil in processed foods; tempeh, tofu, soy milk, soy yogurt, textured vegetable protein)
Nuts and seeds: walnuts, sesame, pumpkin, and sunflower seeds, hazelnuts, pecans, almonds, cashews, nut butters such as almond or tarini	Peanuts and peanut butter
Vegetables: all raw, steamed, sautéed, juiced or roasted vegetables	Corn, creamed vegetables
Oils: cold pressed olive, flax, safflower, sesame, almond, sunflower, walnut, canola, pumpkin	Butter, margarine, shortening, processed oils, salad dressings, mayonnaise, and spreads
Drinks: filtered or distilled water, decaffeinated herbal teas, seltzer or mineral water	Alcohol, coffee and other caffeinated beverages, soda pop or soft drinks
Sweeteners: brown rice syrup, agate nectar, stevia, fruit sweetener, blackstrap molasses	Refined sugar, white/brown sugars, honey, maple syrup, high fructose corn syrup, evaporated cane juice
Condiments: vinegar, all spices, including salt, pepper, basil, carob, cinnamon, cumin, dill, garlic, ginger, mustard, oregano, parsley, rosemary, tarragon, thyme, turmeric	Chocolate, ketchup, relish, chutney, soy sauce, barbecue sauce, teriyaki, and other condiments

Things to watch for:

• Corn starch in baking powder and any processed foods
• Corn syrup in beverages and processed foods
• Vinegar in ketchup, mayonnaise & mustard is usually from wheat or corn
• Breads advertised as gluten-free which contain spelt, oat, kamut, rye
• Many amaranth and millet flake cereals have corn
• Many canned tunas contain textured vegetable protein which is from soy;

look for low-salt versions which tend to be pure tuna, with no fillers

• Multi-grain rice cakes are not just rice. Purchase plain rice cakes.
• Many oats have wheat flour mixed with them. Avoid oats unless certified to be gluten free.

READ ALL INGREDIENT LABELS CAREFULLY

Elimination Diet Shopping List

Fruits Apples, applesauce Apricots (fresh) Bananas Blackberries Blueberries Cantaloupe Cherries Coconut, Figs (fresh) Grapefruit Huckleberries Kiwi, Kumquat Lemon, lime Loganberries Mangos Melons Mulberries Nectarines Papayas Peaches, Pears, Prunes, Raspberries, Strawberries * All the above fruit can be consumed raw or juiced Vegetables Artichoke Asparagus Avocado Bamboo shoots Beets & beet tops, Bok choy Broccoflower Broccoli Brussels sprouts Cabbage Bell peppers Carrots Cauliflower Celery, Chives Cucumber Dandelion greens, Eggplant Endive Kale Kohlrabi Leeks Lettuce — red or green leaf & Chinese Mushroom Okra Onions Pak-Choi Parsley Potato Red Leaf Chicory Sea Vegetables – seaweed, kelp Beans (All beans except soy) Lentils – brown, green, red Split peas * All the above beans can be dried or canned Nuts & Seeds Almonds Cashews Flax seeds Hazelnuts (Filberts) Pecans Pistachios Poppy seeds Pumpkin seeds Sesame seeds Sunflower seeds Walnuts *All the above seeds can be consumed as butters and spreads (e.g., tahini)

Vegetables cont. Snow peas Spinach Squash Sweet potato & yams Swiss chard Tomato Watercress Zucchini * All the above vegetables can be consumed raw, juiced steamed, sautéed, or baked Non-Gluten Grains Amaranth Millet Quinoa, Rice -brown, white, wild; Teff, Buckwheat, Gluten-free certified oats Vinegars, Apple Cider, Balsamic, Red Wine Rice Tarragon Herbs, Spices & Extracts Basil Black pepper Cinnamon Cumin Dandelion, Dill Dry mustard Garlic Ginger Nutmeg Oregano Parsley Rosemary Salt-free herbal blends Sea salt Tarragon Thyme Turmeric Pure vanilla extract Cereals & Pasta Cream of rice Puffed rice Puffed millet Quinoa flakes Rice pasta 100% buckwheat noodles Rice crackers

Breads & Baking Arrowroot Baking soda Rice bran Gluten free breads Flours: rice, teff, quinoa, millet, tapioca, amaranth, garbanzo bean, potato, tapioca, Rice flour pancake mix  Flesh Foods Free-range chicken, turkey, duck Fresh ocean fish, e.g. – Pacific salmon, halibut, haddock, cod, sole, pollock, tuna, mahi-mahi Lamb, Water-packed canned tuna (watch for added protein from soy) Wild game Dairy Substitutes Almond Milk, Rice Milk Coconut Milk, Oat milk Beverages Herbal tea (non- caffeinated) Mineral water Pure unsweetened fruit or vegetable juices Spring water Oils Almond, Canola, Olive Pumpkin Safflower Sesame Sunflower Walnut Sweeteners Fruit sweetener (Mystic lake Dairy, or Wax Orchards, or apple juice concentrate) Molasses Rice syrup Stevia Condiments Mustard- (made with apple cider vinegar) Nutritional yeast

Substitutions and Alternatives for Use in an Elimination Diet

To replace: Use:

	Milk	Rice, almond, coconut, or homemade nut milk (1/2 cup raw nuts or seeds with 1 cup water blended until smooth)
Cheese		Rice and almond brands – read labels and watch for casein free brands
Eggs		Energe egg replacer; or blend 1 T. flax seeds in blender with ¼ cup water and allow to thicken
Peanut butter		Nut butters made from almonds, cashews, macadamia, walnut, pumpkin, hazelnut, sesame (tahini)
Breading		Grind any allowable rice cracker and use as breading
Ice cream		Rice Dream (vanilla), 100% frozen fruit juice bars (Dole and Tazo brands); Cascadian Farms berry sorbets
Soda		Knudsen, seltzer and juice; water; diluted juice
Jams		Cascadian Farms all-fruit jams, Sorrel Ridge or Polaner (read label carefully)
Sugar		Fruit juice concentrate (Mystic Lake Dairy or Wax Orchard); brown rice syrup; Stevia
Pasta		Rice noodles (e.g., Mrs. Leepers, Pasta Risio and Food for Life brands), 100% buckwheat udon noodles; cellophane noodles made from bean threads
Wheat bread		Rice cakes, rice crackers (Trader Joe’s), rice almond and rice pecan breads, Energe brown rice or tapioca bread
Wheat cereals		Perky’s nutty rice, Crispy Brown Rice, puffed rice, puffed millet, cream of rice
Wheat flour		Rice, quinoa, amaranth, millet, teff, arrowroot, tapioca bean; nut and seed flours – use in combination with others to replace the full amount of wheat flour