Elimination diet protocols can vary by physician, says Sharon Zarabi, a registered dietitian at the Katz Women's Health Institute and director of Northwell Health.
“My approach varies depending on my client's current diet, personality, and relationship with food. I usually remove child support in stages (not all at once) and teach them so that they know the reason for what we are planning, ”says Zarabi. .
A popular example of an elimination diet is the low FODMAP diet. Mendes on. The goal of this diet is to provide immediate symptom relief, identify trigger foods, and then allow slow and careful reintroduction of foods. “The acronym FODMAP stands for fermentable oligo-, di-, monosaccharides and polyols. These are tiny carbohydrates found in many foods (such as apples, broccoli, wheat, soybeans, and foods containing high fructose corn syrup) that can worsen symptoms of irritable bowel syndrome and other digestive problems, says Dr. Mendez.
It is important to note that the FODMAP diet (like any other elimination diet) is not meant to be followed all the time. And a nutritionist should lead it, the doctor adds. Mendes on. “The liquidation process usually takes two to six weeks, followed by a reintegration phase,” she says. Following such an extreme protocol can affect overall nutrition, so it is important to keep the elimination phase to a minimum.
While elimination diets can vary slightly in protocols and specific foods that are eliminated, the process typically involves:
Liquidation stage
According to Mori, the first step in an elimination diet is to eliminate all suspicious foods (or food groups), including cooked, raw, and protein foods. Often, a person cuts out all suspicious foods at once (such as cutting out all types of dairy and gluten) before slowly reintroducing them.
This phase of the diet is followed for approximately two to four weeks without exception, so if you accidentally eat food, it is recommended to start over. Sometimes symptoms may get worse before they get better; this usually happens within the first few days after the start of the withdrawal phase.
Zarabi recommends that her clients keep a food diary to track their withdrawal symptoms, which also helps them stay on track. “We can explore together, collaborate and redefine what works and what doesn’t,” she says.
Reintroduction phase
After an assigned elimination phase, potentially trigger foods are usually reintroduced into the diet to see if any negative effects occur, Mori says. However, if your symptoms persist even after carefully avoiding suspicious foods for more than four weeks, it's time to consider other causes of your symptoms.
Before reintroducing excluded foods, make sure you have been symptom-free for at least five days. Start with one meal at a time. Dr. Mendez recommends starting with a small amount of food, even a teaspoon. If well tolerated, continue to slowly increase serving sizes.
Do it gradually until you reach a full meal or until you notice a threshold or amount of food at which symptoms return, Dr. Mendes says. It is best to limit the reintroduction phase to one new product every three days, as this is the time it takes for symptoms to return if needed. 