Diet & Nutrition

What Is an Elimination or Exclusion Diet?

Julie Lynn Marks
By Medically Reviewed by 
Reviewed:
Medically Reviewed
elimination of foods like shellfish, dairy, gluten, sugar
Will cutting out, or eliminating, a common food help you feel better?Adobe Stock
Most diets are designed to help you lose weight or improve your health. An elimination diet is different. The goal with this plan is to help you feel better by identifying foods that are making you sick.

How an Elimination Diet Works

Though there are different types of elimination diets, they’re conceptually the same: You stop eating certain foods for a few weeks and then slowly reintroduce them one at a time.

This strategy can identify food allergies, sensitivities, or intolerances that may cause unpleasant reactions.

The “elimination” phase of the diet typically lasts two to four weeks. You may be asked to stop eating one food, multiple foods, or entire food groups. If a certain food is causing a reaction, your symptoms should go away by the end of this period.

The next step is “reintroduction.” During this phase, you’ll slowly add food items back to your diet and record your symptoms. Your doctor may also perform other tests to pinpoint which foods could be triggering your issues.

Once you know the problematic foods, you and your doctor can create a new eating plan to help prevent your symptoms.

An elimination diet may be beneficial for people with a variety of health conditions that are related to food reactions.

You might try an elimination diet to see if certain foods are causing symptoms, such as:

  • Bloating, gas, indigestion, or other gastrointestinal issues
  • Achy joints
  • Fatigue
  • Headaches
  • Brain fog
  • Frequent colds or immune system issues
  • Mood swings, anxiety, or depression
This diet can be complex, so it’s important to do it safely and correctly.

You should follow an elimination diet only under the supervision of a medical professional.

What Are the Potential Health Benefits of an Elimination Diet?

An elimination diet can help you figure out which foods are causing you to feel bad. This can be a game changer for people with food allergies or intolerances.

Food allergies are on the rise. About 32 million people in the United States have a food allergy, which includes 5.6 million kids younger than 18.

Additionally, an elimination diet can help improve symptoms of other medical conditions that may be triggered by food reactions. Some of these include:

  • Irritable Bowel Syndrome (IBS) or Other Gastrointestinal Disorders IBS is a common gut disorder that causes unpleasant issues like diarrhea, cramping, abdominal pain, gas, and constipation.

    Research has shown that elimination diets may help reduce these symptoms in some people with IBS.
  • Eosinophilic Esophagitis (EoE) A chronic condition, eosinophilic esophagitis is characterized by inflammation in the esophagus.

    A review published in 2020 found that elimination diets were “highly effective treatments for eosinophilic gastrointestinal diseases.” Another study showed that more than 75 percent of patients with EoE who followed an elimination diet reported fewer symptoms and less inflammation on biopsy tests.
  • Celiac Disease Symptoms of this autoimmune condition are triggered by gluten, which is a protein found in wheat. A diet that eliminates gluten is the only way to treat celiac disease.

  • Attention Deficit Hyperactivity Disorder (ADHD) ADHD is a neuropsychiatric disorder that affects about 7 percent of kids and adolescents. According to a study published in 2020, an elimination diet was effective in reducing symptoms for 30 percent of children with ADHD.

  • Eczema or Allergic Conditions Emerging research is showing that food sensitivities may play a role in eczema — an inflammatory skin condition that causes itching, redness, and rashes.

    A 2015 clinical case report found that some people with asthma reported symptom improvement and less dependence on medicines when they followed an elimination diet.
  • Migraine Migraine is a neurological disease characterized by repeated episodes of symptoms, usually including debilitating headaches, that can impact a person’s quality of life. In a 2010 study, participants who followed an elimination diet reduced their average number of headaches from nine to six.
  • Other Conditions Certain foods are known to worsen symptoms of other diseases, especially autoimmune or inflammatory disorders. An elimination diet may be used for various health conditions.

Weight Loss Effects

Despite its name, an elimination “diet” is not designed to help you lose weight. In fact, cutting out foods or entire food groups can make restricting calories more challenging for many people.

On the other hand, some individuals with food allergies who follow an elimination diet may feel better and lose weight, but the actual diet probably wasn’t the reason for this effect.

People with a history of eating disorders, such as anorexia or bulimia, should avoid an elimination diet, as it could trigger unhealthy habits.

Examples of Elimination Diets

There are different ways to follow an elimination diet. Some plans are more restrictive than others. For instance, you may need to remove just one suspected food, or you may eliminate six food types or even more.

The number of foods you eliminate will depend on your symptoms, the suspected triggers, how motivated you are, and other factors. Typically, the elimination diets that are more restrictive yield the best results.

The popular six-food elimination diet excludes these items:

  • Dairy Products This food group includes milk, yogurt, cheese, butter, and ice cream.
  • Wheat Foods that contain flour, bran, or gluten may be restricted.
  • Eggs Eggs and condiments that contain eggs, like mayonnaise or salad dressings, are frequent triggers.
  • Soy Soy-based products include edamame, soy sauce, and tofu.
  • Nuts and Seeds Peanuts and tree nuts are often culprits to eliminate.
  • Fish Shellfish is an especially common food allergen.
Other foods or substances that are frequently restricted on an elimination diet include:

  • Citrus Foods Oranges or grapefruits may be on your list to remove.
  • Certain Vegetables Tomatoes and peppers are often eliminated.
  • Artificial Sweeteners Aspartame and other non-natural sweeteners might need to be removed from your diet.
  • Oils Dairy-based butters and certain oils may need to be avoided.
  • Legumes This category includes beans, peas, and all soy-based products.
  • Sugars Candy and sweets might be restricted.
  • Others Certain spices and extracts may need to be avoided, along with caffeine and alcohol.

Elimination-Style Diets

Some other examples of elimination-style diets include:

  • Low-FODMAP Diet This diet plan involves restricting certain carbohydrates that may cause intestinal problems. The low-FODMAP diet is usually recommended for people who have symptoms of IBS.

  • Gluten-Free Diet With a gluten-free diet, you’ll stop eating any foods that contain gluten. This includes wheat, barley, and rye products.

  • Few Foods Diet You restrict your diet to only a few foods that you don’t usually eat.

  • Specific Carbohydrate Diet This plan allows for certain types of carbohydrates while restricting others.

  • Lactose-Free Diet With this diet, foods that contain lactose (a sugar found in milk and milk products) are avoided by those who are lactose-intolerant.

Meal Planning for an Elimination Diet

If you decide to follow an elimination diet, you might need to plan or prepare your meals ahead of time.

A registered dietitian or food and nutrition practitioner can assist you in creating an appropriate strategy. These experts are trained to help you read food labels and incorporate the correct amount of nutrients into your diet. The Academy of Nutrition and Dietetics offers a resource to help you locate a dietitian in your area.

Be sure to start your elimination diet at a convenient time when you will be more apt to follow it successfully. It’s not a good idea to begin the diet before a vacation or other big event that you know will test your willpower.

You might want to look online for recipes that will accommodate your eliminated foods. Some people also like to prep their meals for the week to make mealtime quick and easy.

What to Expect if You Try an Elimination Diet

If you try an elimination diet, here’s what to expect:

  • You will eliminate certain foods from your diet for a short period of time and then reintroduce them gradually.
  • A medical professional will monitor your diet and progress.
  • You will keep a written record of your food intake and symptoms.
  • You may undergo certain medical tests before, during, or after the diet to help better identify food triggers. For example, people with EoE may need repeat biopsies to see if inflammation in their esophagus improves or worsens when foods are removed or added back.

  • You and your healthcare provider will come up with an individualized eating plan based on the results you find. This may include foods to avoid or consume in smaller amounts.

Pros and Cons of an Elimination Diet

As with any eating plan, there are pros and cons of following an elimination diet.

Here are some of the benefits:

  • You’ll feel better. The goal of an elimination diet is to identify triggers that are causing your symptoms. If you can successfully avoid these foods, your quality of life may improve.
  • It’s temporary. An elimination diet is intended only for a short amount of time, which makes it easier for some people to successfully complete.
Some downsides of an elimination diet are:

  • It can be restrictive and hard to follow. You may have to eliminate some of your favorite foods completely, which is difficult for some people.
  • It takes time to plan. You’ll likely spend more time tracking your food intake, planning your grocery list, and preparing your meals.
  • It might not work. Despite your best efforts, you may not be able to identify food triggers that are causing your unpleasant symptoms.
  • It could lead to malnutrition. If you stay on the diet for a long time, you may develop a deficiency in iron, calcium, vitamin B12, vitamin D, or other nutrients.

Tips for a Successful Elimination Diet

Here are some tips for a successful elimination diet outcome:

  • Work with a qualified professional. An elimination diet can be challenging. Make sure you are working with a doctor or dietitian who can help you through the process.
  • Follow your plan carefully. Don’t deviate from your diet or allow yourself to cheat.
  • Prepare your own food. Most restaurants can’t guarantee that certain foods aren’t contaminated with something you’re trying to avoid.
  • Record your reactions. Keeping a detailed journal of your food intake and symptoms throughout the process can help you and your provider pinpoint problematic foods.
  • Don’t stress. Do your best to follow the plan, but don’t worry if you can’t easily identify triggers. You may need to repeat the elimination phase or cut out different foods. Try to be patient during this process.

Resources and Other Types of Diets to Try

Here are some other types of diets you might be interested in learning more about:

The following resources may be helpful if you decide to try an elimination diet:

Editorial Sources and Fact-Checking

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