Elimination Diet

Understanding and Management of Food Allergies and Sensativities

Why have I been recommended to follow an elimination diet? 

Your practitioner suspects that certain foods in your diet are causing symptoms of ill health. 

Food allergies and sensitivities can aggravate many conditions, including skin disorders, 

allergies, autoimmune disease, digestive disorders and fatigue, just to name a few. 

The elimination diet program will help you determine if you are sensitive to anything in your 

diet. This is done by initially eliminating the most common food and chemical substances to 

which people are sensitive. Then each suspect food is challenged individually to ascertain its 

effect on your body. 

 The program will help you discover which foods suit your body best, and help you to plan 

the diet most beneficial for your short-term and long-term health. 


How do I follow the diet? 

To begin the program, the Elimination Diet needs to be followed for 7-21 days, to allow 

allergens to clear from the body and symptoms to improve. Any of your symptoms which are 

food-related should have improved after 21 days. 

On the following pages you will find shopping lists for two different dietary plans. Your 

practitioner will let you know which one to follow. It is very important that you eat only the 

foods listed under ‘Enjoy’, and completely avoid the foods listed under ‘Avoid’. Note the 

special instructions for food preparation. 

There is a diary provided in the following pages for you to record your daily diet and any 

symptoms you are experiencing. Daily recording is vital to help you and your practitioner 

identify the causes of your symptoms. 


Why are there two diet levels? 

Most people will start on the General level as a first option, and if required, will move onto the 

Sensitive level. Your practitioner will recommend a level of the diet which suits you. 


1. General Level: 

The General level eliminates the most common dietary allergens, including wheat (and other 

gluten-containing grains), dairy, eggs, soy, nuts, peanuts, fish, shellfish, corn, tomatoes, citrus 

fruits, chocolate, alcohol and caffeine. Most people will find that this diet provides significant 

relief from food-related symptoms after a week or two. 


2. Sensitive level: 

For those individuals who don’t respond to the General Elimination diet, there is another 

dietary plan designed to pick up a wider range of food sensitivities. The Sensitive level is a 

diet based on those foods which are least likely to be responsible for food sensitivities or 

allergies. By limiting the diet to a small number of foods, all probable allergens are removed, 

including salicylates, amines, preservatives, colours, yeasts, legumes and certain meats, as 

well as the foods eliminated in the General levels. 

How will I feel? 

In the first few days of the diet, some people may feel tired or have cravings or headaches. 

This may be a result of withdrawal from caffeine and certain foods. This is a perfectly normal 

response, and won’t last long. Note any symptoms in your diary and please contact your 

practitioner if you have any unusual or prolonged symptoms or any other concerns. After the 

initial adjustment, the elimination of dietary allergens may result in improvement in a wide 

range of symptoms, such as fatigue, headaches, bloating, pain, mood disorders, skin 

problems and more. Once your health symptoms have improved significantly, and you have 

followed the diet for at least one week, you are ready to start food challenges. 



 How do I challenge a food? 

The challenge stage involves reintroducing each group of suspect foods in turn, and 

carefully noting any symptoms in your diary over the following days. Any new or returning 

symptoms experienced are likely to be attributable to that food. The food is then removed 

from the diet to see if symptoms clear again. 


1. The elimination diet is continued throughout the food challenge stage 

2. One new food group is reintroduced every three days (see guide below) 

3. At least three servings of the food need to be eaten on the challenge day, at 2-3 

separate meals 

4. After the challenge day, return to the elimination diet for 2 days, and observe any 


5. If you react to a food on the challenge day, don’t consume any more, and return to 

the elimination diet. After any reaction, continue on the elimination diet until 

symptoms have resolved before moving on to the next challenge. 

6. Challenge foods that cause no symptoms are not incorporated back into the diet 

until all challenges are completed 

7. Challenge foods need to be challenged individually – eg. when challenging eggs, 

don’t serve them with cheese and bread 

8. Use the patient diary to keep a detailed record of all foods eaten and your reactions 

throughout the elimination and rechallenge program 


If you react to certain foods, you are not deprived of that food group forever. However, you 

need to give your body a rest from the foods to which you react for the next 6 months. 

Gradual dietary reintroduction may be possible after this time. 



Do not introduce any food that you can’t remember having eaten before, or have 

had an obvious reaction to in the past. 

The body can become more vigilant for problem foods after they are eliminated for a period 

of time, so when you rechallenge a food, the reaction can be much more noticeable than it 

was when you ate the food in your normal diet. This is very helpful for identifying troublesome 

foods, but it may mean a more severe reaction. With unknown foods or a history of 

reactions, especially facial swelling or breathing difficulties, medical supervision is essential for 

each food challenge. 


Rechallenge protocol: 

Eat the challenge foods listed below divided into to 2-3 servings over the course of the 

challenge day.


SENSITIVE LEVEL – These additional challenges are to be conducted after the above challenges are complete.

 Choose foods you have not identified as offenders – eg. if you are sensitive to dairy, don’t choose the cheese option for amines


I’ve had allergy tests before, why do I need to use this diet? 

Allergy tests, such as skin prick tests and blood tests can be unreliable in around 50% of cases. 

Both positive and negative allergy test results can be false. Food allergies and sensitivities 

can only be accurately identified by careful dietary elimination and rechallenge. 


Will I become deficient in certain nutrients? 

Nutrient deficiency on the program is unlikely if you make healthy dietary choices. Continue 

to eat from all the allowable food groups, including grains, vegetables, fruits, meats, and fats 

and oils. Your practitioner may prescribe specific hypoallergenic nutrient supplements if you 

require them. 


Any handy hints to make the programme as easy as possible? 

• Involve the whole family. This will make meal planning easier and can improve your 

family’s health. 

• Try to start the diet at a time where you are free from social engagements and when 

stress levels are low, in order to make the adjustment easier. 

• Children and their carers need close supervision to ensure they do not sneak in 

"treats" which may invalidate the diet; it may be helpful to wait for school holidays 

before starting the program. 

• If there’s a dinner or a party you can’t postpone, you can break your diet for a day 

and treat the occasion as a food challenge. Record food consumption and 

symptoms as usual, and return to the elimination diet for at least 5 days until 

symptoms clear. 

• If you consume caffeine on a daily basis, you may want to gradually reduce your 

intake over the week preceding the diet to reduce withdrawal symptoms 

• Cook larger meals than you will eat so you have leftovers for snacks the same day. 


For more information contact us on 07 83 83 83 2

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