Elimination diets remove a food or group of foods from a person’s diet for a set period of time. This helps determine whether specific foods or ingredients in foods contribute to symptoms. Diets are individualized based on each patient’s history, eating patterns, and overall symptom picture. Examples of common elimination diets include gluten-free and/or dairy-free elimination trials, a low FODMaP diet, and more comprehensive elimination diets.

The process of outlining and then following an elimination diet can take effort and time both for practitioners to explain and for patients to conduct. However, successfully discovering adverse food reactions can potentially alter the courses of several diseases and lead to profound symptom improvements.¹

Defining Adverse Food Reactions

In 2010, the National Institute of Allergy and Infectious Diseases’ expert panel of the United States proposed definitions for adverse food reactions (AFRs).² AFRs are classified in two distinct categories, immune-mediated and nonimmune-mediated.

• Immune-mediated AFRs include food allergies; these may be immunoglobulin (Ig) E-mediated, non-IgE mediated, mixed IgE-mediated, or cell-mediated responses.
• Nonimmune-mediated reactions (primarily food intolerances) may be caused by metabolic/enzymatic, pharmacologic, toxic, or infectious agents, or can be structural or psychosocial in origin.

AFRs can also be undefined and idiopathic in nature³ and in this case are often referred to as a food sensitivity.

Testing for Adverse Food Reactions

Food allergies that are IgE-mediated, can be accurately assessed through widely available tests. Anyone with a suspected Ig-E mediated food allergy should work closely with a trained allergist or physician since the reactions can be life-threatening.