Elimination Diet

When nutrition researcher Jeffrey S. Bland, Ph.D., needed volunteers to follow an elimination diet-that is, to avoid certain foods with the goal of improving health-he found 106 willing participants in the Seattle area. The group consisted of 92 women and 14 men, ranging in age from 28 to 55. All were considered healthy, meaning that physical examinations and mainstream medical tests had turned up nothing out of the ordinary.

Yet these people didn't feel well. They reported an array of vague, chronic symptoms: fatigue, muscle aches, joint pains, digestive upsets, headaches, sleep disturbances, and lapses in memory and concentration that several described as brain fog.

Mainstream physicians are not wellequipped to help people with such complaints. When standard exams and tests find nothing abnormal enough to qualify as disease, most conventionally trained doctors are at a loss. They may admit as much. Or they may decide that patients with vague, chronic symptoms are hypochondriacs. Or they may suggest that these people see psychiatrists. Meanwhile, the patients bounce from one doctor to the next, looking for answers and getting increasingly frustrated with the healthcare system.

But the group from Seattle was lucky enough to capture the attention of Dr. Bland, founder and chief executive officer of HealthComm International in Gig Harbor, Washington. First, he had the group members complete a questionnaire in which they rated the severity of their symptoms. Then he administered six tests, including one that measures the liver's ability to remove potentially harmful substances from the blood and another that measures the "leakage" of certain molecules from the digestive tract. These tests are seldom used in mainstream medicine, but they are considered standard by naturopathic physicians, who are more nutrition-oriented.

Next, all 106 study participants began an elimination diet. They gave up dairy products, beef, pork, veal, alcohol, caffeine, and foods containing gluten, the protein that gives bread products their spongy elasticity. They were allowed to eat rice and corn but not wheat, oats, rye, or barley. In addition, 84 of the participants took a multivitamin/mineral supplement.

After 10 weeks, Dr. Bland had the entire group fill out the symptom questionnaire a second time. Those on the diet-only regimen recorded a 22 percent improvement in symptoms. That figure jumped to 52 percent among those on the diet-plus-supplement regimen. These people also showed significant improvement on three of the six tests of digestive and liver function.

Confusion over Food Allergies

Some people benefit from an elimination diet because they have food allergies. In a true allergy, exposure to an offending substance-called an allergen-triggers a quick, predictable response. In hay fever, for example, exposure to pollen kicks in a massive release of histamine, a compound that in turn produces nasal congestion, runny nose, and itchy, watery eyes.

According to the American Academy of Allergy and Immunology, an estimated 2 percent of adults and 5 percent of children experience this type of reaction to foods. In a true food allergy, eating even a morsel of an offending food-peanuts, for example-quickly produces symptoms. Your tongue will likely swell or itch, and you'll get a rash on your skin. You may also develop a headache, stomach cramps, extreme flatulence, and diarrhea. In rare cases, an allergic reaction may result in anaphylaxis, a potentially life-threatening condition in which blood pressure drops, the throat swells shut, and breathing becomes difficult.

But the vast majority of people who experience problems when they eat certain foods don't have true food allergies. Jonathan Brostoff, M.D., director of the allergy clinic at Middlesex Hospital in London, estimates that up to 10 percent of the general population has food intolerances, in which vague symptoms usually develop gradually and unpredictably.

Food Intolerance?

Eliminate the Possibilities

If you suspect that you have a food intolerance, you may benefit from an elimination diet. But before you try one on your own, Anne Simons, M.D., suggests pursuing a blended-medicine approach. Start with a visit to your primary-care physician to rule out other potential health problems-for example, an ulcer or colitis. Then consult an allergist or immunologist, who can test you for allergies. If you don't have any, you can follow an elimination diet to help pinpoint the source of your symptoms. Your doctor or practitioner can guide you through the steps.