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Elimination Diet


The Elimination Diet is designed for those individuals who have expressed sensitivities to certain foods, and are attempting to identify those foods. Atypical reactions to food can either be a result of a true food allergy or a hypersensitivity reaction. Adverse responses to gluten in wheat or casein in milk may be considered an allergic response, whereas reactions to bisulfite, tyramine, or erythrosine dye (coloring) in foods may be considered a non-immunologic hypersensitivity reaction. The food elimination diet allows for the recognition of both these types of adverse atypical reactions to food.

Symptoms which may suggest the need for use of the elimination diet include:

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Itching of the eyes or nose after eating Runny nose
Headaches Hay fever-like symptoms
Eczema Nausea
Bloating after meals or diarrhea Vomiting
Congestion or phlegm of the bronchial tubes after certain foods

The Elimination Diet is prescribed for five to seven days and is composed of foods known to have a low hypersensitivity. Food intake is limited to such foods as rice, lamb, gelatin, peaches, pears, carrots, lettuce, artichokes, sesame oil, apples, salt, sugar, jams, and jellies. All medications are usually eliminated, including vitamin pills and aspirin, as well as products such as beer, coffee, and chewing gum. By the end of the seventh day, all symptoms should be relieved, after which new foods are added one at a time at regular intervals, usually one to four days. The patient is instructed to keep a food diary, recording the time new foods are consumed, as well as any allergic reactions which might occur. Hypersensitivity is confirmed by correlating repeated appearance and disappearance of symptoms with consumptions and exclusion of the suspected food at one to four day intervals. From this information, a rotation or exclusion diet can be developed for management of the problem.

Specialized Elimination Diets which limit protein intake exclusively to animal or vegetable sources have also been devised.

The nutritional adequacy of the Elimination Diet depends upon the duration of the diet, as well as the number and types of food sensitivities.

If a severely restricted diet is followed for an extended time period, serous vitamin, mineral and caloric deficiencies can occur without supplementation. Diets of this type are usually prescribed for only five to seven days.

With a less restrictive Elimination Diet which permits foods from all food exchange groups, it may be possible to consume adequate amounts of all nutrients, though supplementation with additional vitamins and minerals is recommended once it is been determined that these are not a source of the reaction.

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1/2 grapefruit 2 ounces of lamb liver, sauteed
2 teaspoons sesame oil 1/2 cup brown rice
1 tablespoon maple syrup  


1/2 cup grapefruit juice 3 ounces ground lamb patty, broiled
1/2 cup raw carrots 1/2 cup steamed spinach
1/2 cup lime gelatin  


1/2 cup grapefruit juice 4 ounces lamb leg, roasted
1 baked sweet potato 1 pear
1 rice biscuit  1 tablespoon grapefruit marmalade 
1 cup romaine lettuce   2 teaspoons sesame oil and lemon juice dressing 

Nutrient Content:

Calories: 1,467 Fat: 30%
Cholesterol: 250 mg Protein: 17%
Fiber: 15g   
Carbohydrate: 53%   

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The foods which are most commonly reported to cause allergic reactions are:

Milk Eggs Beef Chicken
Fish Pork Wheat Strawberries
Nuts Chocolate Corn Tomatoes
Shellfish Oranges Cola drinks

Certain food additives and artificial coloring agents have been implicated as well.

The following Elimination Diet is presented for information and comparative purposes only. It should not be considered appropriate for all persons with suspected food allergies.

The number of food exchange list units listed below apply only to the sample Elimination Diet.

Bread and Cereal Exchange List:


Rice Tapioca
Rice biscuit Rice bread
Sweet potato  Plain, lemon or lime flavored gelatin 

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• All wheat and corn products

Fat Exchange List:

4 or more servings per day


  • Sesame oil

Avoid: All others

Fruit Exchange List:

3 or more servings per day


  • Lemon
  • Grapefruit
  • Pear

Avoid: All others

Meat and Meat Substitute Exchange List:

8 servings per day


  • Lamb

Avoid: All others

Milk Exchange List


  • None

Avoid: All

Vegetable Exchange List:

2 servings per day


  • Lettuce
  • Swiss Chard
  • Spinach
  • Carrots

Avoid: All others

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Miscellaneous Exchange List


Sugar cane Salt
Royal baking powder Baking soda
Cream of tartar  Lemon extract 
Vanilla extract  Maple syrup (made from sugarcane flavored with maple extract) 


All others not noted above


Include six to eight cups of fluids, such as purified water, per day.


Alpers, D.H., R.E. Clouse, and W.F. Stenson. 1983. Manual of Nutritional Therapeutics. Little, Brown, & Co., Boston, 457 pp.

Lowlor, G.J. Jr., Fischer, T.J., "Manual of Allergy & Immunology". Little, Brown & Co., Boston, 1981.

Pennington, J. 1978. "Nutritional Diet Therapy", Bull Publishing Co., Palo Alto, Ca., 106 pp.

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