Monday, July 15, 2024

Food Intolerance and Elimination Diet



When evaluating nutritional status, it should be taken into consideration that each individual’s metabolism is different and that their body may react differently to different foods. Genetic, environmental, socio-economic conditions, intestinal barrier integrity, presence of dysbiosis, exercise, hormone levels, stress, etc. Many factors can cause foods to be perceived as friend or foe by the body. Food intolerance or non-allergic food sensitivity is the term used for various physiological responses associated with compounds found in foods. Although a food, beverage, food additive or a compound found in food may cause symptoms in one or more organs and systems, we cannot talk about true food allergy here. For this reason, various autoimmune diseases, neurological diseases, easy weight gain, and some hormonal imbalances may occur. In food allergies, the reaction to the food occurs immediately after ingestion of the food, whereas in food intolerance, the reaction to the food can usually occur gradually, a few hours after consuming the food (24 hours or 48 hours). The relationship between the food and the reaction to the food is not obvious; this effect may be masked. For this reason, food intolerances may also be used as “masked food allergy” instead of “food intolerance” in some sources. It is difficult to pinpoint the food that causes the reaction in food intolerance. Symptoms may begin with complaints such as headache and chronic fatigue, which can be seen in almost everyone, and as long as some foods that cause the reaction continue to be consumed, people’s health may be negatively affected. If a person is exposed to excessive amounts of toxicants, pesticides, or other synthetic chemicals, the more quickly food intolerance reactions can occur. Food intolerance occurs in the body such as diarrhea, constipation, reflux-gastritis, gas bloating, nausea vomiting, itching-redness on the skin, brain fog, depression, memory problems, headache-migraine, swelling-pain in the joints, fatigue, edema, weight gain may cause symptoms.

People with food intolerances may experience changes in symptoms from day to day. When questionable food is consumed, stress etc. If changeable factors also come into play, changes such as an increase or decrease in symptoms may occur.
These disorders can negatively affect people’s health and quality of life. The most clinically preferred treatment to prevent the occurrence of these symptoms is the elimination diet. Elimination diet is a treatment method characterized by removing foods that have the potential to affect negatively the person from the diet and then gradually adding the removed foods and identifying the foods that cause negativity.
This diet should be followed for at least 3 weeks. Sometimes the process can be extended up to 6-8 weeks. Afterwards, the foods removed from the diet are added to the diet one by one and any symptoms that may occur in the body are monitored. After each new food is tried, the body is observed for 72 hours. If no symptoms occur, a new food is added to the diet after 72 hours and the same protocol is followed. If the newly added food causes symptoms in the body, the symptoms should be waited for the symptoms to improve before trying a new food and this food should be removed from the diet for another 3 weeks.

During the elimination diet process, the 5 R protocol is applied.
Remove: Remove foods to which the person is sensitive or intolerant from the diet.
Replace: Replace stomach acid, bile or digestive enzymes that may be deficient.
Reconstruction: Rebuild the intestinal flora with pre-probiotics.
Repair: Repair the intestinal wall with nutrients such as bone marrow water, collagen and L-glutamine.
Rebalance: Regain balance with lifestyle changes such as healthy eating and exercise.

During the elimination diet application process, the foods to be eaten must be planned, procured and prepared in advance. It may be difficult to find food suitable for the plan due to the sauces and methods used outside. Since there are many restricted nutrients, the missing nutrients should be replaced by using food supplements. The elimination diet program must be implemented together with a dietitian.
As a result, the elimination diet, the foods that cause the person’s symptoms are identified and a new diet is created accordingly. During the elimination diet process, intestinal integrity, increased microbiota diversity, decreased chronic inflammation in the body, weight loss, and a decrease in the symptoms of chronic diseases can be achieved by consuming foods with high antioxidant content, high fiber content, and high probiotic content.

Esra Toktay
Instagram: @uzmandiyetisyenesratoktay


  1. Brostoff J, Gamlin L. Food Allergies and Food İntolerance: The Complete Guide to Their İdentification and Treatment. United States, Healing Arts Press, 2000.
  2. SAĞLIK & BİLİM 2022: Beslenme-2, 2022 –

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