Elimination Diet Reintroduction

What is an Elimination Diet Reintroduction Chart?

Among the stages of the elimination diet, the reintroduction phase can be the most difficult. Determining the steps involved while attempting to maintain the elimination process can be challenging, as this phase requires strict adherence to its protocols. 

The reintroduction phase aims to increase a person's food options after the elimination phase. This eliminates certain food groups from the diet and gradually adds "challenge foods" one at a time (Keasey, 2014).

Since the foods they are testing may exacerbate symptoms like gas, bloating, or diarrhea that they experienced before beginning the diet in the first place, people may be reluctant to start the reintroduction phase. But to ensure that people get the nutrients they require to live healthy lives, they must eat a varied diet (Mapson, 2022). 

An Elimination Diet Reintroduction Chart is a resource designed to guide individuals in their reintroduction phase. It identifies food sensitivities and helps establish a list of foods individuals can include. It does this by providing a user-friendly approach that involves individually introducing food groups back to the diet, allowing 72 hours between foods used to observe whether symptoms or reactions occur (Carter, n.d.).

If an individual experiences stomach pain, uncomfortable gas, or bloating symptoms, they should stop eating the food immediately and use the chart to document their experiences. They can keep the food item in their diet plan without symptoms. Following the 72 hours or once symptoms have cleared, they can introduce another challenge food and begin the process again until they have cleared their list (Carter, n.d.). 

Using an Elimination Diet Reintroduction Chart, individuals or clients can document their experiences of challenging foods, devise a list of foods they may be intolerant to, and incorporate foods they can incorporate into their normal diet. In doing so, individuals can ensure they consume the essential nutrients required for a healthy gut microbiome and overall lifestyle.

How Does It Work?

An Elimination Diet Reintroduction Chart is a dynamic resource that visually demonstrates the process of the reintroduction phase within an elimination diet. Here’s how it functions:

Step 1: Identify foods to reintroduce

Individuals should make a list of foods that were removed from their diet during the elimination phase. The order in which foods are reintroduced can be sorted in several ways depending on the individual; one method may be by reintroducing foods based on which item they missed most during the elimination phase.

Step 2: Reintroduce one food item

Individuals should be encouraged to introduce one food at a time. The food should aim to be consumed in its purest form. For example, when raising wheat, individuals should aim to consume 100% whole wheat cereal without added sugars or preservatives. Individuals should aim to eat this item in two or three servings a day, for three consecutive days, alongside foods on their elimination diet.

Step 3: Track symptoms and reactions experienced

Across the three days of reintroduction, participants should note any symptoms or changes they may feel with the food item.

Step 4: Reintroduce another food item

Following the three days (72 hours) of reintroduction, if participants are without any symptoms, they may add that food to their food plan and reintroduce a new food item. However, individuals should stop eating food with persistent symptoms and wait for symptoms to stop before reintroducing fresh food.

Step 5: Retry problem foods

After individuals have gone through the list, they may try the food that caused symptoms using the same process as Step 3. If the food causes symptoms again, this may indicate an intolerance or sensitivity to that item, and individuals should immediately stop eating that food.

Step 6: Create a final list

Once all food items have been tested, individuals should have a clear list of food items to include in their diet. Individuals may also have a list of things they may be intolerant or sensitive to and should avoid consuming these food items.

To begin your reintroduction phase in the elimination diet, access our Printable Elimination Diet Reintroduction Chart here or download the PDF copy as a reference.

When Would You Use This Chart?

Our Elimination Diet Reintroduction Chart can be used by practitioners, such as registered dieticians and general practitioners, to guide their clients in the reintroduction phase of their elimination diet. Clients mustn't have any present, persisting symptoms before beginning the reintroduction phase.

• Following an elimination phase: Following the elimination diet phase, it can be challenging to identify a beginning point when navigating the reintroduction phase. This chart can help you or your clients plan and manage the steps involved (Carter, n.d.). 
• Individuals with food intolerances: Individuals experiencing reactions to food groups, such as gluten or dairy products, may use this chart to clarify which products from these foods cause reactions. Some foods may have more than one component. For example, dairy products can include casein, lactose, and whey, but not all dairy products contain all three. Individuals can then use this chart to help them identify which dairy components they may be intolerant to and narrow down which products to include or avoid in their diet (Carter, n.d.). 
• Individuals experiencing inflammation may experience bodily inflammation as a low-grade reaction or food-related sensitivity, resulting in a leaky gut. The chart can be used as a resource in the elimination diet to help identify trigger foods, heal the gut lining, and provide a roadmap for dietary management (Grigorescu, 2020). 
• Gut healing: The elimination diet promotes a primarily plant-based diet, except lean meats like chicken or turkey (depending on which foods are eliminated). Increasing uptake of plant-based items results in a higher intake of essential nutrients and minerals, such as antioxidants and phytonutrients, which heal the gut from toxic substances and inflammation (Grigorescu, 2020). 

This chart can help individuals heal their gut by providing a dietary management strategy that maps out which foods may be causing gut irritation and inflammation and identifies which foods are gut-friendly.

What Do the Results Mean?

When undertaking the reintroduction phase of an elimination diet, experiences may vary amongst individuals depending on several influencing factors. These may include lifestyle, genetics, intolerances, and adherence to the diet. Here are some everyday experiences and what they may mean for an individual: 

• Individuals may experience intolerance symptoms: When reintroducing foods back into their normative diet, individuals may experience inflammation and immune response as a reaction to a specific food item. This can identify which foods individuals may hold intolerances and sensitivities to (Carter, n.d.). 
• Individuals receive a roadmap to their intolerances: By reintroducing foods, individuals can identify which foods they may be intolerant or sensitive towards, allowing them to make informed decisions about which foods they consume. 
• Increased awareness of food items: The reintroduction phase of the elimination diet can enhance an individual’s understanding of food items and their effect on their body. This can be experienced as changes in taste buds or preferences, as well as a greater recognition of the changes in the body when consuming certain foods like trigger foods (Grigorescu, 2020).   
• Reduced Inflammation: By identifying the allergen or inflammatory foods in the reintroduction phase, individuals can reduce inflammation in the body, allowing it to heal. Reducing inflammation can also reduce the risks of developing chronic illness symptoms and autoimmune conditions such as dysautonomia (LB et al., 2022).

The journey to enhancing health and nutritional management can be achieved by accessing our Free Elimination Diet Reintroduction Chart. This resource provides a comprehensive, user-friendly guide to a practical reintroduction phase.

Research & Evidence

The Elimination Diet is a strategic approach to identifying and managing food sensitivities and digestive issues. This diet involves systematically removing certain food groups to pinpoint triggers for symptoms like digestive discomfort, low energy, and weight fluctuations (Grigorescu, 2020). It's a process that not only alleviates chronic symptoms but also offers a chance for the gut to recover from potential damage.

At its core, the Elimination Diet is about understanding how different foods impact your body. Initially, it involves removing potential trigger foods to see if symptoms improve. This phase is crucial for healing and resetting the gut. However, it's equally important to reintroduce these foods gradually.

Avoiding certain food groups long-term, especially those rich in fiber, can deprive the body of essential nutrients and disrupt the balance of gut microbiomes (Grigorescu, 2020; Mapson, 2022). This imbalance can lead to further digestive issues, including conditions like IBS or leaky gut.

The reintroduction phase is a critical component of the Elimination Diet. It involves slowly adding foods to the diet, which is essential for diversifying the gut microbiome. A varied diet ensures that the gut bacteria receive a wide range of nutrients, promoting a healthy digestive system and overall well-being.

The Elimination Diet is highly adaptable, catering to the unique needs of each individual (Karen and Johnson MD, n.d.). It often starts with an educated guess about potential food triggers, guiding the initial elimination phase.

Tools like the Elimination Diet Reintroduction Chart are invaluable during this process. This chart helps document the reintroduction phase meticulously, creating a personalized list of foods to include or exclude, enhancing dietary management, and reducing the risk of health issues related to poor gut health.

The Elimination Diet is more than just removing foods; it's a comprehensive approach to understanding and managing your dietary health. By carefully eliminating and reintroducing foods, individuals can gain insights into their body's unique responses, leading to a healthier, more balanced diet and improved overall health.

References

Carter, L. (n.d.). How to Reintroduce Foods on the Elimination Diet. DrLizCarter.com. https://www.drlizcarter.com/wp-content/uploads/2017/06/Elimination-diet-re-introducing-foods-v1.pdf

Grigorescu, A. (2020). Elimination Diet, Comprehensive Guide. The Institute for Functional Medicine. https://www.anabellegrigorescu.com/uploads/8/0/9/5/80956610/elimination_diet_-_comprehensive_guide_v9.pdf

Karen & Johnson MD (n.d.). The Elimination Diet Explained: The Facts You Need to Know. Karen and Johnson MD. https://karendjohnsonmd.com/dev/wp-content/uploads/2019/10/The-Elimination-Diet.pdf

Kearsey, K. (2014). Elimination Diet: Reintroducing Challenge Foods. Katekearsey.com. https://www.katiekearsey.com/elimination-diet-challenge-foods/

LB Health & Lifestyle (2022). How to Reintroduce Foods After Elimination Diet. LB Health & Lifestyle. https://lbhealthandlifestyle.com/how-to-reintroduce-foods-after-elimination-diet/

Mapson, A. (2022). How to reintroduce foods after an elimination diet. Goodnessme-nutrition.com. https://www.goodnessme-nutrition.com/ibs/how-to-reintroduce-foods-after-an-elimination-diet/