Elimination Diet Basics

[quicksilver3121]

I'm really having trouble finding some good and basic foods to start an elimination diet with. I really don't know what are safe or trigger foods for me.

Can anyone give me an idea of a basic starting elimination diet? I've cycled through a few different diets in the past 2 months during this flare but nothing has seemed to help. I think I've had too many bad meals on weekends to know if anything truly works :-(.

Things feel like they might be getting worse so I'd like to try a true elimination diet to see if I can figure out what foods are alright and what are bad for me.

 

[ebarker2]

I like

The Elimination Diet: Discover the Foods That Are Making You ...
Book by Alissa Segersten and Tom Malterre

My thinking on food has changed a lot though since i read this.

The basics are to stop all processed foods. That is already a complex issue, but I'm more and more convinced its the biggest part of the story.

Then make sure that you are mostly eating high quality vegetables. Avoid all grains for the moment.

Here are some other recommendations:

• Ensure each meal contains resistant starch and fermentable fiber. Feed microbiome 1/3 of daily food, to ramp up SCFA ie. butyrate.

Resistant Starches sources:

Plantain is best. Green bananas Oats, cooked and cooled potatoes and rice.

Fermentable fibre sources:

Jerusalem artichoke, asparagus, celeriac, chard, root vegetables, Chicory Root, Acacia gum, brussel sprouts, oranges, flax seeds, seeweed (carrageenan), onions.


• Quality of ingredients is key.

• Focus on freshness and quality of fats. No industrially fried food ever. That means no crisps or fake crisps. Eat only oil from olives, avocadoes, coconut. Only heat coconut oil to cook, very low heat, do not heat other oils. Rancid/burnt oils are main source of lipopolysaccharides. Seriously toxic especially in combination with alcohol. Raw chocolate is fine. Cooked chocolate the chances are that fats are rancid/burnt.

• Protein: high quality, raw where possible. small amounts of Parmesan cheese, Jarlsberg for Vit K2. Raw duck eggs and wild eggs. Lamb, liver, small amounts of red meat, preferably raw. Never charred ever. Raw fish, cooked in lemon. When eating lentils and chickpeas soak 24 hours cook 2 hours. Nuts should be fresh, not roasted, still in shells or they go rancid. Not many nuts, but good variety.

• Max. 25 grams fructose max. i.e. 3 bananas day, 3 fruits. If drinking alcohol reduce fructose/sucrose to 0. But avoid alcohol if at all poss..

• Dark leafy greens and salads every meal. Fresh organic vegetables make up 80-90% of bulk and diet. Favour tubers and root vegetables. Purple sweet potato, beetroot.

• 24 hour protein fast every 7 days can really help, and/or 14-17 hour intermittent fast every so often.

• Reduce grains to a minimum. Mostly white rice, cooled.

• Snack on fresh food, fresh veg. Carrots, fennel, Jerusalem artichoke. Try to avoid snacking on the go. Better to be hungry.

• Eat mindfully. If digestion is not particularly good, improve vagus nerve tone; drink bitters with each meal or after meal, hum, sing, omm, wash face in cold water. Research Vagus nerve support for more info.

 

[quicksilver3121]

I have inflammation and bleeding already, so I don't think fresh veg is a good idea right now. I would really like something which is soothing to the gut, but doesn't trigger any auto-immune responses at the same time.

 

[Cat-a-Tonic]

Last year I did a liquid elemental diet for a little while to try to get my flare under control. When I started introducing foods again, they told me to stick to the low-FODMAP diet, so I did that. At first I did just very basic foods, mostly chicken broth and white rice. Then I'd add in one food at a time, like baked fish and then baked chicken, rice crackers, almond milk, and so on. I used the low-FODMAP diet as a guideline and from there I picked out foods that were very bland and low-fiber that I knew would probably be easy on my system. That worked quite well for me. I also journaled everything that I was eating and how I was feeling, so that I could correlate symptoms to what I had eaten. I'd definitely recommend keeping a food & symptom journal, that was very helpful to me. Good luck!

 

[ebarker2]

Sorry yes that list represents where we are trying to get to. For inflammation right now, cut right down to a high quality bone broth. Then after symptoms die down a bit, try adding some juices (kale, cucumber, spinach etc). See if any combo of the light green veg. juices is ok. If not, try soups of sweet potato and beetroot, blended. Then, as things pick up, White rice, cooled if poss, if not, in bone broth.

Once inflammation is down (this could take weeks but hopefully things will calm down in a few days), then start looking to the resistant starches; see if you can take inulin (in water as a drink), and acacia powder. These will already start feeding the microbiome.

its an important process to get started so the mucosa can mend.

The auto immune response is being triggered through intestinal permeability. Beyond gluten and processed foods, other things can trigger it. One of the standard triggers is sodium lauryl sulphite so make sure there is none in the house, in detergents, toothpastes etc.

Also lower stress, and avoid ingesting or contact with toxins like paints, cosmetics etc. Sleep is important to healing.

 

[ebarker2]

Last year I did a liquid elemental diet for a little while to try to get my flare under control. When I started introducing foods again, they told me to stick to the low-FODMAP diet, so I did that. At first I did just very basic foods, mostly chicken broth and white rice. Then I'd add in one food at a time, like baked fish and then baked chicken, rice crackers, almond milk, and so on. I used the low-FODMAP diet as a guideline and from there I picked out foods that were very bland and low-fiber that I knew would probably be easy on my system. That worked quite well for me. I also journaled everything that I was eating and how I was feeling, so that I could correlate symptoms to what I had eaten. I'd definitely recommend keeping a food & symptom journal, that was very helpful to me. Good luck!

Glad that worked. My concern with the low FODMAP diet is that it actually starves the microbiome. While that will help with issues like SIBO, in the longer term it seems to me a recipe for damage to the mucosa and the epithelial wall.

The problem of what we can and can't process is really complex because its not just about inflammation to the gut wall; its also about having the bacteria to help the process of digestion, and having the hydrochloric and bile acids to break the foods down in the first place. If you don't eat fiber, the bacteria that break it down will die out, so it becomes much harder to process. The remedy may be to introduce fibrous foods in very small amounts and work up.

 

[Cat-a-Tonic]

I didn't mean to imply that I get no fiber in my diet - I do make sure to get soluble fiber every day. I have a teaspoon of psyllium husks daily and I also eat oatmeal regularly.

 

[Magnolia24]

There is a free guide you can download on scdlifestyle.com It walks you through the steps of the elimination diet, and slowly adding in more foods in a really clear and simple way. I found it really helpful when I started SCD.

 

[The Real MC]

The perplexing thing about CD is that no two patients have the same trigger foods.

A good place to start is the bland diet. Stick to it for a few days until inflammation goes down. Then gradually introduce other foods while keeping notes which ones are safe and which ones are not. It can be painful, but it worked for me and the benefits were worth it.

I found that outright elimination wasn't always necessary. For example, while I can't eat raw nuts, cooked nuts and peanut butter don't bother me.

Abstract the trigger foods down to the lowest common denominator. In my case I found that tabasco sauce and similar condiments along with pepperoni pizza caused problems, so I abstracted those two trigger foods to hot peppers. Narrowing the list makes it easier to remember.

I agree 100% with the caution on processed foods. I found that they irritate my system. A lot of restaurant chains use processed foods which led me to cut way back on eating out. Processed cheese will cause a blockage on the adhesions on my resection points - it landed me in the hospital the day after a dinner at Friendlys, in which the swiss cheese on the burger was tougher than usual (and I ordered swiss to steer clear of processed american cheese!).

A lot of processed foods - some you would least expect - are sold in grocery stores. One example is balsamic vinegar, which I love on salad. When balsamic vinegar started causing problems, one check of the ingredients on the bottle revealed it was not real balsamic vinegar. When I got the real stuff, I was fine. Reading the ingredients when grocery shopping is essential.

 

[wild_one353]

start with a low sugar and high fiber diet, make sure you get essential macronutrients: fat protein carbs, and micronutrients: calcium potassium(beans potatoes bananas) etc. and a general variety but again its supposed to start out simple.

The main ideas id say are to have a control period which will be used a comparison to yoru experimental period, the control period could be about 1-2 weeks where you follow this basic diet and record your current state of health or whatever you are tracking, sleep, gi issues, energy levels etc.
For experimental period, change one variable that you will test for 1-2 weeks and see how it affects you, and then compare this to your control period and decide if there is any improve of declines you can attribute to the new change/experimentation period. This is how I've done it for years and developed my regimen testing hundreds of things, if you want to know what I've discovered send me a message or go it completely alone if you wish.

 

[Jess_inToronto]

I agree with a lot of what Real MC has said. Trigger foods are different for everyone, and because of this, even a "standard" elimination diet works differently for each person.

Keeping a food diary is therefore extremely important. I followed a paleo diet for six weeks with no improvement before my diagnosis of CD, but I kept a detailed food and symptom diary. So I could at least identify a few foods that made things WORSE, even if "better" wasn't a state I reached on that diet.

Ditto on avoiding processed foods. Even if you have to check the ingredients on everything you eat for a while (and unfortunately doing so makes you want to lie down on the aisle in the grocery store and sleep), knowing what you're eating is extremely important. Don't assume that just because the bag says "rice cakes" the only ingredient will be rice.

 

[dejavucandace]

I have inflammation and bleeding already, so I don't think fresh veg is a good idea right now. I would really like something which is soothing to the gut, but doesn't trigger any auto-immune responses at the same time.

I hear yah. Very hard to eat healthy and avoid more inflammation/bleeding/pain. I am seriously considering paying the $400 CDN for a food allergy/sensitivity test. You reach a point where you are scared to put anything in your mouth but then wonder how to ever find out exactly what is the problem.