Working exclusively with elimination diets gives much insight into how avoiding common foods can often result in nutritional gaps in your diet. Tweaking what you eat to manage food issues needs to benefit you, and not cause other problems!
Some food eliminations will matter more than others- lets look at which ones you need to be extra careful about and what you can do to make sure what you are eating is supporting your individual health.
Tip #1 - If you are eliminating dairy foods: you need to replace more than just calcium.
Many people with food issues take out dairy from their diet and replace with foods such as almond milk and coconut yoghurt. These foods are great in filling that emotional hole left by removing dairy but may not be replacing the lost nutrients..
We all know about needing to replace calcium- have you checked if these dairy replacement foods provide the equivalent amount of calcium as their dairy counterparts?
Look for 250-300mg calcium per serve of the dairy free milk and yoghurt- some brands are better at doing this than others. Coconut yoghurt and ice creams tend not to provide calcium at all.
What about the energy (calories) and protein provided by dairy? Often our dietary intake is pretty good with providing protein with meats, legumes and nuts & seeds filling that gap nicely. Maybe more of an issue if going vegetarian or vegan: non animal protein sources need to be purposely added to the diet, with nuts, seeds and legumes leading the charge and of course (if tolerated)- soy, and any calorie deficit made up with alternative protein and energy sources.
Tip #2 - Taking out wheat can leave gaping nutritional holes
Taking out some foods really matter if they represent a whole food group. Wheat is an excellent example as it represents a whole food group and is commonly self excluded in food in people with food sensitivities.
Wheat can be replaced by many wheat free alternatives such as oats, and if going gluten free the replacement with gluten free grains such as quinoa, buckwheat, rice, millet, teff, and corn can really help to fill these gaps. We are spoilt by the variety of gluten free foods to choose from such as the many GF breads readily available.
The secret is to choose WHOLEGRAIN wheat free or gluten free grains as this is the best way to support your biome in your gut. There is much talk about 'healing the gut' but not enough being said about choosing a VARIETY of WHOLEGRAIN TOLERATED GRAINS. Wholegrains are key to supporting a healthy community of microbes in our guts, and not meeting this need may mean we are not properly supporting our gut health in the long term.
What does wholegrain mean? It means less processed, for example w bread with +++ seeds and more wholemeal than white, it means quinoa in its most natural state, it means rolled oats or buckwheat flakes. It means brown rice over white rice, it means popcorn over chips.
"Research ranks diets low in whole grain as second only to diets high in sodium in causing greatest risks of morbidity and mortality." – https://www.mdpi.com/1129924
Wholegrain not only are packed with dietary fibre but boosted levels of magnesium, potassium, selenium, zinc, iron, iodine, folate, niacin, vitamin E, and phytochemicals and these elements are thought work synergistically in producing health effects.
If you are avoiding wheat- make it a priority to include many different wheat free or gluten free wholegrains to enhance your gut biome and long term health.
Always check for Coelaic Disease with a blood test before removing wheat from your diet or your child's diet.
Tip #3 - Elimination diets risk unwanted weight loss: know how to keep in healthy energy foods
Every body assumes that weight loss is a good thing- it is not if it is the result of a restricted diet and consequent under nutrition. Nobody benefits from a poor nutritional quality diet.
Keep in the healthy calories (yes they do exist!).
Energy comes from the macronutrients: protein, fats and carbohydrates. There are plenty of healthy choices for all of these.
Healthy fats: we all know about omega 3 fatty acids: think salmon and other higher fat fish, avocado, olive oil, and of course nuts and seeds and their pastes/butters (best choose unsalted or low salt). If your food elimination means these choices are out of reach, talk to your Specialist Dietitian for alternatives.
Healthy proteins: eggs, nuts, seeds, legumes, fish, seafood and lean meats all come to mind. Have meats in moderation, unless the type of elimination requires more, while plant based protein foods such as legumes, seeds and nuts provide a plethora of wonder health promoting nutrients such as whole grain fibre and many micronutrients.
Carbohydrates: all prove energy, with extra carbohydrates essential with breast feeding (9 normal serves as apposed to 5, with a serve = 2 slices bread according to the Australian Dietary Guidelines). Choose wholegrain for 70% of your starchy choices. It is a state of fact that overall, we tend to eat far to many of the processed non wholegrain types.
Tip #4 - Aim for balance
A quick look at the Australian Dietary Guidelines gives you an idea of the amounts and types of foods across the food groups you need to meet you macro and micronutrients needs.
The usual pattern is more fruit than required (but if you are not having enough, try to have 2 whole fruits a day, and less commonly in a processed form), up the vegetables to AT LEAST 5 handfuls a day (most of us don't eat enough!), increase those wholegrains, reduce those treat foods (do we really need multiple treat foods daily?), choose healthy fat sources, moderate meat intake, and get enough low fat dairy foods to meet your calcium needs (usually 3 serves daily, one serve being a small tub of low fat yoghurt or a glass of low fat milk).
You don't need to eat exact amounts each day, just average out over a few days to overall meet your needs. Check out recommendations at this website: https://www.eatforhealth.gov.au/sites/default/files/content/The%20Guidelines/n55a_australian_dietary_guidelines_summary_131014_1.pdf
Check out the Mediterranean diet- the best evidenced based eating plan for supporting a healthy long life!
Tip #5 - Eliminate triggers- not nutrients
Knowing a little bit more about what we need to eat to be healthy can help you navigate an elimination diet without losing essential nutrients. Finding alternatives is the key. To make the process easier, knowing which food products to choose can help enormously in making your elimination easier to implement and help you more easily discover your food triggers. Do it once, do it right and don't put your dietary health on the line.
Elimination diets: get professional health to safeguard your nutrition
Elimination diets should be short term with with minimal eliminations as required to investigate your food triggers and always, replacements suggested to replace the inevitable lost nutrients.
Being told to avoid a list of foods without being told how to do this may end up causing more issues than it solves.
Enlist the help of a Food Intolerance Dietitian in food intolerance and diet elimination to fast track your goal and support you through the process.
Eliminate the triggers: not the nutrients!