Food sensitivities are becoming more prevalent, affecting an estimated 20% of the global population who may face food intolerances or allergies. Additionally, numerous individuals endure symptoms such as bloating and digestive discomfort, prompting them to eliminate certain foods to alleviate their issues.
However, removing foods from your diet without appropriate medical advice is not a sustainable solution and can result in nutrient deficiencies. Read on to learn more.
What is the Difference Between a Food Allergy and an Intolerance?
Food allergies trigger acute reactions almost immediately, with the most severe being anaphylaxis. In contrast, food intolerances are less severe and harder to diagnose. These intolerances often arise when the body lacks the enzymes needed for proper digestion, leading to delayed symptoms such as bloating, headaches, or skin rashes. While skin-prick tests and blood tests are available, the most effective and reliable way to identify problematic foods is through an elimination diet.
Learn more about intolerances and whether you should consider a food intolerance test, along with various recipe ideas for those with food sensitivities, including gluten- and dairy-free options.
What is an Elimination Diet?
An elimination diet is a simple and free way to determine if you have a food sensitivity. It requires no medications, just a commitment to following the plan diligently for accurate results.
This diet should be followed for the shortest time possible to notice symptom improvement. Before starting, gather all necessary information and consult a qualified health professional to ensure your nutritional needs are met and to address any other aspects of your health. For example, if you’re being tested for coeliac disease, it’s crucial not to eliminate any foods until all testing is complete.
How Do I Follow an Elimination Diet?
The NHS recommends tracking your symptoms associated with specific foods to diagnose a food intolerance. After identifying potential culprits, restrict them one at a time to observe any improvements in your symptoms. This trial-and-error method can help pinpoint problematic foods; you might discover that you can tolerate them in moderation.
An elimination diet is best executed using the ‘three Rs’ approach:
- Record – Start by keeping a diary or a digital tracker to note what you eat, when, and any symptoms you experience. Be comprehensive, including snacks, drinks, and condiments, and do this over a 7- to 14-day period. Afterward, analyze your findings to identify any food or drink that may be problematic. If you suspect wheat or gluten, consult your GP, as they may wish to test you for Coeliac disease before eliminating any foods. Similar tests may be recommended for lactose or fructose issues.
- Restrict – Once you’ve identified suspected foods, educate yourself about alternatives and begin eliminating the problematic items while monitoring your symptoms. If multiple foods were flagged, consider consulting a dietitian to avoid nutritional deficiencies. This phase may take time, so refrain from rushing.
- Reintroduce – This step confirms your suspicions and helps you gauge your tolerance threshold. Start by reintroducing a small portion of the suspect food on the first day, gradually increasing the amount over time. If symptoms arise, pause until they resolve before testing another food.
An elimination diet should be used for as short a time as possible, followed by the reintroduction of foods to assess your tolerance levels. This approach ensures a balanced diet while minimizing negative impacts on beneficial gut bacteria.
If you suspect your symptoms stem from a genuine allergy, consult your GP for a referral to an NHS-approved diagnostic IgE testing facility, which can also provide professional dietetic support.
What Are the Most Common Foods Associated with Intolerance?
-
Fructose
This natural sugar is found in fruits, honey, and certain syrups. If you suspect fructose intolerance, you should also limit your intake of sucrose (table sugar), high-fructose corn syrup, fruit and fruit juices, sorbitol, and sweetened beverages. Common signs of fructose intolerance include abdominal pain, gas, bloating, and diarrhea. The FODMAP diet may be beneficial in managing IBS symptoms.
-
Wheat
Wheat is frequently identified as a cause of digestive disturbances, including bloating. When investigating a wheat intolerance, it’s important to completely eliminate flour and flour-based products, as well as other foods that may contain wheat. Intolerance can vary among individuals; some people may tolerate alternative grains better. If you suspect a wheat intolerance, completely remove it from your diet. You may find that you can handle small amounts of older grain varieties like spelt or kamut, which are higher in fiber and lower in gluten.
-
Gluten
Gluten is a protein found in many grains, particularly in wheat, rye, and barley. Its elasticity makes it a crucial element in many baked goods. Some individuals are intolerant to gluten from all sources, while others may only react to wheat. Diets high in refined carbohydrates can contain substantial amounts of gluten. If you find you can’t tolerate gluten-containing grains, consider using rice, corn, or potato flour. Consult your GP before making dietary changes if gluten is a concern; eliminating it before testing can yield false negative results. Learn more about a gluten-free diet and uncover common misconceptions regarding gluten-free foods.
-
Glucose
Glucose intolerance encompasses various metabolic conditions that lead to elevated blood sugar levels. If you have impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), your body struggles to regulate glucose effectively, causing hyperglycemia. Diagnosis requires medical evaluation. Symptoms may include excessive thirst, dry mouth, fatigue, blurred vision, and frequent urination. Seek medical advice if you suspect glucose intolerance.
-
Lactose
Lactose is a sugar present in all animal milks, and the body requires the enzyme lactase to digest it. Insufficient lactase leads to fermentation, causing symptoms such as bloating, gas, and diarrhea. Many adults lose sufficient lactase production, resulting in lactose intolerance. Those affected may tolerate small amounts of butter, cheese, or yogurt, while others may avoid dairy entirely.
-
Alcohol
Intolerance may stem from alcohol itself or from the ingredients in alcoholic beverages (e.g., grapes in wine or grains in whiskey). Alcohol can disrupt gut health, explaining why some individuals experience digestive discomfort when consuming it with food. Common triggers include red wine, whiskey, and beer. Symptoms of alcohol intolerance can also include nasal congestion and skin flushing, often related to an enzyme deficiency that impedes alcohol breakdown. Intolerance may also arise from other ingredients found in alcoholic drinks, particularly beer and wine, such as sulfites and preservatives.
-
Histamine
Histamine occurs naturally in various foods, and some items act as histamine liberators, prompting our bodies to release histamine. An enzyme called diamine oxidase is responsible for breaking down histamine, but many people do not produce enough of it. Consuming histamine-rich foods may result in headaches, skin rashes, itching, diarrhea, and abdominal pain. Foods high in histamine include wine, beer, cider, pickled items, cheese, tofu, soy sauce, processed meats, and chocolate. For more information on histamine intolerance, visit allergyuk.org.
-
Yeast
Yeast is present in foods such as bread, baked goods, and alcoholic beverages. Symptoms of yeast intolerance can include flatulence, bad breath, fatigue, irritability, sugar cravings, stomach cramps, skin issues, and indigestion. If you suspect yeast intolerance, eliminate it from your diet for a few weeks. Noticeable improvements may indicate yeast as the culprit.
-
Salicylates
Natural chemicals produced by plants, salicylates are found in foods like prunes, broccoli, and cumin. Though less common, intolerance to salicylates can provoke reactions even with minimal intake. A low-salicylate diet may be beneficial.
For more information on food intolerances, visit allergyuk.org.
Read More on This Topic…
What Is a Dairy-Free Diet?
What Is a Gluten-Free Diet?
What Is the Candida Diet?
Top 20 Low-Histamine Foods
This article was last reviewed on 27 March 2024 by Kerry Torrens.
Kerry Torrens is a qualified Nutritionist (MBANT) with a postgraduate diploma in Personalized Nutrition & Nutritional Therapy. She is a member of the British Association for Nutrition and Lifestyle Medicine (BANT) and also part of the Guild of Food Writers. Over the past 15 years, she has contributed to various nutritional and culinary publications, including Good Food.
Jo Williams is a registered nutritionist (RNutr) affiliated with the Association for Nutrition, specializing in public health.
All health content on goodfood.com is intended for general information purposes and should not replace the medical advice of your own doctor or any other healthcare professional. If you have concerns regarding your general health, please contact your local healthcare provider. For more details, see our website’s terms and conditions.
