What Do You Start With on an Elimination Diet?

October 18, 2025 •

4 min read

According to research, food sensitivities may affect up to 20% of the population worldwide. If you're experiencing uncomfortable symptoms, an elimination diet can be a valuable tool for identifying triggers. But with so many factors to consider, knowing what to start with on an elimination diet is crucial for success.

Quick Summary

This guide details the crucial first steps of an elimination diet, including preparation, using a food journal, and the initial elimination phase. It outlines common foods to remove, what to eat instead, and the systematic reintroduction process for identifying your personal trigger foods.

Key Points

Start with Planning: Before you eliminate any food, take a week to create a detailed food and symptom diary to establish a baseline and identify potential triggers.
Consult a Professional: Work with a healthcare provider or registered dietitian to ensure your elimination diet is safe, effective, and nutritionally sound for your specific needs.
Eliminate Common Triggers: For 2-4 weeks, remove high-allergen foods like dairy, gluten, soy, eggs, nuts, and nightshades, as well as alcohol and caffeine.
Focus on Whole Foods: During the elimination phase, eat a variety of whole, unprocessed foods like vegetables, fruits, lean proteins, and gluten-free grains to maintain nutrition.
Reintroduce Systematically: After the elimination phase, reintroduce one food group at a time over several days while continuing to monitor symptoms in your food diary.
Observe and Adapt: Use your food diary from the reintroduction phase to determine which foods cause symptoms and create a long-term diet plan that avoids your specific triggers.
Be Patient: An elimination diet requires diligence and patience; the process is a valuable experiment for understanding your body, not a quick fix.

Step 1: Prepare and Plan for Your Elimination Diet

Before you remove a single food from your diet, preparation is paramount. Rushing into an elimination diet can lead to frustration and inaccurate results. A key component is consulting with a healthcare provider or a registered dietitian, especially if you have an underlying health condition. Together, you can create a safe and effective plan tailored to your needs.

Prep Your Pantry and Kitchen

To avoid temptation, the best practice is to clear your kitchen of the items you plan to eliminate. This reduces the chances of accidental consumption, which could restart the process. Read food labels carefully, as many processed foods contain hidden ingredients like dairy, soy, or gluten. Having a well-stocked pantry with approved foods is a game-changer for staying on track.

Start a Detailed Food and Symptom Diary

Keeping a journal is the single most important step for an elimination diet's success. For at least a week before the elimination phase begins, track everything you eat and drink. Make a note of any symptoms you experience, such as bloating, headaches, fatigue, or skin issues, including the time and severity. This creates a baseline to compare against once you start eliminating foods and will be invaluable during reintroduction.

Step 2: The Elimination Phase

The elimination phase typically lasts for 2 to 4 weeks, during which you completely remove potential trigger foods from your diet. The duration depends on your symptoms and how your body responds. Be aware that symptoms might initially worsen during the first week as your body adjusts.

Common Trigger Foods to Eliminate

The specific foods you eliminate can be customized based on your personal health concerns or your pre-diet food diary. However, a standard approach involves removing the most common allergens and inflammatory foods.

Commonly eliminated food groups include:

Dairy: Milk, cheese, yogurt, butter, and any products containing whey or casein.
Gluten-Containing Grains: Wheat, barley, rye, and oats (unless certified gluten-free due to cross-contamination).
Soy: Soybeans, tofu, tempeh, and soy-based products.
Eggs: Both egg whites and yolks.
Nuts and Seeds: Including peanuts, almonds, cashews, and all other nuts and seeds.
Nightshade Vegetables: Tomatoes, peppers, eggplant, and white potatoes.
Corn: Corn, corn syrup, corn chips, and other corn-based products.
Caffeine and Alcohol: Both can be irritating to the gut and may mask symptoms.
Sugar and Processed Foods: Refined sugars, artificial sweeteners, and processed ingredients can contribute to inflammation.

What You Can Eat During the Elimination Phase

While the list of forbidden foods seems long, there are still plenty of nutritious options to enjoy. Focusing on whole, unprocessed foods ensures you still get adequate nutrients.

Vegetables: Almost all vegetables, especially leafy greens, broccoli, carrots, and sweet potatoes (avoid nightshades if on a stricter plan).
Fruits: A wide variety of fruits, such as apples, pears, and berries (avoiding citrus on stricter diets).
Lean Proteins: Chicken, turkey, lamb, and cold-water fish like salmon.
Gluten-Free Grains: Rice, quinoa, and millet.
Healthy Fats: Olive oil, avocado, and coconut oil.
Beverages: Water and herbal tea.
Herbs and Spices: Use fresh herbs and non-irritating spices to flavor your meals.

Step 3: Reintroduction and Long-Term Plan

Once your symptoms have improved or resolved, you can begin the reintroduction phase. This must be done methodically to accurately pinpoint triggers.

A Systematic Reintroduction Process

Introduce one food group at a time. For example, reintroduce dairy products for 1-3 days before testing another group.
Monitor your body closely. After reintroducing a food, wait 2-3 days while observing your symptoms and recording them in your journal.
Note any reactions. If symptoms reappear, the food you just reintroduced is likely a trigger. Avoid it again for a few months before retesting.
Repeat for each food group. Continue this systematic process until all eliminated foods have been tested.

Comparison Table: Elimination vs. Reintroduction


Aspect	Elimination Phase	Reintroduction Phase
Goal	Allow the body to heal by removing all potential trigger foods.	Identify specific food triggers by systematically adding them back.
Duration	2-4 weeks, or until symptoms resolve.	Varies, depending on the number of foods tested (typically 1-3 days per food).
Food Variety	Limited to whole, non-irritating foods.	Expands as tolerated foods are reintroduced; one food is tested at a time.
Monitoring	Daily logging of symptoms and diet to establish a baseline.	Close observation for returning symptoms after each new food introduction.

Conclusion: Your Path to Understanding Your Body

Starting an elimination diet can feel daunting, but with proper planning and guidance, it is a highly effective way to identify your specific food sensitivities and intolerances. The key is to start with a thorough preparation phase, including a food diary, before moving to a strict elimination of common culprits like dairy, gluten, and soy. The subsequent reintroduction phase requires patience and careful observation to pinpoint exactly which foods are causing issues, leading to a personalized, long-term diet that helps you feel your best. For some individuals, the gut may heal over time, allowing for the reintroduction of some previously problematic foods down the road. Always conduct this process under the supervision of a healthcare professional.

NCBI Bookshelf: Elimination Diets - an overview of the topic

Frequently Asked Questions

The very first step is the preparation phase, which involves consulting a healthcare professional, cleaning out your pantry of trigger foods, and keeping a detailed food and symptom diary for at least a week to identify potential culprits.

Commonly eliminated foods include dairy, gluten (from wheat, barley, and rye), soy, eggs, corn, nuts, and nightshade vegetables like tomatoes and peppers. Caffeine, alcohol, and refined sugar are also often removed.

The elimination phase typically lasts for 2 to 4 weeks, or until your symptoms significantly improve. If you accidentally consume an eliminated food, it's best to restart the 2-4 week period.

If your symptoms do not improve after 2-4 weeks of strict elimination, it may indicate that your triggers are not from the foods you removed. It is important to consult your healthcare provider to investigate other potential causes or adjust your diet plan.

During the reintroduction phase, add back one food group at a time for 1-3 days while monitoring for symptoms. If you experience a reaction, eliminate that food again. If no reaction occurs, that food is likely safe for you. Wait 2-3 days before testing the next food.

Yes, a food and symptom diary is a critical tool for success. It helps you identify subtle or delayed reactions to foods during the reintroduction phase, which you might otherwise miss.

No, an elimination diet is not a long-term solution. It is a diagnostic tool used for a specific period to identify triggers. Staying on a highly restrictive diet for too long can lead to nutritional deficiencies and may promote unhealthy eating behaviors.

After identifying your specific triggers, you can develop a personalized, long-term diet plan with a professional's guidance. This plan focuses on avoiding your trigger foods while ensuring you maintain a balanced and nutritious diet.