How an Elimination Diet Can Help You Eat by Your Own Rules
Eat by Your
Dr. Will Cole
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Your best friend swears that removing cheese from her diet changed her life. Your sister says that cheese is the culprit behind all of her breakouts. But you know, in every bone in your body, that cheese has never done anything to hurt you.
And that’s fair, says functional medicine practitioner (and goopfellas podcast cohost) Will Cole, IFMCP, DC, because it’s probably true. Food isn’t one size fits all. There’s a word for this, and it’s “bio-individuality”: Each of us has a different body, and each body has different needs.
Dr. Will Cole
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To best understand how your body processes different foods, Cole suggests a short-term elimination diet. Cole outlines one detailed method in his new book, The Inflammation Spectrum, but here’s the brief: For somewhere in the realm of four to eight weeks, you take certain foods that may be irritating your body—like gluten, dairy, and nightshades, among others—out of your diet. Then you carefully reintroduce them one by one, taking note of how you feel at each phase. When you’re done, you should have an idea of which foods feel good to you and which don’t.
But the elimination diet isn’t the end of the story. Knowing what does and doesn’t work for your body may make food choices clearer, but it does not necessarily make them easy—or, in some cases, even worth the effort. If committing to a life without baguettes or burrata doesn’t sound like much fun, the good news is: After you weigh the risks and benefits, the choice is yours.
A Q&A with Will Cole, IFMCP, DC
As a functional medicine practitioner, I work with people who want to investigate what’s driving their inflammation. First we see if we can rule out things like underlying gut problems, hormone imbalances, mold or heavy-metal toxicity, stress, lack of sleep, or chronic infections. Then we start looking at food. Every food is either feeding inflammation or fighting it—and which foods do what varies from person to person.
In functional medicine and clinical nutrition, an elimination diet is the gold-standard process for uncovering how the body reacts to different foods. A key principle of functional medicine is bio-individuality: What works for someone else may not be right for you. When done properly, an elimination diet can precisely pinpoint the exact foods that are inflammatory and problematic for you.
The problem with most elimination diets, however—the ones doctors and dietitians have used for decades—is that they are boring, generic, and unsustainable. In my new book, The Inflammation Spectrum, I wanted to make the elimination diet practical, and also able to be tailored to each reader’s unique needs. I want everyone to discover what your body loves and hates. Then you can start calming inflammation with food medicine that is tailored just for you.
That said, access and affordability are important factors to consider. While certain trends are encouraging, like grocery outlets that lean towards cost-effective healthy foods (I like Aldi, Trader Joe’s, and Costco), not everyone has the food and information they need to have this kind of agency over their health.
There are many ways to do an elimination diet. The way I approach it depends on what a person’s inflammation level looks like. Each area of focus—the brain, hormones, digestion, or something else—has its own group of foods to focus on.
There are two main elimination diet tracks in the book: Core4 and Elimin8. The Core4 plan removes four types of food—grains, sugar, dairy, and processed industrial seed oils, like canola oil—for four weeks, then reintroduces these foods one by one. The Elimin8 track is more advanced, and it’s intended for people who have higher inflammation levels. Elimin8 has you avoid eight types of food for eight weeks: the Core4 foods plus four more—nightshades, legumes, eggs, and nuts and seeds.
What is unique about the elimination diet plans I outline is that we aren’t just focusing on food. I go through the research about how things like stress, social isolation, and social media addiction can drive inflammation as well.
Inflammation exists on a continuum—mild symptoms on one end, diagnosable health problems on the other. There are seven systems I often see impacted by inflammation: the nervous, digestive, endocrine, immune, and musculoskeletal systems, as well as those governing detoxification and blood sugar regulation. I also consider how the body’s systems are interconnected and how inflammation in one area can beget inflammation in another (something I refer to as polyinflammation).
In my practice, I have patients check in with each of these systems. The survey I use partially consists of basic health questions: How are you sleeping? Do you get stomachaches? But then I also ask more obscure questions, like: Are the outer thirds of your eyebrows thinning? That may seem insignificant, but thinning eyebrows can indicate potential thyroid issues. Some signs and symptoms we might easily overlook, like the thing with the eyebrows, are really check-engine lights for our body: They indicate something’s up with our health and that we need to tune in. I’ve adapted this survey into a quiz, which you can access through my website or read in The Inflammation Spectrum.
After an individually tailored elimination diet, you know which foods build your health—these are things to eat more of—and which are inflammatory for you. And it realigns how you think about avoiding foods that make you feel like crap. Doing so isn’t punitive or restrictive; it’s a form of self-respect.
This is something I call “food peace.” The truth is: You can eat anything you want to eat. But when you are armed with knowledge about your own body and what works best for it, you can make better-informed decisions. That helps us avoid food shame and subservience to dieting dogma.
The concept of cheating, as it relates to food, is antithetical to sustainable wellness. When it comes to food, nothing is forbidden. Everything is a choice. There is a difference between knowing a food doesn’t work for you and choosing not to eat it and forbidding yourself from having a particular food. The former is food freedom, and the latter is a food prison.
About that food prison: Orthorexia is an eating disorder centered around an obsession with what foods are healthy or unhealthy. It’s associated with feelings of shame, stress, and anxiety about foods that might be considered unhealthy for one reason or another. It’s a real problem, especially in a world of fad diets and endless, conflicting information about what “healthy” means.
While we start the inflammation conversation with food, it’s not just about food. There are several nonfood inflamers I catch in my patients. Stress is at the top of that list.
Stressing about eating healthy foods is not good for your overall well-being, and it actually raises inflammation levels. So someone who appears to eat a junky diet may have glowing health because of the positive influences of a low-stress lifestyle, a supportive social group, and exercise. Someone else may appear to be a health rock star, throwing back kombucha and kale on the regular, but they may be withering from stress or shame associated with their lifestyle. That can raise inflammation and trigger health problems.
I often see this phenomenon when my patients go on holiday and eat things that would normally cause them issues at home. In the absence of daily stressors and in adopting, even temporarily, a more relaxed mind-set about what they’re eating, they feel better than ever.
Dr. Will Cole, IFMCP, DC, is a leading functional medicine expert and one of the hosts of the goopfellas podcast. Cole specializes in clinically investigating underlying factors of chronic disease and customizing health programs for thyroid issues, autoimmune conditions, hormonal dysfunctions, digestive disorders, and brain problems. His first book, Ketotarian, outlines why and how to pursue a mostly vegetarian ketogenic diet. His latest book, The Inflammation Spectrum: Find Your Food Triggers and Reset Your System, is now available.
This article is for informational purposes only, even if and regardless of whether it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this article are the views of the expert and do not necessarily represent the views of goop.