Elimination Diet - Minnesota Gastroenterology

Elimination Diet The Elimination Diet requires that you avoid the top food allergens—dairy, eggs, soy, gluten, nuts/tree nuts, fish/shellfish for 6 weeks. After 6 weeks, you will return to the office for another EGD (scope). Depending on the results, you may be instructed to begin a food re-introduction phase where your health care team evaluates the relationship between food allergens and your GI symptoms. The Elimination Diet takes time and may require an average of 3-4 EGDs and may result in life-long dietary changes. The following pages contain information on foods to include and exclude while on the Elimination Diet as well as menu ideas and places to shop. It is recommended that you keep a food journal during the elimination process in order to keep track of you symptoms and responses each day.

Foods to Include on the Elimination Diet: Fruits: whole fruits, unsweetened, frozen or water packed Dairy substitutes: Rice milk, hemp milk, coconut milk and coconut yogurt (So Delicious) Natural Lean Animal Protein: Chicken, turkey, lamb, pork, beef, and veal Vegetables: unlimited amounts all raw, steamed, sautéed, juiced or roasted Oils: Cold pressed Olive oil, Coconut oil or Ghee (replaces butter) Drinks: water, herbal teas, mineral water, Vitamin Water Zero, and SoBe LifeWater Sweeteners: (use sparingly) Stevia, brown rice syrup, honey, and agave nectar Condiments: Vinegar, spices including: salt, pepper, basil, carob, cinnamon, dill, garlic, ginger, mustard, oregano, parsley, rosemary, tarragon, thyme, and tumeric Vegetarians: Beans, split peas, lentils and legumes. (If you are not a vegetarian keep these foods to a minimum.) Rice Foods to Exclude on the Elimination Diet: Grains: Wheat, spelt, kamut, semolina(couscous), bulgar and triticale Dairy: Milk, cheese, cottage cheese, cream, yogurt, butter, cream cheese, ice cream, frozen yogurt, non-dairy creamers Soy and Soy products: Soy sauce, soybean oil (in processed foods) tempeh, tofu, soy milk, soy yogurt, textured vegetable protein (sometimes added to processed meats) Eggs: eliminate all eggs and egg substitutes, most mayonnaises contain eggs Nuts/tree nuts: Peanuts, peanut butter, walnuts, hazelnuts, pecans, almonds, and cashews Fish/Shellfish: Salmon, tilapia, walleye, halibut, cod/shrimp, crab, oysters and lobster

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Avoid items that contain emulsifiers or stabilizers. Common emulsifiers include eggs and dairy, palm oil, rapeseed oil, soybean oil, sunflower oil, lard and tallow. Common stabilizers include agar or pectin. Helpful Tips for the Elimination Diet The first 2-3 days are the most difficult. It is important to go shopping and stock up on all the foods you are allowed to have. Eat simply. Cook simply. Plan your meals and have a pot of rice available. Strive to have prepared food on hand so you can grab something quickly. Make a pot of chicken-vegetable-rice soup. Make a large salad. It may be helpful to cook extra chicken, sweet potatoes, and rice so that it may be reheated for snacking or another meal. Eat regular meals and snacks. Strive to eat every three hours to maintain healthy and stable blood sugar levels. Always be prepared and carry food with you when you leave the house. That way you will have what you need and not be tempted to stray off the plan when your blood sugar drops. Try to eat at least three servings of fresh vegetables each day. Choose at least one serving of dark green or orange vegetables. If you are a vegetarian consume more beans, rice, quinoa, amaranth, teff, millet, and buckwheat. If you are consuming coffee or other caffeinated beverages on a regular basis, it always wise to slowly reduce your intake caffeine intake rather than abruptly stop it; this will prevent caffeine withdrawal headaches. Try drinking half decaf and half regular for a few days and slowly wean yourself. Remember to drink a minimum of two quarts of water each day.

Menu Ideas for the Elimination Diet Breakfast ideas: Breakfast shake: 1 c frozen or fresh fruit, 1 c rice or coconut milk, ½ c coconut yogurt (So Delicious), 1 scoop of rice protein powder (Nutra Biotic or Rainbow Light’s Protein Energizer) Oatmeal: ¾ c plain rolled oats, ½ c water and microwave for 1 min and 15 seconds, add your choice of ½ c of milk substitute and ¼ c of berries 3-4 slices of Applegate turkey bacon, 1 c of fresh fruit and 2 T of sunflower seeds 4 Applegate breakfast chicken sausages sautéed in 1 t olive oil and 1 c applesauce 1 c Rice Chex cereal and 1 c of Original flavored So Delicious Coconut Milk

Lunch or Dinner ideas: 3 slices of deli turkey meat, ¼ avocado inside 1 brown rice tortilla (Foods for Life) warm it in microwave couple with 1 c fresh fruit or 1c of mixed greens salad Large salad with grilled chicken. 1 slice of wheat free bread or ½ sweet potato.


Roast turkey breast or turkey burger with brown or wild rice, steamed vegetable salad with vinaigrette dressing. Grilled chicken or steak, brown rice, steamed carrots, small baked potato or sweet potato. Ground turkey, chicken or beef mixed with wheat free pasta or Quinoa and veggies. Chicken, veggie, wild rice soup with rice crackers dipped in hummus

Snacks: Rice cakes or crackers with ghee, or coconut oil, or unsweetened apple butter Veggies dipped in guacamole or hummus Fresh fruit with 2 T sunflower seeds Apple sauce mixed with rice based protein powder 1 c of coconut milk add fresh fruit and eat with spoon 1 large piece of iceberg lettuce fill with seasoned ground meat and guacamole or hummus wrap up and enjoy So delicious Coconut yogurt mixed with Rice protein powder and fresh berries Dinning Out While on the Elimination Diet Many restaurants offer allergen information to make dining out possible. However, it is difficult to control for cross-contact with allergens and dining out should be limited during the elimination phase in order to achieve the best results possible. To limit contamination, you can speak with a manager and explain what modifications you need. You can also access restaurant menus on-line before-hand to select best choices. There are several websites geared towards travel and dining for those with Celiac Disease (gluten allergy) as well as multiple food allergies: www.bobandruths.com, www.glutenfreeonthego.com, www.eatingoutwithfoodallergies.com

Additional Resources: Cookbooks: Recipes for the Specific Carbohydrate Diet by Raman Prasad The Allergy Self Help Cookbook by Marjorie Hurt Jones R.N. Support Groups: The Food Allergy Network of MN – St. Paul Phone: 651-644-5937 http://www.foodallergysupportmn.org/ Minnesota Food Allergy Association – Minneapolis Phone: 763-315-8788 http://www.minnesotafoodallergy.org/ Food Allergy Awareness Supporters - Waconia Phone: 952-442-6254 or 952-442-4900 http://faas.weebly.com/ Northland Food Allergy Support Group - Duluth Phone: 218-878-333


Shopping Guide Many of the recommended food items on the Elimination Diet can be found at your local grocery store. Make sure you read the manufacturer’s labels as ingredients may change without notice. The following grocery stores chains may have special sections or products that allow for easier shopping while on the Elimination Diet. Whole Foods Fresh & Natural Foods Trader Joes Lund’s and Byerly’s, Rainbow Foods, Health Food section Cub Foods, Health Food section (ask about the “Tree of Life” order book to special order items you cannot find on the shelf) The following specialty grocery stores may have an additional selection of foods that are acceptable for the Elimination diet. Anoka

Anoka Food Co-op 1917 2nd Ave S/ 763-427-4340

Burnsville

Valley Natural Foods 13750 Ease 138th St / 952-891-1212

Cambridge

MN Organic Merc. Food Co-op 1709 E Hwy 95/ 763-689-4640

Eagan

Bittersweet Bakery 2105 Cliff Rd/ 651-686-0112

Hudson

Fresh N Natural 1701 Ward Ave Ste 200 / 715-377-9913

Minneapolis

Linden Hills Food Co-op 4306 Upton Ave S/ 612-922-1159 Seward Co-op Grocery 2201 E Franklin Ave/ 612-338-2465 Wedge Community Food Co-op 2105 Lyndale Ave/ 612-871-3993

Minnetonka

Lakewinds Natural Foods 17512 Minnetonka Blvd/ 952-473-7875

Plymouth

Fresh N Natural 4234 Lancaster Lane / 763-559-0754

St Paul

Capital City Food Co-op 26 W 10th St/ 651-298-1340 Hampden Park Food Co-op 928 Raymond Ave/ 651-646-6686 Mississippi Market Co-op 1500 West 7th St / 651-690-0507 622 Selby Ave / 651-310-9499 Whole Foods 30 South Fairview Ave / 651-690-0193

Shoreview

1075 West Highway 96 / 651-203-3663

Stillwater

River Market Community Co-op 221 N. Main St./ 651-439-0366

Woodbury

Tailor Made Nutrition 8160 Coller Way/ 651-702-2522


Dietary Shopping Guide (Avoid: fish/shellfish, nut/tree nuts, dairy, soy, eggs, and gluten) Whole Grains

Proteins

Vegetables - unlimited (fresh or frozen)

Fruits -unlimited (fresh or frozen)

Miscellaneous

Wheat Free Flours  Amaranth flour

Lean Meats

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Apples Applesauce (no sugar added)

Fats/Oil

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Apricots Bananas Blackberries

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Bob’s Red Mill® Flour Millet Flour Pamela’s® Flour Potato Flour Quinoa flour Rice flour Tapioca Teff flour

Breads

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Corn Tortillas Enjoy Life® Bagels Plain or Cinnamon Raisin Foods for Life® Whole Grain brown rice Bread, Brown rice tortillas and English Muffins

Pasta and Rice

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Basmati rice Brown rice Uncle Ben’s® 90-second white or brown rice packs White rice Wild rice 100% Buckwheat noodles Glutano® compasta Pagodas® Quinoa pasta Quinoa Rice Noodles

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®

Bob’s Red Mill Rice and Shine Cream of Rice Enjoy Life® Granola Erewhon ® crispy brown rice cereal Plain oatmeal Puffed rice Rice Chex®

Snacks

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Applegate Farms® deli meat, chicken breakfast sausages and bacon

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Beef Chicken (smart® chicken) Deli Meat (packaged) Hormel Natural®

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Lamb Mild Italian Pork Sun dried tomato Turkey Veal Wellshire Farms® bacon

Seeds

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Flax Poppy seed Pumpkin Sesame Sunflower Tahini spread

Milk Replacements

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Coconut milk Fortified oat milk Fortified rice milk Hemp milk

Canned Beans

Cereals

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Corn Chips (Tostitos® baked or original) Cornmeal/polenta Ener-g® Pretzels Mary’s® gone crackers original flavored, sticks and twigs Popcorn (air popped or stovetop use coconut oil) Terra® Sweet potato and veggie chips Unflavored rice crackers and rice cakes Snappy® crisps baked peas

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Azuki Black Garbanzo Kidney Pinto White Hummus

Other

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Amy’s Organic® Bean/lentil soups, Black Bean Chili, Lentil soup, Lentil vegetable

Artichoke hearts Asparagus Beets Bok choy Broccoli Brussels sprouts Cabbage Carrots Cauliflower Celery Collard greens Corn Cucumber Daikon Eggplant Endive Grape tomatoes Green beans Green onions Hearts of palm Jicama slices Kale Kohlrabi Leeks Mushrooms Mustard greens Okra Onions Pea pods Peas Peppers (all varieties) Plantains Potatoes (w/skin) Radishes Romaine Salad greens Salsa Scallions Spaghetti sauce Spinach Summer squash Sweet potatoes (w/skin) Swiss chard Tomatillos Tomato Tomato sauce Turnips Water chestnuts Watercress Yucca Zucchini Amy’s ®organic vegetarian vegetable and roasted tomato soup

Blueberries Cantaloupe Cherries

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Grapefruit Grapes Honeydew

Beverages

Kiwi Mandarin oranges Mango Nectarine Orange Papaya Persimmons Peach Pear Pineapple Plum Pomegranate Prunes Raspberries Strawberries Tangerines Watermelon

Avocado Coconut Oil Ghee Grapeseed Oil Olive Oil Safflower Oil Sesame SunButter®

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Water Kambucha® Tea brands Honest or GT’s

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La Croix® SoBeLife® Zero Tea, hot/iced Vitamin Water® Zero

Condiments

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Garlic Herbs and spices, fresh or dried Kaufman’s ® Apple butter spread Lemon/lime juice Mustard Pacific® and Imagine® broth Vinegars

Other Fruits

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Del Monte® No Sugar Added mixed fruit cups

Sweets/Treats: (Strive to keep to a minimum)

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100% all fruit bars 100% fruit sorbet Enjoy Life® Chocolate chip cookies or cereal bars Jennie’s Bakery® Coconut macaroon cookies and pound cake Mochi Rice Dream

Sweeteners

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Agave nectar Honey Jam Molasses Rice Syrup Stevia
