After elimination diet, people reintroduce one at a time and after three days without symptoms they can assume that food is safe. But I’ve seen some people who seem to have symptoms only after consuming food regularly for several days. I know this myself. I can have a tomato here and there, but if I eat a lot of tomatoes over a few days, my joints begin to hurt. Is this common? If so, does it call into question the accuracy of the reintroduction phase?

Chris Kresser:  Yeah, I don’t know that it’s common but it’s certainly true that foods can have a cumulative effect over time, and the reintroduction phase is just a guideline. And the three-day thing is just a guideline, and the truth is, as you suggest, there are many different ways that food intolerances can manifest. And it’s also true that if someone is relatively well-rested and not stressed, and you know they’re on vacation, they might be able to tolerate a wide range of foods that they can’t tolerate when they’re at home, or if they can drink coffee when they’re on vacation, whereas they can’t when they’re at home and working. So the process is just basically training patients to observe these things and get more in touch with their bodies and be able to pay more attention. And in most cases even without explicit instruction, they’ll notice that okay, yeah, so I reintroduced tomatoes and I didn’t have any issues. But I notice that if I eat them regularly I start to, just as you’ve noticed that. And that tends to happen in patients as well.