Response from Laura Schoenfeld:
As far as elimination diets are concerned, there are probably dozens, if not hundreds of different varieties of elimination diets. I think most of them tend to focus on the foods that are most consistently offenders in people’s diets. So if you think about, for example, the big seven allergens, things like wheat, dairy, soy, peanuts, tree nuts, shellfish, and fish … I feel like I’m missing one, but the foods that are known to be big allergens tend to be ones that are eliminated on reset diets or elimination diets.
As far as foods like beef and pork, I don’t see a lot of meat sensitivity, but I have seen some. It’s not something that I think is common enough that I would want to remove it from someone’s diet immediately. Doing a Paleo reset diet is already complicated enough and already challenging enough if somebody is coming from a Standard American Diet, so eliminating meat would probably make that even more challenging, and it would also make getting enough protein challenging, so I don’t necessarily think beef, pork … I don’t know if they eliminate fish or poultry. I’m assuming they don’t, but I don’t think eliminating beef and pork right out the gate is necessary. Even eggs, I would say, tend to not be that big of a deal.
It’s one of those things that you really have to decide what the patient’s issue is and whether or not that level of elimination is really warranted. For example, I have a lot of clients that come to me that are already on a Paleo diet, so maybe they need to remove things from the Paleo diet to make their symptoms better. There are certain restrictions like a low-FODMAP diet. There’s the autoimmune protocol. There’s very low carb, ketogenic. There’s a higher-carb Paleo diet. So there may be some foods that they’re currently eating on a Paleo approach that aren’t working for them that you can then do a more tailored elimination diet for, but if you’re just going straight with the 30-day reset protocol that Chris set out in his book, then that really gets rid of most of the foods that most people are sensitive to, things like gluten, grains, dairy, legumes, which tends to be more of a gut issue than a food sensitivity issue, but I’d say the majority of people that go through that protocol are going to have 50 to 80 percent of their symptoms fixed at that point. And then if they’re still having lingering issues and you’re concerned that possibly there might be some sensitivity to other food proteins, then removing certain things like beef, pork, and eggs might make more sense.
Hopefully that makes sense. I don’t know the Institute for Functional Medicine’s actual protocol, so I can’t comment on the differences, necessarily, but I will say that there are so many different types of elimination diets, and a lot of them have very similar guidelines, so use your clinical judgment when you’re working with a patient, and think about what their particular issues are. Like I said before, something like a low-FODMAPs diet might make more sense for someone with IBS than doing a typical strict Paleo approach because the Paleo diet tends to be very high in FODMAP foods, so that could potentially make their gut symptoms worse. We’re going to talk a lot about individual conditions that people might have that can benefit from different dietary approaches. I don’t know exactly what week that’s going to be, but we have a bunch of different presentations that are going to be during the exposome section that will talk about different therapeutic diets for different conditions, so that will hopefully help you get a little bit of a guideline as far as where to start with certain patients.