Reintroducing Food Groups

Elimination Diet Food Reintroductions

1.       Decide which food group to reintroduce first.  Generally, the order does not matter.
·         Dairy foods
·         Wheat/gluten
·         Citrus
·         Corn
·         Eggs
·         Soy
·         Peanuts
·         Nightshades, if eliminated
·         Other eliminated foods (chocolate, sugar, caffeine, food additives that you think you might react to)

2.       Eat 2-3 average size portions of a pure form of foods from that food group through the course of one day.  A pure form would mean that the food does not have additives or other ingredients that you have been omitting from your diet (e.g. sugar).  Following are examples of pure foods from some of the groups.

Challenge	Food	Serving Size
Milk	Skim, 1%, 2%, or whole milk	1 cup
Cheese	Any whole milk cheese without additives	1 ounce
Wheat	100% whole-wheat cereal (Wheatena) or 100% whole-wheat noodles	1 cup 1 cup
Rye, Barley	Rye Crackers Cooked barley or rye cereal	3 ounces 1 cup
Oats	Certified gluten free oatmeal	1 cup
Citrus	Orange or orange juice (no additives	1 medium orange or 1 cup orange juice
Corn	Fresh or Frozen corn	¾ to 1 cup, 1 cob
Egg Yolk	Yolk-scrambled egg	1 egg yolk
Egg White	Egg whites, scrambled	1 egg white
Soy	Edamame Soy milk, (plain)	½ cup 1 cup
Peanuts	Raw or dry roasted peanuts or peanut butter	¼ cup peanuts 1 Tbsp peanut butter

3.       If you want to test nuances of sensitivity within a food group, it is recommended to expand testing to include a variety of sources.  An example would be to test cow milk, cheese, sheep cheese, and goat cheese.  In the wheat category, some people might also test spelt, emmer, or other more ancient forms of wheat or sprouted  or sourdough wheat.

4.       After one day of eating from that food group, take the food back out of your diet.  You will keep this food out of your diet through the end of the reintroduction phase regardless of your reaction.  Observe your reactions for two days.  This gives you time to notice both immediate and delayed reactions.  Write down anything that feels different from when you were in the full elimination phase of the diet.  Examples of potential reactions include:

a.       Skin irritations or break outs

b.      Gas, bloating, and/or abdominal pain

c.       Diarrhea or constipation

d.      Headache

e.      Fatigue, depression, anxiety

f.        Muscle or joint pain

5.       If you do not have any symptoms after two days, reintroduce the next food group.  Remember that you are challenging each group individually, so be sure to keep each food group out of the diet after challenging it even if you have no reaction, until you’ve completed all food reintroductions.

6.       If you DO have symptoms after challenging a food, stop eating that food and allow the symptoms to completely clear before starting your next challenge.  You will need to remove the food from your diet for 3-6 months before re-challenging to test for a long term reaction.  During this time, your health care provider may recommend dietary supplements to help promote intestinal health, such as probiotics or mucilaginous herbs.

7.       Repeat steps 2-4 for each food group.

8.       Make sure to track your food intake and symptoms and contact your healthcare provider if you have any questions while reintroducing foods.