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The Elimination Diet

Updated March 9, 2023

This article originally appeared in the December 2002 McDougall Newsletter and has been updated in March 2023.

By Johh McDougall, MD

John Smith writes, “I have constant pains in my head, my body tingles all over, my stomach rumbles constantly, the third toe on my left foot throbs at night – I have tried all the painkillers and antidepressants my doctor knows to prescribe.  Help!  I have been a vegetarian without results. Do you know of any diet that might solve my problems?”

The answer is, probably.  I am always amazed at the powerful impact diet has on health – even with problems that on the surface do not appear to be diet-related.  But this should not surprise me because our foods are the most frequent, intimate, and diversified contacts we have with our environment.  Molecule for molecule, we interact with the components in our foods more than with air or water, and, obviously, substances found in food are more complex than the compounds found in air or water.

At the very least, I know how John Smith and others desperate to find relief can find out if a change in diet will help them and that is to try the most therapeutic of all diets – the elimination diet.  This is the last step in searching out a dietary cause for health problems and is not recommended for the average person seeking relief from obesity, high cholesterol, and generalized fatigue.  The standard McDougall approach of a low-fat, vegan diet and exercise will solve the problems for most people.  And the Maximum Weight Loss Program that eliminates refined foods (including flour products) and sugars will help even the most calorie-efficient person lose weight (See the November 2002 McDougall Newsletter at  The “elimination diet” is truly for those people who are desperate and want to get well NOW – and who feel they have tried everything else.

The elimination diet was originally devised for people suffering from allergic problems.  The ultimate and best test for identifying a substance suspected of causing an allergy is to eliminate the substance (whether it is a food, or a pollen, or a chemical compound), and then to note if the symptoms disappear and the person’s health improves.  Confirmation of the diagnosis is made by adding the offending substance back to the diet and observing if the illness returns.  Don’t overlook the obvious truth that elimination of the villainous substances is also the ultimate – and only treatment for “curing” the allergy and other food-induced problems.

The elimination diet asks you to eat the foods that are least likely to cause you any type of adverse reaction, including allergic reactions.  When you begin this diet, allow about one week in order to completely clear your body of foods that were eaten before starting the diet.  By the end of this week, if the trouble was indeed due to foods, you will be relieved of your problems, in other words “cured.”  You have found a place you can go for relief.

During the elimination period, all foods should be thoroughly cooked, because cooking alters the proteins, making them less likely to provoke an adverse response.


Starches (all cooked), including:

brown rice

sweet potatoes

winter squash

taro (or poi)


rice flour

puffed rice

Most Green and Yellow Vegetables (all cooked), including:


beet greens


summer squash



string beans




Avoid onions, green pepper, cucumbers, and radishes; they can be very troublesome for the stomach (indigestion).

Fruits (all cooked)

Avoid all citrus fruits, including oranges, grapefruits, tangerines, lemons, limes, etc. and tomatoes.









Only salt is allowed (if not restricted for other health reasons).  This means no salad dressings, mustard, lemon juice, vinegar, pepper or other condiments.


water (sparkling water is OK)

After one week, your food-caused problems should have ended and you should be feeling well.  If this is the case, you can begin adding other foods back to your diet, but only one at a time, to determine if any of these caused your unpleasant reactions.  For testing purposes, each “new” food should be eaten in large amounts three times a day for two days.  If the food does not cause a reaction, you can conclude that it is not a troublemaker.  Most reactions occur within a few hours, but some may not show up for several days.  Each food must be tested individually; do not introduce two new foods at once.  When you do have a reaction to a specific food, you must wait four to seven days before testing the next item.  This interval gives you the time you need to clear your system of that allergy-causing food.

If the elimination diet seems too severe for you right now, then follow the McDougall Program, which eliminates six of the leading causes of food allergies: dairy products, eggs, chocolate, nuts, shellfish, and fish.  If your problems persist, then the next suspects to eliminate are wheat, corn, citrus fruits, tomatoes, and strawberries–the most frequent causes of adverse reactions among foods in the vegetable kingdom.

A dietary approach is the safest, most sensible, least expensive, and most effective step you can take for testing and for treatment of health problems that once seemed to be a mystery to you and your doctor.  If this is what you need, you will not be disappointed with your efforts.