Elimination Diets vs Microbiome Testing: Which is right for you?

diet, wellness

In our modern age, we have a wider variety of foods available to us than ever before. As wonderful as this is, if we have learned anything from the increasing rates of food allergies, sensitivities, and intolerances over the past decades, it’s that not all of these foods are good for us. As bio-individuals, our bodies react differently to different foods and no two people are the same. For example, kale may be wonderful and act as an anti-inflammatory for many people, but if you are sensitive to Oxalate, it may cause a pro-inflammatory response for you. So how do you know which foods are right for you?

Elimination diets and microbiome testing are simple and effective ways to help you figure out which foods are nourishing you and which are harming you. Though they don’t do quite the same things (we’ll get into that in a minute), they can both be useful in determining the ideal diet for you. Let’s take a look at both so that you can get an idea of which is right for you.

Who can benefit from an elimination diet or microbiome testing?

The short answer is – just about anyone who is interested in being healthy. In recent years, the role of food in inflammation, immune function, mood disorders, and chronic health conditions has become more widely acknowledged. Putting the time and effort into figuring out what foods contribute to your good health and which foods degrade your health can have serious long-term health benefits for anyone. It can be particularly useful when it comes to weight control, disease prevention, and anti-aging. However, if you are living with chronic health conditions, struggling to lose weight, or concerned about your levels of chronic inflammation it may be even more critical for you. It’s important to keep in mind that elimination diets can have adverse effects for some people (keep reading for more on this), so it’s always a good idea to check with your doctor before beginning one. Neither of these tests is meant to replace medical advice. If you are experiencing symptoms that you are concerned about or you have known health issues please seek help from a medical professional. I also recommend you discuss the results of your elimination diet or microbiome test with your doctor.

Elimination Diets

Since the formal introduction of the elimination diet, by Dr. Albert Rowe in 1926, it has become a standard method of testing for food allergies, intolerances, and sensitivities. An elimination diet, also known as an exclusion test, involves eliminating foods from your diet for a set period of time, generally between two weeks and two months, then reintroducing those foods one at a time to see if any of them cause an adverse reaction, physically, mentally, or emotionally. If a particular food produces symptoms, that food is removed completely from the diet, usually for three to six months, and then another attempt to reintroduce the food is made. It can take up to two years and a gut flora replenishment plan to be able to successfully reintroduce foods. In some cases, foods may need to be eliminated permanently. Elimination diets can involve removing one suspect food, all but a few foods, or anywhere in between. If you don’t have specific foods that you suspect may be adversely affecting you, a good place to start may be by implementing an elimination diet that excludes common ”problem” foods – wheat, eggs, dairy, peanuts, tree nuts, soy, sugar, artificial additives, preservatives, and food colorings. Here are some pros and cons to elimination diets:

Pros

  • You can tailor it to your needs – You can completely personalize an elimination diet to test one ”suspect” food, most of the food in your diet, or anywhere in between.
  • Tried and true – This is a well-tested, established method of getting to the bottom of your food allergies or sensitivities.
  • Accurate results in real-time – The results are based directly on how you feel, so they are reliable, re-testable, and immediate upon food reintroduction.
  • Work with your doctor – Your doctor can provide guidance and oversight to help keep you on track throughout the process and help you to interoperate your results.
  • It’s free – Aside from the cost of food (which you have to pay for anyway), it’s free!

Cons

  • Not for everyone – Reducing the variety of food that you consume can impact the nutritional value of your diet, so if you have an acute illness, are frail, vitamin or mineral deficient, malnourished, pregnant, nursing, or have a history of eating disorders this may not be the best option for you.
  • More work – During the elimination and reintroduction phase, these diets require tight control over your diet. You may have to spend more time than you’re accustomed to planning meals and cooking food from scratch.
  • Time efficiency – Elimination diets can take weeks to months to complete. Over this time period, you may have to opt-out of eating out, your favorite holiday meals, etc.
  • Limited results – You are only going to get results for the specific foods you eliminate and then reintroduce.

Microbiome Testing

The gut microbiome is the community of microorganisms that live in our digestive tract and its importance in overall health, as well as its role in ill-health, has come to the forefront of functional medicine in recent years. Thanks to the raise of metagenomics and next-generation sequencing, microbiome testing has become a fast and accurate way to test the human microbiome. This type of testing can determine the composition and diversity of the microorganisms living in your gut and what those microorganisms are doing. It can give you insights into what foods are causing pro-inflammatory or anti-inflammatory responses, the health of your gut lining, digestive health, and more. Depending on the company, they may also test for parasites, viruses, fungi, archaea, and phages. From this information, you can get personalized food and supplement recommendations, along with appropriate dosages just for you. Here’s how it breaks down:

Pros

  • Safety – Because it doesn’t require food restriction, the test is a safer option for those who could be hurt from the food restrictions involved with a traditional elimination diet.
  • Comprehensive results – Testing the microbiome can give you a picture of how your body is affected by hundreds of different foods in one fell swoop.
  • Convenience – Simple at-home stool collection kits make these tests quick, easy, and discrete. Taking the test does not require you make any changes to your diet or lifestyle.
  • Time efficiency – The only time commitment here is to collect your sample and fill out a questionnaire.
  • Information – Microbiome testing can produce and compile much more data than a traditional elimination test, giving you a better picture of how your gut is functioning as well as actionable ways to improve your gut health.

Cons

  • Accuracy – Because these tests are done from a single stool sample, they are more of a snapshot in time than a comprehensive insight into all that is going on inside your gut. Comparisons between intestinal biopsies and microbiome testing can show significant discrepancies in the diversity and types of microbes found. Furthermore, our gut microbiomes are not static. They can even fluctuate from moment to moment depending on the time of day, what we just eat, exposure to stress, and more. Therefore, it’s possible that these tests may miss a food reaction and label something as ”safe”, which is not. I suggest that after getting your results and implementing the recommended dietary changes, you continue to pay attention to whether any foods you are eating seem to be producing symptoms or adverse effects. All that being said, these tests are getting more accurate and reliable over time as more data is collected and technology improves.
  • Cost – These tests generally cost between $99 and $149, though the cost has become more affordable over time and may continue to do so.
  • Understanding the data – These tests can produce a lot of data. Some companies seem to do a better job than others of breaking down that data to make it more understandable and actionable, so if you don’t have a medical background, look into how different companies present the data before deciding on which to choose.

Each of these testing methods has its value and limitations. Elimination tests can be a hassel, but the results are indisputable. Microbiome testing is an exciting new field with a lot of potential, but some are concerned that the enthusiasm and claims of the companies offering these tests is disproportionate, given our actual understanding of the gut microbiome. However, there are many stories out there of people who have seen real health benefits from implementing the recommendations from their results (myself included).

Whichever method you choose, the important thing is that you are taking action to improve your health and quality of life and that’s awesome!

Have you tried an elimination or microbiome test? How did it go? Let me know your thoughts in the comments section.

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