Questions regarding the elimination diet

[CrohnsKiller]

Hi Jeff,

I have been on McDougall's diet since the beginning of August to see if it will help with my Crohn's-related, inflammatory arthritis. When I started the diet my arthritis was in my right knee, left forefoot, and it had begun to start affecting my lower back and hip. Within about 4 days of starting the diet, I noticed some improvement with the size of the inflammatory cyst in the back of my knee and maybe a little less in my foot and the pain in my back was gone. I used to have a hard time walking down the stairs in the morning, but now that has improved. I had to take a blood test since I'm on Imuran, and I had my sedimentation rate checked this week (after about a month on the diet), and I was really disappointed and shocked to see that my sed rate had RISEN 10 points. It goes without saying this is a huge disappointment. I've been trying to figure out how this could be. Any thoughts on that?

With all that, I've been contemplating the elimination diet and reading your suggestions as to how to go about it. I have a few questions.

When I start the diet, do I need to wait until most or all of the inflammation resolves before testing new foods?

I just need a bit more explanation on this:

My preferred version of the full elimination diet is to base each meal on one starch food and one to two vegetables. This way, if they are still having reactions, it is easier to identify the offending food as there are only 3 foods. Sometimes, they need to go down to two or even just one food for a few days. Then, once we have had a baseline of foods that dont react to for a week or two, then start the process of testing foods. One at a time from the safe food list, for up to 3 days. If in 3 days they have no reaction, then they can test the next food. If they react to a food, eliminate it, wait 4-5 days, then add another food.

In reading the foods that are accepted on the elimination diet, can one eat anything within those guidelines? When you say "base each meal on one starch and one to two vegetables" does that mean you can vary those starches and vegetables within the day, or just stick to those 3 foods for 3 days? I'm wondering if I just need to eat only, for example, sweet potatoes and broccoli for a few days or if I can eat other starches like winter squash and rice and mix up the veggies.

Also when it's listed that most cooked vegetables are OK, does that mean I can start right off with pretty much any cooked vegetable or do I need go through them one by one? And do you need to cook lettuce? It also says most cooked fruits are OK but lists pears separately, does that mean raw pears are ok?

[JeffN]

Hi Jeff,

I have been on McDougall's diet since the beginning of August to see if it will help with my Crohn's-related, inflammatory arthritis. When I started the diet my arthritis was in my right knee, left forefoot, and it had begun to start affecting my lower back and hip. Within about 4 days of starting the diet, I noticed some improvement with the size of the inflammatory cyst in the back of my knee and maybe a little less in my foot and the pain in my back was gone. I used to have a hard time walking down the stairs in the morning, but now that has improved. I had to take a blood test since I'm on Imuran, and I had my sedimentation rate checked this week (after about a month on the diet), and I was really disappointed and shocked to see that my sed rate had RISEN 10 points. It goes without saying this is a huge disappointment. I've been trying to figure out how this could be. Any thoughts on that?

With all that, I've been contemplating the elimination diet and reading your suggestions as to how to go about it. I have a few questions.

When I start the diet, do I need to wait until most or all of the inflammation resolves before testing new foods?

I just need a bit more explanation on this:

My preferred version of the full elimination diet is to base each meal on one starch food and one to two vegetables. This way, if they are still having reactions, it is easier to identify the offending food as there are only 3 foods. Sometimes, they need to go down to two or even just one food for a few days. Then, once we have had a baseline of foods that dont react to for a week or two, then start the process of testing foods. One at a time from the safe food list, for up to 3 days. If in 3 days they have no reaction, then they can test the next food. If they react to a food, eliminate it, wait 4-5 days, then add another food.

In reading the foods that are accepted on the elimination diet, can one eat anything within those guidelines? When you say "base each meal on one starch and one to two vegetables" does that mean you can vary those starches and vegetables within the day, or just stick to those 3 foods for 3 days? I'm wondering if I just need to eat only, for example, sweet potatoes and broccoli for a few days or if I can eat other starches like winter squash and rice and mix up the veggies.

Also when it's listed that most cooked vegetables are OK, does that mean I can start right off with pretty much any cooked vegetable or do I need go through them one by one? And do you need to cook lettuce? It also says most cooked fruits are OK but lists pears separately, does that mean raw pears are ok?

The purpose of the ED is to find safe, non-reactive foods. The best and simplest way to do that is to test foods. Testing takes several days to make sure the food is safe. The less variety there is in the beginning, the easier it is to identify an unsafe food.

Once safe foods have been established, they can be included ad libitum. However, any new food should be included at each meal for up to 3 days to make sure it is non-reactive. If you react within the 3 days, eliminate that food and what a few days before testing another one.

I hope that makes sense

In Health
Jeff