Six Food Elimination Diet

Eosinophilic esophagitis (or EoE) is an inflammatory allergic disease that is caused by an abnormally high level of white blood cells (eosinophils) in the esophagus. This can happen in response to a food or environmental allergen. This resulting inflammation in the esophagus can create constrictions, making it hard to swallow. A specific diet, called the Six Food Elimination Diet, has been shown to reduce or eliminate the symptoms of EoE. 

What is the Six Food Elimination Diet?

The Six food Elimination Diet eliminates the six key allergenic foods that are often at the root of EoE. This includes Milk & Dairy, Soy, Eggs, Wheat, Peanuts & Tree Nuts, and Seafood (fish and shellfish). For 4 to 6 weeks you will remove ALL of these foods. A 100% elimination of these foods is critical for calming down symptoms before beginning a reintroduction process. If you don't get these foods out completely you may not be able to heal or determine which specific foods are behind your symptoms. It is important to plan for this diet, and to eat foods prepared at home, as eating out can expose you to cross-contamination (exposure to foods you are trying to eliminate). 

After 4 to 6 weeks on the elimination phase of this diet, or until your symptoms calm down, you will begin a slow reintroduction process. Use a food journal to keep track of your daily symptoms, the foods you consume each day, and how you feel after reintroducing a new food. Each week for the following six weeks you will reintroduce one food group. For Dairy & Milk, start with one serving of milk at breakfast, and then if no symptoms occur, continue with another serving at lunch and dinner. Do this for at least 3 days, then remove the food from your diet again for 4 days. During this time, watch for a potential delayed food reaction. Keep the food out of your diet while you test for the other foods (even if you had no reaction). If you had a reaction to milk then wait to test the next food group until your symptoms calm down again. It is important to get back to baseline before each new food reintroduction. Test for eggs next in the same manner. Continue next with soy (tofu, tempeh, soy milk), and then seafood (fish and shellfish), then reintroduce nuts next, and finally, wheat. Use an artisan organic wheat bread (with no other ingredients other than wheat flour, water, salt, and yeast) to test for wheat. Be sure to track all of your symptoms in a journal!

Use the search feature on this site to search for recipes for this diet. All of the recipes tagged for the Six Food Elimination Diet are designed for the Elimination phase of this diet. During each week of the reintroduction phase, add the food you are testing to the search feature along with Six Food Elimination Diet to find recipes to work for that specific food reintroduction. 

The Six Food Elimination Diet is beneficial for anyone with:

  • Swelling of the throat
  • Difficulty swallowing foods
  • Abdominal or chest pains
  • Vomiting
  • Weight loss
  • Failure to thrive in children

What can I eat on the Six Food Elimination Diet?

First, let's go back over what is eliminated from this diet. Post this list to your refrigerator and remember that ingredients with different names can hide in processed foods. This is why it is best to work towards preparing your meals and snacks at home using whole food ingredients. 

Foods EXCLUDED from the Six Food Elimination Diet:

  1. Milk & Dairy (butter, milk, cheese, yogurt, sour cream, cream cheese, kefir, casein, lactoglobulin, lactoalbumin, lactose, whey, hydrolyzed whey, hydrolyzed whey protein, whey protein)
  2. Soy (tofu, tempeh, soy milk, edamame, soy beans, miso, soy sauce, tamari, TVP, soy protein isolate, soy cheese, soy ice cream)
  3. Eggs (whole eggs, egg whites, egg yolks, mayonnaise, custards, ice cream, frosting, meringue, fresh pasta, egg albumin)
  4. Peanut & Tree Nuts (peanuts, peanut butter, almonds, cashews, pistachios, pecans, walnuts, Brazil nuts, hazelnuts, almond extract, tree nut oils, nut flours and meals)
  5. Fish & Shellfish (all fish, clams, mussels, oysters, scallops, shrimp, crab, lobster)
  6. Wheat (wheat flour, all purpose flour, bread, baking mixes, wheat berries, spelt, triticale, einkorn, durum, semolina, emmer, farro, farina, kamut, couscous, bulgar, wheat bran)

Foods INCLUDED on the Six Food Elimination Diet:

  • Dairy substitutes (coconut milk, oat milk, hemp milk, organic vegetable shortening, coconut milk ice cream, dairy-free "butter")
  • Soy sauce substitute (coconut aminos, soy-free marinades made with coconut aminos)
  • Egg substitute (chia egg, flax egg, egg-replacer)
  • All seeds and seed butters (pine nuts, sunflower seeds and Sunbutter, pumpkin seeds, chia, flax, sesame seeds and tahini)
  • Gluten-free and wheat-free grains and flours (teff, brown rice, amaranth, millet, buckwheat, sorghum, barley, and rye)
  • All meat and poultry
  • All legumes other than soy
  • All vegetables and fruits
  • Olive oil, avocado oil, grapeseed oil, coconut oil

How do I begin a Six Food Elimination Diet?

  1. Sign up and become a member on this site
  2. When you set up your user profile or use the search feature, choose Six Food Elimination Diet. 
  3. Then search for recipes to add for breakfast, lunch, and dinner and add them to your meal plan or meal planning calendar. 
  4. Plan for 4 to 6 weeks on the Elimination phase of this diet and another 6 weeks for the Reintroduction phase. Make sure you schedule this properly to avoid times you may be traveling. 
  5. Join our Nourishing Meals Community Facebook Group to get notified with new recipes and more! Everyone is welcome.