What is the 6 Food Elimination Diet?

The Six Food Elimination Diet (SFED) is a therapeutic dietary approach designed to help individuals with eosinophilic esophagitis (EoE) identify food triggers by removing the six most common allergenic foods from the diet. These foods include:

• Milk & Dairy

• Soy

• Eggs

• Wheat

• Peanuts & Tree Nuts

• Fish & Shellfish

These six food groups are known to contribute to a majority of food-triggered immune responses in individuals with EoE. By fully removing them for a period of 4 to 6 weeks, you allow inflammation in the esophagus to calm and create a clearer baseline from which to begin reintroducing foods. The diet is not just about avoiding certain foods—it’s a process of discovery and healing, allowing you to better understand your body and create a personalized path toward wellness.

A 100% elimination of these foods is essential for 4 to 6 weeks to allow the esophagus to heal and symptoms to improve. After that, a carefully structured reintroduction phase helps identify which foods are triggering symptoms.

Who is the 6 Food Elimination Diet For?

This diet is especially beneficial for individuals experiencing symptoms related to EoE, such as:

• Swelling of the throat

• Difficulty swallowing foods

• Abdominal or chest pain

• Vomiting

• Weight loss or failure to thrive (especially in children)

It may also benefit those with unexplained food sensitivities or suspected allergic gastrointestinal symptoms not resolved with basic elimination diets.

How the 6 Food Elimination Diet Works:

Phase 1: Elimination (4 to 6 weeks) Remove all six major allergenic foods completely. 100% avoidance is essential to allow symptoms to subside and inflammation to calm. This includes eating only home-prepared meals to avoid cross-contamination.

Phase 2: Reintroduction (6 weeks) Once symptoms improve, reintroduce one food group per week while carefully tracking symptoms. Reintroduce each food for 3 days, then remove it for 4 days to watch for delayed reactions. Only introduce one new food group at a time, and always wait for symptoms to subside before testing the next food.

We recommend keeping a detailed food and symptom journal throughout the process to identify trigger foods.

Foods to Avoid on the 6 Food Elimination Diet:

These six food categories must be fully eliminated:

• Milk & Dairy: Butter, milk, cheese, yogurt, sour cream, kefir, cream cheese, whey, casein, lactose, lactoalbumin, lactoglobulin, hydrolyzed whey protein

• Soy: Tofu, tempeh, soy milk, edamame, miso, soy sauce, tamari, TVP, soy protein isolate, soy-based dairy replacements

• Eggs: Whole eggs, egg whites, egg yolks, mayonnaise, custards, meringue, ice cream, fresh pasta, egg-containing baked goods

• Peanuts & Tree Nuts: Peanuts, almonds, cashews, pistachios, walnuts, Brazil nuts, hazelnuts, pecans, nut butters, nut oils, nut flours

• Fish & Shellfish: Salmon, tuna, cod, shrimp, crab, lobster, scallops, mussels, clams, oysters

• Wheat & Gluten-Containing Grains: Wheat flour, spelt, kamut, triticale, semolina, durum, farro, emmer, couscous, bulgur, wheat bran, wheat-based pasta, breads, and baked goods

Foods to Eat on the 6 Food Elimination Diet:

You can still enjoy a variety of nourishing, flavorful foods while avoiding the top allergens. This diet focuses on simple, whole food ingredients that are safe and anti-inflammatory.

• Dairy Substitutes: Coconut milk, oat milk, flax milk, hemp milk, coconut milk ice cream, dairy-free "butters"

• Soy-Free Alternatives: Coconut aminos, soy-free sauces and marinades

• Egg Replacements: Flax egg, chia egg, commercial egg replacers (without soy)

• Seeds & Seed Butters: Sunflower seeds and SunButter, pumpkin seeds, chia, flax, sesame and tahini (unless also removed by practitioner)

• Gluten-Free Grains & Flours: Brown rice, quinoa, teff, millet, sorghum, amaranth, buckwheat

• Proteins: All meats and poultry (organic and grass-fed preferred)

• Legumes (excluding soy): Black beans, lentils, chickpeas, split peas

• Fruits & Vegetables: All fresh fruits and non-allergenic vegetables

• Fats & Oils: Olive oil, avocado oil, coconut oil, grapeseed oil

• Snacks & Treats: Seed-based energy bites, coconut-based treats, fresh fruit, veggie sticks with guacamole or seed-based dips

Benefits of the 6 Food Elimination Diet:

Many individuals with EoE or unresolved food sensitivities experience profound benefits from this structured approach:

• Reduction or elimination of EoE-related symptoms

• Clearer identification of specific food triggers

• Improved ability to swallow and reduced esophageal inflammation

• Increased energy and overall wellbeing

• More regular digestion and reduced GI distress

• Better nutrient absorption, especially in children with failure to thrive

This approach offers a powerful way to identify and eliminate food triggers, empowering individuals to regain control of their health.

Challenges of the 6 Food Elimination Diet:

While effective, this protocol does come with challenges:

• The diet is restrictive and requires diligent planning

• Eating out becomes difficult due to cross-contamination risks

• Hidden ingredients in processed foods can make adherence challenging

• Emotional or social aspects of eating may feel limited

Because of its complexity, many people do best starting with a gentler approach such as removing gluten and dairy first. If symptoms persist—despite nervous system support, gut-healing practices, and lifestyle changes—then the Six Food Elimination Diet may be an appropriate next step.

How to Start the 6 Food Elimination Diet:

1. Join Nourishing Meals® to access compliant recipes, personalized meal plans, and grocery list tools.

2. Set your user profile to "Six Food Elimination Diet" to filter recipes easily.

3. Plan meals ahead using our calendar-based planning tool and recipe filters.

4. Start with 4 to 6 weeks of strict elimination. Avoid travel and social events where food exposure may be difficult to manage.

5. Keep a food and symptom journal to track progress and guide reintroduction.

6. Use our advanced recipe filters to add back one food at a time during the reintroduction phase.

7. Join the Nourishing Meals Community Facebook Group to stay supported and inspired throughout the process.

This diet may feel like a big shift, but it can uncover the root of long-standing symptoms and bring profound relief when followed carefully. You deserve to feel well, and this structured approach can help you get there—one healing meal at a time.