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October 27, 2018

"Any food allergies or dietary restrictions?"

"Yes, I can't have any nuts, chia seeds, corn, soy, nightshades, dairy, peanuts, shellfish…"

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"Hold on, hold on—I need to get a pen."

I'm a food writer. With food allergies. The above has been a typical (read: painful) interaction when dining out for the past year. It started off with a couple of innocuous bumps on my chin in August 2017 while I was on a family trip in Greece. I brushed it off as a result of the copious amounts of cheese, pasta, and gelato I'd eaten in Italy the week before.

But then it spread like wildfire on my face overnight. They weren't large, deep, cystic-like blemishes but rather very small and numerous. My mother said it was heat rash; we'd been bouncing from beach to beach for the last couple of weeks. My sister said it was a random breakout. "You're always so stressed!" My tía insisted that I must have brushed my face against something that caused an allergic reaction (contact dermatitis). She sent me to the home of her go-to, back-alley facialist in Athens for extractions, who must have had her own theories she shared during our session but were lost on me since I spoke no Greek and she no English. From what I gathered, she blamed it on my menstrual cycle.

Upon returning to New York City, I did what I always do when my skin gets troublesome: cut out all dairy, most meat except fish, added and refined sugars, white breads, pasta, potatoes, and alcohol. I reverted to my usual high intake of veggies, chia seed puddings, overnight oats, nuts, nut milks, nut butters, beans, and whole grains in between restaurant visits for stories I was covering, where I ate everything since it's my job. 

No matter how "healthy" my diet was, the red bumps on my skin remained.

Food is my first love. I've been covering restaurants, food, and travel for about six years. But I eat an extremely clean diet when I'm not out dining at restaurants. I am also mindful when I eat out. I used to boastfully joke that "I'm not friends with people who have allergies or dietary restrictions" when servers would ask the now dreaded question: "Any food allergies or dietary preferences?"

But those bumps that began in the summer never went away, no matter how "perfect" or "healthy" I thought I was eating or how vigilant I was with my skin care. They only got worse. I was massively embarrassed and would ping-pong from spackling on lots of makeup to hide the bumps to stripping it all away and faux-proudly declaring that I was "embracing my flaws." I visited various allergists countless times, insisting that they each give me every prick and blood test under the sun for food allergies. They all turned up inconclusive with the exception of a mild sensitivity to sweet potato. I even tried an at-home food sensitivity kit from EverlyWell. Also inconclusive. The rashes on my face persisted.

According to a recent study in the Journal of Allergy and Clinical Immunology1, approximately 4 percent of Americans have a food allergy, with women and those of Asian descent the most affected. But this doesn't account for the thousands of people who are subclinical, or have food sensitivities. So while I wasn't dropping dead from anaphylactic shock if I ate a peanut, the rashy acne I was experiencing is just one among a laundry list of symptoms of a food sensitivity (which include anxiety, depression, joint pain, asthma, acne, bad breath, constipation, diarrhea, fatigue, brain fog, hyperactivity, and even stubborn weight loss).

How my mystery skin issues led me to the elimination diet.

"Have you tried an elimination diet?" a health-minded friend shared with me while I was lamenting over my troubled skin. "Apparently, that's the only way to know." This was the last thing I wanted to do. Ever. Sure, reducing the amount of inflammatory or naughty foods I ate was easy enough, but eliminating whole food groups entirely for months at a time? That was career suicide. But I was at my wit's end. Frustrated with the state of my skin, I was prepared to do anything.

An elimination diet removes foods that are most likely to irritate your body for just a few weeks and gives your body a chance to calm down and focus on healing.

"Then when you bring those foods back one by one, you can identify what specifically is helping or hurting your health. We are all different, with unique genetics and health issues, so this second stage of the elimination diet, the reintroduction stage, will look different for all of us," says functional medicine practitioner William Cole, D.C.

According to the Food and Drug Administration2, the major food allergens are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soybeans. I wiped out all of them from my diet immediately, apart from fish. Additionally, I obliterated gluten altogether, nightshades, and chia seeds, since I ate them in abundance. Alcohol took a sabbatical so I could further heal. Corn got the ax too since it is widely genetically modified food.

For three weeks straight, I avoided these foods like the plague. Here are a few lessons I learned along the way:

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1. Your social life takes a backseat.

Man, was I the hardest person to go out with! With so many foods (and drinks!) on the banned list, I would either skip social outings with my friends altogether or be THAT person who orders a salad while everyone else is having burgers, avo toast, and all the fun foods. I would compensate by being super chatty and dominate conversation so hopefully no one would notice I wasn't eating. Or I would drink a TON of water, coffee, and juice. Then I would go home and eat my "permitted" foods.

2. You have to be hypervigilant. And I mean hypervigilant.

Over the course of my elimination diet, I became VERY aware of how all my food is prepared. At home it was easy to control, but when dining out, I would have long and tedious conversations with the server about what exactly was in the food or how it was prepared. I would grill them over and over again, asking if they were ABSOLUTELY SURE the Brussels sprouts were fried in olive oil and not peanut oil or butter, or if there were any nuts or shellfish hiding in the dressing of the salad? They were flustered. I felt like a jerk making them go back and forth, asking them to double check with the chef. My guests would smile nicely, but I could tell they were squeamish.

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3. People will not take you seriously, so prepare yourself.

If you're not going to drop dead on the floor if you are in the same room as a peanut, I learned that people don't take very kindly to food sensitivities (unless they themselves have one, in which case you will most likely immediately launch into a lengthy pity party together). More often than not when dining out, servers really didn't know everything that went into their own food and would ask if I had a "deadly" allergy? When I would reply, "No, my allergy isn't deadly, but I am avoiding x, y, and z," you could see immediately that they thought I was being a high-maintenance customer probably trying to lose weight or hopping on the latest health trend.

My face was a wreck, but apparently the risk of death was the only way I could get people to pay attention. So I actually just started saying that the laundry list of foods I was avoiding was deadly in order to avoid the judgment. It is just easier when they are doing their best to make sure you don't die in the dining room. I began to adore restaurants that were kind and open to food allergies and modified diets (and I have a very good list now in NYC).

4. Your social life and career will recover.

As a food writer, I would wear my ability to eat anything and everything like a badge of honor. But when I would share that I was on an elimination diet with people, I would get the obvious "How do you do your job then?" or "Are you going to change careers?" And in truth, it did make my job very difficult! I had to arrange to cover stories that would fit within my new eating habits, or work on topical pieces that didn't necessarily mean physically eating. I was worried people wouldn't take me seriously either in my professional life. But I realized, for as many foods that I couldn't (temporarily) eat, there are a ton of other foods that I could eat! I focused on eating foods that were available to me, and it really did open a whole new world of what I could eat. I also started covering non-food-related topics like travel, beauty, and lifestyle.

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5. I experienced a reduction in symptoms (goodbye, acne!).

Yes, I did see a reduction in my rashes and acne! During the third week of my elimination diet, I noticed that my face was less inflamed and bumpy and began healing. It wasn't clear by any means, but I saw the subtle beginnings of improvement. This helped me keep at it.

6. I learned that what's healthy for someone else might not be healthy for me.

I used to pat myself on the back for how "healthy" I thought my diet was. It was laden with whole grains, beans, nuts, legumes, tons of veggies, matcha and was dairy-free and refined-sugar-free! But what's healthy for somebody else may not be healthy for you, and I began to see how much an overindulgence of nuts, seeds, and beans was affecting my health and skin. Having categorical definitions of foods as "healthy" or "not healthy" can be extremely misleading because even foods we currently define as healthy can have adverse reactions in our bodies—depending on how much of them we eat, how they're produced, and our own individual genetic makeup. When I started my elimination diet, I saw just how much I abused nuts, seeds, and beans because I was told they were healthy. But they weren't actually healthy for me—quite the opposite, in fact!

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7. Once I got the hang of it, I felt really empowered.

When I began my elimination diet, I thought I would never live without my daily bowl of overnight oats, chia puddings, or nut butters. Not only were they delicious mornings I looked forward to but an outlet for creativity (I loved coming up with fun combos!). But I had to re-shift my eating patterns, and successfully doing so gave me a sense of empowerment—that I was in control and that food did not control me. People can be "addicted" to all kinds of foods, even "healthy" ones like oatmeal and nuts! I certainly was. 

8. It's not really over in three weeks.

Three weeks is just the tip of the iceberg on an elimination diet. After a minimum of three weeks of temporarily avoiding the foods on the banned list, you reintroduce them one by one. This is called the reintroduction phase. You pick just one of the offending foods previously eliminated, eat a normal serving of it, and wait a day or two to see if you have any reactions to it. If there are no reactions, then you can slowly add it back into your diet (don't overdo it!). But this means individually reintroducing each food, which translates into about two or three more weeks tacked onto the original three-week elimination phase. The more foods you've eliminated, the longer the reintroduction phase takes. The better you can clearly control the reintroduction and observe your reactions (or lack thereof), the better you can safely scratch off a food from a sensitivity. But if you reintroduce two banned foods at the same time and have a reaction, it's hard to tell which food caused the reaction. I learned this the hard way when I, too, excitedly dipped my toe back into the waters of nuts and seeds and set myself back with more rashes.

So was an elimination diet worth it? For me, it definitely has been because my skin has definitely improved.

It's taken me several tries to perform an elimination diet correctly due to a variety of things like hidden allergens in foods I was unaware of at meals, traveling, and social reasons. I've also learned that you may not be categorically allergic to one group of food but rather a specific food within that category, like let's say hazelnuts and not cashews. This also lengthens the process if you want to get very specific.

You can perform a guided elimination diet under the care of a nutritionist or specified program or fly solo like I did (self-guided). I'm not done with my elimination diet journey, either. I'm still working on eliminating and reintroducing foods to see how not only my skin but my body as a whole improves or doesn't. The biggest take-away I've come out with is that not all foods—even those labeled healthy like oatmeal, nuts, seeds, and nightshades—are beneficial for everyone. It's a matter of testing out what foods make you feel best, and that's different for everyone. 

Want to turn your passion for wellbeing into a fulfilling career? Become a Certified Health Coach! Learn more here.