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Do Elimination Diets Work?

An increasing number of people are opting to eliminate specific foods from their diet in an attempt to improve their health while decreasing unwanted health symptoms often misattributed to food intolerances.

However, research actually indicates that weight loss, and specifically fat loss, reduces chronic inflammation throughout the body and is as effective as food elimination in improving overall health and alleviating symptoms of specific health conditions in ways people often misattribute to health improvements achieved by eliminating certain foods from the diet.

To better understand how weight loss, and specifically visceral fat loss, provides comparable health improvements to those experienced by removing “harmful” foods from the diet, it’s important to first understand what an elimination diet is and how it’s purpose differs from diets intended for weight loss or visceral fat loss.

Understanding Elimination Diets

An elimination diet, or food restriction diet, is actually a prescribed eating plan designed to improve overall health by eliminating specific foods thought to be contributing to specific health conditions as a result of a:

  • Food allergy
  • Food intolerance
  • Food sensitivity

Key Insight: The goal of an elimination diet is to identify and eliminate specific food(s) contributing to the unwanted health conditions and causing your body to constantly send out inflammatory responses that result in a number of serious health issues.

Researchers have determined that eight specific foods: shellfish, soy, gluten, nuts, peanuts, eggs, and milk account for over 90% of the food allergy reactions and are thought to contribute to several of the symptoms associated with a number of serious health conditions, including:

  • Autoimmune Disorder
  • Arthritis
  • Asthma
  • Chronic fatigue
  • Cognitive decline and neurodegenerative diseases, including Parkinson’s and dementia
  • Inflammatory bowel disease
  • Migraines
  • Mood disorders, including depression, and anxiety
  • Skin flare-ups like eczema, hives, and acne
  • Autoimmune disorders

The Visceral Fat-Health Connection

Nearly all the benefits attributed to the removal of “bad” foods from the diet can also be realized through a reduction in harmful body fat, specifically visceral and organ fat.

Visceral fat, or deep fat, is different than typical “subcutaneous” fat (the fat typically stored underneath the skin and typically known as belly fat or body fat). It is a form of body fat consisting of gel-like white adipose tissue and is most commonly stored deep in the abdominal cavity.

Visceral fat builds up in the arteries and actually wraps itself around several vital organs, including:

  • The Liver
  • The Intestines
  • The Stomach

What makes this white adipose tissue, or visceral fat, so much more dangerous than traditional body fat is that it actually changes the way these organs function by releasing adipokines, hormones that communicate with the organs and causes increased levels of inflammation in the body.

Adipokines are actually involved in a ‘good-bad’, yin-yang homoeostatic balance1, meaning they can provide substantial benefits: cardioprotection, promoting endothelial function, angiogenesis and reducing hypertension, atherosclerosis, and inflammation when present in appropriate amounts.

However, when present in excess and released in large volume as a result of too much visceral fat, adipokines have been implicated as a major contributor to several unwanted health conditions, including (but not limited to) autoimmune disorders, arthritis, diabetes, cardiovascular disease, atherosclerosis, migraines, and cardiovascular disease2.

The good news is that weight loss, and specifically visceral fat loss, is effective in reducing inflammation in the body, improving health in ways that people commonly attribute to results achieved by restricting specific foods from their diet.

Bottom Line: Research now demonstrates that reducing adipokines through weight loss has effects that are very similar to those observed through food restriction; both elimination diets and visceral fat loss result in significant reduction in the release of proinflammatory proteins throughout the body, which reduces inflammation and relieves symptoms associated with several health issues.

Health

A significant weight loss of 24% from baseline weight, using a very low-calorie diet resulted in significant improvements in circulating levels of adipokines, plasminogen activator inhibitor type 1, and adiponectin, which is most likely attributed to weight loss and not macronutrient intake or restriction3.

Autoimmune Disorders

Autoimmune disorders are conditions that cause your immune system to mistakenly attacks parts of your body, mistaking the cells, tissue, or organs as foreign bodies and releasing antibodies that caused inflammation and actually attack healthy cells; these disorders include:

  • Rheumatoid arthritis
  • Lupus
  • Inflammatory bowel disease
  • Type 1 diabetes

There is a growing body of research linking the secretion of adipokines, released by excess adipose tissue and obesity, to low-grade inflammation resulting in a number of symptoms related to various autoimmune disorders, including inflammatory and rheumatic autoimmune diseases4.

Arthritis

Osteoarthritis (OA) is a degenerative joint disease that causes the cartilage that cushions joint movement to break down, resulting in pain and swelling. Although OA can affect any joint in the body, it is most commonly found in the knees, hips, back and joint of the fingers.

OA has an obvious relationship to obesity: The more weight that’s placed on a joint, the more stressed it becomes, and the more likely it will wear down, become damaged, and develop arthritis.

But it’s not just the extra weight that results in damage to the joint. The adipokines created and released by excess visceral fats result in a constant state of inflammation, which influences the development of OA5.

Rheumatoid arthritis (RA), another form of arthritis, is a chronic inflammatory condition that affects the joints of the body. Unlike OA, and since it is considered an autoimmune disease, RA also affects several organs and body systems, including the eyes, skin, and cardiovascular system.

Roughly 66% of those diagnosed with RA are overweight or obese, which is the same proportion of people in the regular population. In those suffering from RA, however, the increased level of body fat creates health issues in addition to the traditional increased risk of diabetes and cardiovascular diseases typically associated with obesity.

Key Insight: Researchers have found the excess fat in people with RA is often centered around the abdomen (known as visceral fat), which further increases the risk for heart disease and insulin resistance by 50% when compared to those without RA.

These fat cells, or adipocytes, release proteins called cytokines that, in excess, cause constant, low-grade inflammation throughout the body and are the same chemicals that influence the development of OA6.

Asthma

Obesity is a significant risk factor for asthma. While the specific reasons for this correlation remain a mystery to researchers, the prevailing thought is that the inflammation resulting from changes caused by excess visceral fat contributes to inflammation of the airways and restricted airways in those who are obese or overweight.

Research demonstrates that patterns of airway inflammation in people carrying excess weight and have asthma are reversed when these subjects lose weight as a result of bariatric surgery7.

Chronic Fatigue

Chronic fatigue syndrome (CFS) is a complex and debilitating disorder affecting multiple body systems and is diagnosed in those experiencing six or more months of fatigue and demonstrating between four and six of 8 minor symptoms, including:

  • Headaches
  • Muscle pain
  • Joint pain without swelling
  • A sore throat
  • Tender or swollen lymph nodes in the neck and underarms

Key Insight: Obesity has been correlated with fatigue, sleep problems, and less satisfaction with general health, functioning, and vitality, but the CDC estimates that nearly 90% of CFS cases go undiagnosed8.

Recent studies have indicated that CFS is linked to inflammation and is the result of the body’s immune system reacting to perceived infections in the body and as a result of cytokines, the cell signaling molecules, being released by adipokines found in visceral fat9.

Parkinson’s and Dementia

A number of studies indicate that obesity is associated with poor cognitive performance, cognitive disorder, increased cognitive decline, and dementia10.

Incidences of dementia, including Alzheimer’s disease, continues to steadily increase and appears to have a direct correlation with rising obesity rates. Currently, nearly 50 million people are affected by dementia; a number that is expected to increase to nearly 80 million over the next decade.

Not only has obesity been associated with an increased risk of dementia, but it has also been associated with:

  • Mild cognitive impairment
  • Poor working memory
  • Executive function deficit

Key Insight: Research has yet to establish the exact connection between obesity and increased risk of cognitive decline; while further research is needed, the likely contributor is systemic and central inflammation related to increased levels of white adipose tissue and visceral fat in the body.

Not only has obesity been shown to cause negative health issues in the developed adult brain, but inflammation resulting from increased visceral fat has also been shown to cause distinct and lasting changes in the brains of children and adolescents, leading to a long-term association between obesity and cognitive function and brain health11.

Obesity and related health conditions are clearly associated with impaired cognitive performance, accelerated cognitive decline and even dementia in later life. Interventions targeting mid-life obesity may prove beneficial in reducing the cognitive risks associated with obesity12.

Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD) is a condition resulting from chronic inflammation and caused by a combination of genetic and environmental factors, including obesity and excess amounts of stored visceral fat.

The incidence rate of inflammatory bowel disease has consistently increased over the last twenty years, and specifically in developing countries. Researchers attribute this increase in IBD to dietary changes, sedentary lifestyles, and increased obesity rates.

Studies examining the link between obesity and IBD have consistently demonstrated that proinflammatory adipokines released by adipose tissue contribute to the observed correlation between obesity and IBD. Additional research has demonstrated that weight loss disrupts development of IBD and other autoimmune conditions13.

Migraines

Obesity is associated with increased occurrence of migraine headaches. Specifically, increased levels of body fat, and specifically visceral fat, elevates the secretion of proinflammatory adipokines.

This increase in adipokines has been attributed to increased risk of migraines and migraine inflammation. Lower overall levels of total fat-free mass (FFM) has also demonstrated to be a significant contributor to increased risk of migraines in people who are classified as overweight and obese14.

Mood Disorders

Scientific research has established a direct correlation between depression and increased amounts of visceral fat, especially in women considered to be obese or overweight.

These studies demonstrate that the presence of increased amounts of visceral fat is an important contributor to depression, as well as further demonstrating depression’s connection to increased risk of diabetes and cardiovascular disease. Interestingly, the same studies found no association between depression and the presence of subcutaneous fat – only visceral fat.

Researchers attribute the connection between depression and visceral fat directly to the chemical changes caused by the propensity of excess visceral fat to the increased number of proinflammatory proteins secreted into the affected areas of the body15.

In contrast, increased total lean body mass was strongly associated with fewer symptoms of mood disorder, including fewer symptoms of anxiety and depression. These findings further suggest a strong correlation between body compositions and mood disorder16.

Skin Flare-Ups

The presence of visceral fat has also been linked to skin breakouts and skin flare-ups, including eczema, psoriasis, and hives. In expressing these inflammation-induced flare-ups, the skin is typically providing an indication of a health problem elsewhere in the body, most often in the area of the gut, stomach, or liver.

Interestingly, the research found that the people who were obese or overweight were more likely to have eczema than people who were not obese or overweight. In fact, subjects with an elevated body mass index were found to be nearly 10 times more likely to have eczema than those with lower body mass indexes. These findings have led to the conclusion that obesity is associated with increased prevalence and increased severity of eczema, increased chronic health conditions, greater reliance on health care, and overall poor health17.

Psoriasis is often considered a result of an autoimmune condition, but it can be triggered by other factors, including metabolic syndrome and obesity18.

Chronic spontaneous urticaria (CSU), more commonly known as hives, is a common skin condition that is often difficult to determine an exact cause. Recent research has suggested that metabolic syndrome and hyperlipidemia, or high levels of fat in the blood, are more prevalent in people with CSU; this finding is a clear indication that hives are associated with inflammation caused by visceral fat and more common in people who are overweight or obese19.

Reducing Inflammation and Improving Health

While eliminating specific foods from your diet may be an effective way to manage food insensitivity and reduce inflammation in the body, research demonstrates that reducing waist size and visceral fat from the abdominal region has proven to be as effective as food elimination in alleviating symptoms and related to several health issues.

If you would like any support with this, IH would be happy to help. Contact us today to learn more, to schedule a time to meet one of our doctors, and to learn more about what you can do to safeguard your long-term health.

1. “Role of adipokines in cardiovascular disease. – NCBI.” 2 Jan. 2013, https://www.ncbi.nlm.nih.gov/pubmed/23160967.
2. “Adipokines mediate inflammation and insulin resistance. – NCBI – NIH.” https://www.ncbi.nlm.nih.gov/pubmed/23781214.
3. “Effect of weight loss on adipokine levels in obese patients. – NCBI.” 3 Aug. 2011, https://www.ncbi.nlm.nih.gov/pubmed/21887104.
4. “Obesity as a Risk and Severity Factor in Rheumatic … – NCBI – NIH.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4227519/.
5. “Obesity and Arthritis | Obesity – Arthritis Foundation.” https://www.arthritis.org/living-with-arthritis/comorbidities/obesity-arthritis/fat-and-arthritis.php.
6. “How Fat Affects Arthritis – Arthritis Foundation.” https://www.arthritis.org/living-with-arthritis/comorbidities/obesity-arthritis/fat-and-arthritis.php.
7. “Obesity and Asthma – NCBI – NIH.” 1 Oct. 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480522/.
8. “Examining the impact of obesity on individuals with … – NCBI – NIH.” 24 Jun. 2013, https://www.ncbi.nlm.nih.gov/pubmed/23799656.
9. “Cytokine signature associated with disease severity in chronic … – PNAS.” 25 Jul. 2017, http://www.pnas.org/content/early/2017/07/25/1710519114.
10. “Obesity and cognitive decline: role of inflammation and vascular ….” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237034/. Accessed 29 Nov. 2018.
11. “Obesity and cognitive decline: role of inflammation and vascular ….” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237034/.
12. “The relationship between obesity and cognitive health and decline..” 11 Sep. 2017, https://www.ncbi.nlm.nih.gov/pubmed/28889822.
13. “Interaction of obesity and inflammatory bowel disease. – NCBI.” 21 Sep. 2016, https://www.ncbi.nlm.nih.gov/pubmed/27672284.
14. “The effect of body fat mass and fat free mass on migraine … – NCBI – NIH.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3829270/.
15. “Depressive symptoms and increased visceral fat in … – NCBI – NIH.” 27 Apr. 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2739059/.
16. “Body composition and depressive/anxiety symptoms in … – NCBI – NIH.” 23 Dec. 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3913787/.
17. “Association between obesity and eczema prevalence, severity and ….” https://www.ncbi.nlm.nih.gov/pubmed/25000233.
18. “Overweight and obesity may play a role in the pathogenesis of chronic ….” 12 Jan. 2018, https://www.ncbi.nlm.nih.gov/pubmed/29327369.
19. “Overweight and obesity may play a role in the pathogenesis of chronic ….” 12 Jan. 2018, https://www.ncbi.nlm.nih.gov/pubmed/29327369.

Written by Dr. Roz Ranon of Integrative Health. Dr. Roz Ranon, NMD is an Arizona board-certified Naturopathic Physician practicing with Dr. C at Integrative Health with a focus on Hashimoto’s Thyroiditis.

Learn more about Dr. Ranon here

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