The Elimination Diet Unlocks Priceless Data about the Individual

The Elimination Diet Unlocks Priceless Data about the Individual


– [Woman] This podcast,
including any related materials, such as show notes, links,
and supportive materials, is provided by Metagenics Institute, the educational arm of Metagenics, Inc., for general informational and
educational purposes only. This podcast does not
constitute medical advice and should not be considered a substitute for discussions between individuals and their healthcare providers. The podcast presenters’
views are entirely their own and do not represent the
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referred to as affiliates. Metagenics Institute and its affiliates do not endorse or recommend any specific healthcare providers,
products, or other items or services that may be
discussed or mentioned in this podcast. Podcast participants
may receive compensation from Metagenics Institute
and or its affiliates. Metagenics products are
not intended to diagnose, treat, cure, or prevent any disease. – There is a staple of
personalized lifestyle medicine that has shocked my
colleagues, my patients, and me in how substantially it reduces symptoms for so many conditions. The simple solution is
the elimination diet. On this episode of “The Practice,” Doctor Deanna Minich shares
implementation strategies for inspiring compliance
with an elimination or metabolic detoxification diet. These diets are the key to unlocking treasure troves of unique data about the individuals willing
to stick to the protocols. – It’s my first line of
approach with somebody, especially when you have multiple things that you could be doing. I feel like the elimination
diet cuts through all of them and really creates a baseline. It’s like a new baseline. It’s like that reset that you need in order to get people
thinking differently, living differently, and
really feeling differently in their bodies. – Testing for food
sensitivities may be expensive and challenging. Results can be misleading, especially with so many people’s results
indicating sensitivities that might have more to do with increased intestinal permeability,
known as leaky gut. After all, the body will create antibodies for any substance that is
leaking through the gut wall. A reliable alternative
is to have the patient experience their reaction to foods as they are reintroduced after
a 28-day elimination diet. The elimination diet gives specific, experiential evidence
that can motivate people to make changes. As with most protocols, the
challenge is compliance. Join us as Doctor Deanna Minich provides the three key principles
to share with your patients before starting them
on an elimination diet. (bright music) Doctor Deanna Minich, I’m so excited to have you with me today. – I’m excited to be here with you. Thanks for having me. – My pleasure. So we’re gonna talk today
about the elimination diet and also the detox food plan. You’ve just published
five amazing case studies on this process that you went through with the elimination diet. And so I wanna start first
with just explaining. What do you mean by the elimination diet? It’s been around for a long time. But you had a particular
protocol that you followed. – I’m so glad that you asked me about the elimination diet,
because like you said, it’s been around forever. It feels like forever. I mean, there are other
scientific publications, not just mine, that do focus
on the elimination diet and all the things that
it can do for people. So in these cases, we
used a standard protocol set forth by the Institute
for Functional Medicine, which is eliminating a
number of different things, many of the top offenders, allergens, the top eight allergens
that are well recognized. And then we look at- – Can you just run through what those are? – Some of those allergens? – So that we’re all on the same page. – Sure. Corn, soy, wheat, eggs, dairy, shellfish, those are some of the top
ones that we focus on. And of course peanuts,
legumes of various types. In some elimination diets, they take off some more of the nuts,
and in others, they don’t. What I also think about
as I have a patient go on the elimination diet is what are the foods that
they’re eating a lot of, because so many people
don’t have good, healthy intestinal function, right? And so that insult to injury, what are they seeing over and over again? What might be causing
some of their symptoms. So in some cases we can
take the elimination diet and couple that with low
histamine-containing foods. So some people might be
responding to high histamines in foods, not just the
histamines in their body. So strawberries, spinach,
some of the things that we would think of
as good, healthy foods, but maybe not so good for certain people. – This is so important, because I see this a lot in my patients who, you know, maybe they’re
making a green smoothie for breakfast every day. They’re putting the
spinach in and the kale, and they think that
they’re being so virtuous. And it turns out they have
intestinal permeability. They’re having reactions, like histamine to the constituents,
the healthy constituents they have in their smoothie. So could you speak to
that a little bit more, because I’m always looking
for, in my practice, what’s surprising. And once you start looking for increased intestinal permeability,
you see it so often. – It’s true, yeah. And one of the things that goes along with the elimination diet is
something called rotation. And so three to four
day rotations of foods, because most people get on food jags. So we get into this rut
where we have oatmeal for breakfast every day of our lives, and we think it’s a good thing. And then we find out that our body doesn’t do well with grains. And we have all kinds of gut issues. And so one of the principles I do bring in is that of variety. So every three to four days, changing up that food,
changing up the colors of food, even, and rotating
through those colors. – Love it. – [Doctor Minich] Yeah. – Good, so let’s dive
into some of the data that you published with your cases. Which one’s your favorite? Which one do you think
is the most important, especially in terms of
talking to practitioners that maybe have one foot in
the functional medicine world or personalized lifestyle medicine world and one foot in the more traditional, conventional medical world? – Yes, and by the way, these five cases that were published in the “Alternative and Complementary Therapies Journal,” they were also with other people. So I’m a co-author. And I wanna give credit to all of the- – Yes, shout out. – Wonderful people that
actually did a lot of the work. One of them does come to mind. And it was a woman, 35 years old, who presented with a number
of different symptoms. So she had everything from brain fog, she couldn’t concentrate. She had gastrointestinal disturbances. She had hormonal issues. At the time she had endometriosis. So she was diagnosed with a number of different classical health conditions that I would say, within the
functional medicine model, all kind of seem to go together. So whenever I think gastrointestinal, I do think reproductive tract, as well. Like, what else is going on? So in her case, what made it interesting and profound was it was probably
the most challenging one, not because of her symptoms
but because of her situation. Part of the year she’s a ski instructor. The other part of the year, she’s working in a deli
in a national park area. And so she’s torn between both places. And when you’re up in the mountains or at a ski resort, you
don’t really have access to a lot of different foods. – Right. – Or if you do, they’re very select, they’re very expensive. So how is she gonna make this work? And I remember that first week that she ran into this, and
she had so much motivation. She wanted to do this. She wanted to get better. And she was willing to
do whatever she could. But she did have these
practical challenges. So after- – This is so good, because I feel like whether you live in the mountains or not, we all have those patients. – [Doctor Minich] We do. – Who are challenged by trying
to do something like this, like the elimination diet. – Well, another thing to
add to this whole picture was she, living in California, was exposed to all these
wildfires at the time that they were going on. – So the air quality was poor. – Then the air quality was poor. And she was having all
these breathing issues. And now she’s developing
more of an asthmatic type of condition. So not only can she not
get access to the food because it’s just not available, but now she can’t even go outside, because now she’s going to be confronted with air particulates. So it really compounded the situation. So the first week in, it was difficult. And I think it’s good to acknowledge where we have patients with
their difficulties, right? – Yeah, totally. – And to really be there
for that first week of starting that elimination diet. – And meet them where they are, which is part of what I hear you saying. – Being that she was so motivated, it wasn’t difficult to help her in the ways that we could. And then the second week,
she did much better. The fires had come down. She kinda got the groove of,
okay, I need to eat this. These are some menus. I’m going into town to get my food. I feel like so much is about preparation. It’s about mindset first of all. If somebody is really motivated, they’re gonna make this work. – Totally. – So we just have to give
them different strategies. So she had, I believe it
was, if I have it correctly from the case study,
within that 21-day period that we did the elimination diet, she had a 77% resolution of her symptoms. – Wow. – Across the board. – 77%, including the endometriosis, which we know is an
inflammatory condition. – We used the medical
symptom questionnaire. – So talk about this for a moment, ’cause I love, in all the case studies, you used the MSQ, and you
tracked symptoms over time. Every case that I saw, you
had a significant reduction. Talk a little bit about what that is, and I believe we can actually get it on the IFM website, right? – Yes, and I would highly recommend it to any practitioner to have a metric, because I don’t know how many times you’ve seen people where they say, “well, I’m not any different.” And then you have them
do the questionnaire, and it’s like, “well, wait a minute. “You just went down 20 points.” So we need to see that in numbers. And then when they see
that, they’re thinking, “oh my gosh, that’s true,
I did make those changes.” It kind of reverts back. So the medical symptom questionnaire looks at different body systems. It’ll look at cognitive function, emotional function, gut
function, brain function. It’s a really nice, all-systems way to peer into somebody’s condition. So it’s not diagnostic. And it is not looking at a diagnosis. So we weren’t able to
look at her endometriosis. That was something that her
medical doctor was doing. But we could look at her gut function, whether or not she was
having more moodiness around her cycle, because
she actually did continue on. From the elimination
diet, we transitioned her into another plan. So we had her for about a good two months. – And what was the plan
you transitioned her to? – To the IFM, Institute
for Functional Medicine, detox food plan. I have a lot of passion around this plan, because I teach that food
plan for the institute and helped to cobble that together with the whole team. And essentially the detox food plan is very supportive of liver and gut. So the elimination diet
starts the process. There’s a sequence to all of this, right? And so we can eliminate, take things out, and then we put things that are back in that are very nourishing for the body, nourishing especially
for the liver and the gut through the detox food plan. And you can tailor it. All of these plans, even
though they look very cookbook and very finite on paper,
you can always tweak. Some people are just not ready
for the elimination diet. – It’s too extreme. – It’s extreme, and then they’re thinking, “oh my gosh, what do I do with my family?” And so then I say, “let’s pick one thing.” And one of my nutritionist mentors, Barb Schultz, had told me, she said, “Deanna, have the
patient say what would be “most difficult to give
up, and that’s probably “the thing that’s keeping
them in their pathology.” – Yes. – (laughs) And so it’s like,
I can’t give up cheese. I can do everything
else, but not the cheese. Well, it’s probably the cheese that they really need to give up. So maybe you need to
kinda lead into the cheese once they get the trust and
they have the comfort level. – And maybe some momentum. – Yeah, they start to see some reduction of their symptoms. They start sleeping better. And then they start thinking, “well, “maybe there’s something to this.” And then you go for the heavy hitters, the things that are really difficult, like sugar and you know,
that’s not an allergen, but it is something
that we do try to reduce or eliminate on the elimination diet. – And alcohol. I always think about, when I talk about elimination diet, in my practice, I live in the Bay area, so we’re close to Napa Valley, right? We’ve got all these amazing wines. And so I often have my patients say to me, “oh, I can do all of
it, but I’m gonna keep “drinking my wine every night.” – Right. (laughs) – And we give alcohol to animals to induce intestinal hyperpermeability. And so it’s, we know that it pokes holes in the gut lining. And I think it’s such an important part of the elimination diet. – I’m so glad that you mentioned alcohol, because I feel like there’s
a mixed message around it. – Totally. – Right, so you hear, oh,
the Mediterranean diet. – It’s so good for you.
– They drink alcohol. – Red wine every night. – Yes. And if you look at the literature, I would say that’s not always the case. And so much depends on the
individual’s constitution. But regardless if it’s alcohol or coffee, one of the things I like to do is just to get people
off of the substances that are primarily
changing their behaviors and their mood so that
you can actually see how much energy you have. Like, how do you really sleep? Let’s just get rid of all those stimulants and depressants and see what happens. – The addictive substances,
they tend to rob you of deep sleep and REM sleep. And I always think about, with alcohol, there’s also the increased
risk of breast cancer. There’s the effect of alcohol
on the estrogen pathway. – [Doctor Minich] Yup. – We could definitely
go down that rabbit hole for a long time and discuss it. But I wanna come back to the practitioner who
is faced with a patient maybe similar to the
one you just described and is trying to figure
out, like especially within an insurance-based system, how do I start to implement some of these
functional medicine concepts? And I feel like the elimination diet is this three-week commitment. It’s pretty simple to review. You could have a handout that has all of the seven things that you’re giving up. It’s almost like a gateway tool to practicing more functional medicine. So do you think of it that way, too? – Absolutely. It’s my first line of
approach with somebody, especially when you have multiple things that you could be doing. I feel like the elimination diet cuts through all of them and
really creates a baseline. It’s like a new baseline. It’s like that reset that you need in order to get people
thinking differently, living differently, and
really feeling differently in their bodies. One of the things that I find, too, is that it creates a better
state of body awareness. Even within that first seven to 10 days, they have a better sense
of, oh, my mood, my sleep. Oh, I do get a stomachache. How come I haven’t noticed
that I had a stomachache before whenever I ate these
vegetables or this food, whatever it was. By day 21 of being on
the elimination diet, they are very hyper-aware, in a good way, about their bodies. And so as a newcomer
into functional medicine or integrative medicine, number one, to what you said, meeting the patient where they’re at, how far are they willing to go, because if they’re willing to do the whole program, much
like this 35-year-old woman, where she said, “I’ll just do anything. “I really wanna get
rid of these symptoms.” And she’s so young to be having that whole panoply of different
things going on for her. – Yeah, brain fog at
35 is not a good thing. – Yeah. And she was very active. She had a lot of things going for her. It’s not that she was just sedentary and had a day job and- – She’s a ski instructor. – Yes, yes. (laughing) I mean, she’s incredible. – She has an active life. So I wanna connect a couple of dots. – Sure. – Because I can tell you, as someone who went through the
allopathic, traditional training as an obstetrician, gynecologist, I was taught that
endometriosis is retrograde, menstruation, that there’s
an inflammatory process that’s occurring with
ectopic endometrial tissue. I was never taught about
the connection to the gut. And so I wanna make sure that we’re tying those two things together, because this woman has kind of a complex story. But she had brain fog. And brain fog makes me think immediately of the gut-brain axis. And so I love that, as you said, elimination diet is sort
of this great leveler. – Yeah. – And what I found is
that almost regardless of the symptoms that a patient has when they present to me, elimination diet reduces those symptoms. They may come to me and
say, “I’m perimenopausal. “I hate my husband. “I wanna go on hormone therapy.” And so we do some testing,
but often I’ll start an elimination diet,
just in that first visit. – Yes. – And it makes such a difference in terms of the HPA axis and just sort of all these regulatory
systems that are involved in inflammation. – You said so many things there. I’ll just dive into one
of them that you said, which is such a great point. When we do the elimination diet, when we actually experience it, and I would encourage all of you, even before trying it
out with your patients, to actually do it yourself. – Yes, please. – Because then you can see the challenges. You can see how your body changes. You can see your thought process. What triggered me to think about this was when you said about somebody’s husband or their job or, all of a sudden you start coming clear and clean on so many things, because perhaps that brain fog starts to clear. You start to feel more energized. You start to feel like more of yourself. – Yes. – And then you’re thinking, why did I make all these choices? Maybe, and that really
got me down the path of thinking more holistically,
more open-mindedly around the elimination
diet and doing other types of modalities in conjunction with it, because I started to see this happening. And I wasn’t well equipped. – Yes. – So that may happen, where a patient goes down that path, just of three weeks where they’re changing their food. But they’re gonna change
their lives, they really are. – It changes their lives, and it changes, you talked earlier about what
I would call interoception, kind of that sense of the
conversation with the body, which I think we’re trained out of. We’re not trained to be so attuned to what’s going on in our gut or what’s going on, do I have brain fog, how’s my memory. So developing that interoception, I think, is so important on an elimination diet. And as you said, I think
there’s a state of mind that comes from going
through an elimination diet and then certainly the
detox plan afterwards that can provide that kinda clarity and maybe almost like taking off the veil of maybe speaking your truth for the first time in many years. And so I love watching that process unfold and trying to kind of hold space for it and shepherd it for our patients. – Yes, and to know that that could happen and to have a support
system built in for that. – Yes. – One of the things I like to do a lot is doing more groups. – Yes. – Because if you have a group going through the elimination diet, they all support each other. Oh, I’ve fallen off the track. I had something I wasn’t supposed to. Don’t worry, here’s a recipe. Let’s get you back on. It’s almost like the group supports the energy of that group, and there’s just that synergy that happens. – Well, there’s the social genomic process that’s occurring. I mean, and it’s amazing to witness it. I’m sure you’ve seen
this over and over again, where they start sharing recipes and they get ideas about
how to eat the rainbow and make it reasonable. They get ideas about,
okay, my daughter’s having truffle fries at a restaurant. How do I avoid eating the truffle fries with the sugary this and that? And so you’re able to have
this much bigger picture, I think, of how to cope
with the challenges that come up with elimination diet. – Well, especially the family challenges, what you just mentioned. I mean, how many times where somebody is doing the elimination
diet solo in their home, and then they have to make separate meals and separate groceries. And so having the group is very supportive for like, oh, this is my tribe. This is where I can talk
about the elimination diet, and I don’t have to worry so much about what I’m hearing at home. I feel like that’s one
of the bigger issues. – It is, the troubleshooting
with the home environment. – With the home environment. And for a while, I was asking women to come in with their partners or spouses so that they could both
hear the same message, because it felt very fragmented. She would get home, and then it was like she would actually crash and not be able to have the same momentum
in starting the program, because she didn’t have quite that same emotional support. So that’s why, you know, three things before people start an elimination diet that I think are really important. First is the mindset. It’s all about the mind. If you don’t get the mind on track, the body can’t follow. It’ll just be, it’ll fall flat. The second thing is home. And it’s not just the
relationships at home but really clearing the home space, because I know for me, if I
have chocolate in the house or certain things that
I shouldn’t be eating, it’s better not to have them there. – Yes, I call that clearing
the decks. (laughs) – It has to be clear, it does. – Clear the decks, clear the
fridge, clear the pantry. – And it feels so good to do that. – Yes, you lose weight just doing it. (laughing) – For various reasons, yeah. So you clear, even if
you feel overwhelmed, it’s like, the refrigerator,
clear out the refrigerator. Take a picture before and after. Bring it to your support group, and show them the difference. – Post it on social media. – Yes, a refrigerator makeover. So there’s that. That’s number two, home. And then number three, the social support. In whatever order you think
that that’s important. So again, I always ask people before they start a program, what is your motivation level
on a scale of one to 10? And I remember somebody telling me once, he was a musician. He was in his 40s. And he was prediabetic, really
heading towards diabetes. And I said, “so tell me
on a scale of one to 10, “how motivated are you to
do this elimination diet?” And he’s like, “seven.” And then I wanted to
explore, well, what’s a 10? His music. So then I was like,
okay, I need to anchor in my discussion about this elimination diet with his love of music and somehow talk about how he can’t be
the nighttime musician on the weekends if he
doesn’t have his health. – That is beautiful. – [Doctor Minich] How’s he gonna do that? – Yeah, you contextualized it for him. – Yeah. – And I wanna also say,
for the practitioners who are new to the elimination diet, I think you know this already, but Deanna’s a very advanced
practitioner, right? You’re famous for your
work with nutrigenomics. You developed many of these food plans. You led the whole process with IFM, with this particular elimination diet. – With teams, lots of
teams of people, mm hm. – Lots of teams of people. And I just wanna also
say, I used to prescribe the elimination diet when I was working within an insurance-based system. I had 20 minutes with patients, at most twice a year. And I was so surprised at
how just an elimination diet could make such a difference in terms of my patients’ symptoms. Another thing I love about
these five case studies you published, and we’ll give you links so that you can see them, as well as some of the older
data on elimination diet and why it’s been validated. My why is that I wanna transform
a broken healthcare system. And I feel like the way that we do it is with these small, methodical steps of adding to the evidence base, convincing more and more
mainstream physicians that there’s good science behind some of these strategies. We know that 70% of healthcare costs are lifestyle-related
and therefore preventable with things like the elimination diet. So tell us a bit about how
you see that evidence base. How do these five case studies add to it? We talked about the 35
year old with the brain fog and the endometriosis. But you also have a 57
year old with elevated ALT. You also have, I think,
a 40-something year old with chronic eight-year history of pain of the shoulder and knees. I just wanna make sure that,
for the orthopedic surgeons, there’s a value here. For the people who are
practicing internal medicine, there’s value here. So how do we add to this evidence base? What do these case studies provide for us? – Sure. Well, first and foremost, I mean, I share with you that same mission. I do think that if we
can empower all of you, as practitioners, to see food as medicine, and there’s evidence galore on that. I mean, you go to PubMed
and you start looking at all the research on dietary patterns and chronic disease, I mean, I don’t think we can
arm wrestle that at all. I mean, it’s pretty clear
that there’s a connection. When we’re looking at the
elimination diet specifically, we are looking at, what are the allergens? What are the things that
we can take out of the diet in order to create more
healing for that patient? And that might look like
better gut function. It might look like less shoulder pain. It might look like less brain fog. It might be clearer skin. Whatever it is, I have
seen across the board a reduction of 50 to 70%
of that symptomatic noise. – Yes, absolutely. So 50 to 70%. Pharmaceuticals can’t touch that. That’s what I think is so amazing here, because I was taught, you have anxiety, you prescribe a benzodiazepine. Now we prescribe the latest SNRI. You have depression, you
prescribe the SSRI or SNRI. And yet food is such a needle mover. 50 to 70% reduction of symptoms. – Well, and I think people not only wanna be healthier, they wanna be happier. I really do believe this. And perhaps that’s a sense
of purpose and meaning. And one of the things that
I see in the research, this is just kind of clustering now, is the relationship between food and mood. So, and even simple things like people eating more fruits and vegetables having less psychological distress. And these are large studies. These are like 60,000 Australian adults. These are like, larger
studies really showing the evidence for food and mood. And so what’s gonna happen
on the elimination diet is people start to get cleaned up and they get rid of that noise. And they start feeling better. Then they’re gonna be much
more compliant with changes with different behaviors, because they’re just gonna feel good. Back in 2014, we did 3,000 people on the elimination diet with the Institute for
Functional Medicine. And we collected data on 700 of them. We just simply did the
medical symptom questionnaire before and after. The number one symptom
that rose to the top, if we look at all those different systems on the medical symptom questionnaire, was emotional health. – Yes, huge. – And I had never thought
that that would ever be the case. I thought, oh, probably
gut health or joint pain or brain fog. But if you can get at
somebody’s emotional health, then you’ve got them, because
that’s going to get them feeling better. And then they will be much more compliant and sustainable with that plan. You’re gonna feel good for helping them. I mean, it’s like a win-win, really. – It’s such a virtuous cycle. And I wanna contextualize
the food-mood connection, because I think this is
such an important piece. We know that food is the number one driver of microbiome function. We know that stress is probably the second most important driver. And maybe we can cite some of those papers that you talked about,
like from Australia. But I think when it comes to anxiety, depression, burnout,
just feeling irritable, we often don’t think
about the gut-brain axis. And yet food can hugely
change the function of the gut-brain axis. – [Doctor Minich] It can. – So I just wanna connect
that to the root cause, which is often how the gut
is talking to the brain. It’s a bidirectional relationship. – It is bidirectional, absolutely. And so many people are
devoid of nutrients. So yes, the gut microbiome is helping to metabolize things. Most people don’t have a
functional gut microbiome. They have dysbiosis, which means that they have more bacteria
that are unserving, right? They’re kind of, they’re creating molecules
that are inflammatory in the gut and causing issues. And so by feeding good, healthy food, we start to change that milieu. And we start to change the gut microbiome, which will change mood and
memory and immune function, neurological function. I mean, it just goes on and on. We do need to get our patients
to be nutritionally replete, because one of the things that buffers us from all the toxicants in
the environment is nutrients, minerals, carotenoids, phytonutrients, having good, healthy levels of protein. People are on all these
high protein diets, which I think is okay, but most people aren’t digesting that protein, either. – Right, totally true. So as we start to wrap up, any last words about how you’ve added to the evidence base and
where we go from here? – Well, I’d like to see
more of us publishing. – Yes. Yes. – I feel like, and I’ve
asked all of my students who mentor with me,
like these nutritionists that were in this program,
we had nine nutritionists and 34 different people
that they were coaching as part of this, and I was
mentoring the whole process. And I encouraged them all. I said, “we need to publish. “You need this for your own credentials, “but then also to help
the community of science.” And even if it’s a case study, we may say, “oh, but it’s just one person.” Well, but one person, we
can start to see patterns, and we can start to see threads. And like you said, these
are five case studies of all very different people being helped by the same approach. And it was not necessarily personalized. It was a simple blanket protocol of the elimination diet. And it helped them all. Again, that 50 to 70%
reduction in symptoms. So I hope that this is
adding to the evidence base for functional medicine
in the way that it can. And I’d like to see more. I would encourage all of us,
even if it’s a case study, to feel comfortable with that. Get that word out. It is significant. And even a cluster of case studies. So small steps, but hopefully
in a larger direction of helping people to see
and connect those dots. – I love that, thank you. I feel like, you and I are also involved in the N of one study. And I was taught, when I graduated from Harvard Medical
School 25 years ago, that the best evidence was
always kind of considered the randomized trial, which
is actually very difficult to do in personalized lifestyle medicine, because we’re rarely
just changing one thing. Often we’re changing kind
of an integrated system. And so I feel like the N of one study is gonna become increasingly important. In fact, at Harvard I was taught that it is equal to a randomized trial. So I feel like case studies
are an important part of this evidence base. It can demonstrate the sort of changes that can occur, 50 to
70% symptom reduction with an elimination diet. So I wanna thank you for your contribution to the literature. And thank you for being
with us today, Deanna. – Thank you for having me. It’s been fun. – [Woman] Thank you for being with us for this episode of “The Practice.” You’ll find extensive show notes, including links and supportive materials, over at ThePracticePodcast.tv. While you’re there, explore other topics and use the Ask and Answer button to ask your burning questions
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