Impact of Food Immunoglobulin G-Based Elimination Diet on Subsequent Food Immunoglobulin G and Quality of Life in Overweight/Obese Adults

Abstract

Objectives: The goal of this study was to assess changes in serum immunoglobulin G (IgG) food antibody titers and quality-of-life measurements following a targeted elimination diet in overweight/obese adults. Methods: We performed a randomized control trial. Participants were randomized in a 2:1 ratio to either an intervention group or waitlist group for 3 months. Food IgG testing was performed on all participants. The intervention group was instructed to eliminate up to 10 foods, for which they had high titers of IgG and communicated with health coaches for nutritional counseling for meal planning and adherence. The waitlist group did not receive their IgG testing results or health coaching. Primary outcome was serum IgG titers for foods eliminated during the trial, compared with baseline concentrations. Secondary outcomes were healthrelated quality of life measured by Patient-Reported Outcomes Measurement Information System (PROMIS-29) and change in participant-identified symptom severity measured by Measure Yourself Medical Outcome Profile. Exploratory outcomes were changes in body weight and waist circumference. Results: IgG antibody concentrations decreased in 83% of the targeted foods in the treatment group and in 60% of the foods in the waitlist group, but this was not found to be a statistically significant difference. The intervention group reported improvement in sleep during the trial compared with waitlist, which was the only statistically significant finding in the study. Conclusions: The findings are consistent with changes in IgG titer measurements following an elimination diet based on IgG testing. Future larger clinical trials are necessary to determine the degree to which these findings are generalizable.

Functional medicine health coaching improved elimination diet compliance and patient-reported health outcomes: Results from a randomized controlled trial

“…[22,25,59] In addition, for those patients with inflammatory conditions, positive changes in immune responses measured through serum IgG food antibodies and peak eosinophil counts have been used to suggest a beneficial health impact of the elimination diet. [23,25] However, a targeted elimination diet that recognizes and removes food triggers may not only help alleviate disease-specific symptomatology, it may also help to both reduce hyperactive immune responses and to support healthy microbiome composition and function. [20][21][22][23][24][25][59][60][61] In addition, the systematic elimination and reintroduction of foods in an elimination diet can be helpful in identifying foods that may be causing subclinical inflammation and other relatively mild adverse reactions that may collectively impair quality of life.…”

“…[23,25] However, a targeted elimination diet that recognizes and removes food triggers may not only help alleviate disease-specific symptomatology, it may also help to both reduce hyperactive immune responses and to support healthy microbiome composition and function. [20][21][22][23][24][25][59][60][61] In addition, the systematic elimination and reintroduction of foods in an elimination diet can be helpful in identifying foods that may be causing subclinical inflammation and other relatively mild adverse reactions that may collectively impair quality of life. Further studies are warranted to confirm the positive impact of an elimination diet on patient-reported health and quality of life metrics in other relatively healthy populations.…”

“…[40][41][42] Previous studies have demonstrated that elimination diets can improve measures of cognition and sleep, which is strongly associated with mental health and quality of life. [25,[65][66][67] While this study did not directly evaluate the sleep of participants, the research team hypothesizes that enhanced sleep may be one of the mechanisms underlying the dramatic mental health improvements in both arms of this study.…”

“…[15][16][17][18] Clinical trials of elimination diets have been shown to reduce symptoms of inflammatory bowel disease, irritable bowel syndrome, esophagitis, and migraine headaches while potentially improving some aspects of quality of life in generally healthy adults. [19][20][21][22][23][24][25] While elimination diets are a useful tool in overcoming disease and optimizing health, compliance can be difficult due to numerous physiological, psychological, and environmental barriers. Health coaching is a promising approach to overcoming compliance challenges as it has been shown to provide support in surmounting these types of challenges to lifestyle and behavior changes and reduce risk of chronic diseases.…”

Belgian consensus on irritable bowel syndrome

“…However, other studies could not detect an association between high levels of IgG to certain food and clinical symptoms (99,100). Moreover, an elimination diet based on results of IgG testing failed to improve IBS symptoms significantly better as compared to patients on a waiting list (101), questioning the validity of this approach. Finally, large exclusion diets harbour a risk of nutritional deficiencies as revealed by studies in patients with documented food allergy (102,103).…”