Try These Food Substitutes for the Six Food Elimination Diet! (2024)

The six food elimination diet (SFED) is one of the most popular diets if you have eosinophilic esophagitis (EoE). To help identify foods that cause an exacerbation of your symptoms associated with EoE, this diet eliminates the 6 most common allergens that have been associated with causing eosinophilic esophagitis:

Cow’s milk
Eggs
Peanuts & tree nuts
Seafood (fish & shell fish)
Soy
Wheat

These 6 foods are commonly cooked within restaurants or in the average home and are contained in much if not most of the food Americans eat on a regular basis. We will discuss substitutes you can use to alter recipes into EoE-friendly recipes to improveyour quality of eating.

Wheat

Try These Food Substitutes for the Six Food Elimination Diet! (1)

Wheatisone of the most common allergens, or triggers, associated with eosinophilic esophagitis in both children (2nd most common trigger) and adults (most common trigger).

Wheat includes 4 proteins that may cause the allergic reactionassociated with symptoms of EoE. The 4 proteins are albumin, globulin, and gluten (gliadin and glutenin). Unfortunately, there is limited and conflicting research as to how other grains that include these same proteins react with eosinophilic esophagitis.

You may have heard that if you are following an SFED diet, that you should also exclude barley and rye. This rumor, however, has very limited and inconsistent research to support it. Because barley and rye have similar proteins as wheat, you should discuss whether elimination is best for you with your healthcare provider or dietician.These grains are also often packaged in the same factories with wheat and may have some wheat in them.

You should be careful with some gluten-free products on the market, as they have been refined in a manner that eliminates their nutritional content of iron, B vitamins, and trace minerals.

Wheat Substitutes

In recipes, you can swap wheat flour with these flour sources:

Cow's Milk

Try These Food Substitutes for the Six Food Elimination Diet! (2)

Cow’s milk has been identified as another of the most common triggers associated with eosinophilic esophagitis in both children (most common trigger) and adults (second most common trigger).

The protein in milk that causes reactivity with EoE is known as casein. Aside from cow’s milk, other foods that commonly have the same protein includes: cheeses, ice cream, coffee creamer, whey protein, chocolate, and marinades.

Milk Substitutes

Good substitutes that you can use to avoid cow’s milk but maintain similar nutritional value are:

Fortified rice milk
Fortified hemp milk
Flax milk

It is important to take notice that almond milk or cashew milk cannot be used as a substitute for cow's milk, as they are both tree nuts that are eliminated from an SFED.

Eggs

Try These Food Substitutes for the Six Food Elimination Diet! (3)

Replacing egg can be a little trickier due to the number of reasons we use eggs in food preparation. Here are a few ideas that you can use to replace eggs in your cooking needs.

Flaxseed Flour Substitute for 1 Egg – Great for Binding

1 Tablespoon Flaxseed Flour
3 Tablespoons Water
Stir until egg-like

Chia Seed Substitute for 1 Egg – Great for Leavening

1 Tablespoon Chia Seed
1/3 Cup Water
Stir and set for 15 minutes.

Agar Agar Substitute for 1 Egg – Great for Binding

1 Tablespoon Agar Agar
3 Tablespoons Water

Ripe Bananas Substitute for 1 Egg – Great for Moisture

1/2 Cup Mashed Bananas

Applesauce Substitute for 1 Egg – Great for Moisture

1/4 Cup Applesauce (unsweetened)

Mashed Potatoes Substitute for 1 Egg – Great for Binding

2 Tablespoons Mashed Potatoes (White or Sweet)

Peanuts and Tree Nuts

Try These Food Substitutes for the Six Food Elimination Diet! (4)

Peanuts and tree nuts are difficult to replace in cooking recipes. Tree nuts include many different types of nuts. Here are a few of the more common tree nuts that should be eliminated:

almonds
cashews
macadamia nuts
Brazil nuts
pine nuts
pistachios
walnuts

Peanuts and tree nuts are usually used for taste and texture rather than a basic need for the recipe. These can usually just be skipped in the recipe, or you can try replacing with rice cereal or a gluten-free whole grain.

If you are looking to replace the nutritional value, you can use seeds that include: chia, flax, and hemp.

Seafood

Try These Food Substitutes for the Six Food Elimination Diet! (5)

Fish and shellfish are great sources of protein and Omega-3 fatty acids, which are good for the health of your heart. Like peanuts and tree nuts, you are unlikely to find a similar replacement for the seafood. However, for the protein, you can use other low-fat meats like poultry. Likewise, as a replacement for the Omega-3 fatty acids, you can increase your consumption of flaxseed and canola oil.

Soy

Try These Food Substitutes for the Six Food Elimination Diet! (6)

Soy is difficult to match in taste and you may have to add salt. However, there are a few options for replacing soy in recipes.

Soy Substitutes

Chick peas
Coconut milk
Clive juice
Plum vinegar

Substituting Foods

Ensuring that you maintain a well-balanced diet will ensure that you do not suffer from malnutrition while following an SFED diet. Using allergen food substitutes in your cooking will allow you to still use your favorite recipes. Finding which substitute works best for you is a very personal choice. Experiment with these suggestions to find what you like best.