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The most drastic form of the elimination diet is to fast for the first five days, taking nothing but bottled spring water. This method has several drawbacks. Fasting requires a great deal of will-power and it is bad for anyone who is underweight and in poor health. Even for those who are not underweight, there are major metabolic changes that occur during fasting, as the body begins to break down its fat reserves. These metabolic changes, and others which occur when food is reintroduced, may themselves produce symptoms. For these reasons, we would not recommend fasting except in certain very difficult cases.
One step up from fasting is the lamb-and-pears diet, probably the best known type of elimination diet. This is something of an oddity because lamb is quite a common food in Britain. The diet originated in the United States in the early days of clinical ecology – America does not have the steep upland pastures that have made sheep-farming so popular in Great Britain, so lamb is not widely eaten there. While sensitivity to lamb is unusual, it does occur in Britain, so a lamb-and-pears exclusion phase is less appropriate here than on the other side of the Atlantic.
A modified version of the lamb-and-pears diet, used by some doctors, is turkey-and-pears or turkey-rice-and-pears – turkey being less commonly eaten in Britain than lamb. While these diets are useful when someone has a great many sensitivities, they are unnecessarily strict for most people. Again, they require a lot of will-power, and they involve eating huge quantities of two or three foods, which is never a good idea.
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