Carbohydrate Intolerance - 2 Week Carbohydrate Exclusion & Reintroduction Protocol
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2week Carbohydrate Exclusion & Reintroduction Protocol
ROE
HEALTH
+
Carbohydrate Intolerance
2 Week Carbohydrate Exclusion &
Reintroduction Protocol
Dr. Eoin Roe DC MCHIRO CFMP
©2021 ROE CLINIC
©2021 ROEHEALTH | 12week Carbohydrate Exclusion & Reintroduction Protocol
CONTENTS
Why Do Carbohydrate Exclusion? What is this guide for? .................................................................... 3
What is Carbohydrate Intolerance?........................................................................................................ 4
Carbohydrate Intolerance Survey ........................................................................................................... 5
The Two Week Carbohydrate Elimination Protocol ............................................................................... 7
The Elimination – Allowed Foods ..................................................................................................... 10
Foods That Are Not Allowed ............................................................................................................. 12
What to expect ................................................................................................................................. 13
After the Two Week Test – The Reintroduction .................................................................................. 15
General Guidance for CI & a Healthy Diet ............................................................................................ 19
Notes .................................................................................................................................................... 21
©2021 ROEHEALTH | 22week Carbohydrate Exclusion & Reintroduction Protocol
Why Do Carbohydrate Exclusion? What is this guide for?
What this guide is for:
• To reduce intake of carbohydrate in the diet to improve health, energy
and vitality.
• To help the person undertaking the exclusion to find their personal level
of tolerance to processed and simple carbohydrates.
• Identify food sensitivities that are potentially problematic for the person
undertaking the diet
• As part of a weight loss program
What it is not:
• A diet - Ultimately this protocol is a test not a diet it is an
elimination/reintroduction protocol designed to help people fine tune
their diet for better health
• A protocol suitable for controlling an Autoimmune (AI) condition – it
may help but generally those attempting to manage an AI condition will
require stricter, slightly different restrictions and more careful
reintroduction protocols.
• A keto diet – though the person may enter ketosis whilst undertaking the
exclusion – A ketogenic diet is an extreme carbohydrate exclusion and
should be undertaken with the help of a practitioner knowledgeable
about ketogenic diets.
• A complete exclusion of dietary carbohydrates - you will still be eating
carbohydrates in vegetables that are included in the protocol
Disclaimer
To the extent that any information is provided through this E-book, it is for general
informational purposes only and is not intended to constitute or substitute for (i) medical
advice or counselling, (ii) the practice of medicine including but not limited to psychiatry,
psychology, psychotherapy or the provision of health care diagnosis or treatment, (iii) the
creation of a physician-patient or clinical relationship, or (iv) an endorsement, a
recommendation or a sponsorship of any third party, product or service. If you have or
suspect that you have a medical problem, contact your health care provider promptly.
Information and statements are not intended to diagnose, treat, cure, or prevent any
disease.
©2021 ROEHEALTH | 32week Carbohydrate Exclusion & Reintroduction Protocol
What is Carbohydrate Intolerance?
Many people suffer from a condition known as carbohydrate intolerance, or CI.
This is perhaps the most well hidden epidemic of our time and is being made
worse by the prevalence of sugar and other high-carbohydrate foods common
to our diets.
Carbohydrate Intolerance and the full spectrum of ailments that accompany it,
begins as a hidden problem. CI then progresses to a functional disorder
producing symptoms, such as fatigue, that negatively affect quality of life.
Gradually, this process generates serious illnesses such as diabetes and heart
disease.
While best viewed as a single, escalating progression of the same problem,
carbohydrate intolerance has series of distinct stages:
Early stages
The symptoms can be elusive, often associated with difficult-to-diagnose
blood-sugar problems, fatigue, intestinal bloating and loss of concentration.
Middle stages
The worsening condition is known in the medical community as carbohydrate-
lipid metabolism disturbance or hyperinsulinism. It causes more serious
conditions such as hypertension, it elevates triglyceride levels and LDL “bad”
cholesterol while lowering HDL “good” cholesterol, and increasing body fat.
Final Stages
CI manifests as an array of more serious problems, including obesity and
various diseases such as diabetes, cancer and heart disease. These end-stage
conditions are part of a set of diseases that are now well recognized by modern
medicine. They are referred to as Syndrome X, or Metabolic Syndrome.
So how do you know if you are suffering from carbohydrate intolerance? In the
next section you will find a Carbohydrate Intolerance survey, which is the first
step in reclaiming your optimal health.
The next step is doing the Two-Week Elimination Protocol, which will help
determine just how sensitive your body is to carbohydrates.
©2021 ROEHEALTH | 42week Carbohydrate Exclusion & Reintroduction Protocol
Carbohydrate Intolerance Survey
Carbohydrate Intolerance (CI) happens when people’s bodies are unable to
properly metabolize the amount of carbohydrates they consume. Take the
following survey to figure out if you are carbohydrate intolerant.
YES NO
Do you experience poor concentration after meals?
Do you experience intestinal discomfort after meals
especially gas or bloating?
Do you have polycystic ovaries? (Ovarian cysts)
Are you often hungry between meals or soon after eating?
Are you often fatigued? (Once per week or more)
Do you sleep poorly? (Don’t sleep uninterrupted for 7-9
hours each night.
Has your waist increased with age?
Do you find it hard to control your weight even if
undertaking calorie-restricting diet or never manage to
reach your weight loss goal?
Do you have a low fat, low protein diet?
Do you crave sweets, chocolate or caffeine daily?
Is there a family history of chronic disease, heart disease,
stroke, diabetes and cognitive decline?
Count the “YES” answers to the above questions. If you have 2 or more YES
answers, you are at a higher risk for CI. If you have less than 2 YES answers, you
are at a lower risk for CI.
A higher level of risk doesn’t mean that you have a serious health condition. It
means that due to your present situation (lifestyle, health, and habits), you are
in danger of developing a health condition associated with that risk factor.
©2021 ROEHEALTH | 52week Carbohydrate Exclusion & Reintroduction Protocol
Even if you do not answer yes to 2 questions in the above quiz, it can still be
very beneficial to undertake an exclusion for a couple of weeks you can learn a
lot about how you are reacting to foods.
©2021 ROEHEALTH | 62week Carbohydrate Exclusion & Reintroduction Protocol
The Two Week Carbohydrate Elimination Protocol
The premise for food elimination and reintroduction protocols is very simple:
• Stop eating certain groups of foods for a period of time and then
• Reintroduce them in a controlled way noticing how these effect you
This elimination protocol has been special designed to tell you if you are
carbohydrate-intolerant, and if so, by how much and how to remedy it.
The Two-Week Test requires you to take an active role in the process of self-
evaluation. You will actually feel what it is like to have normal insulin levels,
optimal blood sugar and, in many cases, be finally free of signs and symptoms
associated with CI, all within a short time frame.
This is by far the best way to take steps towards a healthier diet.
Before you start it is important to emphasize the following:
Remember The Two-Week Elimination Protocol is a TEST and NOT a diet
• This is only a test and not a permanent diet — it will only last two weeks
and should not be pursued beyond this 14-day period unless you have
specific guidance from a healthcare professional.
• You should never experience hunger during the test
• You can eat as much of the non-carbohydrate foods as you want, and as
often as you need
©2021 ROEHEALTH | 72week Carbohydrate Exclusion & Reintroduction Protocol
What Does the Carbohydrate exclusion do to your physiology?
By undertaking carbohydrate exclusion you are influencing the way your body
works to convert food to energy and nutrition by influencing:
• Blood sugar balance, and the associated role that insulin and cortisol play
in hormone balance and the knock on effects to other hormones in the
body including brain function, cardiovascular function, thyroid function,
adrenal function and sex hormones.
• Gut repair – eating a high carb, high sugar, high processed fat diet is
extremely stressful on your gut and requires more nutrient resources to
process, even though this sort of diet does not provide any adequate
nutrition.
• Removing foods that you are sensitive to, can reduce inflammation, not
only in your gut but also systemically throughout the whole body, which
again has a modulating effect on hormone balance and any ongoing
inflammatory processes.
Before you start the test it is a good idea to record the following information
(You will find space at the back of this book for the notes):
• Write down any health issues that you are having. This should include
things like, how you are sleeping, levels of fatigue, moods, headaches &
muscle or joint pains, gastrointestinal discomfort and any other issue you
are having at the moment. Take your time it can take a few days to recall
them all at once.
• Weigh yourself, whilst the goal of undertaking the Two-week test is to
improve your health many people will also loose weight and you can use
weight as a good guide to track you progress.
• Plan your meals and snacks for the duration of the test, this is an especially
important for the first three days
©2021 ROEHEALTH | 82week Carbohydrate Exclusion & Reintroduction Protocol
Additional things to consider before taking the test
• Plan to do the test at a time when you do not have distraction or you are
away from home for an extended period. For the purpose of the test you
need to complete the full 2 weeks to gain any useful information – if you slip
up and eat a portion of carbohydrate you will need to start the 2 weeks again
• Buy sufficient foods that are on the allowed list so that there is always
something from the allowed list that you can eat when hungry – do not allow
yourself to get hungry eat as much as you want from the allowed list of foods
• Remove as much of the food from your home on the Not allowed list to help
avoid temptation
• Do not worry about fats or calories while taking the test eat as much as you
want
• Drink plenty of water
• Always eat breakfast within 1 hour of waking.
©2021 ROEHEALTH | 92week Carbohydrate Exclusion & Reintroduction Protocol
The Elimination – Allowed Foods
It is not the purpose of the Two-Week Test to restrict calories or fat. It merely
restricts many carbohydrate foods. For a period of two weeks, you MAY eat as
much of the following foods as you like during the Two-Week Test.
Please note if you know you are allergic or sensitive to a food that is on the
allowed you should continue to avoid it during the Two-week test
Plants foods
Raw and Cooked vegetables Tomato, onion, garlic, greens such as spinach,
kale, chard, and all lettuces, broccoli, cauliflower and Brussels sprouts (for
those with thyroid dysfunction, cabbage-family veggies are best eaten
thoroughly cooked), carrots, zucchini, etc.
Tree nuts (and nut butters) Macadamia, almond, walnut, for example. (Does
NOT include peanuts or cashews).
Coconut Cream, oil, milk and flour.
Animal Foods
Meats - As preference organic meats are preferable they are not always
available and can be very expensive. We are lucky in Ireland that much of our
animal produce is grass fed and due to strict EU laws is of a very high quality.
Beef Look for organic & or grass-fed varieties (If you are living in Ireland the
majority of beef is grass fed and beef from local butchers is of a very high
quality)
Turkey, Chicken, Duck Look for organic & or grass-fed varieties
Lamb Look for organic & or grass-fed varieties.
Fish: Wild-caught oily cold water fish (Mackerel, sardines, salmon, etc.) are
excellent but any of the fish and shellfish found in the water around Ireland is
suitable.
Dairy
Unprocessed Cheeses Hard: Cheddar, manchego, Parmesan, etc. Soft Feta,
Brie, Camembert, mozzarella, etc.
Cream: Heavy cream, sour cream, full-fat crème fraise.
©2021 ROEHEALTH | 102week Carbohydrate Exclusion & Reintroduction Protocol
Fats
Dairy Butter & Cream
Oils Avocado, coconut oil and olive oil
Drinks/Liquids
Vegetable Juices
Coffee or tea: If you usually drink it. But no milk or added sugar or sweetener
of any kind
Vinegar: balsamic, apple-cider, etc.
Water good clean and adequate amounts of water are essential for good
health during the test it can be very beneficial to drink water minimum 8
glasses per day.
Alcohol – Limited intake
Pure, distilled spirits: Small amounts of gin, vodka, whiskey.
Dry red wines: Cabernet Sauvignon, Merlot, Pinot Noir, Cab Franc,
Shiraz/Syrah, Chianti.
Dry white wines: Chardonnay, Pinot Grigio, Sauvignon Blanc.
©2021 ROEHEALTH | 112week Carbohydrate Exclusion & Reintroduction Protocol
Foods That Are Not Allowed
You may NOT eat any of the following foods during the Two-Week Test.
PLANTS
All sugar products: Includes basically anything with honey, sugar, agave,
fructose, crystals (e.g. beet crystals), cane, extract, or syrup in its ingredient list.
Sweets and desserts: Cake, cookies, ice cream, muffins, sweets, gum, breath
mints.
All non-caloric sweeteners (natural and non-natural): Includes stevia, xylitol,
erythritol, aspartame, splenda, etc.
Many canned and prepared veggies: Read the labels to make sure they don’t
contain hidden sugars!
Bread: Sliced bread or rolls of any kind (whole-grain, multi-grain, flaxseed, rye,
gluten-free, etc.).
Pasta: All types.
Crackers: Includes chips, rice cakes, and similar foods.
Packaged energy bars: And all packaged foods promoted as fuel for athletes.
Ketchup and other sauces: They often contain hidden sugars.
Corn: Bread, tortillas, etc.
Rice: Wild rice, brown rice, white rice, basmati rice, etc.
All wheat and wheat products: Whole wheat, faro, bulgur, khorasan,
millet, etc.
Quinoa: Includes quinoa seeds and all products (e.g. quinoa pasta).
Potatoes: Any kind (russet, red, blue, etc.)
Soy products – Like Tofu, Miso, Soy sauce
Fruits and berries: Bananas, apples, pears, oranges, grapefruits grapes,
blueberries, strawberries, cranberries grapefruit, watermelon, cantaloupe,
honeydew.
Legumes: Beans, lentils, fava beans, peas, chickpeas, peanuts, etc.
©2021 ROEHEALTH | 122week Carbohydrate Exclusion & Reintroduction Protocol
MEAT
Processed meats: Sausage, pastrami, salami, pepperoni, etc.
Smoked products: Jerky (beef, buffalo, etc.), smoked fish.
Many canned and prepared meats: Read the labels to make sure they don’t
contain hidden sugars!
DAIRY
Milk Of any kind cows, goat or sheep’s milk, Milk powders and substitutes such
as oat milk or soy milk. Almond milk is acceptable.
Yogurt and kefir: All types, including full-fat yogurt.
Processed cheeses: Stay away from pre-sliced, single serving, pre- shredded
FATS
Avoid corn, safflower, or canola and other vegetable oils during the test and
after
DRINKS
Fruit Juice Any type — orange, berry, watermelon, and etc.
All fizzy drinks Diet and non-diet soda.
All diet drinks Diet shakes, etc.
“Enhanced” Beverages: Vitamin water, mineral water with “health” additives
or flavorings.
Sports drinks All
Sweet wines Liqueur, Champagne, rum, etc.
General Rule
If it comes in a box, bag, jar or can, there’s a good chance it’s a no food for the
Two-Week Test. Be sure to read the ingredients for all packaged foods, as some
form of sugar or carbohydrate is typically added.
Better yet, simply avoid all packaged and processed foods for two weeks!
Now that you know which foods to eat & which to avoid, you can start the
Two-Week Test!
What to expect
©2021 ROEHEALTH | 132week Carbohydrate Exclusion & Reintroduction Protocol
For many people undertaking the Two-week test will mean a significant change
from their normal diet. With such a big change you can expect to notice some
changes, overall these will be positive.
After the First three days most people report that they start to have more
energy and they are feeling better, the cravings subside and they have better
mental focus.
This is great because it gives you the encouragement to continue with the test
and beyond.. But, there is always a but… getting there can sometimes be
challenging, thankfully not too challenging and usually short lived.
The First 3 days
These are definitely the most challenging you can experience cravings for foods
especially sweets and carbs that you are used to eating regularly.
You may also experience some of the following symptoms
• Headaches
• Brain fog
• Muscle and joint aches
• Tiredness
These are usually transient and will subside over a few days; here are a few
pointers to help you manage them
• Drink plenty of water
• Reduce coffee and tea intake
Eat Breakfast within 1 hour of eating – make sure it is high in protein, even if
the thought of eating breakfast makes you feel sick you must force yourself to
eat something even a small amount. As your blood sugar stabilizes the nausea
will subside and you will be feeling better.
©2021 ROEHEALTH | 142week Carbohydrate Exclusion & Reintroduction Protocol
After the Two Week Test – The Reintroduction
Congratulations if you have completed the Two-week test, are you feeling
better? Is your energy better? Are you sleeping better, feeling less depressed?
Have you lost some inches around your waist?
If you answered yes to any of those questions or you lost body fat you probably
have CI to some extent.
If on the other hand you noticed no difference in the symptoms you were
hoping to address, it may be that CI is not a significant problem for you or that
you need more specific help from a functional medicine practitioner to get to
the root cause of your issues.
The Reintroduction of food that you are about to undertake is an equally
important part of the process. It is true that you will feel better for removing
the excess Carbohydrates from your diet, but if you start eating too much of
them again or too quickly, especially if you do not remove the ones that are
problematic for you, you will be back to square one very quickly.
So please review this section carefully and complete the reintroduction as
thoroughly as you can. The main reasons for this are to:
• Evaluate your personal level of carbohydrates that you can handle
without relapse
• Remove any foods that you have an adverse reaction to
STEP 1 – Re-evaluation of symptoms
Re-evaluate your original list of complaints after the Two-Week Test.
• Is your energy better?
• Are you sleeping better?
• Are you feeling less depressed?
• Have you lost inches around your waist?
Depending on the degree of your CI you have been suffering from you may feel
dramatically better than you did before the test, especially if you experience a
large weight loss.
©2021 ROEHEALTH | 152week Carbohydrate Exclusion & Reintroduction Protocol
Any fat loss during the test is not due to reduced calories, but rather to the
increased fat- burning resulting from reduced insulin (many people eat more
calories than usual during this two-week period). Although some of the change
in weight may be due to water loss, a significant amount will be due to fat loss.
As insulin levels fall to normal it is common for blood pressure to drop as well
so If you are on medication for high blood pressure, ask your health-care
professional to check your blood pressure several times during the test, and
especially right after. Sometimes, blood pressure drops significantly and your
medication may need to be adjusted or eliminated.
Important
Do Not reduce your medication or stop taking it without the knowledge and
guidance of the GP or person who prescribed your medication
Step 2: Re-incorporating foods into the diet.
The best way to add foods is in the following order. Each day, add one serving
of one food to your midday meal, starting with the first and working your way
down the list.
You want to try only one of these foods per day, meaning that on day two, you
do not include a serving of the food that you had the previous day.
Order of reintroduction:
• Legumes
• Low-glycemic fruits (berries, grapefruit, prunes)
• Medium-glycemic fruits (apple, orange, pear, strawberries)
• Gluten-free grains (whole oats, brown rice)
• Grains with gluten, if not intolerant
• 1 teaspoon of organic honey with coffee or tea (excluding agave, or any
other kind of sugary substance)
©2021 ROEHEALTH | 162week Carbohydrate Exclusion & Reintroduction Protocol
It is important to reintroduce the foods 1 at a time and at your mid day meal.
The reason for this is that one of the symptoms you are going to be looking for
is tiredness or loss of energy after eating. If this happens after an evening meal
this may just feel normal and is easy to ignore. It is less easy to ignore if you
eat lunch and then feel the need to have a sleep straight afterwards.
It can be difficult to keep track of what you have tried and what you have not,
so for this period of the test I would advise that you keep a food diary. You will
find preprinted work sheets at the back of this book that you can use to help
you keep track of what you are eating, drinking and any symptoms that you
may be experiencing.
Reactions to foods
When you reintroduce foods you need to pay attention to the symptoms that
they may be causing. Pay specific attention to the symptoms that you wrote
down before doing the test. If any of these return you have either:
• Eaten a food that doesn’t agree with you
• Eaten too much carbohydrate and you body is struggling to handle it
Symptoms that you should pay particular attention to are:
• Energy levels after eating - fluctuations either up or down
• Gastrointestinal complaints – bloating, pain, indigestion, diarrhea,
constipation, etc.
• Headaches
• Immediate skin reactions especially around the lips
• Itchiness – over the whole body but especially in the mouth or throat
If you have an immediate reaction to a food take this as a sign that you should
not be eating that food at all in any quantities.
©2021 ROEHEALTH | 172week Carbohydrate Exclusion & Reintroduction Protocol
If you see old symptoms return after reintroduction of carbohydrates for
instance:
• You’re getting cravings again.
• You are gaining weight again.
• Your blood pressure rises significantly after it was reduced.
• Any other previous symptom returns
It is a sign that you are eating too much carbohydrate in total & if any of these
situations occur, reduce your carbohydrates intake by half.
You can also experiment to see which particular foods cause symptoms and
which don’t. For some people returning to the Two Week Test and begin the
process again is the best way to proceed.
It is possible to use elimination / reintroduction protocols to look for hidden food
sensitivities but it is outside the scope of the Two-week test. If you feel food
sensitivities are an issue for you a functional medicine consultation may be a more
appropriate prior to starting any dietary change.
©2021 ROEHEALTH | 182week Carbohydrate Exclusion & Reintroduction Protocol
General Guidance for CI & a Healthy Diet
In order for many people to have a healthy diet most bread, crackers, cereals
and other grains, which are highly processed should be completely avoided.
Even those labeled “whole grain” or “100 percent “whole wheat” are
processed in some fashion.
Read ingredient lists carefully. Use real-food whole grain products, if you can
find them. These include sprouted breads, whole oats (which take 30 to 45
minutes to cook), and other dense products made with just ground wheat, rye,
or other grains. If you are in doubt, avoid them.
Some people can tolerate simple carbohydrates, such as fresh fruits, plain
yogurt and honey, but not complex carbohydrates such as sweet potato, whole
grains, beans or other starches. During the post-test period, it’s possible to
determine whether you can tolerate any of the above foods and how much you
can tolerate.
From time to time, you may feel the need to go through a Two-Week Test
period again to check yourself, or to quickly get back on track after careless
eating such as during the holidays, vacations or periods of stress.
Many people find the loss of grains in the diet leaves the digestive tract
sluggish and a little constipated. After years of eating lots of carbohydrates,
your intestine gets used to that type of bulk. If you become constipated during
the Two-Week Test, or afterwards, when a lower amount of carbohydrate in
the diet is maintained, it could be due to a number of reasons:
• Dehydration – Drink plenty of clean water
• Lack of Fiber in the diet
Dehydration.
If you don’t drink enough water, you could be predisposed to constipation.
During the Two-Week Test, you’ll need more water up to two to three liters per
day.
©2021 ROEHEALTH | 192week Carbohydrate Exclusion & Reintroduction Protocol
Lack of Fiber
If you require a fiber supplement, be sure to use the ones that do not contain
sugar, so read the labels. Psyllium is a high-fiber herb that is an effective
promoter of intestinal function. Adding plain unsweetened psyllium to a glass
of water, tomato juice, or healthy smoothie can keep your system running
smoothly. Add one teaspoon a day for a few days to make sure it’s tolerated,
then move towards one tablespoon a day.
Another excellent source of soluble fiber is chia seeds again soaked in water for
1 hour or more. 1-2 dessertspoons in a 200ml glass of water taken with every
meal can be very beneficial.
Other Nutrients. Adequate intake of natural fats can also be helpful in
preventing constipation. Vegetables, legumes such as lentils, and fruits are also
great sources of fiber. So if you become constipated, it may simply be that you
need to eat more vegetables and fruits.
General Info
Occasionally, some people get tired during or after the Two-Week Test. Most
commonly it’s from not eating enough food, or not eating often enough.
The most common problem is not eating breakfast.
Maintain your optimal food balance once you successfully finish the Two-Week
Test by adding back the right amount of tolerable carbohydrate foods, you will
have an excellent idea of your carbohydrate limits.
Now, you’re on your way to balancing your whole diet. During this process,
take the time to learn which of the choices available in supermarkets, farmer’s
markets, and elsewhere are truly healthy, and which should be avoided.
While there’s nothing radical about the notion that refined carbohydrates are
unhealthy, many radical diet plans make it seem like all carbohydrates are
deadly, they are not. It’s a lot more important to find your level of tolerance.
Once you know it, eat only healthy carbohydrates — lentils, fresh fruit,
unrefined grains (if tolerated), and organic honey as a sweetener.
©2021 ROEHEALTH | 202week Carbohydrate Exclusion & Reintroduction Protocol
Notes
Before Taking the 2 week test After the 2 week test
Weight kg/lbs.
Blood Pressure / mmHg / mmHg
Symptoms Prior Symptoms After
©2021 ROEHEALTH | 21You can also read
