Diet: Identifyng a Food Allergy Danielle S., Registered Dietitian
Identify your Food Allergy/Intolerance with an Elimination Diet
It might seem that nowadays, everyone has some sort of food allergy, sensitivity or ailment. A common statement that I hear is something along the lines of: “My grandparents drank whole milk, ate full fat dairy and had no problems with gluten. Why, suddenly is everyone intolerant?”
The answer is multifactorial on your Diet:
- First of all, the quality of our food is far different from what our grandparents consumed. Most of the convenient foods today contain so many chemicals and fillers. They are filled with refined flours, simple sugars, food dyes, and preservatives. These foods are incredibly difficult for our bodies to digest. Long-term consumption can lead to digestive problems, high blood sugar, migraines, reflux, elevated cholesterol, obesity, poor sleep, fatigue, joint pain and more. The foods that our grandparents consumed in their diet, though they might have been higher in animal fat, were far more natural. They didn’t resort to boxed mixes with added fillers. Instead, most items were REAL food made from scratch.
- Secondly, overall awareness regarding food sensitivities, intolerance and gut function as increased exponentially. What our grandparents might have considered a chronic cold could today be found to be a result of food sensitivity.
Really—think about it— how can we possibly expect our bodies to run smoothly when we overstimulate with coffee, energy drinks, “healthy” energy supplements, protein bars that have ingredient lists for days, sugar-filled-granola bars and cereals, microwavable meals, and these are the “healthier” of the fake food that makes up the bulk of the Standard American Diet (S.A.D—how appropriate, right? ☺)
I encounter many people (I used to be this person) who said, “Well, I eat dairy every day and I have for years. I can’t possibly be sensitive to it.” However, these same people experience acid reflux, migraines, rotate between diarrhea and constipation, have sugar cravings, chronic pain, bloating, stomach aches, gas, acne, congestion….do I really need to continue? All of those symptoms, though unfortunately common, are not normal. Our bodies are not designed to function that way. So what do we do?
If you have a functional medical doctor or dietitian, they can order a food sensitivity test to help you pin point the exact foods in your diet that are causing your body problems.
“But I’ve been allergy-tested and I don’t have any food allergies!”
There are different types of inflammatory responses in the body from your diet.
- When you get allergy tested, they are testing an IgE-mediated response.
- This is an immediate reaction, occurring several minutes or hours after eating a particular food and symptoms range from mild to severe.
- They can be as “benign” as an itchy mouth or as severe as hives or an anaphylactic response requiring an EpiPen.
- This test is typically done through the blood however most adults have their ‘trigger food’ figured out because the reaction is so quick.
- For example, if milk causes immediate diarrhea or tomatoes create lip swelling, and walnuts close your throat –it’s usually fairly obvious because the symptoms occur so quickly to the offending food.
This isn’t where diet testing should end.
- The second most adverse reaction to food is a result of an autoimmune response such as with celiac disease.
- According to the University of Chicago Celiac Disease Center, “Celiac disease is an inherited autoimmune disorder that affects the digestive process of the small intestine.
- When a person who has celiac disease consumes gluten, a protein found in wheat, rye and barley, the individual’s immune system responds by attacking the small intestine and inhibiting the absorption of important nutrients into the body.
- Undiagnosed and untreated, celiac disease can lead to the development of other autoimmune disorders, as well as osteoporosis, infertility, neurological conditions and in rare cases, cancer.”
This last adverse response to food is the one that I encounter most commonly in my practice and it is also the most difficult to identify. I’m referring to the non-immediate (delayed) IgG and IgA response commonly known as a food intolerance or food sensitivity. Unlike an immediate IgE food allergy response, IgG and IgA symptoms may take several hours or days to present. This makes it extremely difficult to pinpoint exactly what foods are causing what reaction in the body especially because people tend to eat the same foods over and over. How do you know if almonds cause your mental fogginess or eggs cause fatigue or dairy increases your acne if you eat them every day?
Sherwood Family Medicine, a Functional Medical Center states that “testing for IgG and IgA food intolerances/sensitivities is confusing for many healthcare providers as they are not typically trained on this type of reaction as it is neither obvious nor life-threatening, however intolerances and sensitivities are gaining public awareness as people are removing offending food groups in order to help support autism/spectrum disorder treatment plans, chronic diseases, and reduce inflammation in the body with success.”
If you have access to a functional medical doctor or dietitian, they can usually help you order the appropriate IgE, IgG and IgA lab tests. If you don’t there are still ways to help identify the source of you discomfort.
Keep in mind that they are different ‘branches’ of your immune system and being allergic to a food doesn’t mean you are intolerant and vice versa.
When standard testing methods aren’t available or cost permissive, many health professionals recommend following an Elimination Diet. According to the Elimination Comprehensive Guide by the Institute for Functional Medicine, eating the wrong types of food can impair digestion and absorption of nutrients. This can weaken immune function. A compromised immune system leaves you more susceptible to developing sensitivities. There are many approaches to an elimination diet. The purpose is to remove offending foods, decrease the burden on the immune symptom, and allow time for symptoms to resolve. This diet can help identify true allergies, sensitivity or intolerance to foods.
Elimination diets are best when you allow 4-6 weeks minimum away from offending foods.
Some choose to eliminate all common food allergens (gluten/grains, soy, dairy, eggs, peanuts, corn, nuts/seeds, nightshades) and then gradually re-introduce one new food at a time. For others, the full elimination is too extreme. In that case, you might choose to start with eliminating just one allergen that you suspect is causing you problems (ex: dairy) for 4-6 weeks. After that time frame, you can re-introduce the food to assess for adverse reactions. The way to re-introduce is to consume the food 2-3 times within one day. Wait 2-3 days before consuming that food again and do not add in any new items at this time. If any adverse reactions occur (congestion, foggy brain, headache, joint pain, stomach distress, bloating, itchy skin, heart palpitations, etc) continue to eliminate that food, as you have a clear intolerance. If no adverse reaction occurs, you can continue to consume that food and re-introduce the next food that you have eliminated.
Like I stated earlier, you might not think that you have any adverse reactions, but believe me, you’ll be surprised. Many of my patients report that foods that they use to consume on a daily basis “suddenly” cause problems. In reality, they had grown so used to heart burn, congestion, joint pain, bloating, etc and thought those symptoms were “normal.” Those symptoms disappeared when the food was eliminated and as soon as they were re-introduced, the symptoms came back roaring.
The benefit to an elimination diet is that if you eliminate a problem food and feel “normal” again, it will be much easier for you to detect exposure to a problem food.
This is a great way to learn your body and learn which foods fuel you vs those that cause inflammation and harm. If you do the elimination diet, it is extremely important to completely remove all forms of the eliminated foods. Even small amounts can create an inflammatory response and prevent you from experiencing relief.
Please note that an Elimination Diet is not to be used as a crash weight loss program. You are supposed to consume plenty of non-inflammatory nutrient dense foods during the process. These are best conducted under the guidance of a health care professional, but if you don’t have access to one, they can be conducted alone. Be sure to keep a food/symptom journal so that you can clearly track your progress! Next week, I will guide you through an elimination of gluten, dairy and eggs and provide healthy options to ensure you still get adequate nutrition. ☺
An excellent resource for the Elimination Diet from the Institute of Functional Medicine can be found here.
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