“Are you kidding me?
Those are my favorite foods?” was Steve’s disbelieving response when asked if he would stop eating beef and milk products after his food sensitivity test panel showed severe reactivity to those items. This is a common response when food is implicated as the causative culprit of headaches, joint pain, acne or other illnesses. Unfortunately, our food today is not the food of our grandparents. More than we understood before, food is often silently contributing to chronic illnesses like arthritis, heartburn and migraines.
The food our grandparents ate was more often than not from a local farmer who was working with the land and using natural fertilizers. The farm animals were free range and ate unmodified grass and hay. Today, most animals are no longer free range. They do not eat grass but are penned in feedlots and fed very high-calorie genetically-modified corn with a high omega 6 content. Add to that hormones and antibiotics and we are eating a very different meat than what was on the market at the beginning of the 1900s. Vegetables and fruits have been modified to be bigger and to look better. Unfortunately, they are usually harvested long before ripe and are chemically treated to ripen en route to stores — a very different product than the fruit of the past.
It is postulated that these and other significant changes in our food chain have promoted reactions to foods that have not been seen in the past. Once Steve stopped consuming the foods that were triggering his inflammation, his arthritis and heartburn were completely resolved.
Food Allergies and Intolerances
Reactions to foods can range from mild symptoms like heartburn and bloating to extreme allergic responses that include facial and throat swelling, which if not treated can result in death. In the National Institute of Allergy and Infectious Disease (NIAID) guidelines published December 2010, food allergy was described as “… an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food.”1 These types of responses are mediated by an antibody known as IgE. The guidelines did not address delayed food reactions but did describe food intolerances as “…foods or food components that elicit reproducible adverse reactions but do not have established or likely immunologic mechanisms are not considered food allergens. Instead, these non-immunologic adverse reactions are termed food intolerances.”2 In other words, a food intolerance can be defined as any adverse symptom or reaction related to food intake that is not currently recognized as an IgE-related immunological response. The medical community is just beginning to appreciate that a major component of the immune system is in the lining of the gut; and that there truly may be more to the biologic activity and reactivity than we have appreciated to date.
Whatever the medical community will eventually agree to call them, reactions to various foods are a serious problem. There are approximately 5 million children in this country who have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), 66 percent of whom take some form of stimulant to control symptoms..3 In a study published earlier this year in the respected journal, Lancet, 64 percent of children diagnosed with ADHD had improvement in cognition and behavior after following a restricted diet. In an NPR interview Dr. Lidy Pelsser, the lead researcher compared ADHD to eczema. “The skin is affected, but a lot of people get eczema because of a latex allergy or because they are eating pineapple or strawberries.”
These reactions occur relatively quickly so it is easy to establish a cause-and-effect relationship. Considering the results of the study, it is interesting to contemplate that approximately 3.2 million American children could be freed from the stress of the hyperactive, scattered world in which they live if given the right diet.
It takes time to determine if a specific food is the culprit, and delayed reactions to food can make the diagnosis even more complicated. Though the information that food choices are related to migraines has been known since the 1950s, it has been disregarded in an era of prescription medications and in a system that does not allow time for physicians to educate patients about this hidden cause of misery. A chronic migraine sufferer said it very poignantly: “I’m only disappointed that this information isn’t better known and respected by the medical community at large. I could have saved years of suffering.”4 Other disorders that have been linked to foods are insomnia, restless leg syndrome, joint pain, headaches, heartburn, autism and acne.
Recently, the media has focused on gluten sensitivity and Celiac disease — conditions which alter the lining of the gastrointestinal tract to varying degrees. Gluten is a protein that is found in wheat, barley, rye and spelt grains and related products. It is estimated that 2.2 million people in the United States have celiac disease.5 There seems to be an increasing number of people who are diagnosed, though this could be due to more frequent testing as awareness increases. There is speculation that the overall increase of intolerance and disease is due to consumption of foods which have more gluten content, a result of industrial manipulation.
Joint pain, resistance to weight loss, fatigue, brain “fog,” muscle pain, rashes, mouth ulcers with or without gastrointestinal symptoms have all been linked to eating the grain protein gluten. Testing for gluten sensitivity is challenging. Internists and gastroenterologists test for blood levels of specific antibodies and may perform genetic testing. Integrative physicians and others perform antibody testing, genetic testing and may also recommend stool testing.
Another disease that has been linked to food intake is arthritis. In the 1950s researchers proved the association between food and arthritis.6 Studies were small but the effects of low allergenic diets on symptoms and inflammatory markers were impressive. The arrival of modern medications and insurance company limitations on doctor visit times has moved the medical community away from considering a dietary origin of the inflammation causing arthritis. It takes considerably more time to assist someone to change her lifestyle and eating habits than to write a prescription that will mask symptoms.
There are different ways to test for food intolerance and allergy, all of which have limitations. Current available testing methods range from simply measuring antibody levels (IgE and IgG) to measuring the molecules that are released from the white blood cells and platelets when whole blood is exposed to a variety of potential allergens, this is called mediator release testing (MRT). Another method is called the antigen leukocyte cellular antibody test (ALCAT) which determines counts and sizes of white blood cells before and after incubation with a number of possible allergens including chemicals and molds. A number of allergy societies feel that this test is not reliable as studies do not always yield the same responses.
Following testing, the company that provided the test, make personalized diet recommendations based on the results. An individual is given recommendations that include avoiding the foods with the most reactive response for six months, those with moderate responses for three months and using the mildly reactive foods in a four day rotation diet. Patient testimonials are effusive, but only those with positive responses seem to be available. Unfortunately, we cannot rely on these testimonials as scientific evidence.
Another less expensive, but more time consuming option, is an elimination diet. A person is asked to stop eating a number of foods that are most associated with illnesses and reactions and given a number of alternative food options. The foods that are avoided in an elimination diet are: gluten- containing products, all beef and cow products, chocolate, citrus fruits, coffee, corn, eggs, peanuts, pork, refined sugar, seafood, soy-containing products, tea, tomatoes, tree nuts, yeast-containing products, additives and trans fats. After a period of time (ideally two weeks) each food group is re-introduced and responses are captured in a diet diary. Symptoms will usually return within a few days of exposure to the “guilty” food.
Be an Informed
Understanding that our number one external exposure is food—we consume tons in our lifetimes, that the food industry has promoted the use of petrochemicals and genetic modification that has not been proven to be safe, and that intolerances manifest in unique and variable ways — are fundamental in understanding that food can be contributing to illness. If you endure chronic symptoms for which there seems to be no diagnosis, it may to time to consider whether the food you eat is contributing to your suffering.
So is this really all about what we cannot eat? The short answer is, “No.” It is about awareness and about learning to choose the right food for you. It’s about being an informed consumer — literally. If you are having persistent symptoms, it is important to seek medical attention and to be evaluated. If you are told “everything is normal,” but continue to feel unwell, listen to your body and find a qualified healthcare professional who can help you determine which foods might be causing your unique responses. Physicians and other healthcare practitioners who have personally experienced or have seen the power of dietary changes in patients are more likely to consider food as a contributing factor to illness.