Food allergies are a hot topic these days – remember when you could have a dinner party without considering your guests’ dietary restrictions? For many of us, those days are long gone. Many people are going gluten-free or dairy-free or eliminating other common foods from their diets. Is this just a passing diet fad? Why go to all of that trouble?
Many common health problems and symptoms can be linked to food reactions, including digestive disorders, chronic joint and muscle pain, headaches, depression, anxiety, skin conditions, ADD/ADHD, fatigue, and many, many others.
What is a food allergy?
Food reactions can come in multiple forms and in many cases the mechanisms behind them are not fully understood. A classical food allergy is an immediate reaction to food that happens through the immune system, leading to the generation of IgE antibodies and ultimately to symptoms such as hives, asthma, eczema, and in severe cases, a life-threatening reaction called anaphylaxis. Most of us are familiar with this type of food reaction.
Other types of reactions to food are mediated by the immune system through IgG or IgA antibodies, or through other mechanisms, with a delay between consumption of the food and the experience of symptoms as long as 48 hours or more. These reactions may be called food allergies, food sensitivities, or food intolerances.
There are also food intolerances that are not mediated by the immune system at all but are caused by a lack of enzymes needed to digest certain foods, as in lactose intolerance, or by certain molecules in food causing drug-like effects in the body, as in histamine reactions.
With all of these different terms and the differences of opinion among health care professionals and researchers about how to label different types of food reactions, it’s not surprising that food reactions are a controversial and confusing topic.
For those with classical food allergies, testing usually involves skin prick testing in an allergist’s office. For those with other, delayed-type reactions to food, the process can be a bit more complicated.
A food allergy elimination diet is one commonly used strategy to determine whether you react to foods. There are a number of different ways to do an elimination diet, some much more restrictive than others. The basic premise is the elimination of all of the most common foods that people react to, and any foods that you consume frequently in your regular diet, for a period of several weeks. After symptom improvement is achieved the eliminated foods are reintroduced one at a time to determine if there is any reaction to them. This can be a very enlightening process, although it is admittedly lengthy and can be tedious.
Other methods of assessment include testing for IgE, IgG, and IgA antibodies and cytotoxic testing which measures changes in white blood cell size and shape in response to different foods. A naturopathic doctor can help you determine which strategy is right for you and coach you through it.
Once you’ve figured out what foods you react to, what can you do about it? For most people with delayed-type food reactions, the foods they react to will need to be completely eliminated for a minimum of 3 months. During this time, strategies for healing the digestive tract and calming the immune system to make it less susceptible to food reactions are implemented. My goal is for patients to be able to reintroduce foods on a “once in a while” or “rotational” basis without return of their symptoms. Of course, this all depends on the individual patient and their specific situation.
It may sound like a complicated process but for patients who have food reactions, it’s well worth the time, effort, and investment. The wonderful thing about determining what foods patients react to is that it gives them a measure of control over their symptoms. Once you know what will trigger your symptoms, you have a choice of whether to avoid the triggers or whether it’s worth it to you to enjoy a piece of birthday cake or slice of pizza, knowing you may pay for it the following day. The key is to determine what diet works best for you and your body on a regular basis, while ensuring that your digestive and immune systems are as healthy as they can be.
Brostoff, Jonathan and Linda Gamlin. The Complete Guide to Food Allergy and Intolerance. New York: Crown Publishers, Inc.