Is Your Food Making You Sick?
by Amy Culp, RD, CSSD, LD
Health Contributor
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A Look into Food Allergies, Intolerances & Sensitivities
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As a registered dietitian, I often have clients tell me, “I’m allergic to______________ (fill in the blank with any food you can think of).” But upon further assessment, I typically find the symptoms they describe are not that of a food allergy, but rather a food intolerance or sensitivity. To get the record straight, let’s take a look at the differences between food allergies, intolerances and sensitivities.
According to The American Academy of Allergy, Asthma and Immunology, more than 3 percent of all adults have one or more food allergies and 6.5 million of us (or 2.3 percent of the general population) are allergic to seafood. The number is even higher among American children (at 6 percent), and continues to grow. In fact, the prevalence of food allergy among children under the age of 18 has increased by 18 percent from 1997 to 2007.
What is a Food Allergy?
A food allergy is an immune system response to compounds (usually protein) in foods. Food allergies occur when the body mistakes the food eaten as an invader and sends antibodies (called Immunoglobulin E or IgE) to fight it. When a person with a food allergy eats an offending food, IgE triggers a chain of reactions that result in the body releasing chemicals, such as histamine, in an effort to expel the “invader” from the body. Depending on the tissue in which these chemicals are released, a person will present a variety of food allergy symptoms.
Common Food Allergens
Milk, eggs, peanuts, tree nuts (such as walnuts, pecans and almonds), wheat, soy, fish and shellfish are considered “the big eight” because they are the most common food allergens. Together they make up about 90 percent of all food-related allergic reactions. Eggs, milk and peanuts are the most common allergens in children. Unlike adults, children can sometimes outgrow their food allergies, especially to milk or soy. Interestingly, the foods that adults or children react to are those they eat often. For example, in Japan, rice allergy is more frequent, whereas in Scandinavia, codfish allergy is more common.
What is a Food Intolerance?
Food intolerance is a digestive system response rather than an immune system response (as in food allergies). Food intolerances occur when the digestive system is unable to digest a particular food. For example, lactose intolerance is caused by a deficiency of the lactose enzyme needed to digest the carbohydrate lactose in dairy products. Intolerances to some chemical ingredients added to food to provide color, enhance taste and protect against the growth of bacteria are also common.
Food Intolerance Symptoms
Some symptoms of food intolerance overlap with food allergy symptoms. However, food intolerances only affect the gastrointestinal tract (GI). Common symptoms that occur from food intolerance include nausea, vomiting, diarrhea, bloating, stomach cramps and heartburn. People with food intolerances are usually able to consume small amounts of that food without experiencing adverse reactions, while even small amounts of food allergens can cause severe reactions.
What Are Food Sensitivities?
Sometimes, symptoms and tests results do not result in a diagnosis of a food allergy or intolerance. Regardless, disruptive symptoms remain. So, what to do? I asked a colleague who specializes in food sensitivities, Kylie Bentley, registered dietitian and certified LEAP therapist, for more information. Bentley states that “both food allergy and food sensitivities are immune mediated, meaning that they evoke chemical mediator release that results in symptoms. Food allergies are IgE mediated, while food sensitivities release IgG, IgM, immune complexes and T cells. The food sensitivity reactions are delayed instead of being immediate as seen in food allergies, but they still trigger the immune system.”
Food Sensitivity Symptoms
Bentley states that when she sees a client suffering from Irritable Bowel Syndrome (IBS), migraines, recurring headaches or fibromyalgia, she strongly suspects food sensitivities.
Why? “There is extensive research supporting the connection between immune mediator release triggering inflammation and each of the conditions/symptoms mentioned above,” states Bentley. “I have seen proof time and time again in my clients, as well as my colleagues' clients, who have experienced symptom relief upon removing foods they are sensitive to.”
Diagnosing Food Allergies, Intolerances, and Sensitivities
If you suspect you are having a problem with some of the foods you eat, you should visit an immunologist, a doctor or registered dietitian specializing in food sensitivities. The healthcare provider will then complete a thorough history and assessment. They may ask you to keep a food diary and jot down any symptoms that you notice from the foods you eat.
The next step some healthcare providers recommend is an elimination diet. An elimination diet involves removing the suspected food causing problems, such as eggs, and substituting another food, or in this case, a different source of protein. If you remove the food and the symptoms go away, a diagnosis can typically be made. If you eat the food again (under the healthcare provider’s direction) and the symptoms return, then a diagnosis can be confirmed. Of course, this technique should not be used if the symptoms are severe or frequent. This technique can be time consuming, confusing and challenging.
Immunologists may use skin tests or blood tests (RAST and ELISA) to help with diagnosing a food allergy. Some may also use a double-blind food challenge, which involves eating small amounts of foods that are in opaque capsules and then monitoring for a reaction. Both the patient and the physician are unaware of which foods are in the capsules, hence the name double blind.
But what about those folks who have been told that they do not have a food allergy or intolerance, but are still having symptoms, they feel may be linked to food? Bentley told me about a program that she uses that is able to test for food sensitivities, called LEAP (Lifestyle, Eating and Performance).
“LEAP is a patented blood test for non Ig-E food sensitivities using the latest technology to accurately isolate the specific foods and/or additives provoking a reaction. The test covers 150 common foods and chemicals/preservatives consumed by Americans on a regular basis. After the test is taken, individuals are guided through their results by a registered dietitian or certified LEAP therapist (CLT) who is trained to guide the individual through a personalized program.”
Bentley sums it up well, “The reality is that we all have to eat every day. The food we choose to eat is information to our bodies — good or bad. If you’re in pain, your body is getting a bad signal somewhere, sometime.” Living with a food allergy, intolerance or sensitivity can be a challenge. With the help of a trained professional, those who are suffering can find relief, and helpful ideas for incorporating food that not only tastes great, but is also good for you.
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Are You Allergic?
Dairy Allergies - Watch the labels
The Kosher food labeled “pareve” or “parve” almost always indicates food that is free of milk and milk products. A “D” on a product label next to the circled K or U indicates the presence of milk protein. These products should be avoided.
Soy Allergies - In more than soy sauce
You probably already know that soy is the main ingredient in tofu and most other textured vegetable protein. But what you might not know is that many food flavorings and sauces contain this ingredient. Also, if you’re allergic to soy, make sure to avoid shoyo sauce, miso and tempeh.
Egg Allergies - Use an egg substitute
If you have an intolerance, try an egg substitute instead. These products contain mostly egg whites and can be found in almost all grocery stores.
Nut Allergies - A ubiquitous food additive
Peanut butter and/or peanut flour have been known to be used in homemade chili and spaghetti sauce as thickeners.
Wheat Allergies - A long line of substitutes
Wheat is in more foods than you might guess. It’s found in couscous, bran and spelt, traces of it can even be detected in food starch and soy sauce. Luckily, there are a long line of substitutes you can use instead of wheat, such as rye, potato and rice flour.
Seafood Allergies - Try other lean meats for your B12
This protein can be substituted with chicken, turkey or other lean meats. Since most shellfish are rich in vitamin B12, you can still get enough of this nutrient by increasing your intake of eggs (so long as you’re not allergic!) and turkey.
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Amy Culp, RD, CSSD, LD, co-owner of sCULPture Nutrition & Fitness, LLC and consultant sports dietitian at The University of Texas, is a nutrition therapist and Board Certified Specialist in Sports Dietetics. She specializes in sports nutrition, eating disorders and weight management. She can be reached at amyculprd@sCULPturetexas.com.
---------------
As a registered dietitian, I often have clients tell me, “I’m allergic to______________ (fill in the blank with any food you can think of).” But upon further assessment, I typically find the symptoms they describe are not that of a food allergy, but rather a food intolerance or sensitivity. To get the record straight, let’s take a look at the differences between food allergies, intolerances and sensitivities.
According to The American Academy of Allergy, Asthma and Immunology, more than 3 percent of all adults have one or more food allergies and 6.5 million of us (or 2.3 percent of the general population) are allergic to seafood. The number is even higher among American children (at 6 percent), and continues to grow. In fact, the prevalence of food allergy among children under the age of 18 has increased by 18 percent from 1997 to 2007.
What is a Food Allergy?
A food allergy is an immune system response to compounds (usually protein) in foods. Food allergies occur when the body mistakes the food eaten as an invader and sends antibodies (called Immunoglobulin E or IgE) to fight it. When a person with a food allergy eats an offending food, IgE triggers a chain of reactions that result in the body releasing chemicals, such as histamine, in an effort to expel the “invader” from the body. Depending on the tissue in which these chemicals are released, a person will present a variety of food allergy symptoms.
Common Food Allergens
Milk, eggs, peanuts, tree nuts (such as walnuts, pecans and almonds), wheat, soy, fish and shellfish are considered “the big eight” because they are the most common food allergens. Together they make up about 90 percent of all food-related allergic reactions. Eggs, milk and peanuts are the most common allergens in children. Unlike adults, children can sometimes outgrow their food allergies, especially to milk or soy. Interestingly, the foods that adults or children react to are those they eat often. For example, in Japan, rice allergy is more frequent, whereas in Scandinavia, codfish allergy is more common.
What is a Food Intolerance?
Food intolerance is a digestive system response rather than an immune system response (as in food allergies). Food intolerances occur when the digestive system is unable to digest a particular food. For example, lactose intolerance is caused by a deficiency of the lactose enzyme needed to digest the carbohydrate lactose in dairy products. Intolerances to some chemical ingredients added to food to provide color, enhance taste and protect against the growth of bacteria are also common.
Food Intolerance Symptoms
Some symptoms of food intolerance overlap with food allergy symptoms. However, food intolerances only affect the gastrointestinal tract (GI). Common symptoms that occur from food intolerance include nausea, vomiting, diarrhea, bloating, stomach cramps and heartburn. People with food intolerances are usually able to consume small amounts of that food without experiencing adverse reactions, while even small amounts of food allergens can cause severe reactions.
What Are Food Sensitivities?
Sometimes, symptoms and tests results do not result in a diagnosis of a food allergy or intolerance. Regardless, disruptive symptoms remain. So, what to do? I asked a colleague who specializes in food sensitivities, Kylie Bentley, registered dietitian and certified LEAP therapist, for more information. Bentley states that “both food allergy and food sensitivities are immune mediated, meaning that they evoke chemical mediator release that results in symptoms. Food allergies are IgE mediated, while food sensitivities release IgG, IgM, immune complexes and T cells. The food sensitivity reactions are delayed instead of being immediate as seen in food allergies, but they still trigger the immune system.”
Food Sensitivity Symptoms
Bentley states that when she sees a client suffering from Irritable Bowel Syndrome (IBS), migraines, recurring headaches or fibromyalgia, she strongly suspects food sensitivities.
Why? “There is extensive research supporting the connection between immune mediator release triggering inflammation and each of the conditions/symptoms mentioned above,” states Bentley. “I have seen proof time and time again in my clients, as well as my colleagues' clients, who have experienced symptom relief upon removing foods they are sensitive to.”
Diagnosing Food Allergies, Intolerances, and Sensitivities
If you suspect you are having a problem with some of the foods you eat, you should visit an immunologist, a doctor or registered dietitian specializing in food sensitivities. The healthcare provider will then complete a thorough history and assessment. They may ask you to keep a food diary and jot down any symptoms that you notice from the foods you eat.
The next step some healthcare providers recommend is an elimination diet. An elimination diet involves removing the suspected food causing problems, such as eggs, and substituting another food, or in this case, a different source of protein. If you remove the food and the symptoms go away, a diagnosis can typically be made. If you eat the food again (under the healthcare provider’s direction) and the symptoms return, then a diagnosis can be confirmed. Of course, this technique should not be used if the symptoms are severe or frequent. This technique can be time consuming, confusing and challenging.
Immunologists may use skin tests or blood tests (RAST and ELISA) to help with diagnosing a food allergy. Some may also use a double-blind food challenge, which involves eating small amounts of foods that are in opaque capsules and then monitoring for a reaction. Both the patient and the physician are unaware of which foods are in the capsules, hence the name double blind.
But what about those folks who have been told that they do not have a food allergy or intolerance, but are still having symptoms, they feel may be linked to food? Bentley told me about a program that she uses that is able to test for food sensitivities, called LEAP (Lifestyle, Eating and Performance).
“LEAP is a patented blood test for non Ig-E food sensitivities using the latest technology to accurately isolate the specific foods and/or additives provoking a reaction. The test covers 150 common foods and chemicals/preservatives consumed by Americans on a regular basis. After the test is taken, individuals are guided through their results by a registered dietitian or certified LEAP therapist (CLT) who is trained to guide the individual through a personalized program.”
Bentley sums it up well, “The reality is that we all have to eat every day. The food we choose to eat is information to our bodies — good or bad. If you’re in pain, your body is getting a bad signal somewhere, sometime.” Living with a food allergy, intolerance or sensitivity can be a challenge. With the help of a trained professional, those who are suffering can find relief, and helpful ideas for incorporating food that not only tastes great, but is also good for you.
---------------
Are You Allergic?
Dairy Allergies - Watch the labels
The Kosher food labeled “pareve” or “parve” almost always indicates food that is free of milk and milk products. A “D” on a product label next to the circled K or U indicates the presence of milk protein. These products should be avoided.
Soy Allergies - In more than soy sauce
You probably already know that soy is the main ingredient in tofu and most other textured vegetable protein. But what you might not know is that many food flavorings and sauces contain this ingredient. Also, if you’re allergic to soy, make sure to avoid shoyo sauce, miso and tempeh.
Egg Allergies - Use an egg substitute
If you have an intolerance, try an egg substitute instead. These products contain mostly egg whites and can be found in almost all grocery stores.
Nut Allergies - A ubiquitous food additive
Peanut butter and/or peanut flour have been known to be used in homemade chili and spaghetti sauce as thickeners.
Wheat Allergies - A long line of substitutes
Wheat is in more foods than you might guess. It’s found in couscous, bran and spelt, traces of it can even be detected in food starch and soy sauce. Luckily, there are a long line of substitutes you can use instead of wheat, such as rye, potato and rice flour.
Seafood Allergies - Try other lean meats for your B12
This protein can be substituted with chicken, turkey or other lean meats. Since most shellfish are rich in vitamin B12, you can still get enough of this nutrient by increasing your intake of eggs (so long as you’re not allergic!) and turkey.
---------------
Amy Culp, RD, CSSD, LD, co-owner of sCULPture Nutrition & Fitness, LLC and consultant sports dietitian at The University of Texas, is a nutrition therapist and Board Certified Specialist in Sports Dietetics. She specializes in sports nutrition, eating disorders and weight management. She can be reached at amyculprd@sCULPturetexas.com.
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