Awareness about the impact of food on our overall health has steadily increased in recent years. We have shared our Twelve Nature’s pHarmacy Principles to Eat by (Parts 1 and 2), which provides an overall framework for choosing the best foods to help you thrive in the 21st century. This framework maximizes organic, health-promoting whole foods, while avoiding symptom-provoking processed foods, sugars, cow dairy, and gluten- and gliadin-containing grains. Some people, despite eating well, still suffer from digestive and systemic issues that may be food-related. Allergies, delayed sensitivities, and food intolerances may be to blame.
While most people are familiar with immediate food allergies that can come on quickly with potentially severe reactions, many are unfamiliar with delayed food and chemical hypersensitivities, and food intolerances, that can cause a range of subtle yet persistent symptoms that often fly under the radar. These symptoms can disrupt daily life and lead to digestive discomfort at best, and chronic health issues at worst, significantly impacting our well-being. While symptoms of food intolerances and delayed sensitivities may be similar, their origins differ. This blog will review these potential reactions, as well as how to test for and manage them for better health and wellbeing.
Definitions
Immediate Food Allergies are mediated by IgE cells in the immune system and can cause severe, immediate reactions, such as anaphylaxis. Common allergens include peanuts, tree nuts, and shellfish.
Food Intolerances are often due to the lack of specific enzymes needed to digest certain foods. Lactose intolerance, caused by a deficiency in lactase, is a common example.
Delayed Sensitivities are more complex and can be due to chemicals, toxic metals, food additives, as well as foods themselves. They are moderated by Type II, III, or IV immune reactions and often result in delayed symptoms, making them harder to diagnose.
Prevalence
Delayed food sensitivities and food intolerances are quite common, affecting a significant portion of the population. It’s estimated that up to 20% of people experience some form of food sensitivity, although many remain undiagnosed. Understanding the nature of food sensitivities is the first step toward managing them effectively.
Common Symptoms and How They Differ from Immediate Allergic Reactions
The symptoms of food intolerances and food sensitivities can vary widely and often emerge later than those of immediate food allergies. They may take hours or even days to appear after consuming the offending food, which can make identifying the specific trigger challenging. Common symptoms of food sensitivities and food intolerances include:
- Bloating and gas
- Abdominal pain and cramping
- Diarrhea or constipation
- Nausea and indigestion
- Fatigue
- Headaches or migraines
- Skin issues like rashes or eczema
- Joint pain
In contrast, immediate food allergies typically cause rapid onset symptoms such as hives, swelling, difficulty breathing, and anaphylaxis. The later and often milder symptoms of delayed food sensitivities mean they can easily be overlooked or mistaken for other health issues.
Common Food Intolerances
Food intolerances can be triggered by various components in foods. The most common culprits include dairy and gluten, but can also include additives like dyes and preservatives.
Dairy intolerance often arises from lactose, a sugar found in milk, due to the body’s insufficient production of lactase, the enzyme needed to digest lactose. Dairy sensitivity, on the other hand, is typically a reaction to a protein found in dairy products. Some people are sensitive to casein, while others react to the whey proteins lactalbumin or lactoglobulin. Both intolerance and sensitivity can cause digestive discomfort like bloating or abdominal pain, and a delayed sensitivity to dairy can even lead to inflammation and chronic immune-related conditions like eczema.
With gluten, a protein found in wheat, barley, and rye, the terms “intolerance” and “non-celiac gluten sensitivity” are used interchangeably. Unlike celiac disease, it doesn’t damage the intestines but can still cause symptoms like bloating, diarrhea, and fatigue. A full 15% of the population has some type of sensitivity to gluten. We recommend that everyone consider going gluten-free.
FODMAPs, which include fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, are short-chain carbohydrates that some people cannot fully digest. These poorly absorbed carbs can ferment in the gut, leading to gas, bloating, and pain, especially in individuals with irritable bowel syndrome (IBS).
Histamine sensitivity occurs when the body cannot adequately break down histamines found in aged cheeses, fermented foods, and certain alcoholic beverages, resulting in symptoms like headaches, hives, and digestive issues. Other common food sensitivities include reactions to soy, nuts, shellfish, and nightshades (like tomatoes and eggplants), each potentially causing a range of digestive and systemic symptoms. Identifying and managing these sensitivities through dietary adjustments can lead to significant improvements in health and comfort.
How Food Intolerances and Sensitivities Affect Digestion
Food intolerances and sensitivities can significantly impact digestion, leading to a range of uncomfortable and sometimes debilitating symptoms. When someone with a food issue consumes a trigger food, their digestive system may struggle to process it properly. This can result in symptoms such as bloating, gas, constipation, diarrhea, and abdominal pain. For example, individuals with lactose intolerance lack the enzyme lactase needed to break down lactose, leading to fermentation of the undigested lactose in the colon and causing gas and bloating. Similarly, those sensitive to FODMAPs experience fermentation of these poorly absorbed carbohydrates in the gut, resulting in excessive gas production and discomfort.
Beyond immediate digestive distress, food sensitivities can also contribute to chronic inflammation and disruptions in the gut microbiome. Persistent inflammation from repeated exposure to trigger foods can damage the lining of the gastrointestinal tract, potentially leading to conditions such as leaky gut syndrome. This condition allows undigested food particles and toxins to enter the bloodstream, triggering systemic immune responses and inflammation. Additionally, imbalances in the gut microbiome caused by food intolerances and sensitivities can affect overall digestive health, reducing the efficiency of nutrient absorption and compromising immune function. It is important to understand and manage food sensitivities to maintain optimal digestive health and overall well-being.
Diagnosing Food Sensitivities
Elimination Diet: Diagnosing food intolerances and delayed food sensitivities can be a complex process, but several effective methods can help identify problematic foods. One of the most commonly used approaches is the elimination diet. This involves removing suspected trigger foods from your diet for a period of time, usually 2-4 weeks, and then gradually reintroducing them one by one. During the reintroduction phase, you monitor and record any symptoms that arise. This can be tedious for some.
Food Diary: Keeping a food diary is another valuable tool in diagnosing food sensitivities. You can use the Food and Drink log in our printable Food & Drink Journal. By meticulously tracking everything you eat and noting any symptoms you experience, patterns can emerge that reveal potential food sensitivities. This method requires patience and consistency but can provide significant insights into your digestive health.
Hydrogen Breath Test: Hydrogen breath tests are particularly useful for identifying intolerances to lactose and fructose. These tests measure the amount of hydrogen in your breath after consuming a specific sugar, with elevated levels indicating poor absorption and potential sensitivity.
Standard IgE Immediate Allergy Testing: This is the standard pinprick testing, done on your arms or back, by an allergist. In some cases, your body may have a low level IgE response that does not lead to anaphylaxis, but may cause a rash or a hive or two either immediately, or hours after ingesting a particular food. A RAST test or radioallergosorbent testtests for the amount of specific IgE antibodies in the blood which are present if there is a “true” immediate allergic reaction Whether skin or blood, allergists often recommend elimination diets and food journals as IgE testing is not foolproof.
Delayed Hypersensitivity Testing: Dr. Jaffe recommends LRA by ELISA/ACT® delayed hypersensitivity testing, which measures the response of your body’s white blood cells, the lymphocytes, to a variety of food and environmental chemical antigens. This includes Type II, III, and IV reactions. These tests expose your blood sample to a variety of antigens and watch the response of the lymphocytes in real time. By identifying and removing the offending foods, food colorings, and additives, and instituting a nutritional program that may include dietary supplements to replace missing nutrients, many people have obtained lasting relief from their symptoms. While there are other delayed sensitivity tests out there, the LRA by ELISA/ACT tests and treatment plans are the most comprehensive.
Consulting with healthcare professionals is important to the diagnostic process. Dietitians, nutritionists, and doctors can provide guidance, support, and interpretation of test results. They can help develop a tailored plan to identify and manage your food sensitivities, ensuring that you maintain a balanced and nutritious diet while avoiding trigger foods. Their expertise is invaluable in navigating the complexities of food sensitivities and achieving optimal digestive health.
Managing Food Sensitivities
Effectively managing food sensitivities involves a combination of dietary modifications, vigilance, and strategic planning. The first step is to eliminate the identified trigger foods from your diet and find suitable alternatives. For instance, individuals intolerant to lactose can opt for lactose-free dairy products and those who have a dairy sensitivity can choose plant-based milk alternatives like almond milk. Similarly, those with gluten sensitivity can choose gluten-free options such as quinoa. It’s important to ensure that these substitutions still provide the necessary nutrients to maintain a balanced diet.
Reading food labels meticulously is crucial for avoiding hidden sources of trigger foods. Many processed foods contain ingredients that can exacerbate reactions, such as gluten in sauces and soups or lactose in baked goods. By carefully checking labels, you can identify and avoid these hidden triggers. When eating out or traveling, strategies such as researching restaurants in advance, communicating your dietary needs to staff, and carrying safe snacks can help manage food sensitivities. Many restaurants now offer allergen menus or are willing to accommodate special dietary requests, making it easier to enjoy meals away from home without compromising your health.
Dietary supplements can also play a supportive role in managing food sensitivities. Multivitamin/Multimineral supplements can help to restore balance to an overly-taxed system. Probiotics are beneficial for maintaining a healthy gut microbiome, which can improve overall digestive health and potentially reduce sensitivity reactions. Prebiotic fiber helps to stimulate the growth of healthy bacteria by feeding the microbes in your gut. Consulting with a healthcare practitioner can help determine the most appropriate supplements for your specific needs. By combining these approaches, individuals with food sensitivities can maintain their digestive health while enjoying a varied and satisfying diet.
The Role of Gut Health in Food Sensitivities
A healthy gut microbiome plays a crucial role in managing and reducing food sensitivities. The gut microbiome, which consists of trillions of bacteria and other microorganisms residing in the digestive tract, is essential for proper digestion, nutrient absorption, and immune function. Imbalances in this microbiome, often caused by a diet high in processed foods or low in fiber, can lead to increased gut permeability, commonly referred to as “leaky gut.” This condition allows undigested food particles and toxins to enter the bloodstream, potentially triggering immune responses and exacerbating food sensitivities. Therefore, maintaining a balanced and diverse gut microbiome can help mitigate the effects of food sensitivities and improve overall digestive health.
As noted above, probiotics and prebiotics are key interventions for supporting gut health. Separate from supplementation, incorporating probiotic-rich foods like sauerkraut and fermented vegetables into your diet can be beneficial. Foods high in prebiotic fiber, such as lentils, beans, seeds, and nuts, can help sustain a healthy gut environment. Additionally, other gut health interventions, like reducing stress and avoiding unnecessary antibiotics, can further support a balanced microbiome. By focusing on gut health through dietary and lifestyle changes, individuals can potentially alleviate food sensitivities and enhance their overall well-being.
Conclusion
Delayed food sensitivities, while often less dramatic than immediate allergies, can significantly impact daily life through uncomfortable symptoms like bloating, gas, and abdominal pain, and can also be the harbinger of more chronic immune-related conditions. By accurately diagnosing sensitivities, allergies or intolerances and implementing effective management strategies, individuals can better understand their unique needs and find relief from the symptoms that affect their daily lives, paving the way for a healthier and more comfortable future.
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