In the first part of our series on allergies, OHbaby! expert naturopath, Natasha Berman, explains the difference between a food allergy and an intolerance.
Do you feel queasy after eating cake, bloated after bagels, or rashy after ratatouille? Maybe you have noticed your child has a spot of eczema, or has trouble sleeping after certain meals. You're not alone.
Many people have adverse reactions to all kinds of foods; most of these are caused by food intolerance and not a food allergy. There is a huge misunderstanding about these terms and they are frequently confused and misused. In my clinic, I often hear people say things like, "Oh, I think I'm allergic to…" I really do cringe when I hear this, as the word "allergic" has become almost redundant in its overuse. Although allergies are definitely on the increase, they are still relatively uncommon, whereas at least 50 to 60% of the population suffer from food intolerance.
What is a food allergy?
The term food allergy relates to immune reactions mediated by the immunoglobulin E (IgE). An immunoglobulin is a protein that carries out various roles in the body's immune response. Our bodies contain five of these: Immunoglobulins G, A, M, D, and E. Immunoglobulin E triggers the most significant reactions. However, not all food reactions are related to our immune system and this is where the confusion arises. For example, tyramine - found in strawberries, cured meats, and cheese - can trigger migraines in some people. This is a brain reaction, not an immune-based reaction. Therefore, these food reactions cannot be picked up via immune testing, such as blood or skin-prick testing.
True food allergies are mediated by IgE immune reactions. These reactions are almost always immediate in their manifestation, and therefore, most often can be traced back to a particular cause, whether it be a reaction via inhalation or ingestion, or from coming into contact with the skin. These immediate reactions affect the health in a rapid manner and can be life-threatening, ie. swollen lips and tongue or asthma attack. Peanut allergy and shellfish allergy would perhaps be the most well-known of these IgE immune reactions. Anaphylaxis is an extreme physical reaction, and often requires adrenalin to counter the extreme stress-reaction caused in the body.
Allergies and food intolerance are on the increase
Although less people are affected by food allergies than food intolerances, the effects of allergies are more severe. Allergy is ranked as the sixth leading cause of chronic disease today, according to records at the American Academy of Allergy, Asthma and Immunology. Research from the UK has come to similar conclusions. Atopic dermatitis (discussed in "Treating eczema naturally" on page 58 of OHbaby! Magazine Issue 8:Summer 2010) and allergic rhinitis have been increasing rapidly since the mid 1980s.
Food intolerance reactions are often mediated by immunoglobulin G (IgG). Because these reactions can take up to 72 hours to become apparent after exposure, it can be very difficult to pinpoint the trigger food or substance.
Another thing I typically hear from clients in my clinic is, "I know that wheat affects me, but I've done skin prick tests and blood tests, and they come up negative."
This makes sense, because food intolerances are not mediated by IgE as food allergies are, which means they will not be picked up via blood or skin prick testing.
The latest figures coming from Allergenics Allergy Testing Service (www.allergenics.co.nz) show that at least 55% of the population suffers from food intolerance, and this number continues to grow.
Symptoms of food intolerance
The most common symptoms that I see in my clinic are:
So prove it
So how do we prove that you are suffering from food intolerance and not allergies? This is where a lot of the controversy comes in. Because the immune system is not necessarily involved in the cause of food intolerance, medical tests such as blood tests and skin prick tests may not be helpful. Some people need no more proof than simply removing the food item from their diet. The associated symptoms simply disappear; however, for many people, as multiple foods can be involved, the ability to pinpoint the suspect food items is nothing more than a guessing game. Also, the relationship between your body, stress, and underlying dysbiosis (lack of beneficial good bacteria) in the gut can have a huge effect on your body's sensitivity.
On top of that, we have foods that contain high levels of substances which provoke intolerant-like reactions, eg. sausage, wine, tuna, spinach, and tomatoes all contain high levels of histamine, as do some seafoods, strawberries, chocolate, bananas, papayas, and alcohol.
Other foods contain a natural substance called tyramine, which causes the blood vessels to constrict; for example, cabbage, cheese, citrus fruit, seafood, strawberries, salami, cured meats, and potatoes.
Also, additives such as MSG, sugar, food colourings, and preservatives can affect brain patterns and cause aggression, behavioral problems, and migraines.
Food intolerance testing
Diagnosing food intolerance is not an exact science because of the many different types of reactions that can occur. These are the most common tests available:
You are what you eat?
We have learned that at least half the population suffers from a food intolerance, although we do believe this figure to be much higher.
Some of the most common causes of food intolerance (I will discuss these in more detail in Issue 10 of OHbaby! Magazine) are:
I work with allergies and food Intolerances every day in my clinic, and love seeing the improvement in my clients' health during the course of our treatment. My basic treatment protocol is as follows:
1. Allergenics allergy test to find out suspect foods and substances causing the system harm.
2. Elimination of foods (indicated in test results) and tweaking of diet plan.
3. Supplementation to address clients' specific symptoms, such as bloating or imbalance of beneficial bacteria.
4. After three months, Allergenics retest, and follow up along with re-introduction of some foods.
In part two of this article, we will take a in-depth look at the causes of food intolerances and how to eliminate and treat them.
Natasha Berman is a naturopath and medical herbalist and is the managing director of Qunitessence, a natural health dispensary in Titirangi Village, Waitakere. Natasha is a mum of two and is passionate about children's health and wellbeing. Visit qbaby.co.nz and allergenicstesting.com to find out more.