Food Sensitivity

Not long ago television and newspapers were trumpeting a JAMA review of studies about food allergies. The media implies that we’ve been duped or have imagined things—i.e. most people who think they are allergic are wrong. The review study actually concluded only that there is little agreement among dozens of earlier studies on how to define, test for, count and treat food allergies. The scientists’ best estimate is that between 1% and 10% of the population suffer “food allergies”—that’s a pretty big range.1 Interestingly, public opinion polls show that upwards of 30% of the public believes they have a “ food allergy”. Who right?

“What we have here is a failure to communicate” as Luke said.* I believe the problem is semantics. In the study’s technically correct definition of “food allergy,” the immune system mounts a specific and very vigorous and possibly life-threatening response. This serious type of food reaction is generally discovered in childhood and is most often triggered by milk, egg and peanuts. (Read my article on peanut allergy options.) Also high on that list are fish, shellfish, tree nuts, seeds, soy and wheat. Although allergists successfully give desensitizing shots, most people just avoid the offending foods.

The confusion comes because there are many other ways we can react badly to food and, if a pollster called, a person might offhandedly call any one of them an “allergy”. Most common are “food intolerances” such as “lactose intolerance.” A large percentage of the population lacks the enzymes to digest milk. The undigested milk then causes intestinal discomfort. (Probiotics and lactase enzymes are helpful.) Similarly, many are intolerant of the gluten component of common grains like wheat and rye. Supplementing specific gluten-digesting enzymes can help those “gluten-intolerant” folks. Celia disease is an extreme intolerance to gluten where, because of an autoimmune response, the digestive tract becomes so inflamed that serious consequences such as osteoporosis are possible. (With so many ways we can react negatively to dairy and grain, it isn’t surprising that many people feel better if they just avoid them.)

“Food sensitivities” are also common. One way to isolate what foods cause you trouble is to keep a food diary or do a pulse test. Read more on those by clicking here. These can be acquired at any stage of life apparently due to increased permeability (leakiness) of the intestinal wall. When the normal intestinal barrier is in poor repair, elements of food that haven’t been thoroughly digested can be absorbed into the blood stream and alarm the immune system into thinking there is an enemy attack. Symptoms can be most anything, from a chronic rash or wheezing to headache or depression. Here again, probiotics are the best weapon. After a person’s intestines have been healed for a period of time, they often can go back to eating the previously problematic food. Food sensitivity can cause (or at least aggravate) almost any health complaint or disease. In a 2023 HBN interview with Susan Linke, MBA, MS, LD, RD, CLT, CGP she discussed how they are different from allergy, what causes them and most importantly, what to do about them.

One simple tool is to keep a food diary and watch for patterns where a food is connected to a reaction (it may be days later),= You can print out this form–it may be a little help.

For an effective DIY analysis, consider a trial of the “elimination diet” as a simple self-test for food sensitivity. My old friend, the late William Crook, MD (author of The Yeast Connection Handbook and many other books) taught me about the elimination diet. It is useful for tracking down mysterious aggravations caused by food. (Note: not a substitute for an allergist if symptoms are serious.) Buy a copy of his child-friendly Tracking Down Hidden Food Allergies or devise your own plan.

In essence, for about 2 weeks, stop eating the ingredients you usually consume. At least eliminate the common allergens listed above. (A variation is called the “rare foods diet” because you eat foods that you rarely do.) For example, if you don’t usually eat rice—eat rice. If you just never eat lamb—eat lamb. Temporarily adopt a very streamlined diet so you know exactly what you are eating. (E.g. no pre-mixes, sauces, stews, canned soups, casseroles, etc. because there are so many ingredients that you won’t know what potential troublemaker it might contain.) After the clean-out period, re-introduce foods one at a time while watching for and recording reactions. It’s best not to add more than one major food every two days because reactions are sometimes delayed at least that long.

* No, not a biblical reference, rather from the 1967 movie, Cool Hand Luke.

1 JAMA. 2010 May 12;303(18):1848-56. Diagnosing and managing common food allergies: a systematic review. Chafen JJ, Newberry SJ, Riedl MA, Bravata DM, Maglione M, Suttorp MJ, Sundaram V, Paige NM, Towfigh A, Hulley BJ, Shekelle PG.