The difference between food allergies & food intolerances

Can you remember when you went to school as a kid?

We could take anything to eat to school. These days nuts are banned, sometimes seeds (sesame seeds), eggs and even kiwi fruit!

The banning of these foods is because they cause an allergic reaction which is IgE mediated. This is when your body has an immediate response to a food antigen that can cause breathing difficulties (anaphylaxis), hives, rhinitis, atopic dermatitis and often a predisposition to asthma. The most common food allergens are tree nuts, peanuts, cow's milk protein, wheat, soy protein, eggs, shellfish and fish.

Whereas celiac disease is considered non-IgE mediated response because it involves other components of the immune system. Gluten is found in rye, barley and wheat and the diagnosis can be made on by taking the history of the patient, blood test (looking for gluten antibodies) or biopsy.

So what's happening?! Why in the last 20 years has everything gone pear shaped?

One of the theories is the 'Hygiene Hypothesis' and that means that we have become so 'clean' in the last 30-50 years that we are not allowing ourselves to become exposed to bacteria and germs the way we used to. We are constantly using cleaning agents to clean our hands, houses, cars and environment that we are living in a hospital environment. Out door play is also becoming less frequent and we are spending more time in doors in our lovely sanitised capsule. I remember fondly as a child making mud cakes for my dolls and not bathing everyday!

My personal belief is that our overall gut health has deteriorated over the last 50 years due to the exposure of environmental toxins, processed foods, antibiotics and genetics. Our gut flora gets out of balance and is unable to cope with all of the external load we keep giving it and therefore creates an inflammatory response to it, which can often turn chronic if not rectified. This can create a 'leaky gut' or symptoms can arise from an episode of gastroenteritis (post infection IBS).  You will also find that our gut health can be inherited from our parents. Are there any autoimmune disorders in your family? Has any of your family passed away from bowel cancer etc.?

Another term that you may often hear to these days is 'food intolerances/sensitives'. This is when you may get a reaction from a certain food, but it can be up to 48 hours later. Such reactions may include headaches, bloating, stomach pain, flatulence, diarrhoea, hyperactivity. These reactions are also not detected on a typical skin prick test that is used to test IgE reactions and can often be difficult to detect because the reaction is so delayed the food source can be hard to pin point.

Generally the elimination process begins with avoidance of the suspected food, along with a food diary to note any symptoms when the food has been re-introduced. This can be a long and tiring process. The awkward part of food intolerances is that every one has an individual threshold, and it can take time (and a lot of sore tummies or rushing off to the toilet) to find what works for you.

The most common non-immune response can be from cow's milk, gluten, soy and chemical compounds such as glutamates, salicylates and histamines. In the last 5 years or so there are more tests available to identify food intolerances by testing your IgG levels to certain foods. The ALCAT test has been used in a few studies with positive results in identifying food triggers. The test uses blood serum for lab findings. Unfortunately, this method can be invasive for most children. The ALCAT test also can test chemical sensitivities and herbs and spices (the more you test for, the more expensive it is).

There is also now available Gluten Sensitivity Panels for those that have not fallen in the celiac bracket. This test can be done easily via a finger prick for a blood spot sample. Or if testing is a little out of your reach now, try removing the suspected food for 2-3 weeks and slowly introduce it and notice take note of any reaction. You can also check if any symptoms have cleared up while the food has been removed this way too.

If food intolerances are a problem for you, press the button below to contact me today!

References

Boettcher, Erica (MD) and Crowe, Sheila, E. (MD), 'Dietary Proteins and Functional Gastrointestinal Disorders', The American Journal of Gastroenterology 2013; 108: 728-736

Gibson, Peter, R. 'Food Intolerance in Functional Bowel Disorders', Journal of Gastroenterology and Hepatology 26 (2011) Suppl. 3; 128-131

Pietschmann, Nicole (PhD), ' Food Intolerances: Immune Activation Through Diet- Associated Stimuli in Chronic Disease', Alternative Therspies, July/August 2015 Vol. 21,4