Food Intolerances

What we eat plays a huge role in our overall health. Dr. Cheatum went into detail on a well rounded diet in the Foundations of Health: Diet series. This is a good general guideline to follow. However, for some people, simply eating a well-rounded healthy diet isn’t enough to keep symptoms under control. Our body may be responding to seemingly healthy foods in unexpected ways, causing unwanted symptoms. It’s with these types of cases that we have to do a little more digging to figure out potential triggers. Luckily, there are a whole host of dietary recommendations and therapeutic diets for various complaints and conditions that can be used as a starting point for pinpointing your trigger foods.

Some examples of particularly well studied conditions with dietary triggers include heartburn and  IBS. However, even symptoms that are not related to digestion can be triggered by what we eat. Things like headaches, joint pain, skin conditions, autoimmune conditions, and more could all be due in part to a dietary trigger.

The reason why certain foods cause symptoms for individuals is varied. It could be that you don’t produce the enzyme to break down a component of that food (such as in lactose intolerance). Maybe you react more strongly than most to a certain compound in the food (such as a headache sufferers reacting to amines). In some cases, immune reactions can occur to certain foods.

Allergy vs Intolerance

The terminology for food sensitivities can get a little mixed up at times. Food allergies are an immediate (minutes to hours) immune response to a food and can be life threatening. This shouldn’t be confused with a food intolerance. Food intolerances can have an immune component, but not always. The types of antibodies produced in response to food intolerances are not the same as with a food allergy. Immune reactions due to a food intolerance can be delayed, unlike a true food allergy, and do not pose an immediate threat of potentially being fatal when ingested.

Can we test for food intolerances?

It would be really nice if there was just one test that could tell you what you should and should not eat. Unfortunately, it isn’t this easy. Most food intolerance testing is looking at your immune response to foods. The problem is not all food intolerances have an immune response. This is one reason food intolerance testing may not be the best option for your case.
​
Additionally, even if the reaction you are having to a certain food is an immune response, our bodies produce different types of antibodies. With lab testing, you may be testing IgG antibodies, but maybe the reaction you are having is actually an IgA reaction. There are labs that test for both IgG and IgA antibodies, but that doesn’t completely solve the problem. Each laboratory that runs food intolerance testing uses their own standards for testing that are not universal and are not all created equal. It can be difficult to validate this means of testing when there isn’t a standard for this testing. There absolutely are labs that perform quality food intolerance testing with both IgA and IgG antibodies, but this can get costly and there is never a guarantee all food intolerances will show up given the scientific community’s lack of fully understanding the role of this type of testing in determining food intolerances. For all of these reasons, the gold standard for determining food intolerances is an elimination and re-challenge diet.

Elimination/Re-challenge diets

Change can be difficult, especially when the habit is very pervasive in our lives and not avoidable - like eating food throughout the day. Changing what you eat can seem like an insurmountable task, but our goal at this point is to simply understand how food is impacting you. View an elimination/re-challenge diet as an experiment. You can gain the knowledge of how certain foods are impacting your health and take action to prevent this type of reaction in some cases. At the very least, with the knowledge you gain from a well carried out elimination/re-challenge diet, you can make informed decisions with your eating habits.
​
Determining what to eliminate for this experiment is a difficult task. Since we can’t eliminate all food, determining the most likely triggers for your case is an important first step. A dietary diary is a helpful tool if you don't have any idea where to start. After writing down all the foods you eat and timing of your symptoms you may start to notice a pattern with certain foods. Here's a sample diet diary that you can use to track this information:

diet_diary_template.pdf
File Size:	43 kb
File Type:	pdf

Download File

---

If a diet diary isn't illuminating for you, I recommend seeking the help of a professional who can help guide you through the process. Most Naturopathic physicians have training in nutrition and have knowledge on which therapeutic diets are best for certain conditions along with knowledge of which foods are the biggest culprits when it comes to food intolerances.    

***If you know you have a true allergy to a food (an anaphylactic reaction), do not attempt to reintroduce this food.***