Identifying Food Intolerances

Identifying Food Intolerances

Food intolerance is a likely culprit in almost every scenario. Also known as food sensitivity, food intolerance is both commonplace and extraordinarily diverse in terms of the possible symptoms it can cause. These symptoms often assume a chameleon-like quality, changing apparently at whim: one day a headache, another day a bloated stomach.

Read And Learn More: Health Problems And Dietary Solutions

• To compound matters, the effects of unwittingly consuming something tasty yet pernicious often do not make themselves known for several days, making the culprit hard to isolate. No wonder so few people ever ascertain the real cause of their niggling health problems.
• Instead, they just learn to live with them, having taken antibiotics, steroids and other pills, or rubbed in all sorts of creams, to no avail.

Food Intolerances Common Symptoms

If food intolerance is indeed the root of your problem, your symptoms are likely to be one or more of those listed. In addition, you might also experience asthma and nasal congestion, or even hyperactivity.
We are all, of course, unique in our biochemical makeup. so the list is by no means exhaustive, but it does cover the most common reactions to a problem food. Sensitivities can affect every system of the body, and many people are astonished to find that something they eat can actually make them feel depressed, or bring on their asthma.

• Almost every possible digestive symptom you can think of can be attributed to a food intolerance, from constipation to diarrhoea (and back again), to bloating, flatulence and pain.
• Having outlined the elusive nature of food intolerance, I would hasten to add that identifying the offender is relatively easy, once you know how. I, therefore, recommend you invest some energy into considering this area before researching other possibilities.
• Another reason you should think seriously about incriminating something you’ve eaten is that the whole area of intolerance is frequently dismissed, overlooked and ignored by conventional medicine, so chances are that if you do have a food sensitivity, nobody’s noticed.

Food Intolerance Test

Food Intolerances Further Causes For Suspicion

There is good reason to suspect a food intolerance if:

1. you have at least one of the symptoms listed on pages xv- xviii which has so far evaded medical explanation
2. symptoms come and go, inexplicably
3. you crave certain foods.

• This last point is especially telling. It is cruelly ironic that you quite possibly crave the foods which are compromising your health.
• It’s often the very foods we love, and eat too much of for our own good, which turn out to be culpable. It’s a bit like being addicted to a harmful substance, such as tobacco.
• It’s bad for you but you want more. Bear in mind also that an intolerance can develop at any age you can indulge your love of a particular food with impunity for years, then suddenly develop an intolerance just by dint of overdoing it.

Food Intolerances Name That Reaction

It is important to understand that there is a difference between food allergy and food intolerance. If you have an allergy to a particular food – known as an allergen – you probably already know about it. The reaction you experience from consuming an allergen is usually immediate and unquestionably caused by the food in question. Typically, a rash, swollen lips or tongue or headache may occur.

• True allergies are rare fewer than 5 per cent of the population are believed to be affected. In severe cases, an allergic reaction can cause anaphylactic shock, an extreme reaction to a food (peanuts, dairy or shellfish in many cases) whereby the individual experiences difficulty breathing or speaking, dizziness and collapse, due to sudden loss of blood pressure.
• In such situations, immediate medical intervention is critical, as there is a real threat to life.
• The allergic reaction is caused by the allergen triggering an immune system response. The body’s immune system, in order to fight what it mistakenly perceives to be a threat, releases immunoglobulin E (IgE) antibodies.
• The production of these IgE antibodies results in the release of chemicals such as histamine, which give rise to the allergic response.
• Allergies often run in families (which are thus known as ‘atopic families’). Typical atopic allergic reactions include eczema, hay fever, rhinitis and asthma. The gene for an atopic allergy is passed from parent to child, though not all children will inherit the gene in question.

Food Intolerances Diagnosing An Allergy

If you suspect an allergy and would like to have it confirmed, you should consult your. GP about testing. There are two tests you can have a skin prick test or a blood test. The skin prick test involves scratching the skin and then applying a dilute solution containing an extract of a suspected food (the allergen) to the skin.

• If you have a true allergy to that food, a reaction will occur within a few minutes – an itchy red rash or red bump will appear.
• The blood test, known as a RAST (radioallergosorbent test), measures levels of IgE antibodies in the blood for specific foods. The results are conclusive, even though your own experience of ingesting a particular allergen will probably have told you the same thing.

Food Intolerance Test

Defining Food Intolerances

The fiendish intolerance is different. Its slippery, evasive nature makes it less identifiable. Perhaps it is because intolerances don’t behave in a neat, orderly fashion that medics tend to downplay their significance. Traditionally, science has it that intolerance is rare and does not induce an immune response, and therefore you cannot test for an intolerance in the same way you can an allergy.

• Some nutritional heretics claim that that is simply not true – that the human body does indeed create antibodies to foods which create an intolerance reaction, and that those antibodies, and therefore foods, can be identified by blood tests.
• However, instead of stimulating the production of IgE antibodies, a food intolerance stimulates a different type of antibody: IgG. The production of IgG antibodies is slow, however, so the reaction to the offending item is delayed, by anything from a couple of hours to a few days.
• The evidence that a food intolerance does stimulate an identifiable immune response is increasingly convincing but still highly controversial.
• In 2004 the medical journal Gut reported a randomized controlled trial of patients with irritable bowel syndrome which found that those who avoided foods to which they were found to have IgG antibodies were significantly more likely to have a reduction in symptoms than those who did not avoid IgG-positive foods.
• The authors concluded that ‘Food elimination based on IgG antibodies may be effective in reducing IBS symptoms and is worthy of further biomedical research.’ That biomedical research has been ongoing and suspicions have continued. In 2005 an editorial in the American Journal of Gastroenterology suggested, in relation to IgG-mediated food intolerance in irritable bowel syndrome, that ‘perhaps now is the time to revisit some of the immunological reactions to dietary antigens that, in the past, have been dismissed as irrelevant’.

Indeed, when researchers did just that, in 2007, they found that, of 5,286 patients who reported a wide range of chronic medical conditions, and who had taken a food-specific IgG blood test, 76 per cent experienced a notable improvement in their symptoms when they eliminated the foods to which they tested positive.

• Experts can be a strange lot and it is extremely difficult to say for sure just how many people are food-sensitive. Food intolerance expert Dr James Braly estimates that up to 50 per cent of people have an unknown food sensitivity.
• The British Nutrition Foundation (largely funded by the food industry), on the other hand, claims that only 1 to 2 per cent of the population can claim a genuine food intolerance, with many others – 20 per cent of people – only imagining such an affliction.
• My experience as a nutritional therapist compels me to believe that the truth lies somewhere in between. Whatever the true figure, the fact is that I consistently find that, once a suspect item is removed from a client’s daily diet, long-standing health problems clear up almost immediately.

Food Intolerance Test

Foods Most Likely To Cause A Reaction

It is usually a protein within food which is responsible for any adverse reaction. For this reason, many people who are sensitive to dairy foods are fine with butter, which is virtually pure fat, and those sensitive to fish often find they can take fish oils, which also contain no protein. The foods to which you are most likely to react are:

1. Wheat-based foods (see below for common foods usually made from or containing wheat)
2. Dairy foods (mainly cow’s milk produce but you can also be sensitive to sheep or goat’s milk products)
3. Gluten grains
4. Eggs – either egg white, yolk or both
5. Yeast
6. Soya
7. Chicken
8. Nuts – especially cashews, almonds, peanuts, brazils
9. Kiwi fruit
10. Shellfish
11. Corn.

Foods Typically Made from or Containing Wheat

Gluten-containing Grains

Wheat Intolerance

• The most common culprits are, indisputably, wheat and dairy, with wheat intolerance being in my experience by far the most prevalent.
• I never fail to be astonished at how frequently wheat intolerance turns out to be the main offender. Removing the offender can often have an effect akin to waving a magic wand symptoms vanish. Sometimes these symptoms have plagued the individual in question for a lifetime.
• But there is a cause for everything, and once that cause is identified and removed, the healing process can begin.

Why is wheat such a frequent offender? First, the human body does not adjust readily to a new food and wheat is a relative newcomer to our diet in terms of human evolution (we started cultivating it around 10,000 years ago).

• Secondly, wheat has been engineered to such an extent that many people are simply not able to digest the gluten it contains.
• Gluten is a protein which makes bread doughy and heat-resistant and lends itself particularly well to bread, pastries, cakes and other modern-day staples.
• It is this gluten content which is incompatible with so many people. There are four main gluten-containing grains wheat, rye, barley and oats. Each contains a different type of gluten and wheat gluten is a much more common offender than the gluten found in the other grains.
• Many people cannot tolerate wheat gluten, yet have no problem with other gluten-containing grains. However, an unfortunate few suffer from a severe form of gluten intolerance called coeliac disease.
• In people with coeliac disease, gluten damages the gut lining, eroding the microscopic villi (finger-like protrusions) which line the intestinal wall and whose job it is to absorb nutrients from food. The result of villi erosion is malnutrition, weight loss, diarrhoea and weakness.
• Anyone with this condition needs to follow a strict gluten-free diet for life. Until only a few years ago the only way to diagnose coeliac disease was via a biopsy of the intestinal lining. Now, a simple blood test can reveal whether or not a patient has this condition.
• Finally, when you consider how much of the stuff we eat, you begin to understand that wheat might cause a few problems.
• And we do tend to overdo the monotonous, wheat-rich modern diet cereal or toast for breakfast, a sandwich for lunch and a quick bowl of pasta in the evening, day in, day out, constitute a recipe for reaction for the typical busy Briton for whom convenience and speed are paramount.
• Wheat is cheap and versatile so it is grown intensively, making its abundance a food manufacturer’s dream.
• You may suspect at this point that I am wheatish, but be assured I am not. I am not sensitive to wheat products myself and can eat them with impunity (though prefer not to overdo it).
• I am, however, mildly dairy intolerant most of the time it gives me no trouble, but if I go on a bit of a cheese-bender (I am totally addicted to the cheese of any kind) I will develop eczema on my legs.
• The torturous itching is sufficient to make me renounce dairy for a few weeks, during which time eczema clears up nicely, only to return the next time I fall off the cheese wagon.

Dairy Intolerance

• Why are milk products so frequently indicted for health crimes? Well, designed by Nature exclusively for calves, cow’s milk contains proteins which many people find hard to digest and lactose (milk sugar) which causes problems for those who lack the enzyme (lactase) required to break it down.
• Lactase deficiency is not uncommon. Nor is it surprising when you consider that, once weaned off mother’s milk, it is not entirely natural to switch to drinking the milk of another mammal, which is significantly different from human milk.
• Lactose intolerance is fundamentally a metabolic abnormality and does not involve the immune system. Typical symptoms of lactose intolerance include abdominal pain and diarrhoea, and excessive gas and bloating.
• In children it can cause middle ear infection (otitis media), asthma, eczema, rhinitis, hyperactivity and poor sleep.
• Your GP can arrange for you to have a lactose intolerance test if you suspect that you have this condition. On the plus side, you might be able to digest yoghurt and hard cheeses, such as parmesan, as these contain very little or no lactose.

On the odd occasion when a client tests positive to the dairy exclusion test, his or her initial concern is for calcium intake.

• Nutritional orthodoxy has it that we should all eat plenty of dairy foods because they are rich in calcium. That much is true, but doesn’t explain why, when we consume so much dairy in the West, osteoporosis remains rife, compared to other countries where much less is consumed. The link between dairy foods and osteoporosis is a bone of contention in itself.
• To suggest avoiding dairy is no less than a nutritional heresy and we have been weaned onto the idea that, without the stuff, our bones would crumble like biscuits. The controversy continues to rage and remains unresolved.
• A scientific review of all the studies on dairy and bone health found that, although some studies found dairy to be beneficial, most found that it had no effect on bone health at all, and a few even found it to have a detrimental effect.
• The good news for the dairy-intolerant is that there is plenty of calcium in other foods. You can get calcium from dark leafy greens such as watercress, kale, broccoli, spinach and rocket, and nuts and seeds – especially almonds and sesame seeds.

How To Identify A Food Intolerance

Some nutritional therapists – and many therapists of other disciplines, unfortunately – routinely advise all their clients to stop eating all wheat and dairy products, indefinitely. I totally disagree with this simplistic, blanket approach.

• First, it can make you feel wretched to have to avoid a food you really like, all the time. Wheat and dairy are two significant staples of the Western diet and you only need to avoid them completely if doing so noticeably improves your health.
• Secondly, you might be avoiding them for no good reason, if they have no discernibly negative effect on your health. That is not to say that I would recommend them in large amounts on a frequent basis to anyone.
• Refined wheat products that is, the white stuff, such as pasta, white bread and pastries have no real nutritional value. What’s more, they can have a detrimental effect on blood sugar levels.
• If you would like to identify any intolerances you may have, there are two systems you might want to consider: the exclusion test and the ELISA IgG blood test.

Food Intolerance Symptoms

The Exclusion Test

• This is considered the gold standard and is indeed my preferred choice. The exclusion test works best with foods that are consumed frequently – that is, on most days. It is accurate and, what’s more, costs nothing, other than a shot of willpower.
• There are a few variations on this theme, but I have found the system described below to work consistently well. Although I believe food intolerances to be fairly common, I believe multiple food intolerances to be fairly uncommon, so therefore do not see the need to routinely recommend expensive blood tests.

Here’s how you do an exclusion test.

1. Keep a food diary for four to seven days. Write down everything you eat and drink throughout each day. Make sure the diary reflects your typical food intake – for accuracy’s sake, it is best not to include days where you have deviated from the norm and eaten unusual foods. This is a useful way of seeing just how much of any one food or drink you consume – you might find yourself shocked at just how much chocolate you eat, or how little water you drink throughout the day.
2. After four to seven days, take a close look at your food diary. Are there certain foods you eat every day, such as bread or cheese? Perhaps you eat an egg sandwich every day at the office? In this case you might suspect both wheat and egg.
   • Use coloured highlighter pens to mark the most likely offenders which make their way into your diet. Do you crave these foods? Decide which food is eaten the most frequently this will be the food you will test first. I nearly always get my clients to start with wheat-based foods, because most people eat so much of the stuff.
3. Once you have decided which food you are going to eliminate (temporarily) from your diet first, do some preparation. Investigate alternatives and stock up on foods which will be replacing your suspect.
   • If you are avoiding dairy foods, you will need to avoid all milk, cheese, yoghurt and cream, and anything containing whey or casein (as these are milk proteins).
   • This means reading food labels. You should also avoid produce made from sheep’s or goat’s milk – if you are sensitive to cow’s milk there is the possibility that sheep and goat produce are OK, but for the purposes of this investigation it is best to exclude them.
   • Please note that eggs do not fall into the ‘dairy’ category so you can continue to eat them during a dairy exclusion. Larger supermarkets and health food stores stock soya, rice and oat milk, which make good alternatives to dairy milk. Sadly, there are no real alternatives to cheese.
   • Soya ‘cheese’ is a travesty and best resisted, to avoid disappointment.
4. When you’re ready, eliminate your chosen suspect for seven days. It is essential that you do this strictly, otherwise, the test won’t work. If you eat ready meals, snacks or any other processed food, you absolutely must read ingredients lists and make sure that they do not contain the food you are eliminating. Use the sample food diary on page 15 to monitor your results.
5. During the elimination period, keep a note of any symptoms and write these down in your diary. Do you find they are much improved, eliminated, or unchanged? How is your energy and general mood?
6. After seven days of avoiding the food under suspicion, you can look forward to the test, which involves eating the food in question. Make yourself a nice big meal or snack containing that food. This is called the ‘challenge’. So, for example, if you have avoided all wheat-based foods you could make some toast, a sandwich or a bowl of pasta. It does not matter if your dish contains other foods.
7. Eat and enjoy your meal or snack, but do not eat this challenge food again for at least another three days.
8. Wait and see what happens over the next two to three days. What happened after you reintroduced the food? Which, if any, of your symptoms returned, and how bad was the reaction? Write down this information in the diary.

Food Intolerance Symptoms

The Exclusion Wheat-free Alternatives

1. 100 per cent rye bread
2. 100 per cent rye crispbread
3. Porridge oats
4. Oat cakes
5. Barley
6. Millet
7. Corn and corn-based products, including corn pasta and polenta
8. Potatoes and potato-based meals, such as potato and cucumber salad, baked potatoes with various fillings
   rice and rice-based products, including rice cakes and rice noodles, rice pasta
9. Quinoa
10. Shop-bought or home-made muesli (made from oats, rice flakes, millet flakes, soya flakes, nuts, seeds, flaked almonds, desiccated coconut, and dried fruit)
11. Egg salad
12. Beans and lentils (chickpeas in particular add tasty bulk to a meal)
13. Mixed bean salad
14. Buckwheat – inc. Buckwheat pasta (despite the name, buckwheat is wheat-free).
15. Tamari soya sauce (tastes the same as ordinary soya sauce but without the wheat)
16. NB Spelt, which has become popular of late, is still wheat, even though it contains less gluten than ordinary wheat. Therefore it should be avoided if excluding wheat.

The Exclusion Interpreting the Results

• Clients often ask me how they will know they have an intolerance to the food they have tested, and I always tell them they will be left in no doubt.
• If you are sensitive to food which you have avoided for a few days and then consume in copious amounts all in one sitting, your symptoms will manifest with a vengeance.
• So, for example, you may find that, several hours after eating the challenge food, your energy level plummets and you develop a bad headache.
• Alternatively, you may find that, after a week of being IBS-free, your stomach bloats and you have pain and flatulence more debilitating than pre-test levels.
• Interestingly, the stronger your intolerance to a food, the greater your reaction will be after you reintroduce it into your diet.
• If you get a positive reaction which leaves you in no doubt that you and the food in question are incompatible, you should continue to avoid it.
• Obviously, if nothing much changes when you are avoiding your prime suspect, and nothing much changes when you reintroduce it, you can assume that you don’t have a sensitivity to that particular food.
• If this is the case there is no reason why you should continue to eliminate it from your diet, although I would not recommend heavy dependence on any one food for fear of developing an intolerance to it in the future Furthermore, if you always eat the same food, you always get the same nutrients, which means you may not get the full range of nutrients your body requires.

Food Intolerance Symptoms

Once you have established the results, you may wish to repeat the test, this time with another food you have placed under suspicion. You can challenge just about any food you like.

• I do not recommend testing more than one food at a time because, as well as drawing heavily on your willpower reserves, you will be left uncertain as to which food is the actual culprit.
• There is also the possibility that, after carrying out a couple of exclusion tests, you may decide that food intolerance isn’t your particular nemesis, in which case you ought to consider investigating another dietary cause of your health issues.
• At least you will have eliminated one possibility, which brings you closer to your goal.
• On the whole, avoiding one type of food is not such an onerous task. You just find palatable alternatives.
• Often when I suggest to a client that he or she may be sensitive to wheat and that an exclusion test is advisable, the first reaction is one of wild-eyed panic, as if I had just suggested a water fast wearing only sackcloth.
• Nearly always, even the most entrenched eating habits can be modified clients frequently return with tales of newly discovered and much preferred provender, such as the alternatives to wheat-based products listed.
• Frequently, people find that their symptoms improve, but do not vanish. I interpret this as meaning one of two things.
• Either you have further food sensitivities in addition to the one you’ve just identified, or there is more than one root cause of your health problems.
• If, for example, your symptoms improve but do not disappear when you are off wheat, you might want to consider the possibility that you are gluten sensitive, or dairy sensitive – just take a look at your food diary and see which foods you have highlighted.
• Once you have exhausted all possibilities as far as obvious food intolerance is concerned, you’ll have to consider other possible causes, as outlined in the chapters that follow.

The Exclusion Blood Test

• This method of food intolerance testing costs a not inconsiderable sum of money but is fast, virtually painless and requires no willpower.
• Another great thing about this test is that you can take your own blood sample – a small finger prick suffices – and send it off for analysis yourself.
• This method works well for less ubiquitous foodstuffs than those listed above, but whose effects may be equally pernicious.
• I favour this approach when I believe multiple sensitivities are at play, and when the more obvious suspects have already been tested using the exclusion method, and eliminated from enquiries. Therefore I find I recommend the blood test quite rarely.
• As far as I am concerned, it comes a poor second to the exclusion test.
• Known as the IgG ELISA (enzyme-linked immunosorbent assay) test, a sample of blood is tested for the presence of IgG antibodies to foods.
• Antibodies, as you may recall, are created by the body’s immune system to fight what it perceives to be an enemy invader. So the presence of antibodies in the blood in readiness to deal with the enemy food is an indicator of food intolerance.
• By avoiding offending items altogether (for at least four months) it is possible to grow out of an IgG sensitivity – the immune system simply ‘forgets’ to react to them and no longer identifies them as the enemy.

Food Intolerance Symptoms

The Exclusion Case history

• Caroline, a 45-year-old housewife, came to see me because she had been suffering from myriad symptoms that remained unresolved after years of futile investigations.
• Her main concern was her stomach pains – she regularly suffered from lower abdominal pain, accompanied by bloating and constipation.
• As well as digestive problems, she suffered from regular headaches and insomnia. Her food diary revealed that she typically ate toast or a wheat-based cereal for breakfast, a ham or tuna sandwich for lunch and meat, vegetables and potatoes for dinner – often with bread.
• I asked Caroline to do a wheat exclusion test for seven days. We didn’t meet until about six weeks later due to her various commitments, but when we did meet, she remarked on the changes she’d noticed straight away – her insomnia cleared up soon after starting the elimination so she stayed off wheat and she was now sleeping very well.
• Her abdominal pain and bloating had gone, her bowel movements were regular, on a daily basis, and her headaches had vanished. She also commented on her weight loss – 5 to 6 lb – with which she was ‘absolutely delighted’.
• Weight loss is not unusual in wheat-sensitive people who start to avoid wheat -I encounter this all the time. Before you renounce all wheat, however, bear in mind that much of this loss is water, not fat.
• Caroline felt much better off wheat – she commented that everything felt ‘calmer’. She certainly wasn’t going hungry her typical diet now included yoghurt with pureed I fruit for breakfast, avocado and prawn salad and soup for lunch, and chicken, potatoes and mixed vegetables for dinner.

Food Intolerances Further Investigations

Healing a Leaky Gut if you have or believe you have multiple food sensitivities. Leaky gut (or intestinal permeability) is a condition which predisposes you to a multitude of possible food sensitivities because damage to the gut lining allows undigested food particles to pass into the bloodstream and trigger an immune response.