Written by Suzannah Moss - FHG Editor

Our daily diet is regularly blamed for causing chronic health complains and digestive problems. Is this warranted, though? Let’s take a rational look at how food  can make some people ill, how to find out whether you’re one of them, and what to do about it.

We are living in a sensitive world- a food sensitive world.  Get into a conversation at a party with a group of people you’ve only just met and, while contemplating the canapés, chances are somebody will reveal a problem with a particular snack or ingredient being offered by the hosts. Intolerant to gluten? Watch out for those min bagels, then. Fish bring you out in a rash? Take care to avoid that sushi. Dairy give you abdominal pain? Stay well clear of the cheesy dip. And it’s contagious: someone who’s abandoned soy and declares they feel much better is often enough to prompt others to give it a go, to see whether it makes any difference to them.

Do we all really need to be so careful? Although food intolerances and allergies are undoubtedly on the rise, many medical experts question whether so many of us need to take obsessive precautionary measure to avoid foods we think are making us ill – all nutritionists are fearful of the consequences of such dietary restrictions on our health.

Perhaps not surprisingly, our paranoia concerning the food we eat has lead to an increase in the number of questionable tests available on the market, whose supporters claim can (relatively) accurately diagnose your allergy triggers. We are being assailed with sometimes  contradictory, often non-medical advice, coming from homeopaths, herbalists, naturopaths, and other complementary therapists recommending suspect of discredited treatments or tests.

Whatever the truth, many people experiencing unpleasant symptoms that they believe may be caused by food remain baffled about how best to resolve their problems. One major source of confusion regards the definitions and types of food sensitivities – specifically the differences between genuine food allergies, and the less severe and alarming reactions to food that tend to under the broad term of food intolerances.

Here, we look at these in turn, with some key questions to help you identify any potential sensitivity.

What is a food allergy?

This is an immediate and inappropriate response towards a food, stimulated by the immune system – the body’s defence mechanism. Immune system antibodies (called IgE antibodies) mistakenly perceive the particular trigger food to be an ‘invader’ and attack it. This causes a reaction in which inflammatory substances, such as histamine, were released in an attempt to ‘flush out’ the trespassing agent, causing rapid, unpleasant and sometimes dangerous symptoms.

Do you have a food allergy?

First, ask yourself whether you experience any of these reactions soon after eating certain foods:

• Itching or tingling in and around the mouth, especially the lips, gums and tongue?
• Swelling in the mouth or in the ‘narrowing’ or ‘closing’ feeling in the throat?
• Rashes, blotches or redness on the skin anywhere on the body?
• Irritated or crying eyes, or runny nose?
• Wheezing or difficulty breathing?
• Feeling acutely sick or even ending up vomiting.

Answering even one ‘yes’ to these questions may well mean you have a food allergy. The usual culprits are peanuts, tree nuts, (almonds, walnuts, hazelnuts), fish, shellfish, milk, soy, eggs, and wheat. Increasingly, food allergies to raw fruits, vegetables and herbs are being reported, many of which happen to be related to hayfever.

Avoid the food to which you may be reacting and see a doctor, who will be able to refer you for correct allergy tests.

If you did not answer yes to any question, you are probably not food allergic. If your diet is causing your health problems, it may well be a food intolerance.

What is a food intolerance?

This is an adverse reaction to a food, which probably does not involve the immune system, and which typically manifests hours or even days following the consumption of the culprit.

Do you have a food intolerance?

First, ask yourself whether you experience any of these reactions a while after eating certain foods:

• Bloating or pain in your stomach or abdomen?
• A rumbling abdomen – perhaps accompanies by wind?
• Constipation or diarrhoea?
• Tiredness and lethargy?
• Headache or migraine?
• A craving or urge to eat certain everyday foods – such as wheat or diary (ie bread, pasta, cheese)?

One or more ‘yeses’ may – but only may – indicate food intolerance. The more positives, the more likely you are reacting adversely to food. However, it is important to note that occasional reactions to your diet are natural, if only because you have eaten too much (which may lead to indigestion, which is often confused with food intolerance) or if something simply hasn’t agreed with you. This is unlikely to be a food intolerance.

What should I do?

Obviously, if you are in great discomfort or are very worried about your health, see your doctor at once.

But on the whole, if your symptoms aren’t alarming you, the first thing to do is to continue to eat the food, as stopping consuming it may affect doctor’s ability to diagnose any potential intolerance.  Besides, making large-scale changes to your diet could be counter-productive from a nutritional perspective. You also need to ask yourself whether you are eating healthily:

Is my dietary regime as good as it could be?

• Do you regularly eat takeaway foods, processed meals and other prepared produce that you have not made yourself from scratch?
• Do you eat fewer than five portions of fresh fruit and vegetables a day – not including potatoes?
• Do you regularly eat wheat- and diary-heavy meals (eg buttered croissants in the morning, cheese sandwiches at lunch, and then pasta in the evening?
• Do you regularly eat desserts, sweets or candy – say two or three times a day?
• Do you often eat on the move – quickly and without sitting down?
• Do you busy yourself with activity as soon as you’ve finished eating, rather than remaining seated and allowing your body to digest the meal?

The more ‘yeses’, the more likely it is that your diet is not providing  you with the nutrients you need, and that you are not giving your body the time to absorb what it required to function optimally.

Address the issues that apply to you.  Begin to make the time to make your own meals from scratch, using ingredients such as colourful vegetables. Investigate the huge variety of alternative grains around – including millet, spelt and the deliciously nutty quinoa from South America. Make sure you include these in your diet, in addition to wheat and other more regular grains. Incorporate fresh fish into your diet, if you don’t eat it already. Choose more dried fruit options, instead or processes, sugary sweets.

Apply these changes for a month or so, if you’re still having problems then now is the time to start considering food intolerances.

Could it be lactose intolerance?

Lactose is the type of sugar particular to fresh milk (from all mammals). It is also present, to a lesser extent, in all other dairy foods made from milk, such as yoghurts and cheeses.

Some people are unable to digest lactose due to a deficiency in the digestive enzyme lactase, which breaks down lactose in the body.  The principal symptoms of this are abdominal rumbling, disturbance and pain, culminating in frothy diarrhoea, typically half an hour or more after the consumption of dairy produce.

If you are in any doubt, a very simple test is available from your doctor, which measure hydrogen levels in your breath following the consumption of milk. A positive result can confirm lactose intolerance.

Could it be celiac disease?

Occasionally inaccurately dubbed ‘gluten allergy’, celiac disease is a hereditary and lifelong digestive disorder. In this case, gluten – the protein found in wheat, rye, barley and oats – triggers a damaging reaction in the gut, which ‘eats away’ at the sites of the intestine that are responsible for absorbing food.

The symptoms are variable, but typically include exhaustion, diarrhoea, wind, malnutrition, weight loss, a drawn and pale appearance, and oral ulcers. In Western nations , an estimated 1-in-100 to 1-in-300 have celiac disease, and many people are unaware they have it. A very reliable blood test is available to diagnose it. This can be later confirmed by an intestinal biopsy to check for damage in the gut.

Could it be idiopathic food intolerance?

The type of food intolerance describes an adverse reaction where the mechanism is disputed or uncertain. A diagnostic test-diet called an exclusion diet is required to identify such a sensitivity.

Could it be chemical sensitivity?

Some people react adversely to natural substances in food, such as caffeine, alcohol, or chemicals called amines, which are found in strong-flavoured foods such as mature cheeses, salamis and wine. Typical symptoms include rashes and headaches.

There are no tests available for these sensitivities, but many sufferers identify their own reactions and avoid the foods in question. Sometimes, an exclusion diet will help work out what they are.

Could it be psychological?

This is called food aversion. Sometimes thinking that a food causes a problem is enough to trigger a physical reaction. Dieticians specialising in food intolerance can identify food aversions.

What are the treatments?

In the case of food allergy, strict and complete avoidance of the food is usually necessary. In some cases, typically those involving fruits and vegetables, cooked versions of the food may be tolerated. Careful label reading and vigilance is paramount. Your allergist, doctor and dietician will be able to advise, and all will be valuable consultants as you replan your life around your allergy. In some cases medication such as anti-histamines or adrenaline pens – to inject yourself with in the event of an extremely severe reaction – will be needed.

With celiac disease, gluten must be avoided for life, as there is no cure. This will heal the gut, which may have been damaged through years of exposure to the allergen, and your symptoms will probably take months to clear fully. It is, of course, extremely difficult to avoid all gluten grains, as wheat is used as an ingredient and bulking agent in so many processed foods. Again, specialist dietician’s advice can be invaluable.

With lactose intolerance, reducing your intake of dairy foods to a safe threshold level is usually enough to stop symptoms, although some severely lactose-intolerant people may need to completely avoid dairy produce. Some pre-digested, lactose-free milks are not also available.

With idiopathic food intolerance, a period of abstinence from the culprit food, of up to a year, or reducing the frequency you eat it, may well be all you need to help clear up the reaction. In other cases, permanent exclusion will be required.

Next: Food Allergy and Intolerance Tests

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