FOOD INTOLERANCE: Why you might not be stuck with it for life!
For some people, foods considered ‘healthy’ can trigger an adverse response in the body. A reaction to wholesome foods such as fruits and vegetables should ring alarm bells – it’s your body’s way of communicating to you that something isn’t right inside. Food intolerances are typically treatable if the cause is identified. But first, let’s take a look at the difference between food allergy and intolerance, and become familiar with the symptoms of each.
Defining food allergy
Food allergy occurs when a susceptible individual has an immune reaction to a food, causing the release of immunoglobulins (antibodies) and other chemicals into the bloodstream. These immune chemicals can cause the lips, mouth and tongue to swell, an itchy rash (hives) to develop, vomiting, diarrhoea, abdominal cramping and respiratory difficulties. Generally only a small amount of the food is needed to cause an immune response, and in severe cases, the food only needs to be touched or particles inhaled for a reaction to occur.
Common food allergens include peanuts, tree nuts, shellfish, egg, wheat, soy, milk, mustard and sesame. Allergies are usually identified in childhood, however they can develop at any age. Many childhood allergies are outgrown as the immune system develops. Some allergies, such as shellfish and peanut, typically persist into adulthood.
Food allergy vs. food intolerance
A food allergy can lead to life-threatening anaphylaxis and strict avoidance of the allergen follows diagnosis. Food intolerance is not life threatening and diagnosis or management may involve a food challenge i.e. bringing the food back into the diet. Due to these differences, the distinction between allergy and intolerance is important in individuals who suspect their symptoms (or their child’s symptoms) relate to food.
How to spot food intolerance
Many people live with the symptoms of food intolerance without realising that food is the culprit, as reactions can vary greatly in type and severity between individuals, so it is not easily recognisable. Some people experience food intolerance predominantly as digestive symptoms such as bloating, nausea or diarrhoea, while others may feel lethargic, get headaches, acne or skin rash.
For some, symptoms come on quite quickly after eating, making the troublesome food easier to spot. However for many others, the symptoms can be delayed or inconsistent from day to day. Intolerances are usually dose dependent, which means the more you eat of the offending food (or food group), the worse the reaction.
The bottom line – identifying food intolerance can be complicated. Some diagnostic testing is available through a practitioner, though it is costly and limited. Keeping a food diary that clearly documents foods eaten and the timing of symptoms can help uncover which foods make you unwell. A health practitioner who is familiar with food intolerance can help step you through an elimination and challenge diet, to better determine problematic foods and your threshold for reactions to that food.
The Common Culprits
As a naturopath, I’ve seen some wacky reactions to unexpected foods in clinic, however there are particular foods that are commonly problematic:
· Gluten – an umbrella term for the proteins found in wheat, rye barley and oats. The symptoms of gluten intolerance (also referred to as non- coeliac gluten sensitivity) typically appear hours or the day following gluten consumption. Headache, fatigue, brain fog and achiness are among the most common symptoms.
· Lactose – the sugar found in dairy products. Foods particularly high lactose includes milk, cream, soft cheeses, commercial yoghurts and ice cream. The intolerance is usually caused by lack of the digestive enzyme lactase, leading to symptoms of abdominal cramping, bloating and diarrhoea, which appear quite quickly after eating lactose.
· Histamine – an amine that occurs naturally in many aged and processed foods including wine, cheese, pate, meat broth and fish. The common symptoms of food histamine intolerance include flushed, itchy skin, nasal irritation, nausea, reflux, headache and irritability.
· Salicylates – found naturally in colourful fruits and vegetables, salicylate intolerance is often one that is overlooked. In children, salicylate intolerance often appears as a red rash around the mouth and behavioral issues. In adults symptoms can range greatly, from digestive discomfort to mood issues.
· Fructose – the sugar found naturally occurring in fruits, as well as a common sugar additive. Fructose malabsorption is a genetically inherited inability to absorb fructose. Free fructose in the intestine causes water to flood into the space, leading to diarrhoea. Fermentation of the sugar by bacteria and yeasts can also lead to gas and bloating.
· FODMAPS – a group of carbohydrate fibres found in many fruits, vegetables, grains, legumes and nuts. The symptoms of FODMAP intolerance resemble those of irritable bowel syndrome e.g. bloating, burping, cramping, diarrhoea and/or constipation. A common underlying cause for FODMAP intolerance is small intestinal bacterial overgrowth (SIBO).
· Food additives such as flavours, colours or preservatives can affect mood, digestion, respiration and the skin. Some examples include MSG, sulphites, nitrates, benzoates and the artificial sweetener aspartame.
What all food intolerances have in common
All food intolerances have their origin in the gut, whether it is in the small intestines, liver or colon. Some common reasons why intolerances develop include:
· Lack of liver or intestinal enzymes to break down the particular food, which can be due to a range of nutritional and genetic factors.
· An imbalance of bacteria in the gut (termed dysbiosis) or bacteria overgrowing in the small intestine (SIBO), causing the improper processing of foods (typically sugars and carbohydrates such as fructose, lactose and other FODMAPs)
· Having a leaky gut, which exposes food particles to the immune system which otherwise would not make contact.
Given there is generally an underlying reason why intolerance has developed, it stands to reason that if the causal gut issue is corrected, the intolerance will resolve. My experience as a health practitioner has seen many patients’ reintroduce problematic foods after years of restrictive diets. Healing the gut completely by identifying unique issues to the individual is the key to successfully reversing food intolerance. It is often a tricky and involved process, which requires patience and perseverance. With the right attitude and right practitioner guiding you, you don’t have to be stuck with food intolerance for life.
BHSc (Naturopathy) with Distinction