Hippocrates dating back to 400 BC discussed food reactions in the development of various health complaints, it seems ridiculous that formal research studies on adverse food reactions only began in the 20th Century have only recently appeared in scientific journals.
These are a variety of food complaints which more and more people are being affected by, especially in the Western diet. It could be the increased amount of processed food which we eat and lack of natural fruit and vegetables. However, the adverse food reactions, food allergies and food intolerances now affect millions of people; some of whom have been seen by medical professionals, others through their own knowledge of their body and reactions to foods.
These adverse food reactions are believed to be the cause of a variety of common health complaints and diseases are not solely cereals, dairy, carbohydrates but also meats, fruits and vegetables as well as spices, additives, flavourings, sugar, fats, anti-biotics given to livestock etc.
Which are increasingly believed to be responsible for many undiagnosed health complaints which impact treatment and health problems which are mediated by the immune system.
The immune system protects us from illness and disease, by continuously lowering the danger represented by Antigens; parts of proteins which our bodies recognise as dangerous so neutralize it (in a nutshell our immune system is our internal army), in foods and microorganisms like bacteria.
The immune cells identifies a dangerous antigen, they act to neutralize it and prevent it from causing harm in the body. Antigens from bacteria or viruses interact with our cells, which is how we become sick, catch the flu, cold but in food antigens we may risk the attack of a wide range of immune-related symptoms ranging from a runny nose to hives or (worse still), anaphylactic shock.
Consequently, more and more healthcare practitioners are referring patients to dieticians and Allergy Avoidance Diets to identify food allergies and food intolerances in their patients to increase better health and future problems.
The difficulty is that your General Practitioner (G.P) Doctor may not have the knowledge or understanding to deal with your problem and refer you to a Consultant at your local hospital or to a dietician to discuss how to manage your body’s reactions to foods.
There are more and more nutritionists, dieticians and physicians who now consider that the only definitive way to identify and manage adverse food reactions is through an Allergy Avoidance Diet to eliminate and find the cause of the problem through one of the following diets:
~ Elimination Diet followed by food challenges Diet; any food that is suspected of causing an allergy or intolerance is eliminated for a period of four days to three weeks, until symptoms are gone. Therefore, depending on the severity and type of symptoms, the Elimination Diet could range from moderately to severely restrictive in the amount of foods allowed. Elimination Diets typically include a variety of hypoallergenic foods including lamb, pears, apples, rice, most vegetables, most beans and legumes (except peanuts) and the “non-gluten” grains (for example, millet, quinoa, and amaranth). Once the body has adjusted to the absence of suspected foods, these foods are systematically added back into the diet, and any resulting symptoms are recorded every two to four days depending on whether there is a reaction or not.
~ Rotation Diet, in this diet problematic foods are eaten only once every four days.
An Allergy Avoidance Diet may be especially beneficial for those suffering from adverse food reactions.
Food hypersensitivities or food reactions, are classified in two types; immediate or delayed. Immediate hypersensitivity reactions occur within hours or even a few minutes after a food is eaten, typically causing very obvious physical symptoms such as a rash, the hives, a running nose, or a headache or rarely anaphylactic shock, a life-threatening condition in which the throat swells and blocks the passage of air. The foods which are most often the cause of immediate allergic responses include milk, eggs, peanuts, walnuts, soy, strawberries, wheat, fish and shellfish. Many people with immediate food hypersensitivities must completely eliminate the offending food from their diet to avoid the serious symptoms. It may also be similar citrus fruits or apples which cause these symptoms it varies among different individuals.
N.B. Immediate hypersensitivities affect only a small percentage of the population.
Foods known to cause immediate hypersensitivities in a small number of people, have now been implicated as a cause of delayed/masked food allergies in much larger numbers of individuals. Delayed food hypersensitivity reactions are believed to affect millions of people; some physicians have suggested that as many as 50% oa a western population suffer from masked food allergies.
Reactions may be a variety of symptoms; dark circles or puffiness under the eyes, fluid retention, dermatitis, sinus congestion, fatigue, abdominal pain or discomfort, joint inflammation, mood swings, indigestion, migraines, headaches, chronic ear infections, asthma, poor memory, anxiety and depression.
Delayed hypersensitivities do not appear immediately which adds to the problem after consuming a particular food as you may be unsure what you have eaten which caused the reaction possibly blaming the wrong food so suffering again until the correct food is eliminated. The immune response is often considerably delayed making it is difficult to determine which food is causing the symptoms, as a result many people continue unawares of their sensitivity to certain foods. This is why through dietary manipulation as in the Elimination Diet or Rotation Diet, so hidden food allergies are identified. The foods most commonly associated with delayed hypersensitivities include dairy products, eggs, wheat, soy products, peanuts, shellfish, and refined sugar.
Immune-mediated food allergies represent one type of adverse food reaction. Another type of adverse food reaction is called food intolerance which refers to any abnormal physiological response to a food that is not caused by an antibody/antigen reaction whether caused by enzyme deficiencies, or caused by poor function of the digestive tract or a sensitivity whether a natural or synthetic chemical.
The most common food intolerance is lactose intolerance, which affects as many as 30% of American adults, and is particularly common in people of African and Asian heritage.
People with lactose intolerance do not produce enough of the digestive enzyme called lactase, this breaks down the milk sugar (lactose) found in dairy products. The problem is when too much undigested lactose makes its way into the large intestine, people suffer from gas and/or diarrhoea.
Wheat reactions may be known as wheat intolerance, wheat allergy, and wheat sensitivity. Wheat is quite unique in adverse food reactions, for the reason that it has long been classified as the primary “gluten grain” as well as its research history which has been both complicated and controversial. It is necessary in understanding allergy-related issues associated with gluten is important for understanding problems connected to wheat.
“Gluten” is unscientific in its use; if that word is being used to describe any single substance or even category of substances. The term “gluten” used is from the world of industry not science. In industrial baked goods, gluten is the gummy, yellow-gray material that is left over after dough (made from flour and water) has been washed or carbohydrates cooked. This is as the dough is washed, many of the water-soluble substances and starches are washed off and what’s left is a complicated mixture that has traditionally been referred to gluten. The dough used to produce gluten is from many cereal grains including wheat such as rye, barley, which can also be used to produce gluten. In industrial practices, wheat is the common food source for producing gluten.
If a gluten dough-ball is dried out and analyzed, it is found to be 80% protein by weight, the remaining 20% is made up of fats, carbohydrates, and minerals. From a chemical point of view, gluten is a diverse mixture of substances.
There are 4 primary types of gluten proteins:
Glutelins have a more specific name when they are found in wheat where they are called glutenins. The prolamin proteins in gluten have been implicated in the process of protein-based wheat allergy. The role of prolamin protein in food allergy is also complicated because prolamins are found in all cereal grains, not just wheat. The prolamin proteins found in wheat are the gliadin proteins; in oats, they are avenins; in corn they are zeins; in rye they are secalins; and in barley they are hordeins.
Protein-Based Wheat Allergy
With respect to wheat, and within the prolamin family of proteins found in gluten, it is the alpha-gliadin polypeptides that have been most closely linked to food allergy. These alpha-gliadin polypeptides include peptide A, peptide B, and peptide C. These small proteins appear particular to wheat. If gluten is produced from sources other than wheat, the prolamin proteins in the gluten change from gliadins to other types of prolamin proteins, like avenins in oats or secalins in rye. In these non-wheat cases, the allergy-triggered events associated with the prolamin proteins become less predictable, and sometimes fail to occur altogether.
The differences in prolamin protein composition between wheat and other cereal grains have prompted controversy in the area of allergy and in use of the term “gluten grains.” Traditionally, wheat, oats, barley, and rye have been referred to as the “gluten grains” and placed on a par with wheat in terms of allergy. When a person has traditionally been advised to avoid wheat products for allergy reasons, that person has also traditionally been advised to avoid oats, barley, and rye as well. The recommendation in this traditional context has been to avoid all “gluten grains.” The differences in protein chemistry between wheat and all other cereal grains, however, has caused some organizations to start thinking about wheat as a grain that falls into its own unique category and to place restrictions only on wheat and wheat gluten when allergy is the issue. These organizations have largely abandoned use the term “gluten grains,” and have begun to think exclusively about wheat and wheat gluten. These steps have had interesting and controversial consequences with respect to health problems involving wheat allergy. For example, several organizations formed to support individuals with celiac disease have altered their public health recommendations to include acceptability of oats for persons diagnosed with celiac disease. Previously, oats had been categorically avoided as gluten grains for all persons following dietary restrictions related to the diagnosis of celiac disease.
Non-Gluten Sources of Wheat Allergy
There are other components of wheat that have been associated with allergy to the wheat allergy problems associated with wheat’s prolamin proteins. These components include wheat germ agglutinin (WGA), a glycoprotein, and two very short amino acid strings called tetrapeptides (PSSG and GGGP). These substances are present in significant amounts in wheat but do not appear to be present in the same way in other grains.
Whole Grains versus Processed Grains
Wheat allergy-related problems are believed to be triggered in part by the highly processed nature of wheat products in the marketplace. Commercially produced breads are typically formulated to contain a specific amount of highly processed wheat flour (stripped of the germ, the bran, and majority of fibers, vitamins, and minerals) and a specific amount of equally processed wheat gluten. Manipulation of this flour-to-gluten ratio can dramatically improve textures of highly processed breads and baked goods as a result the natural balance of nutrients found in whole wheat is dramatically altered by these processing events, which points to these processing impacts as the major underlying reason for prevalence of wheat allergy. 100% whole grains are the only grains recommended among the World’s Healthiest Foods, these allergy-related considerations involving wheat processing are completely avoided with the World’s Healthiest Foods approach.
The Specifics of Coeliac Disease
Coeliac disease is a health condition that some people associate with simple gluten intolerance. However, coeliac disease is in fact a multi-system autoimmune disease in which changes in liver function, digestive tract function, and the function of other organ systems comes into play. The role of a specific enzyme, called tissue transglutaminase, or tTG, appears to be especially important in celiac disease. Short strands of protein (polypeptides) found in gliadin (one family of wheat proteins) are acted on by this enzyme, and many resulting problems associated with Coeliac disease may result. For some, but not all individuals, a blood test measuring antibodies to tTG can be an effective screening test for Coeliac disease.
Adverse Reaction to Food Additives
Many people are also unable to “tolerate” natural and synthetic chemicals, such as sulfites, that appear in abundance in our food supply. These sulfur-containing preservatives are used in dried fruits, wines, and many other processed foods. Between 1980 and 1999, the United States Food and Drug Administration received more than 1,000 reports of adverse reactions, some fatal, to sulfites. It has been estimated that at least 1% of all people with asthma are sensitive to sulfites.
Synthetic food colourings, including Food Dye and Color Yellow No. 5 (tartrazine), are problematic for many people. Monosodium glutamate (MSG) is one further example of an additive used to increase flavor, particularly in Asian foods. After eating at restaurants that use MSG, many people become bloated or experience severe headaches.
Adverse Reaction to Salicylates
Salicylates and amines are examples of naturally-occurring food substances found in many vegetables, herbs, spices, fruits, and chocolate. These naturally-occurring components of food have been associated with a variety of symptoms including mental confusion, depression, and migraine headaches.
The Role of an Elimination Diet
Food allergies and food intolerances are a major source of undesirable symptoms that negatively impact the quality of life of many people. Therefore, the only definitive way to identify and manage adverse food reactions is through the use of an Elimination Diet followed by carefully organized food challenges.
This process is quite arduous and must be done carefully if adverse food reactions are to be identified, as a result, it is best to perform an Elimination Diet with the support of a knowledgeable health practitioner, however it can be done on your own if like me you are determined.
In an Elimination Diet, any food that is suspected to cause an allergy or intolerance is eliminated. Depending on the severity and type of symptoms, the Elimination Diet may range from moderately restrictive to severely restrictive in the amount of foods allowed.
Food Excluded on an Elimination Diet
Standard elimination diets eliminate the most common allergens, such as wheat, soy, corn, dairy, eggs, gluten, nuts, citrus, fish, chocolate, and shellfish, caffeine, alcohol, and artificial food additives. More restrictive Elimination Diets remove all of the foods previously listed plus those foods that contain salicylates and amines.
The Challenge Phase of an Elimination Diet
The purpose of the Elimination Diet is to avoid all problematic foods for a minimum of four days, or until you experience some relief from your symptoms. It is worth noting that for some people, it takes up to three weeks before improvement is seen. However, once the body is cleansed, the foods that were eliminated are systematically added back into the diet, one food at a time; being noted in a diary.
This re-addition of foods is called the “challenge” phase of the diet. On the first day of food challenges, a food is eaten one to three times during the day. Over the next few days, the dieter returns to the Elimination Diet, and watches for the return of any symptoms.
If any symptoms develop, it is possible that the dieter is “allergic” to the recently reintroduced food. If no symptoms develop, it is likely that the reintroduced food is not a problem for the dieter, and he/she can move on to the next food challenge. To more accurately determine food allergies and food intolerances, it is extremely helpful during the challenge phase to keep a diary of foods eaten and any emotional, mental or physical reactions.
It can take several months to complete an Elimination and Challenge Diet. If a person does not have the time or desire to undertake such a process, a Rotation Diet may be a more appropriate option for managing the symptoms associated with food allergies.
In a Rotation Diet, foods are rotated so that a person eats a food (or food family) only once every four days. For example, if you suspect a sensitivity to wheat, you would rotate wheat-containing foods into your diet every fourth day. It is believed that by decreasing the consumption of problematic foods by rotating them, the symptoms associated with these foods can be reduced.
Thankfully there is an increasing body of scientific literature points to hidden food allergies and food intolerances as a cause of many medical conditions including migraine headache, arthritis, irritable bowel syndrome, asthma, attention-deficit hyperactivity disorder, and recurrent otitis media. Common health complaints such as fatigue and eczema are also attributed to adverse food reactions.
I am glad as being a sufferer who hasn’t been taken seriously by health professionals then the more research then maybe sufferers may be taken seriously rather than hypochondriacs or psychosomatic.
Clinicians and researchers believe that the number of people suffering from adverse food reactions is constantly increasing. They cite several reasons for this:
• Repeated consumption of a limited number of foods: Eating a relatively small number of foods several times during the day; such as wheat, a common food allergen, which is found in breakfast cereals, the bread used to make a sandwich at lunch time, and the spaghetti eaten at dinner time. Also, wheat is a thickening agent used in food processing, so it is a common “hidden” ingredient in many processed foods. Or consider the number of times you can eat corn in one day: in your corn flakes at breakfast, in your corn tortilla at lunchtime, and your corn-on-the-cob at dinnertime. Other commonly eaten foods such as milk and eggs are also a frequent cause of allergic symptoms. The repeated exposure to these foods taxes the immune system.
• Improper digestion and poor integrity of the intestinal barrier: The digestive tract plays a vital role in preventing illness and disease by providing an impenetrable barrier. When the integrity of the intestinal barrier is compromised, a condition coined “leaky gut syndrome” develops. With leaky gut syndrome, partially digested dietary protein can cross the intestinal barrier and be absorbed into the bloodstream. These large molecules can cause an allergic response, producing symptoms directly in the intestines or throughout the body.
One of the causes of leaky gut is an absence of “friendly” bacteria in the intestines. The “friendly” bacteria help maintain the health of the intestines by producing fuel (as short-chain fatty acids) for intestinal cells and by competing with disease-causing bacteria for nutrients. Parasitic infections, treatment with antibiotics, stress, and candida overgrowth can disrupt the proper balance of “friendly” bacteria. It is also believed that not being breastfed or only for a short period of time as an infant or an early introduction of solid foods to infants contributes to leaky gut syndrome and subsequent food allergies.
• Over-worked immune systems: Constant stress, exposure to air and water pollution, and pesticides and chemicals in our food puts a strain on our immune system, making it less able to respond appropriately to the antigens in food.
• Genetics: Food allergies and intolerances seem to be hereditary. Research indicates that if both parents have allergies, their children have a sixty-seven percent chance of developing food allergies. When only one parent is allergic, the child has a 33% chance of developing food allergies.
An Allergy Avoidance Diet emphasizes the consumption of a wide-range of so-called hypoallergenic foods.
These foods include lamb, pears, apples, rice, most vegetables, most beans and legumes (except peanuts) and the non-gluten grains (for example, millet, quinoa, and amaranth).
The only sweeteners allowed are maple syrup or brown rice syrup.
Drinks include rice milk, pear nectar, chamomile tea, and sparkling water -without any added sweeteners.
Foods that are included in an Allergy Avoidance Diet must be carefully selected for each individual, so that all problematic foods are eliminated.
Any food that is known, or suspected, to cause an adverse reaction is either completely eliminated from the diet, or eaten on a rotation basis. Wheat, corn, cow’s milk, eggs, dairy products, peanuts, and soy foods are among the most common food allergens. Many people also react to artificial food additives, such as monosodium glutamate, sulfites, and food colorings; foods containing these ingredients must be eliminated.
If you are simply trying to avoid wheat, dairy, or corn, you can include a wide variety of fruits and vegetables in your Allergy Avoidance Diet. However, if you suspect that you are sensitive to amines and/or salicylates, you must avoid all foods containing these naturally occurring chemicals. Unfortunately these chemicals are widespred in many commonly eaten fruits and vegetables, as well as many other foods. Examples of foods that contain salicylates and/are amines are tomatoes, broccoli, olives, spinach, mushrooms, avocado, all dried fruit, smoked meats, canned fish, hard cheeses, soy sauce, miso, chocolate, cocoa, beer, cola drinks, vinegars, and yeast extract.
N.B. With the Elimination or Rotation diet, be aware that many processed foods contain at least one of the most common food allergens. Milk, soy, wheat, peanuts, and eggs are staples in the food industry, and often appear in foods as “natural flavors,” which means that the food label may not list the ingredient.
Additional Information about Allergy-Related Meal Planning
If you decide to experiment with some of the allergy avoidance methods listed above, you will discover that some allergy-related meal planning is really quite simple. If you decide, for example, that wheat is a food you want to avoid, you automatically know that wheat bread is off your grocery list.
Highly processed foods, or sauces and condiments, you will find that allergy avoidance becomes more difficult, because wheat is not always so easy to spot. Soy sauce, for example, often contains wheat as a key ingredient. So do teriyaki sauce and food starch.
Prepare homemade meals to avoid the risk of hidden ingredients.
Allergy-related meal planning in any of the following five areas, when selecting foods for yourself or your family.
1. Dairy-free meal planning
2. Wheat-free meal planning
3. Egg-free meal planning
4. Soy-free meal planning
5. Yeast-free meal planning
Dairy-free meal planning
In addition to cow’s milk itself, products made from cow’s milk including yogurt, ice cream, sour cream, half and half, cottage cheese, hard and soft cheeses, butter, and puddings can be made from cow’s milk.
One of the most common allergenic proteins in cow’s milk is called casein, and all variations of this word appearing on an ingredient list signify the presence of cow’s milk as a food source: casein, caseinate, calcium caseinate, ammonia caseinate, magnesium caseinate, potassium caseinate, and sodium caseinate.
Casein can be used in food processing as an extender, tenderizer, and protein fortifier, and can be found in unexpected places, including chewing gum, luncheon meats, and imitation sausage. The words “non-dairy” do not necessarily mean that a product does not contain casein, and many non-dairy products on the market, including soy cheeses, almond cheeses, and rice cheeses use casein as a primary protein-boosting ingredient.
Wheat-free meal planning
All of wheat’s components, including wheat bran, wheat germ, wheat starch, wheat nuts, and wheat berries would be excluded from a wheat-free meal plan. Similarly, any type of wheat, including bulgar, durum, and graham would be excluded. Semolina, seitan, triticale, couscous, and tabouleh would also be avoided, along with any product containing the word “gluten” (or a variation of this word) in its ingredient list. These include high-gluten flour, vital gluten, and wheat gluten.
Much more hidden are the food additives that may or may not be made from wheat. These additives include:
• Dextrin, an incompletely hydrolyzed starch that may be derived from the dry heating of corn, potato, rice, tapioca, arrowroot, or wheat
• Caramel color, which can be made from heat treatment of many food-grade carbohydrates, including molasses, corn sugar, invert sugar, milk sugar, barley malt syrup, or wheat starch hydrolysates
• Extracts, including vanillin extract, which often use grain alcohol in preparation of the extract and contain wheat protein residues
Egg-free meal planning
The desert sections of the grocery store contain the most egg-based products, including puddings, custards, ice creams, cakes, cookies, meringues, cream-filled or fondant-filled chocolates, fudge, icings and frostings, doughnuts, and muffins.
Baked goods and baking mixes also frequently contain egg. The list here includes waffles and waffle mixes, pancakes and pancake mixes, and french toast. Egg noodles, breaded meats, breaded fish, breaded poultry, souffles, hollandaise sauce, most mayonnaise, meat loaf, some sausages, many fried rice dishes, egg drop soups, egg noodle-containing soups, and egg substitutes can also contain egg.
On an ingredient list, any of the following words would also indicate the presence of egg: albumin, egg white, egg yolk, dried egg, egg powder, egg solids, ovalbumin, ovomucin, ovomucoid, ovovitellin, and livetin. The fat substitute Simplesse (TM) also contains microparticulated egg protein.
Soy-free meal planning
An ever-increasing number of ingredient-listed items can include some soybean-derived component. Items that indicate or may indicate the presence of soy include: hydrolyzed soy protein, hydrolyzed plant protein, hydrolyzed vegetable protein, texturized vegetable protein (TVP), isolated soy protein (ISP), soy flour, soy grits, soy nuts, soy milk, soy sprouts, isolated vegetable protein, vegetable gum, vegetable broth, or natural flavoring. Soy sauce, shoyu, tamari, miso, tofu, tempeh, natto, edamame, soy oil, soy curd and soy granules would all be avoided on a soy-free meal plan.
Yeast-free meal planning
A yeast-free meal plan is one of the most confusing to implement because of the controversies surrounding residual amounts of yeast in many commercially-prepared, processed foods. For example, small amounts of yeast many become present during the drying of tea, coffee, and spices.
The culturing of yeast is also used a starting point for commercial production of fermented products, including vinegars and ciders. Citric acid, a food additive, is also derived from yeast-culturing and yeast-fermenting processes.
Many cow’s milk-containing products also contain yeast, since yeasts thrive on milk sugar (lactose). This list of products typically includes sour cream, buttermilk, cream cheese, ricotta cheese, and powdered milk. Because yeasts also thrive on concentrated sugars, many canned and frozen fruit juices, and particular fruit juice concentrates, can contain yeast. Since the mid 1970s, several dozen research studies on this topic have appeared in food science journals.
An Allergy Avoidance Diet, when carefully planned, provides sufficient amounts of all essential nutrients. Care must be taken with children and pregnant women to ensure adequate caloric and protein intake.
As adverse food reactions are implicated as a contributing factor in the development of several medical conditions, identifying and eliminating the foods that cause reactions can be helpful for many people. Specifically, an allergy avoidance diet is beneficial for those suffering from irritable bowel syndrome, migraine, recurrent otitis media, rheumatoid arthritis, and asthma.
Individuals following an Allergy Avoidance Diet may experience uncomfortable symptoms caused by detoxification, including headache, muscle pains, or fatigue. These symptoms typically appear 2-3 days into the diet, and disappear within seven days.
When offending foods are reintroduced into the diet, individuals experience mild to severe reactions to food. It is advisable, to follow an Allergy Avoidance Diet, especially a strict Elimination/Challenge Diet, only under the advice and supervision of a health care practitioner.