Food Sensitivity Series (PART 2)
FOOD ALLERGY VS FOOD SENSITIVITY AND HOW TO IDENTIFY FOOD SENSITIVITIES
Food Allergy vs food sensitivity
A food allergy is a TRUE allergy that is referred to as a fixed allergy and claimed as “not curable”. These are commonly tested via an IgE skin prick or scratch test and usually involve allergies to foods such as shellfish, peanuts or nuts, eggs, wheat or soy as well as other environmental allergens. This is a test your EENT doctor performs regularly. A typical true food allergy response occurs in minutes to hours after eating the food which is called a Type I immediate hypersensitivity reaction and can be an anaphylactic reaction where you develop throat swelling, difficulty breathing, and/or hives. This reaction commonly requires immediate medical attention and administration of Epinephrine. Other reactions include eczema, allergic rhinitis, vomiting or abdominal pains.
A food sensitivity is any inflammation-generating reaction against a specific food or food component that does not involve Type I IgE-mediated hypersensitivity or food-related autoimmunity. This intolerance or sensitivity can take days-weeks-months or even years to develop. Typical symptoms include skin rashes such as eczema, psoriasis, and rosacea, headaches, joint pains, brain fog, fatigue, bloating, indigestion, diarrhea or constipation, even infertility or contribute to other autoimmune conditions. It usually takes 1-3 days for a symptom to evolve after eating the food and are considered to be type II, III, or IV delayed hypersensitivity reactions.
So what do we do about all of this?
Treat the root cause to eliminates the cause of symptoms, prevent exposure, and take care of ourselves to prevent recurrence.
We always go back to the beginning and treat the initial insult. Did all of our diarrhea begin when we lost a loved one? We need to address emotional health along with the food triggers. Did our bloating and fatigue start after a round of antibiotics to treat an infection? We need to take a deeper look at our what that antibiotic did to our GI system.
Now, if you want to identify what your food triggers are, the approach you take depends on your symptoms, your level of commitment, as well as, finances. I bring up finances because if you choose to do lab testing, it can come at a modest or steep price.
The most common dietary identification trigger approaches:
Diet Diary --> Elimination Diet --> Food Reintroduction
Food Sensitivity Test --> Elimination Diet --> Food Reintroduction
General Elimination Diet --> Food Reintroduction
Is there a best approach? No. Nothing is 100% certain or 100% accurate except for you listening to what your body tells you.
Healthcare providers and people will tell you that this or that test is the gold standard or best way to figure out your food triggers and intolerances but this is not the truth. The gold standard for identifying food sensitivities today is still an elimination diet. How do you do an elimination diet? Well, now we have hit a debatable topic. This is an area in which healthcare practitioners will continue to have varying opinions and methods on how to eliminate and reintroduce food triggers.
The method ultimately should be tailored to your needs and your triggers.
Dr. Meg's general diet diary and elimination diet protocol
As stated, these recommendations are general and are not meant for every person. In my personal practice, this method changes from patient to patient and it all depends on the type of symptoms, the severity of the symptoms, the food(s) identified, and how long they have been battling their symptoms.
If you want to start identifying which foods are making you experience symptoms you must start with a commitment to a diet diary followed up with an elimination diet. A diet diary is a place where you record all of the foods, beverages, snacks and any extras you consume over a period of time. I prefer a minimum of 7 days for most of my patients.
My log looks like this:
We have a date, time, type of food, and place to log the thing you consume. We also need to log how much you eat and then any symptoms you experience and when. A lot of people ask “Why do you need the location?” Well if you experience bloating every time you eat your meal in the car on your way to work this is a good piece of the picture telling me that you are eating your meal distracted and likely hurried in the car (maybe with a touch of anxiety?). Could this be the root cause of your bloating? It certainly is an important piece of the picture. When recording a symptom, please list anything that occurs during your day by inputting the time of day and what you experienced. Some symptom examples are, and not limited to: diarrhea, constipation, fatigue, muscle aches, gas, bloat, indigestion, headache, brain fog, congestion, low energy, or even symptom relief. It is also pertinent to mark when you take certain medications or supplements during your day as well.
This Diet Diary is meant to highlight and bring your attention to possible triggers for you. After you have completed the log either take a look at it yourself or have a healthcare professional take a look to help link cause and effect. Note that this is not always as easy as it seems, but this truly is where you are going to get the most important raw data to begin an elimination diet.
So, you have done the diet diary and identified some triggers, how do we start an elimination diet? When I address my patients about certain foods, we talk about the importance of staying truly 100% free of that food. Easier said than done, I get it. But if you are going to go through the effort, might as well give it your all. Start with eliminating some or all of the identified triggers for 3 weeks. After this time reintroduce one at a time every 3-7 days. This is a general guideline and gets most people the answers they need. If you do not get the resolution are looking for please consult a doctor about further testing or looking at other areas in which need addressing.
As stated in Part 1 and Part 2, if we are not addressing the root cause of your inner skin inflammation we are not going to heal the way we should for lifelong relief because we are not targeting what is truly upsetting our stomach. Again, the cause of our symptoms certainly could be the foods we are eating, but a lot of times it goes deeper than that. This is where it is important that you have a healthcare provider to help you along this process to make sure all areas of your health are being addressed.
Now, I know that doing a diet diary and an elimination diet is not the best option for everyone. This is why we now have food sensitivity testing. Food sensitivity testing is good because it quickly tests 10-100s of foods and or additives that you would otherwise not look into which could take years to identify. We will discuss this area in Part 3.
Here to empower you with the knowledge of healthiness,
Dr. Meg
Carry on to Part 3 of this series to learn the details about the various food sensitivity testing methods available and the controversy around each one.
Disclaimer: These statements have not been evaluated by the Food and Drug Administration. There are no financial ties to any supplement companies, pharmaceutical companies, or to any of the products mentioned in this post. This post is not meant to treat, cure, prevent, or diagnose conditions or diseases and is meant for educational purposes. As always, please consult your doctor before trying any new treatments or supplements.
