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Food Allergies 24 August 2009

*Quod ali cibus est aliis fuat acre venenem.
(What is food to some is poison to others).
Lucretius, 1st Century BC*

Many people present to my clinic with food allergies and sensitivities. Some practitioners have called food allergies the epidemic of the 21st century. Food allergies and sensitivities are a major and often unrecognised cause of chronic disease. They can occur immediately after birth, even after the first feeding. Click here to see a recent interview I did on A Current Affair about food sensitivities.

There are several theories as to why food allergies are becoming such a major problem:

• Improved sanitation is thought to have resulted in a decreased exposure to bacteria and therefore stimulated our immune systems less.
• Eating foods that we were not genetically designed to eat has also played a role. For more information, see Paleolithic Nutrition. Dairy and wheat are by far and away the most common food allergies in my clinic. Repetitive ingestion of a particular food, especially in large amounts also increases sensitivity to it.
• Food allergies are a vicious cycle. Once you start developing them, the bowel wall becomes increasingly inflamed. This allows large food particles to be absorbed. The body does not like large undigested food molecules and the immune system gets activated against them, creating more food allergies and more inflammation.
• A decline in the numbers of friendly probiotic bacteria in the bowel leading to fungal intestinal overgrowth and ultimately chronic systemic fungal infections..
• Increasing amounts of chemicals in foods such as colourings, artificial sweeteners and preservatives. Meta-bisulphate used as a preservative in dried fruit is a very common allergen in my clinic.
• Natural immunity has been altered by the overuse of antibiotics, vaccinations and the continuous exposure to environmental toxins such as pesticides.
• The increasing incidence of caesarean section (CS) leading to reduced colonisation of the infant bowel with good bacteria.
• Early use of unnatural proteins in formula milk, especially dairy and soy.
• Early exposure to grains especially gluten.
• Exposure to heavy metals particularly mercury which inflame the gut wall. Mercury is still contained in some infant vaccinations.

The bowel is exposed to an enormous amount of allergens every day. The gastrointestinal tract detoxifies the food by dismembering it until it is no longer foreign. This is known as digestion. The body can then use these basic building blocks for its own purposes. Because this process is not perfect, the body has a number of mechanical and chemical processes to protect itself. These include the mucous layer of the bowel, IgA, stomach acid, pancreatic enzymes, pancreatic bicarbonate and probiotic organisms. Note that there are many conditions which will interfere with the bodies ability to protect itself, for example, commonly prescribed stomach ulcer medication dramatically reduces stomach acid production and will therefore increase food allergies. Mercury amalgams and antibiotics are known to disrupt the normal intestinal probiotic organisms. It is also important that there is prompt evacuation of the intestinal contents before bacterial and yeast fermentation products accumulate.

Evidence is mounting that dendritic cells in the intestinal mucosa are the cells which present proteins to the immune system which then become allergens. The gut microenvironment is so important to our health because it conditions the dendritic cells to be quiescent. It is obvious then how important it is to maintain a healthy gut bacterial flora. There are 2 components required to keep the bowel microflora- prebiotics and probiotics. Prebiotics are defined as a nondigestible food that stimulates the growth and activity of the normal gut bacteria. Probiotics are defined as live bacterial preparations with clinically documented health effects in humans. Probiotic organisms help digest food (especially proteins), prevent the overgrowth of pathogenic organisms and yeasts, help repair and protect the gut wall, decrease gut wall inflammation and are involved in immune surveillance.

The gut flora is established at birth with transfer of beneficial bacteria to the infant from the mother while the baby is in the birth canal. This bacterial load is then crucial for development of the infants’ immune system. Research has shown a difference in the gut flora between babies born vaginally and those delivered by caesarian section (CS). It is a good idea to give probiotics to newborns delivered by CS.

Recognising a symptom resulting from a food sensitivity can be difficult. Frequently the initial allergic response can be mentally stimulating – it makes the person feel good. When this stimulatory phase wears off, the undesirable symptoms begin. The stimulatory phase is remembered, encouraging the food to be eaten repetitively. This makes the sensitivity more severe and chronic disease occurs. There is good evidence that people are usually addicted to the foods they are sensitive to. If you’re unwell but can’t imagine life without cheese, you almost certainly have a dairy allergy.

Food sensitivities can be the root cause of multiple different symptoms. As far back as 1922, wheat sensitivity was demonstrated to cause nervousness and anxiety in children. In the 1950’s research found that food sensitivities were excitants and perpetuants of mental illness. Other symptoms can include sneezing, cough, wheeze, urticaria, drowsiness (especially after a meal), insomnia, sweating, bloating, gas, abdominal cramps, joint swelling/pain, diarrhoea, hypertension, tongue swelling, painful swallowing, itching of the soft palate, reflux, asthma, rectal/vaginal itching, seizures (especially petit mal), fatigue, vertigo, headache, anorexia, nausea, tinnitus, diziness, redness of the eyes, recurrent ear infections, recurrent athletes foot/jock itch, eczema, biliary colic, bronchitis and sinusitis. Note that recurrent tonsillitis is frequently caused by a dairy allergy. The most common complaint of allergy is FATIGUE.

Hypertension in particular responds well to elimination of food sensitivities. The other benefit is a global improvement in immune system function.

An individuals ability to develop food allergies is likely hereditary and a life long process. Inhaled allergies are usually mediated by IgE antibodies and are caused by the immediate release of histamine from cells known as mast cells. Food allergies however involve a lot more complicated series of immune reactions. There are two different types of food allergies depending on which antibodies have been activated- fixed and cyclic. A fixed food allergy occurs each time a food is consumed, no matter how long it has been avoided. Fixed food allergies are IgE mediated. If IgE antibodies are activated, the allergy is usually severe and often results in anaphylaxis or wheezing. IgE mediated food allergies only account for 5% of adverse food reactions.

A cyclic food allergy is better described as a food sensitivity and is related to the frequency and quantity of consumption. Increased frequency of eating tends towards sensitivity. Avoidance tends towards tolerance. Food sensitivities are mediated by IgG, IgM and IgA antibodies. If IgM, IgG or IgA antibodies are activated, the reaction is usually low grade and presents with symptoms such as abdominal pain, bloating, diarrhoea and rash. Often the symptoms appear to be completely unrelated to the gastrointestinal tract (e.g. the skin) and this is due to the food sensitivities switching on the immune system in general and because the inflammation of the gut can lead to toxicity “leaking” back into the blood stream. The symptoms can take hours to days to start and can commence at any age so the symptoms are “masked” and not attributed to a food allergy. The six most common foods incriminated in food sensitivities are wheat, corn, egg, yeast, dairy and soy. Remember that alcoholic drinks contain corn, yeast, malt and other cereal grains.

Diagnosis of food allergies and sensitivities can be done in several ways. Techniques used by most doctors with an interest in food allergies include elimination diets, blood tests and skin prick tests. Elimination diets involve eliminating common allergenic foods from the diet and then slowly recommencing suspect foods once at a time. They rely on the ability to guess the likely allergenic food. Blood testing for food allergies in the main Australian laboratories (commonly known as the RAST test) is for IgE antibodies. 100% of people with anaphylaxis to foods, 90% with wheezing, 60% with urticaria and 30% with acute gastrointestinal symptoms will have a positive RAST test. Testing for the antibodies involved in food sensitivities is done by a few specialist labs. Skin testing for food can be unreliable when the pre-made allergenic solutions are used. Diagnosis can also utilise Eastern medical principles of allergy and use techniques such as NAET.

Treatment of the food sensitivities involves:

• Elimination of the food for at least 3 months. The first few days of elimination may be associated with a withdrawal reaction which has just got to be worked through. Many of the IgM, IgA and IgG allergies will resolve over time and with gut repair. This tolerance may take months or even years to develop. Tolerance allows consumption of the food again but only intermittently. Usually the allergy will not develop again if the food is not eaten more frequently than once in 4 days. IgE allergies are usually life long.
• Rotary Diversified Diet. A person who has food sensitivities will always be predisposed to developing more. After the period of food elimination, antibody levels have reduced markedly. Sensitive foods can then (one by one) be slowly reintroduced but should not be eaten more frequently than every 4 days. If they are eaten more commonly than this, antibody levels will build up again. Other foods should also be rotated and not eaten every day to avoid developing sensitivities to them. Lots of different foods from different food families should be eaten and should consist of chemically less contaminated foods, organic where possible. If a rotary diversified diet is not followed long term, new sensitivities and a more complicated medical problem will occur.

General guidelines for a rotary diversified diet are:

1. Any sensitive food should not be eaten more often than once every 4 days. If a previously sensitive food is eaten on Monday, it shouldn’t be consumed again until Friday.
2. Foods from the same family as the sensitive food should not be eaten more often than every 2 days. Click here allergy.pdf for a PDF file on food families. For example, tomatoes and potatoes are both in the potato group of plants. A person sensitive to tomatoes should not have them more often than every 4 days and should not have potatoes more often than every second day.
3. Food family members may not be eaten at various times during a specific day. If you have tomatoes for breakfast, you cannot have potatoes for lunch. You can eat more than one from each food family at each meal- e.g. you can have potatoes and tomatoes for breakfast on one day. You then shouldn’t have tomatoes for another 4 days of potatoes for another 2.
4. Sensitive foods can only be eaten once during a specific day and not throughout the day, even in small amounts. The tomatoes can be consumed at breakfast but not at lunch or dinner. They can be consumed 4 days later.

Other treatments include:

• Replacement of vitamins and minerals which are invariably low after a period of malabsorption.
• Magnesium and zinc help to reduce the allergic response.
• Steps to rebuild the intestinal mucosa and eliminate fungus are crucially important using essential fatty acids, glutamine and zinc carnosine.
• Eliminate chronic fungal infections from the gut with an indidualised anti-fungal regime.
• A good probiotic/prebiotic.
• A dramatic reduction in foods containing refined carbohydrates, chemicals and preservatives.
• If the above testing and treatment regimes to not provide a satisfactory outcome then consideration should be given to exploring Eastern medicine techniques of sensitivity diagnosis and treatment such as Nambudripud’s Allergy Elimination Technique (NAET).
• People with multiple food allergies have them because their bodies are too acidic. When the body is too acidic, there is an increase in the activity of the white cells (which act as garbage collectors). The increase in white cell activity results in reactions to a multitude of foods and other environmental substances.