Food Allergy Fight
Natural practitioners and product manufacturers are working to make all-too-common food reactions easier to stomach.
According to the Food Allergy and Anaphylaxis Network, researchers estimate that less than five percent of Amer- icans suffer from food aller- gies. Although food reactions are common, food allergies are not as prevalent as food intolerance.
Statistics indicate that as much as 15 per- cent of the world’s population experiences intolerance to gluten proteins, and an estimated 30 to 50 million American adults are affected by lactose intolerance.
According to the Centers for Disease Control and Prevention’s (CDC) National Health Interview Survey, an annual survey of about 35,000 households, the incidence of children with food allergies has risen from a rolling average of 3.6 percent for the 2000-02 period to 5.1 percent for the most recent period reported, 2009-11.
With regard to food hypersensitivities (or reactions), it has been estimated that 45 to 60 million Americans suffer from clinically significant food reactions, however one authority on food allergy, James Braly, MD, estimates that number range is closer to 60 to 80 million.
Gordon Siek, PhD, laboratory director with Massachusetts-based Alletess Medical Laboratory, Inc., explained that a food allergy is an adverse immune response to a food protein. “IgE is the antibody that is responsi- ble for ‘allergy,’” he said. “The immune sys- tem misfires and interprets a normally harmless substance—a peanut, for exam- ple—as harmful. IgE mediated food allergic reactions can occur within minutes and are typically associated with symptoms within four hours and range from minor to severe, and in extreme cases, even life-threatening.”
He added that classic food allergy tends to involve one food or a limited number of foods. Once a fixed food allergy has developed, allergic symptoms will occur every time the patient is exposed to the allergic food. Symptoms are not dependent upon the quantity of food eaten, and may occur from very small exposures.
With food sensitivities, reactions are delayed and can occur up to 72 hours after ingestion, Dr. Siek noted. “Measurements of allergen specific IgG antibodies have been used in clinical studies of various allergic diseases and gastrointestinal disorders,” he said. “Specific IgG antibodies may be bio- markers of exposure and may be elevated in patients with irritable bowel syndrome (IBS) and other diseases. Very high levels may Indicate the presence of an ongoing elevated immunologic process. IgG antibodies are the most abundant, comprising of 73 percent of all circulating antibodies. They are associated with delayed reactions that can worsen over time. Delayed reactions are more difficult to notice since they can occur hours or even days after consumption of an offending food.”
In addition, food intolerance is a non- immunological response to a food where the patient lacks the enzyme to properly digest the food. An example of this is lactose intol- erance, Dr. Siek said.
Specialty Products
Creating “allergy-free” products has become standard in thriving nutritional supplement companies, said Dr. Adam Killpartrick, director of clinical development with Innate Response Formulas in New Hampshire. “It is becoming more common for patients to request a supplement tested free of common allergens,” he said. “This is being driven by a couple predominant factors. One, identification of allergies and sensitivities through elimination diets and IgG allergy testing has become a standard aspect to many health care providers integrative approach to patient care. This is being driven by the attention being paid to the role foods play in overall health and the interplay between spe- cific foods and peoples’ biochemical individuality.”
Another driver behind the growth in this category is a demand for the highest quality products, he added. “The nutritional supple- ment industry has become a major player in modern health care and the expectations for the highest degree of quality dictate the exclusion of any ingredients or allergens that may preclude a patient from taking a product.”
Because of the growing number of individuals experiencing symptoms to gluten proteins, consumers are becoming more aware of the ingredients they are ingesting, added Rachel Szpond, regulatory affairs coordinator with Florida-based Enzymedica, Inc., manufacturer of the Enzyme Science practitioner line. “Gluten-free products have become a popular choice for avoiding adverse reactions to gluten. In addition, enzyme supplementation provides digestive support for those with gluten intolerance by promoting optimal digestion and reducing digestive discomfort.”
Health & Food Sensitivity
Further explaining the categories of allergic reactions to foods and their symptoms, Dr. Killpartrick noted there are different types of autoimmune reactions, and that the best- known and well-studied form of food allergies is called a Type 1 immune reaction, also known as immediate-onset, IgE-mediated and/or atopic food allergies, also called “classic” food allergy. “A high propensity of people who suffer from Type 1 reactions are genetically predisposed, to where the immune system begins creating IgE to certain foods,” he explained. “Half of the IgE antibody will recognize and bind to the allergic food. The other half of the antibody attaches itself to a specialized immune cell packed with histamine, called the mast cell. The IgE antibody now only has to patiently wait for re-exposure to food allergens.”
Dr. Killpartrick added that when the aller- gic food is eaten the next time, IgE antibodies attack the antigen and immediately release histamine and other allergy-related chemicals from the mast cell causing such symptoms as: tingling or itching in the mouth; hives, itching or eczema; swelling of the lips, face, tongue and throat or other parts of the body; wheezing, nasal conges- tion or trouble breathing; abdominal pain, diarrhea, nausea or vomiting; dizziness, lightheadedness or fainting.
The most fatal Type 1 reaction is anaphylaxis, which is characterized by: constriction and tightening of airways; a swollen throat or the sensation of a lump in the throat that makes it difficult to breathe; shock, with a severe drop in blood pressure; rapid pulse; and dizziness, lightheadedness or loss of consciousness. Emergency treatment is critical for anaphylaxis, and if untreated, anaphylaxis can cause a coma or death.
Type 3 immune reactions are much more commonly involved in food reactions than Type 1 reactions, Dr. Killpartrick said. “Although an exact number has not been firmly established, it has been estimated that up to 60 to 80 million Americans suffer from clinically significant food reactions, most of whom do not make the connection between the foods they eat and the symptoms they experience.”
Dr. Killpartrick explained that like Type 1 allergies, Type 3 food reactions also involve the immune system by creating an over- abundance of IgG, IgA and IgM antibodies to a specific food. These antibodies, instead of attaching to mast cells like IgE antibodies in Type 1 allergies, bind directly to the food as it enters the bloodstream, forming varying sizes of circulating immune complexes.
These antibodies have the capacity to then target connective tissue. Since connective tis- sue is present in all muscles, joints, organs and arteries, these reactions can lead to inflammation and destruction to any system in the body.
The symptoms associated with Type 3 reactions are delayed in onset anywhere from hours to days. In fact, symptoms of migraine headaches can present up to 72 hours after consumption of a reactive food. Because of the widespread nature of this type of reaction, reactive foods have the capability to provoke more than 100 allergic symptoms and well beyond 150 different medical diseases.
Testing Sensitivities
Unlike allergy or food sensitivity, food intolerance is recognized as a digestive deficiency, noted Enzymedica’s Szpond. “Food intolerance is an abnormal physiological response to an ingested food or food additive. Because food intolerance does not involve the immune system, there is no test for a physician to perform for diagnosing intolerance to a specific food or food group.”
Food sensitivities can also be a challenge to identify due to the time lapse between ingestion and symptom onset. When it comes to isolating and identifying food aller- gies for a patient, elimination diets remain the gold standard, according to Dr. Killpartrick. “And despite being challenging for some patients, there is a dual benefit to elimination diets. The first is that the patient inevitably feels better as their symptoms tend to subside. The second is the identification of the specific foods that are causing symptoms.”
To perform the elimination diet, Dr. Killpartrick explained that after the elimination period, where duration can vary from three to six weeks and at least seven days without symptoms, each food (or food group) is challenged to determine whether it can be reintroduced into the diet. “Challenge one food or food group at recommended levels, eating for three days in a row. For example, if challenging dairy, have one glass of milk three times daily for three days, and document observations. [It] can take up to 48 hours for symptoms to occur. If symptoms occur, stop the challenge. Do not start the next challenge until you have had two full days free of symptoms.”
“Evaluating digestive symptoms while eliminating trigger foods from your diet, may be a good indicator whether you need Digestive assistance,” agreed Szpond. “While an elimination diet allows you to identi- fy a food- induced digestive reaction, reintroduction of eliminated foods provides verification of digestive sensitivity to foods. Supplementing the eliminated foods with enzymes validates the need for digestive support (food intolerance).”
Food Triggers
While it seems food allergies and sensitivities are on the rise, Michael A. Smith, MD, senior health scientist with Florida-based Life Extension, posed the question “Why?”
“Are we diagnosing them better, or is our food chain and soils contaminated with unnatural substances causing more problems? It’s probably a combination of both,” he said.
While there are many theories as to why food reactions are growing, top among the common culprits of distress-inducing sub- stances is gluten, consisting of gliadin and glutenin, the main protein complex of wheat, said Szpond. “In many cases, the body finds these proteins difficult to break down,” she said, adding that although primarily found in grains including wheat, barley, spelt and rye, gluten may also be present in medications, cosmetics and foods which have been cross-contaminated with gluten. “Undigested or partially digested proteins can affect a wide range of human cell functions, which may result in uncomfortable reactions to gluten-containing foods.”
Lactose intolerance is another condition affecting an increasing American population. “It is a condition caused by an insufficient amount of lactase necessary to digest lactose dairy sugar,” Szpond said. “When there is not enough lactase to digest the amount of lactose consumed, water is retained in the bowel, which results in bloating and diarrhea. Lactose that passes into the large intestine is fermented by bacteria, which produce carbon dioxide, hydro- gen and methane gas contributing to bloat- ing, cramping and flatulence.”
In addition, many individuals experience digestive discomfort when consuming a diet rich in fibrous food, such as raw vegetables and beans. “When undigested plant fiber remains in the colon it is fermented by intestinal microorganisms. As a result, impaired digestion of gas forming food may alter the body’s production of probiotics, yeast or bacteria,” Szpond continued, noting that symptoms of bean and vegetable intolerance include occasional gas, bloating and indigestion.
There are currently more than 140 different foods that have been identified as causes of allergic reactions, added Dr. Killpartrick. According to a recent report by the CDC, 90 percent of food allergies are associated with eight food types:
• Cow’s milk
• Hen’s eggs
• Peanuts
• Soy foods
• Wheat
• Fish
• Crustacean shellfish (such as shrimp, prawns, lobster and crab)
• Tree nuts (such as almonds, cashews,
Walnuts, pecans, pistachios, Brazil nuts, hazelnuts and chestnuts)
While common food allergies also come from proteins in seeds, nuts and fruits, Dr. Smith pointed out that almost any food can cause IgE response. “Food sensitivities can develop from just about any food we eat. The more you eat, the greater the chance of developing an IgG response and symptoms.”
Further, age plays a role in food allergies. “Younger kids tend to develop true food allergies more than adults,” Dr. Smith noted. “Kids with IgE responses to food will usually grow out of them with time. However, food sensitivity occurs mostly in adults. Eating your favorite food too much can lead to an IgG response and symptoms.”
Beginning to Heal
Once a food sensitivity is discovered, heal- ing can be complete, and the digestive sys- tem can return to a healthy state. “One just has to know which foods are causing the immune response and avoid them,” said Dr. Smith. “This really can only be [dis- covered] with testing. Additionally, consid- er supplements known to ease gut inflam- mation and heal the lining of gut— sup- plements like carnosine, zinc, licorice and an herb called Picrorhiza kurroa. Finally, improve your [patients] overall digestion with digestive enzymes and probiotics.”
He suggested avoiding a specific type of food or fiber if it causes problems. “Not everyone is gluten sensitive, so not every- one needs to go gluten-free. A rotation diet can be helpful. This is where one eats foods they love on a rotation basis— maybe eating it once every seven to 10 days.”
“Individuals with allergies and food sen Sitivities must avoid exposure to allergens in order to prevent an immune response,” agreed Szpond. But she recommends sup- plements to enjoy favorite—but intolera- ble—foods. “Since food intolerance does not involve the immune system, symptoms may subside by supplementing the diet with digestive enzymes. The popular solu- tion for food intolerance, such as gluten, is to follow a gluten-free diet, eliminating the offending proteins to reduce adverse reac- tions. Elimination diets may be effective in the short term, but once those foods are reintroduced, symptoms return. As a com- plement to a healthy diet, enzyme supple- mentation may assist and enhance the digestion of the offending foods.”
Enzyme Science offers The Identify System, which helps users in an elimina- tion diet pinpoint triggers, provides meal recommendations and evaluates intoler- ance symptoms, if any, to specific food causes. At the end of the program, the par- ticipant reintroduces their original ‘normal diet’ in combination with a unique diges- tive enzyme supplement (Intolerance Complex), which provides digestive sup- port for multiple food intolerances.
Dr. Killpartrick agreed that digestive enzyme-based formulations geared toward helping to break down gluten and dairy proteins are popular for those with digestive issues, but cautioned to use them sparingly. “The standardized dipeptidyl peptidase IV (DPP-IV) has demonstrated the capacity to degrade the immunodominant, proline- containing epitope of gliadin, the primary allergenic protein in gluten,” he said. “DPP- IV has also been shown to markedly enhance the gluten- and casein-degrading capacity of other proteolytic enzymes. From a practice perspective, these types of enzyme formulas do not eliminate the need to avoid these foods if there is a sensitivity to them, but rather provide added support to the digestive system should gluten or dairy be consumed in smaller quantities or acciden- tally.”
Additionally, there are products that sup- port a healthy inflammatory response, specifically in the gut. “A non-enhanced Absorptive form of turmeric works well to promote a healthy inflammatory response in the lower GI, which is critical for patients that suffer from food allergies and certainly those that suffer from leaky gut, a condition that can be negatively affected by food aller- gies,” Dr. Killpartrick said.
Glutamine and/or a combination of ala- nine/glutamine also works well to support the integrity of the lower intestinal system as well as the tight junctions that are so important when dealing with food allergies, he said.
Innate Response products that fall into these categories and would work well to support a healthy digestive system in the face of food allergies are Gluten & Dairy Ultra Shield Enzymes, Inflama-GI and the company’s GI Response.
Recent Advancements
Leading in the advancements for food sensi- tivity sufferers are testing methods. One is an at-home food sensitivity test offered by Life Extension called the Food Safe Test. Dr. Smith explained that the user eats their nor- mal diet and then performs a finger stick. The small amount of blood is applied to paper and sent to a lab that measures the level of IgG. A report comes back with three categories: red, yellow and green—red foods have a high IgG response, yellow moderate and green low.
“Eliminate the red and yellow foods for two weeks and then re-introduce one food at a time into your diet,” said Dr. Smith. “If symptoms develop with that specific food, eliminate it from your diet completely. If symptoms don’t develop, you can eat it on a rotation basis—included it in your diet every five or six days.”
In regard to IBS patients, recent years saw breakthroughs in IgG antibody testing (specifically IgG4) and the measured anti- body in the serum, said Dr. Killpartrick. “This study was interesting because it also demonstrated that patients that suffered with IBS symptoms displayed a negligible response to skin prick testing for the same foods being tested via IgG4 serum testing,” he said. “The IgG4 titres, however, were sig- nificantly higher for wheat, beef, pork and lamb in the IBS patients than for the con- trols. That to me, as a practitioner, demon- strates a more clinically relevant connection between the serum testing than the skin prick test and would more than likely lend itself to better dietary recommendations for an IBS patient to follow.”
References:
The Food Allergy and Anaphylaxis Network. FAAN Annual Report 2011. 2011. Www.foodallergy.org/page/annual-report
U. S. Census Bureau.State and County QuickFacts. Population, 2012 estimate. Retrieved January 28, 2013. Www.quickfacts.census.gov/qfd/states/00000.html
Li, James. M. D. Mayo Clinic. What’s the differ- ence between a food intolerance and food allergy? June 03, 2011. Retrieved from www.mayoclinic.com/health/food-allergy/AN01109
Wangen, Dr. Stephen. (2009). Healthier Without Wheat. 1st ed. Innate Health Publishing. Pg 85.
National Institutes of Health, National Institute of Child Health and Human Development. (2006). Lactose Intolerance: information for health care providers (NIH Publication No. 05-5305B).
Scand J Gastroenterol. 2005 Jul;40(7):8007.
Adverse Reactions
Innate Response’s Dr. Adam Killpartrick offered a staggering and wide-ranging list of potential symptoms of Type 3 reactions that could be causing patients distress:
• Abdominal Pains
• Aches and Pains
• Acne
• ADHD
• Anxiety
• Arthritis
• Asthma
• Autism
• Bloating
• Celiac Disease
• Chronic Fatigue
• Chronic Infections
• Constipation
• Depression
• Dizziness
• Eczema
• Enuresis (Bed Wetting)
• Fibromyalgia
• Fluid Retention
• GI Problems
• Hyperactivity
• IBS
• Itching
• Lethargy
• Loss of Appetite
• Migraine
• Nausea
• PMS
• Psoriasis
• Recurrent Ear Infection
• Recurrent Sinus Infections
• Rhinitis
• Sinusitis
• Skin Rashes
• Stomach Cramps
• Tension
• Urticaria
• Weight Gain
• Weight Loss
• Wheezing
¦ Statistics indicate that as much as 15 percent of the world’s population experiences intolerance to gluten pro- teins, and an estimated 30 to 50 mil- lion American adults are affected by lactose intolerance.
¦ Once a fixed food allergy has developed, allergic symptoms will occur every time one is exposed to the allergic food. Symptoms are not dependent upon the quantity of food eaten, and may occur from very small exposures.
¦ It is estimated that up to 60 to 80 million Americans suffer from clinical- ly significant food reactions, most of whom do not make the connection between the foods they eat and the symptoms they experience.
¦ Elimination diets remain the gold standard when it comes to isolating and identifying trigger foods.
¦ Leading the advancements for food sensitivity sufferers are testing methods, including at-home skin prick tests, and IgG antibody testing.
FOR MORE INFORMATION:
¦ Alletess Medical Laboratory, Inc.,(800) 225-5404; www.foodallergy.com
¦ American Academy of Allergy, Asthma & Immunology, www.aaaai.org
¦ Enzymedica, Inc., (888) 918-1118; www.enzymedica.com
¦ Enzyme Science, (855) 281-7246; www.enzyscience.com
¦ Food Allergy Research & Education, www.foodallergy.org
¦ Innate Response Formulas,(800) 634-6342; www.innateresponse.com
¦ Life Extension, (877) 354-6512; www.lef.org/lifeextension
