Tips, techniques and products to help your patients/clients navigate the tricky world of food allergies and intolerances.
Approximately 20 million people were living in the U.S. with food allergies as of 2021, according to the Asthma and Allergy Foundation of America (AAFA). This number has risen steadily in children over the past 20 years. While there is a distinction between food allergies and intolerances, many medical professionals remain puzzled as to what causes these issues.
Natural health practitioners frequently see cases of both food allergies and intolerances in their practices. And while the physical aspect is challenging to address, the mental and emotional toll on someone with food intolerances or food allergies is doubly so. Best practices for these individuals vary—as much as the patients themselves. Still, new technology, a better understanding of how to treat and manage food allergies and intolerances, and new products which may support people struggling with these continue to grow.
The Most Prevalent Food Allergies and Intolerances Now
Often, food allergies and food intolerances are lumped together. It’s important, though, to recognize the difference in these two groups, said Dr. Jacqueline Eghrari-Sabet, who serves as telehealth medical director for Allergy & Asthma Network in New York. These are very, very different disease states, said Dr. Eghrari-Sabet. A food allergy is a potentially life-threatening reaction to eating a specific food. Even small amounts and cross-contamination, she noted, can lead to severe consequences. In the U.S., the AAFA says foods to which individuals are most allergic include shellfish, milk, soy, peanuts, eggs, wheat, tree nuts, sesame and fish.
Daina Parent, ND is the naturopathic liaison at Standard Process, a manufacturing company based in Wisconsin. She stated that food allergies are known to elicit an immune-mediated reaction and that it’s recommended to avoid these foods altogether. “These reactions can become emergent and medical intervention could become necessary.”
Food intolerances, on the other hand, is the inability of the body to break down a certain food. Usually, this is due to a lack of an enzyme, said Dr. Eghrari-Sabet. “Symptoms are mainly GI (gastrointestinal) with cramps, diarrhea and sometimes headache. There are no respiratory or cardiovascular symptoms and no risk of death.”
Milk and peanuts are the most common allergens for children, while shellfish allergies are more common in adults. “Kids can also be allergic to egg, wheat and soy, but this is more common in infants,” Dr. Eghrari-Sabet explained. The most common food intolerance is lactose, but most individuals don’t see a doctor for this, choosing instead to simply avoid large quantities of cow’s milk products.
At Healing Arts NYC, in New York, Dr. Alicia Armitstead noted that the most common food allergies and intolerances the practice sees are wheat, eggs, peanuts and white refined sugar.
Becky Dattani is the director of professional sales for Enzyme Science, a manufacturer in Florida. She stated that a host of uncomfortable and sometimes even painful issues result from food intolerances. “Symptoms typically emerge within hours after eating and can manifest as bloating, cramps, diarrhea, indigestion, occasional gas, occasional heartburn and other digestive issues,” said Dattani. “To address these challenges, the body requires adequate supplies of digestive enzymes to completely digest food and absorb essential nutrients.” The company produces one type of digestive enzyme, Intolerance Complex, which Dattani stated helps to “bridge the gap and offer support when the body’s supplies fall short.”
What Causes Food Allergies and Food Intolerances?
Dr. Armitstead believes that there are several reasons so many Americans are dealing with both food allergies and intolerances now. “Food allergies and intolerances are growing because the quality of our food is getting worse. With food that is more processed and genetically modified, our body does not recognize it as food but as a toxin and that’s when we become allergic or intolerant to it,” Dr. Armitstead explained. “Food intolerances also happen if we eat the same food over and over again. The body has a difficult time digesting the same food every day.”
Another problem with food allergies and intolerances is that they can cause a great deal of inflammation in the gut, which in turn, may result in a condition called leaky gut. “When leaky gut develops, these food intolerances then literally leak out of the gut and into the bloodstream and can cause inflammation anywhere in the body,” she said. This can cause a host of problems. “If the inflammation settles in the head, then it can cause headaches. If inflammation settles in the sinuses, it can cause congestion,” she noted. “We are aware that this can be true for milk and cheese but other foods can cause this too. If inflammation settles on the nervous system we could feel anxiety, depression or have trouble sleeping.” If, however, it stays in the bloodstream, Dr. Armitstead said it could then cause high blood pressure. “Food intolerances or allergies can cause an array of symptoms throughout the body.”
Andrew Hollar is co-founder of the Fig App which helps individuals struggling with food allergies or food intolerances to navigate grocery stores and restaurants. He believes the basis for the surge in issues with certain ingredients likely stems from multiple factors. Though there are many theories, Hollar doesn’t believe anyone knows for sure.
“A prevalent theory involves changes to the compositions of our gut microbiomes. This is due to increased use of antibiotics, changes in food manufacturing and ingredients, and decreased exposure to the natural environment,” he stated. There was also a time when limiting babies’ early exposure to common allergens was thought to be beneficial. “We now know this is false—early exposure to allergens decreases the risk of developing food allergies—yet many people likely developed food allergies due to this relatively recent practice,” he explained.
Dr. Eghrari-Sabet noted that atopic march is likely to blame for food allergies. Atopic march, also called allergic march, begins with dry skin and eczema in babyhood. According to the AAFA, these skin conditions often develop into food allergies in the first few months or years and are typically followed by nasal allergies and asthma.
Food intolerances are a bit different, said Dr. Eghrari-Sabet. These are reported more often in the adult population and usually centralize on lactose and gluten intolerances, in her opinion.
Best Practices for Individuals Struggling with Food Allergies and Food Intolerances
Dr. Eghrari-Sabet noted that there is one rule for food allergies: strict avoidance. “This is a deadly disease. Carry epinephrine with you always. Ask questions about the food you eat outside of your home that you didn’t prepare.” Dr. Parent agreed, stating that she doesn’t know of any natural products which could assist someone who has a food allergy. Medical intervention is often necessary if an allergen is accidentally ingested.
With food intolerances, noted Dr. Eghrari-Sabet, it’s also wise to avoid the foods that cause trouble—but the consequences for not doing so aren’t so dire. “Food intolerances will cause mainly GI symptoms which are unpleasant and painful [such as] abdominal pain.” If lactose intolerance is an issue, adding a lactase enzyme to one’s eating regime is a good idea as these help break down milk for digestion. “However, you need to use enough enzyme for the amount of dairy you ingest,” noted Dr. Eghrari-Sabet.
Dr. Parent noted that other nondigestive issues are common with food intolerances. These include skin rashes, joint pain, acne, fatigue, mood changes and headaches, among others. There are often misconceptions regarding the differences between a true food allergy and intolerance. Onset is a good place to look first, she noted. “… true food allergies usually have a sudden onset and food intolerances may have a delayed onset. Sources of food allergies should be avoided, while sources of food intolerance may have a place in the diet with the help of supplemental digestive enzymes.”
At Healing Arts NYC, Dr. Armitstead recommends that clients take three simple steps: rotate food, eat real food and take specific supplements that may help their systems. “Rotate your food once every three days,” noted Dr. Armitstead. Plan on having three different breakfasts, lunches and dinners, and rotating through those meals, she said. Next, choose unpackaged when it comes to meals and snacks. “Eat whole foods, nothing packaged or processed, real fruit, vegetables, meat. It’s even more nutritious if it’s local and in season,” she noted. “This way the food has more nutritional value.”
Lastly, Dr. Armitstead recommends that patients support their systems with supplements. However, they should look carefully at these before purchasing. “Take digestive supplements that come from whole foods. Your body will use a supplement made from food rather than in the laboratory,” she said. And finally, “Take digestive enzymes at every meal to help you digest and heal the gut.”
Dr. Parent recommends a similar approach with slight differences. Digestive enzymes, whole food ingredients to support healthy digestion and glutamine supplementation. Glutamine, said Dr. Parent, acts as a building block for other amino acids in the body. While digestive enzymes may be a good choice, Dr. Parent recommends individuals look for key ingredients in these, including pancreatin, bromelain, amylase, lipase and lactase. “While there are many other supplement ingredients known to act as digestive enzymes, these are just a few key players,” she said.
“Standard Process has two products that contain digestive enzymes that may be useful for supporting healthy digestion and nutrient absorption. Enzycore contains digestive enzymes, glutamine and whole-food ingredients. Enzymes break down macronutrients, and glutamine is used as a building block for other amino acids. Whole food ingredients such as kale and beet powder are included to support healthy digestion,” Dr. Parent explained. “Multizyme contains digestive enzymes that support the normal breakdown of macronutrients and general support of digestion.”
For dairy intolerances, Dr. Eghrari-Sabet suggests digestive enzymes as well, specifically a lactose enzyme with milk. This alone often improves the digestion of milk products, she noted.
At Enzyme Science, Dattani stated that “Supplementing with digestive enzymes helps counteract incomplete digestion—and prevent the symptoms associated with enzyme insufficiency.” She explained that when individuals choose a product like the company’s Intolerance Complex, they’re able to put their favorite foods back on their plates.
More Than Just a Physical Strain
One key thing that can be overlooked in dealing with food allergies and intolerances is how challenging and isolating it can be. Hollar noted that while it may seem that someone with one of these issues is alone, chances are they aren’t. He stated that more than 60 percent of the population in the U.S. lives with dietary restrictions. Surprised by that high number? It helps to look at what type of restrictions the 2014 Harris Poll that Hollar cited includes—everything from high-fiber diets to low-salt and sugar diets, and many others.
“At first, that number seemed really high to us, but once we started considering all of the different dietary restrictions that exist, it became much more plausible. For instance, roughly 32 million Americans live with food allergies per FARE. The CDC (Centers for Disease Control and Prevention) found 15 to 20 percent of the population are on a special diet on a given day,” he noted. These, if you look at the charts Hollar explained, include diets for diabetes, hypertension and more. “Estimates vary but anywhere from 15-25 percent of Americans follow a gluten-free diet.
Additionally, individuals who have a lactose intolerance, vegans, vegetarians and pescatarians, those who follow a paleo diet or one to help ease IBS (irritable bowel syndrome) or IBD (inflammatory bowel disease) symptoms—like a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) or Specific Carbohydrate diet are included, among many others.
Of that larger 60 percent group, Hollar stated 10 to 20 percent of individuals experience restrictions that can greatly diminish their quality of life or even be life-threatening. “This means many of your family, friends, co-workers and neighbors are struggling to navigate food, often in silence,” he said. Because we generally eat three times a day, individuals struggling with food intolerances or allergies can spend a good portion of their time worrying—about where to get their next meal and how to navigate that process, explained Hollar. “Visiting restaurants, attending social events and going on vacation are significant sources of stress. For many people with restrictions, it’s easier to avoid social interactions entirely, which can be incredibly isolating.”
That is one of the key reasons Hollar and his team created the Fig app. Once an individual has entered the type of diet(s) followed, the app shows thousands of food options. It can be used at more than 100 grocery stores and restaurants in the United States.
Testing for Food Allergies and Food Intolerances
When someone suspects they have a food allergy or intolerance, what is the best course of action? If a food allergy is suspected, it’s important to work with a qualified health care provider. According to the American College of Allergy, Asthma, & Immunology (ACAAI), an allergist may recommend testing via skin or blood tests to determine if a food allergy is present. Dr. Eghrari-Sabet believes that food allergy lab tests have become much more specific in the past 20 years. “I would suggest Immunocap IgE testing for foods, with component testing where possible,” she noted. “Other older testing is still available, but not nearly as specific, and hence not as helpful.”
Food intolerances are a different matter. A simple Google search results in many articles and news stories that report at-home testing kits for food intolerances aren’t backed by scientific evidence. Some individuals, however, believe these tests to be useful and may help to offer insight into their food intolerance issues. Dr. Armitstead does not refer patients for lab tests for food intolerances.
Dr. Eghrari-Sabet recommends taking a different route for food intolerances than for food allergies. She encourages her patients to try an elimination diet. “Eliminate one food at a time—so just cow’s milk products, or just gluten products—if your symptoms improve, it is wise to keep these foods out of your diet,” she said. “If the symptoms recur when you add them to the diet, again you are best to leave these out of the diet.” If someone really misses cow’s milk and dairy products, she offers another option. “You can also try adding the lactose enzyme with milk products and see if this improves your abdominal symptoms.”
While food allergies and food intolerances are tricky issues to manage, with the help of knowledgeable natural health professionals, there is hope for those who suffer. Hollar has first-hand experience with this—going from feeling hopeless to healing significantly in a short period of time. Hollar stated that he became sick with GI symptoms, itching and brain fog in 2014. It took three years and more than 20 doctors to finally get the answers he was looking for. “In 2017, a functional medicine doctor finally suggested that food might be triggering my symptoms. Within a few weeks of starting a very restrictive medical diet, 90 percent of my IBS symptoms had disappeared,” Hollar said. “It made me a believer in the power of food. It also inspired me to help others looking for answers.”
Healthy Take Aways
• Approximately 20 million people were living in the U.S. with food allergies as of 2021.
• There is a distinct difference between a food allergy—which can result in death—and a food intolerance, which usually causes discomfort.
• Digestive enzymes can be very helpful in treating food intolerances.
• It’s estimated that 60 percent of the U.S. population follows a restrictive diet of some type.
• Of that 60 percent, 10 to 20 percent of the population in the States finds that their restrictive diets impede their quality of life.
For More Information:
Allergy & Asthma Network, https://allergyasthmanetwork.org/
Enzyme Science, https://enzyscience.com/
Healing Arts NYC, www.healingartsnyc.com
Standard Process, www.standardprocess.com