Diet for Allergies & Intolerances
by Sue Kira, Naturopath & Clinical Nutritionist
More about Allergies and Intolerances
– What is the difference between a food allergy, food intolerance or food sensitivity?
– Common signs and symptoms of food allergy
– Common signs and symptoms of food intolerance
– Common signs and symptoms of food chemical sensitivities
– Food allergy testing or an elimination diet?
– Types of allergy and intolerance testing
– Blood IgA, IgE and IgG immunological testing for allergies
– Skin prick and patch testing
– Cross-reactive foods
– Pulse testing for reactive foods
Over the years many people have come to my clinic to see if they have an allergy, or an intolerance to food(s) that may be causing their symptoms.
Symptoms are often varied, such as headaches, rashes, runny nose, skin complaints, bloating, other digestive complaints, fatigue – to mention a few.
This is a big area of concern as more people seem to be getting allergies. Have you noticed that kids cannot take products containing nuts to school, and there are more restaurants, cafes and supermarkets stocking gluten free and dairy free food options?
So what’s going on? Perhaps it’s because food is not what it used to be because of genetic engineering and modifications of food substances. Or maybe our digestive and immune systems are weakening due to extra chemicals in the environment and poor diets. Or is it because of poor lifestyle habits and the extra stresses in an electronic, economically challenged world.
I know from clinical experience, that when someone heals their gut, supports their immune system, has a healthy diet and a good lifestyle, then many of their sensitivities can go away.
Did you know that approximately 80% of our immune system is in the gut? So a proper analysis is very important to find the reason why you have a food reaction or symptoms that make you suspicious that you have an allergy.
When you know the reason, appropriate corrections can be made, such as avoiding the offending substances – at least while your gut and immune system is healing.
The foods considered to be the top 10 most reactive are:
– Dairy: some react to the casein and others, the lactose
– Gluten containing foods: especially wheat
– Peanuts (legumes)
– Tree nuts
– Eggs: can be the whites or yolk
– Citrus: commonly oranges and lemons are the most reactive
– Soy products: it may be the soy or the gluten in the soy sauce
– Fish and/or seafood
– Sesame seeds
– Corn derived products
You may have seen product labels, especially vitamin supplements with the words – ‘does not contain any gluten, dairy, soy, nuts, corn, sesame or eggs’. These are generally the worst offenders, especially gluten.
With food intolerances and allergies, there are many different factors that can make it difficult for you to determine what your body doesn’t like, let alone what foods to avoid – which could leave you with little to eat.
There are often underlying issues with your gut or immune system that may need addressing with your health practitioner, but a low reactive diet (which doesn’t have to be boring) is important to support your body while you work on those issues.
Even if there are no intolerances or allergies, you can initially give your immune system a helping hand by taking out some of the reactive foods that may be placing an extra burden on your immune system.
However, it may be unwise to stay on this diet for prolonged periods because you may miss out on valuable nutrients, unless your doctor or health practitioner has suggested that you should do so, particularly with more chronic conditions.
Apart from the 10 most reactive foods, listed above, if you know you have a sensitivity to other potentially reactive foods or food chemical sensitivities, such as histamine, salicylates, amines or glutamates then you may also need to eliminate those from your diet.
Note: During the early stages of your diet, you may experience symptoms such as fatigue, headaches or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.
Some food allergies can be severe, causing life-threatening reactions known as anaphylaxis. Some people can have allergies to other foods not listed in this article, so a Low Reactive Diet does not ensure you will be eating allergy free, although you will be eliminating the most common reactive foods. Do do not eat any foods that you have previously reacted to, even if they are on the ‘safe’ list. See your doctor or allergist about food reactions you have and don’t use this diet as a soul course of treatment.
This case study shows how a low reactive diet challenge had a profound affect on a young boy’s behaviour.
From my many years of experience in clinic I could write a book about the profound differences made by thousands of my clients who changed their diet to foods that suited their bodies. Here’s one to share with you…
A five-year-old boy had massive shifts in his behaviour. One day he would be ‘off the wall crazy’ and the next day he would be sweet as an angel. His mum couldn’t understand it. Doctors’ blood tests showed normal. She had been to a child behaviour specialist; in one session he would be an angel and in another session, he could not be controlled and wouldn’t listen or sit still.
Fortunately for me (and my clinic space) he was having a ‘good day’ when he saw me. But clever mum showed me a phone video of what he was like on those ‘other’ days so I could see what she was going through.
I asked her about his favourite foods, because people will often crave and eat lots of the very things they shouldn’t have. She said, “that’s easy, all he will drink is milk with chocolate drink powder and eat cheese, chicken nuggets, sausages, potatoes and raw beans. He pretty much eats the same foods every day but his behaviour is different day-to-day”.
My first thoughts were that it must be the dairy products, as this is quite common, but I discovered on different days they used two different brands of chicken nuggets (one with additives and one with no additives). Also he had two different chocolate drink powders he liked and so the reaction only came with a particular mix of the two things.
It appeared that it was about combinations of the additives in the chicken nuggets and the chocolate drink mix.
The only way we could find out was by trying different combinations and monitoring his behaviour. We used a core diet that excluded additives of every type. I wanted to take out the milk first but mum said that he could go for days drinking milk and eating cheese and be fine so we left the milk products in to start with.
His behaviour improved and after a few weeks of good behaviour he started to complain of tummy pains. On questioning the child, it seemed that he had always had these pains but it wasn’t so obvious when all the focus was on his behaviour.
So we talked together and it was actually the boy who said he thought it might be milk. I think he had been carefully listening to what we had been talking about and started to listen to his own body. He wasn’t too worried about giving up dairy milk when we found a delicious coconut milk and added raw cacao powder and sweetened it slightly with rice malt syrup, which agreed very well with his little tummy.
Later, he decided that he didn’t want chicken nuggets anymore and was going to eat ‘big person’ chicken meat instead, which was great as he was then having less gluten and starch from the coating, which he said was also better for his tummy.
A clever boy, who not only felt better with his food choices, but also listened to his body and was the first to say when he wasn’t going to eat something that didn’t suit him.
What is the difference between a food allergy, food intolerance or food sensitivity?
While allergies, intolerances and sensitivities may have similar symptoms, it’s important to understand the difference between them. So just what is the difference? Basically:
– an allergen is an immunological reaction
– an intolerance usually relates to food that the body has difficulty digesting and assimilating and therefore is unable to use correctly, so it becomes toxic to the body, often fermenting and causing reactions
– a sensitivity is a chemical reaction to certain chemicals in foods such as salycilates, glutamates (think MSG), histamines etc.
The chemical reactions from food sensitivities can often be removed by healing ‘leaky gut’ issues and the same can be said for some food intolerances.
However with allergies there has been an immune system engagement where the body recognises a substance to be very dangerous and the body will react stronger with each use in most cases. There are cases of ‘healing’ from these allergies or the body ‘getting used to them’ but in truth this is rare and caution is necessary.
Common signs and symptoms of food allergy
– Tingling or itching in the mouth, especially the roof of mouth or throat
– Hives, itching or eczema
– Swelling of the lips, face, tongue and throat or other parts of the body
– Wheezing, nasal congestion or trouble breathing, asthma
– Abdominal pain, diarrhoea, nausea or vomiting
– Dizziness, light headedness or fainting
Common signs and symptoms of food intolerance
– Headaches, light headedness
– Runny, itching, burning and swelling around mouth nose or eyes
– Skin complaints including rashes, but also hives, eczema, psoriasis etc
– Nausea, vomiting, bloating, diarrhoea, constipation, cramping
– Fatigue, especially after eating, but can be generalised
Common signs and symptoms of food chemical sensitivities
– Behavioural changes
– Sudden outbursts of anger or emotional & teary
– Can get any of the symptoms similar to food intolerances and allergies
As you can see the groups are similar, but the allergy group has more potential to be life-threatening, especially with prolonged use of the food or reactive substance.
Food allergy testing or an elimination diet?
Allergy testing can be expensive and even unreliable, particularly when uncertain if the reaction is an allergy, intolerance or sensitivity. Despite the multitude of available food allergy tests, the elimination diet remains the gold standard for identifying food sensitivities.
As with all tests, the elimination diet can have its flaws, but at least it is inexpensive, relatively easy to do and you experience the results first-hand. This can be a more powerful stimulus for dietary changes than lab testing.
Types of allergy and intolerance testing
Having said that an elimination diet might be the better option to determine food issues, there are times when the tests can be useful. To determine this, you may need help from your practitioner to decide which test will be most appropriate for your symptoms.
To understand a little about the complexity of these tests, I will give a brief overview of the different types of immunological (via blood) tests that can be done.
When I say immunological, I am speaking of the immune system’s reaction to certain substances. Sometimes a reaction can be a combination of airborne and ingested substances.
Or if you have what is termed ‘leaky gut syndrome’ then you may react to more foods while that condition is present, and when the gut has healed, you can then tolerate some of the foods you previously reacted to.
Even if you are given a list of foods to avoid or if in fact, nothing shows up on the results, it does not mean that you don’t have sensitivity towards certain foods or substances. This may occur because of an accumulation of certain foods that take you over the threshold of tolerance.
Let’s say you test for a mild reaction to chocolate, eggs, wheat, milk, strawberries and mint. If you have any of these substances individually you may not have an issue. But if you had pavlova with choc topping and wafers and a peppermint tea later, then the combo could present problems.
But even if you don’t test reactive to gluten and dairy products, but are reactive to others, I suggest to omit gluten and dairy for the duration of the required healing process as these foods place an extra burden on the immune system.
Blood IgA, IgE and IgG immunological testing for allergies
Now let’s look at the blood test options that are available for reactions to substances we consume or inhale.
There are three main immunological tests done via blood: IgA, IgE and IgG, which are all immunological antibody reactions to defend against what enters our body.
These are produced in the greatest quantity in a day. It is one of the most important antibodies as it is the body’s first line of defence against viruses and bacteria. Levels of IgA antibodies with specific foods may rise when the lining of the intestinal tract becomes inflamed or damaged.
Elevated IgA to specific foods can be a sign of damage to the mucous membranes in the gut. Individuals with Crohn’s disease or ulcerative colitis, or even those with suspected leaky gut, may benefit from tests for IgA food reactions. Sometimes a doctor may test to see if you have elevated IgA and if the reading is high, then further tests against specific foods is a good idea.
IgE food allergy
These reactions are essentially immediate reactions that will occur within a few minutes to a few hours (compared to IgG reactions that can take a few days). Immediate reactions are caused by an allergen-specific immunoglobulin E (IgE) antibody that floats around in the blood stream.
IgE-mediated food allergies
These cause your immune system to react abnormally when exposed to one or more specific foods. Some of the common foods that people have an IgE-mediated reaction to are nuts, milk and eggs. You may notice reactions as soon as you eat these foods unless masked by other symptoms or reactions.
IgG (immunoglobulin G)
IgG testing is regarded more as an intolerance test rather than an allergen test because the body gives a more delayed response to the ingested food.
It is still a reaction in the body and this testing can be a useful guide for structuring an elimination diet for many chronic health conditions. The foods that cause these delayed reactions are often hard to diagnose because of the time between consumption and reaction. Generally, an IgG reaction occurs hours to days after exposure to these food antigens.
– IgA shows us what is creating inflammation in the body
– IgE gives us more immediate reactions to foods and substances
– IgG shows us the more delayed responses to foods
We can have a combination of factors and reactions occurring. I like to remember the different types by the letters: A = Aggravates (inflames); E= emergencies (fast reaction); G= general and hard to work out reactions. It’s not as if you need to know these different types as it’s better to get help from a practitioner.
Skin prick and patch testing for allergies
Patch testing is useful for testing for allergic contact dermatitis, often triggered by metal, cosmetic preservatives or various plants. These tests are performed by an ‘allergist’ or immunologist.
Using hypoallergenic tape, commercial standardised allergen paste is applied to a rash-free area of skin, most commonly the individual’s back. The tapes are left in place for 48 hours and kept dry for the entire time. The test site is then read at different time intervals. An eczema-like rash can indicate sensitivity to a specific contact allergen.
This testing is not suitable for food testing, but having said that, when my son was a baby he would get a red rash around his mouth and other parts of his face when he ate certain foods like tomatoes and avocados, particularly as the food would be smeared all over his face due to his eating style. So I delayed him from eating these foods for a few months and then he was fine eating them.
As a child, I remember getting little blisters in my mouth from eating take away foods such as hot dog sausages or ‘Chicko Rolls’ – cooked cabbage and other vegies wrapped in a ‘pastry’ and deep-fried (then I enjoyed them – now I say ‘yuk’).
These examples tell us that we can get some ‘contact’ type reactions to foods. It’s another way your body tells you that this is not right for you.
Skin prick testing
Skin prick testing is performed on a person’s forearm or back by an immunologist. The skin is first cleaned with alcohol and marked with numbers corresponding to the allergens. Using a sterile lancet, a small prick is made into the skin through which a drop of allergen extract enters the skin adjacent to the number.
If you are allergic to the tested allergen, a small itchy lump (wheal) surrounded by a red flare will appear within 15-20 minutes.
Skin prick testing is performed by health professionals who have been trained in the procedure and know how to interpret the results. A doctor may select the allergens, interpret the results and deal with any allergic reaction that might occur.
Skin prick testing has no value in the investigation of suspected reactions to aspirin, food additives or respiratory irritants such as smoke or perfumes. The testing is very good at picking up allergens to substances such as grass, pollens, animal furs and dander, dust, and bites from dust mites, bees and mosquitoes. It is also used to check foods, but not as reliable as the blood immunoglobulin tests discussed earlier.
If you follow a diet where you removed foods that you tested reactive to, but still suffer from allergy symptoms, then there is a possibility that your body reacted to other foods with similar proteins. This is called ‘cross-reactivity’.
For example, if you have a sensitivity to gluten, your body may also react to other non-gluten foods such as cheese, chocolate and coffee, that contain proteins so similar to gluten that your body confuses them with gluten. When you eat these foods, your body and immune system react as if you ate a bowl of wheat pasta.
It is estimated that at least 50% of people with gluten sensitivity are also sensitive to dairy (cheese, yogurt, milk and butter) due to its cross-reactivity with gluten.
Below is a list of common foods that cross-react with gluten:
– Dairy i.e. milk and cheese (alpha-casein, beta-casein, casomorphin, butyrophilin, whey protein)
– Polished wheat (often thought to be gluten free due to processing)
– Spelt (does have small amount of gluten in it too)
If you are gluten-intolerant and still having health issues even after removing gluten from your diet, try eliminating the above foods for at least two months and see if your symptoms improve. Also, ensure you have healed your gut with the help of a natural health practitioner.
After two months, you may wish to reintroduce the above foods, one at a time, to determine which are causing cross-reactions – if any (which could be the result of healing).
Laboratory tests for allergies and intolerances will usually provide a list of possible cross-reactive foods to explore. You may find that some of these will need to be permanently avoided. Even though the cross-reactive foods do not contain gluten, your body ‘thinks’ they do and therefore the inflammation and damage to your body is equal to that of gluten.
This section has only considered the possible cross-reactive foods to gluten, but all food allergies can have potential cross-reactive foods, so please check with whoever does your tests for a list of foods that could be cross reactive to your allergies and intolerances. The best way to check for cross reactive foods is with an elimination diet.
Pulse testing for reactive foods
Another way to check for food intolerances and allergies is through pulse testing. The foundation of the test is based on measurement of your resting pulse rate. This is the rate at which the heart beats after you have been sitting still and relaxed for three to five minutes.
Pulse testing needs a few days of preparation. It requires elimination of any possible reactive substances from the diet for three days, such as the high reactive foods listed in ‘The top 10 most reactive foods’ (point No 2) near the beginning of this article, or any other suspicious foods or food chemicals that you suspect may be an issue.
Before and during the three days check your resting pulse rate for one minute immediately after sleeping and record the reading. Check your resting pulse at various other times throughout the day if fasting, and an hour after eating your normal meal. Make sure it’s always a resting pulse.
Record your results. There shouldn’t be much of a variation in these readings. A healthy normal resting pulse might be around 60-80 beats per minute (60 is healthier).
If your resting pulse is quite high (above 80) then you may need to stay on the low reactive foods longer than a few days. Keep checking your pulse daily until it settles to a ‘normal’ level. This may take weeks for some, and be aware that you may still be eating something that is not on the ‘list’ that doesn’t agree with you, or you have a health condition that needs addressing first. If unsure please check with your health practitioner.
Now begins the challenge. Once your pulse has settled to normal, then on subsequent days, take your resting pulse on waking and then eat a modest quantity of a single food you have eliminated. Check your resting pulse an hour and a half after eating.
If any food raises the pulse by 12 beats per minute, it indicates you have a reactive substance in your body. The higher the difference in the pulse rate, the higher the sensitivity (some foods can cause the pulse to double). If there is no reaction you can try other foods later and throughout the day. If you get a reaction don’t try another food until your pulse goes back to normal.
You may find initially that you get a reaction to almost everything you test. This means that your liver, gut and immune system are stressed and you may need to be on the low reactive foods for much longer than a few days.
Some people can take weeks to clear the build-up of specific foods. With my clients who have used this method, some can take two weeks to settle down from dairy and up to two years with gluten foods. Some can never go back to the foods they once loved as they stay reactive.
There is a proviso that if you become stressed or emotional between pulse testing, the readings can be affected as your pulse may rise. When I refer to a resting pulse rate, that means all readings are done at consistent resting states.
Note: There are several allergy testing methods considered to be ‘unproven’, which means they have not been scientifically validated. These include cytotoxic food testing, kinesiology, vega testing, other electrodermal testing, reflexology, hair analysis and pulse testing.
Although I have described pulse testing, please note that there is no scientific validation of its accuracy. I include it as a possible helpful tool, particularly if you feel you have had a reaction to a food or substance soon after eating it.
As an example of pulse testing, I once went to a restaurant and ate an entrée of seared seafood scallops. Seared meant that they were essentially raw inside and browned on the outside. I felt a reaction and because it was the only thing I had eaten, there was no mistake when I felt my pulse rise.
I could feel my pulse pumping heavily throughout my head. I checked it and it was raging at 150 beats per minute as if I had just run quickly around the block. But I was quite relaxed (apart from checking out the hot looking waiter – only joking).
My normal resting pulse is normally around 60 beats per minute. It felt like I was having an anxiety attack but luckily I knew better.
After an hour it settled, but I wanted to test it again another time as I loved scallops. The next time I ate them was at home after cooking them fully and I was fine. I ate the seared version at another restaurant and again no reaction, which I repeated at another restaurant. So I went back to the original restaurant for the seared scallops and had the reaction again.
Around this time, a client saw me with a problem rash that stopped in a distinct line part way up both arms. She didn’t know why she had the rash. I asked about her work, because her rash was like a contact type allergic reaction I had previously when I trimmed native bushes in my yard.
She told me that she worked in a local fish shop and had to dip the fresh fish into a bucket of clear liquid before putting the fish on the display shelves. She wore short gloves which were pretty useless, because most of the time she dipped the long fish slices deeper than the length of the gloves.
I asked her to find out what was in the bucket and she discovered it was a product called sodium meta-bi-sulphide, a preservative and anti-oxidant used in foods to slow the oxidisation process and keep it looking fresh. This preservative is usually destroyed by the action of cooking.
Sodium meta-bi-sulphide (food additive number E223) is sometimes used on raw meat to keep it pink, on fish and I have heard that it has been used in cakes in supermarkets and even lightly sprayed on salads and chopped fruit in delicatessens and salad bars. Apart from allergic reactions it can induce asthma attacks.
With a bit of detective work I discovered that the same fish shop supplied the restaurant where I had the reactions. Because the preservative is usually destroyed by the action of cooking, my reactions were probably due to eating seared scallops that were only partly cooked.
So my reaction was to the chemical and not the food. If you get a rapid pulse change after eating, it’s a great indicator that something you consumed is not right for your body, whether chemical or food induced.
As a side note, ironically I used to buy fish for my cat from the fish shop where my client worked, but the cat wouldn’t eat it, he would just sniff and walk away. He would only eat fish from the Fish Coop, where I discovered, sodium meta-bi-sulphide is never used. Goes to show that cats know best!
Not all behaviour issues are from food intolerances as there can be many other factors.
I have seen kids with very low zinc levels which created behavioural problems. This occurred because they also had high levels of copper which may have been passed on in utero from use of the ‘pill’ by mum (which can increase copper).
Copper competes with and depletes zinc. Without an adequate supply of zinc in the body, food just doesn’t taste right and kids often won’t eat nutritious foods. Instead they are drawn to eat junk food as the high salt and sugar content is all they can taste. The result? Cranky, irrational and moody behaviour.
But that’s another story.