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Go With Your Gut The 411 on Food Sensitivities

By | October 16, 2019
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When was the last time every person at a restaurant table ordered straight off the menu without a single “no dairy” or “no gluten” request? It’s been a while, hasn’t it?

The culinary status quo involves new rules that are chock-full of dietary restrictions. If it’s not a wheat-free, milk-free nutrition plan everyone is following, it involves no nuts, no sugar, or even full-on vegan.

Often, the restriction is a personal preference that has nothing to do with an actual food intolerance. Occasionally, it’s a misinterpreted gut response. Once in a great while, it’s the real deal.

“Some 15% of U.S. adults say they have at least mild allergies to one or more foods and another 17% have intolerances to foods,” according to a 2016 Pew Research Center survey.

However, a belief about an intolerance can be very different from the scientific reality. In 2017, researchers from Harvard Medical School and other institutions analyzed more than 2 million health records and discovered that only 3.6 percent of adults had documented food intolerances or allergies.

In other words, many people who think they have food sensitivities are actually wrong. Without a thorough allergy screening from a medical professional, it’s difficult to be certain—and even then, it’s not foolproof.

Doctors can diagnose food allergies with blood tests or skin pricks, but the results do not necessarily indicate full-on allergies. About 30 to 40 percent of these reports yield false positives, according to Andres Alvarez Pinzon, PhD, clinical research manager at Stanford University’s Sean N. Parker Center for Allergy & Asthma Research. Food allergies are exceedingly rare, especially for adults (and kids tend to grow out of their allergies, too).

Upwards of 170 ingredients can trigger allergies—typically milk, peanuts, tree nuts, eggs, soy, wheat, fish and shellfish (and occasionally spices and meat). When humans are exposed to foods they are truly allergic to, their immune systems forcefully attack the ingredients. The response to the foods can be mild (like a local rash) or life-threatening (like an anaphylactic reaction).

Celiac disease—an autoimmune ailment caused by a reaction to gluten (a protein found in wheat, rye, barley and malt)—has become a fairly well-known problem. Because the symptoms are so varied, the Celiac Disease Foundation estimates that 2.5 million Americans have the affliction but are unaware of it.

For sufferers, eating gluten causes the immune system to attack the small intestine, causing damage to the intestinal lining. Symptoms can include blistery rashes, stomach pains, gas, joint discomfort, depression and migraines. A blood test, endoscopy or biopsy can pinpoint the disease.

Certain carbohydrates can also be a killer for people with Irritable Bowel Syndrome (IBS), a condition that is characterized by bloating, gas, and diarrhea. At least half of IBS patients feel relief when they avoid short-chain carbs known as fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs).

The majority of people with FODMAP sensitivities are only having reactions to small amounts of FODMAPs. So doctors will put sufferers on diets that are low in all of the FODMAPs—omitting various foods, such as garlic, onions, beans, wheat, dairy and particular types of fruit—and then slowly adding FODMAP sources back into the diet, one by one, to see which ingredients are causing the digestive problems.

In addition to people with celiac disease, IBS, and other random food sensitivities, about 65 percent of adults are lactose intolerant. These individuals do not produce lactase, an enzyme that is essential for breaking down the dairy sugar lactose. When lactose goes undigested, bloating, gas, and diarrhea can follow. To combat this, over-the- counter pills like Lactaid provide the missing enzyme and can be taken before consuming dairy products. Intolerance is one thing, but fewer than 1 percent of adults suffer from true milk allergies (which can cause anaphylaxis and hives).

Food-specific issues, in general, can ultimately be mysterious to both sufferers and scientists. Dozens of compounds exist in any type of food, and one person’s gastrointestinal system may respond to an ingredient completely differently than another person’s. Depending on the food, its form (liquid or solid), the time it is consumed, and a host of other factors, a digestive issue can present itself that stumps the physician (and leads to a lengthy process of elimination that may or may not have an endpoint).

Have an intestinal instinct about a food that isn’t sitting well? Upend that diet. And if that’s not enough, dial the doctor.

Ask yourself, “What is my gut trying to tell me?” Then listen up.

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