Demystifying Food Reactions

FIND AND ADDRESS

YOUR PERSONAL
FOOD TRIGGERS
by HEALTHMEANS
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Packed with nutrients, food has the power to nourish and heal us. But when it disagrees with our bodies,
the result can be just the opposite – pain, fatigue, digestive issues and more.

Even if you think you’re eating a clean diet, you may be sensitive to foods otherwise considered healthy.
Remember, every body is different.

That’s why it’s essential to understand food allergies, sensitivities and intolerances, and other food reactions,
to find your personal triggers. What are the differences and how do you identify offending foods?

Let’s break it down.

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CONTENTS
4 Food Allergies
5 Food Sensitivities and Intolerances
6 Common Triggers
Gluten
9 Dairy
10 Nightshades
11 Oxalates
12 Histamines
13 FODMAPs
14 Uncover Possible Culprits
16 Heal Your Gut
17 Can you Reverse Reactions?
Summary
19 References
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FOOD ALLERGIES
We’ve all heard that food allergies are on the rise. In fact, evidence does show that anaphylactic allergic
reactions seem to be increasing [1]. These days, food allergies impact about four-to-seven percent of
children and about one-to-two percent of adults [2].

A true food allergy will trigger symptoms immediately or up to a couple of hours after eating. Those can
be anything from hives to wheezing to vomiting, or as serious as life-threatening anaphylaxis requiring
treatment with epinephrine.

With an allergy, IgE (immunoglobulin E) antibodies lead to activation of mast cells and the release of
histamine and other chemicals that make up an allergic response.

While any food may be an allergen for someone, the most common food allergens are cow’s milk, soy,
wheat, peanut, tree nuts, shellfish, fish and egg. The good news is, allergies may decrease over time, at
least in children [3].
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FOOD SENSITIVITIES
AND INTOLERANCES
A greater percentage of the population has sensitivities or intolerances to certain foods. Food sensitivities
may produce immunoglobulin A and G (IgA and IgG) reactions. In the case of IgG and IgA reactions, the
immune system produces IgG and IgA antibodies – potentially leading to inflammatory processes.

These types of reactions don’t happen immediately, making it tough to tie them to specific foods. In fact,
symptoms may come on up to 72 hours after exposure to a food trigger. A food sensitivity may elicit
anything from allergy-like symptoms such as rashes and asthma, as well as cramps, constipation, diarrhea,
headaches, brain fog, migraines and more [4].

It’s possible that people may have IgG or IgA sensitivities for years and never realize it as they may not
connect a food with seemingly unrelated symptoms.

Such sensitivities are thought by many in the functional medicine community to be related to increased gut
permeability, otherwise known as leaky gut. This can happen when gluten or an imbalance of bacteria causes
an increase in the blood protein zonulin. As zonulin levels rise, the tight junctions between the intestinal
cells loosen and create space which opens the doors for microbiota-derived antigens and endotoxins to
pass through, kicking off an inflammatory process [5].

If the intestine is permeable, microscopic food particles travel through the walls of the gut lining and cross
into the bloodstream where they are detected by the immune system. Unfortunately, that’s why these types
of sensitivities tend to be foods that you regularly eat.

Yet another distinction among food reactions are considered intolerances. An intolerance typically occurs
when the body lacks the enzymes needed to digest what you’ve eaten, like lactose to break down dairy.
Symptoms of a food intolerance tend to be more digestive and include nausea, stomach pain, gas, cramps,
bloating, vomiting, heartburn and diarrhea. At times, they could manifest as headaches, irritability and
nervousness.

While food allergies and sensitivities may call for avoiding offending foods entirely, a food intolerance may
allow you to consume small amounts of it. Perhaps you could eat a little bit of a hard cheese, for example,
and not feel an effect.
COMMON TRIGGERS
While everyone has unique reactions to food, certain foods show up
more frequently as sensitivities or intolerances. Next, let’s explore a few
types of gluten sensitivity.

GLUTEN
More people than ever are going gluten-free.
But who should eliminate gluten and why?

While we typically think of gluten as being

in wheat products, gluten is a protein also
found in barley, rye, bulgur, couscous,
kamut, semolina, spelt, triticale, wheat germ
and oats. While oats don’t naturally contain
gluten, it’s possible they can come in contact
with gluten-containing grains in the fields and
during processing. So if you’re going to eat
oats and are gluten-free, look for certified
gluten-free oats.
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Celiac Disease
Gluten reactions can be due to celiac disease or non-celiac gluten sensitivity (NCGS). When those with the
autoimmune condition celiac disease consume gluten, it triggers an immune reaction in the small intestine.
As a result, the intestine can become damaged and unable to absorb nutrients. The most common
symptoms of celiac disease include diarrhea, fatigue, weight loss, bloating, anemia and more. For some, the
reaction can even be life-threatening.

A portion of those with celiac disease may believe they are asymptomatic. However, upon eliminating
gluten, they might report improvement in symptoms previously thought to be unrelated like acid reflux,
bloating and gas.

Celiac disease can be diagnosed with a blood test or an intestinal biopsy. The biopsy is considered the gold
standard but blood tests can give an indication.

In addition, DNA tests may show a genetic propensity to celiac disease. Presence of the genes HLA-
DQ2 and HLA-DQ8 increase your risk of having celiac disease [6], but do not necessarily mean that the
disease will manifest.
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Non-celiac gluten sensitivity

Non-celiac gluten sensitivity (NCGS) is a term used to group all other reactions to gluten that aren’t
autoimmune in nature. NCGS is thought to affect anywhere from 0.5 percent to 13 percent of Americans
[7]. Those with NCGS may experience epithelial damage to the gut, immune activation and systemic
inflammation [8].

If you’re sensitive to gluten, you may notice symptoms similar to celiac disease or Crohn’s disease, such as
bloating, abdominal pain, diarrhea and gas [9]. Additionally, many with NCGS report fatigue, brain fog, joint
pain, headaches, skin problems, anemia and mental health challenges.

If you find your body reacts negatively to gluten, it’s best to avoid it entirely. One study showed that it can
take as long as six months for signs of gluten exposure to no longer be detectable in blood tests [10].

Finally, there’s another concern regarding gluten. Studies have found that gluten activates zonulin, the blood
protein that leads to increased intestinal permeability, which in turn could increase the likelihood of other
food sensitivities [11].
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DAIRY
Along with gluten, dairy is often a major trigger, eliciting digestive distress, inflammation, skin reactions and
congestion, among other possible effects. These reactions can be an allergy, sensitivity or an intolerance.

A dairy intolerance may stem from inadequate digestive enzymes needed to break down lactose. In fact, it’s
estimated that only about 35 percent of the population globally can digest lactose over the age of seven or
eight [12].

However, studies have shown that those who eliminate dairy may incur calcium deficiencies [13]. Therefore,
if you’re sensitive to dairy, it’s important to consider adding a calcium supplement and consume non-dairy
calcium sources such as leafy greens, seeds, beans, lentils and almonds.

Interestingly, individuals with gluten sensitivity tend to be more sensitive to dairy as well. One study shows
that number at around 50 percent. [14] Cow’s milk protein elicited an inflammatory response similar to that
triggered by gluten in about half of those with celiac disease.
NIGHTSHADES
While many of these vegetables and fruits contain important nutrients, some people report experiencing
inflammation, pain or gastrointestinal symptoms after eating them. Such a reaction stems from the
alkaloids in the plant – designed to ward off pests while growing.

While it’s possible to have an actual allergy to foods in the nightshade family, the properties of the foods
themselves may also cause irritation independent of an allergy. That’s because some of us lack the proper
enzymes to digest these foods, which may lead to inflammation in the gut and digestive issues. The
alkaloids in nightshades have also been linked to leaky gut and inflammatory bowel disease [15].

In addition to some of the major allergens listed above, there are compounds in certain foods that can
cause intolerances in some people. These compounds include, but are not limited to, oxalates, histamines
and FODMAPs.
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OXALATES
Many nutrient-rich plant foods contain oxalic acid, or oxalates. The list includes items considered super
foods such as leafy greens, berries, beans and tea.

Oxalic acid is another property designed to protect plants from insects and disease, but oxalate foods can
be a problem for some of us. They can actually interfere with the absorption of vitamins and minerals such
as iron and calcium.

Oxalates bind to calcium and create oxalate crystals, which are actually the building blocks of kidney
stones. Such binding also blocks calcium absorption. Additionally, these crystals may travel through the
body and cause muscle pain.

High-oxalate foods include spinach, broccoli, cauliflower, oranges, chocolate, kale and nuts. However, you
can reduce the oxalate content in your food by cooking vegetables or soaking nuts and seeds for 12 hours
(then roasting the latter for 15-20 minutes) [16].

Keep in mind, not everyone is affected by oxalates. However, those with certain conditions may want to
think twice about eating them: recurrent kidney stones, leaky gut syndrome, irritable bowel syndrome,
inflammatory bowel disease, small intestinal bacterial overgrowth (SIBO), autoimmune disease, nutrient
deficiency, chronic inflammation or vulvodynia.

Try reducing your oxalate intake with low-to-moderate oxalate foods for a while and assess any changes in
your health. If you feel better, consider staying on this type of diet.
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HISTAMINES
We typically associate histamines with seasonal allergies, and thus, turn to antihistamines to calm the
reaction. But similarly, foods may contain histamines that kick off an allergic-type reaction in some [17].

Most people can process histamines in food without issue, but some people are intolerant to them. Those
with an impaired ability to metabolize ingested histamine may experience reactions that include diarrhea,
headache, nasal symptoms, asthma, hypotension, arrhythmia, urticaria, pruritus and flushing. Research
attributes this to low levels of diamine oxidase, or DAO, the primary enzyme for metabolizing histamine [18].

Foods high in histamine include aged and fermented items such as cheeses, yogurt, sauerkraut, processed
meats, vinegars, alcohol and leftovers. Additionally, the list includes avocados, legumes, citrus, chocolate,
some nuts, tomatoes, bananas, eggplant and spinach.

If you’re experiencing what are believed to be histamine reactions, consider following a low-histamine
diet. Some foods on a low-histamine diet include organic, grass-fed meats, fresh wild-caught fish, apples,
blackberries, blueberries, coconut, and macadamia nuts.
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FODMAPS
Many individuals with irritable bowel syndrome find they react to foods in a class called FODMAPs, short
for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. In some people, the small
intestine absorbs these short-chain carbohydrates (sugars) poorly, causing symptoms such as cramping,
diarrhea, constipation, bloating, gas, weight loss and malabsorption.

It’s often caused, or exacerbated by, small intestinal bacterial overgrowth, or SIBO. Bacteria is normally
present in the large intestine with small amounts in the small intestine. SIBO is defined as excessive
bacteria in the small intestine [19]. When the bacteria ferment the sugars in the intestine, an individual may
experience gas, bloating, diarrhea, constipation and malabsorption.

To reduce symptoms and help during treatment, consider trying a diet low in FODMAP foods [20]. Some
examples of low FODMAP foods include blueberries, strawberries, carrots, zucchini and eggs, Avoid high-
FODMAP items such as sugar in all forms, beans, garlic, onions, avocados, apples, and grains like wheat.
UNCOVER
POSSIBLE
CULPRITS
Finding your own food sensitivities and intolerances isn’t
always straightforward. Sometimes, it’s clear that certain foods
provoked a reaction. But often, we may not link specific foods
to seemingly unrelated health concerns.

TO FIND YOUR PERSONAL FOOD

SENSITIVITIES, CONSIDER THE FOLLOWING:

1. Try an Elimination Diet

An elimination diet is considered the gold standard for finding food sensitivities [21] and also helping heal
the gut. However, it takes patience.

In a typical elimination-provocation diet, you eliminate certain foods for about three weeks and then slowly
bring them back one at a time. However, if you’re working with a practitioner, he or she may recommend an
alternate timeline for you.

The Institute for Functional Medicine recommends removing the following foods: corn, dairy, eggs, gluten
grains (barley, rye, spelt and wheat), white sugar, shellfish, soy, beef, pork, processed meats, coffee, tea and
chocolate (because of the caffeine).

Instead, focus on eating vegetables, fruit, organic, cold-pressed oils (avocado, grapeseed, olive and
coconut), lean meats and fatty fish, legumes, nuts, seeds and non-gluten whole grains.

For success, be sure to have plenty of approved foods on hand, plan your meals, carefully read all labels
and drink six to eight glasses of water daily.

After the elimination phase, bring back eliminated foods one at a time, with each reintroduced food spaced
out over two days. Keep a food diary of what you eat and carefully watch for any reactions.
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2. Get Tested
DOCTORS AND PRACTITIONERS OFTEN RECOMMEND A NUMBER OF
TESTS TO FIND FOOD ALLERGIES AND SENSITIVITIES AND THEIR POSSIBLE
UNDERLYING CAUSES.

• Blood testing determines allergies to specific foods by measuring IgE antibodies. Food
sensitivities are determined by measuring IgG or IgA antibodies.

However, there’s debate about the accuracy of such tests. Some believe that the presence of
antibodies may not signal intolerance, but rather, that the patient has merely been exposed to
certain foods [22].

Zonulin levels can also be measured by a blood test, and is an effective method to determine
leaky gut.

• Skin testing involves pricking the skin with a lancet with a drop of an allergen extract and
observing the surface reaction. While a potentially itchy experience, it can reveal allergies
although skin testing isn’t always accurate. Skin prick tests are helpful for IgE allergies, but may
not be as accurate for IgG or IgA because those reactions can be delayed.

Given uncertainty about the accuracy of these types of tests, most functional medicine doctors
maintain that an elimination diet is the most definitive form of diagnosis.

• Microbiome labs, which analyze a stool sample, break down the composition of your gut
bacteria, helping pinpoint an imbalance. As discussed previously, imbalances can dysregulate the
immune system and be linked to food sensitivities.

It’s been found that 70-80 percent of the body’s immune cells are found in the gut [23]. And
recent findings indicate that the microbiome may be related to the formation of food allergies
[24] or sensitivities [25].

• A breath test will reveal small intestinal bacterial overgrowth. As mentioned previously,
SIBO occurs when bacteria overgrows up from the large intestine into the small intestine. SIBO
may make you more sensitive to certain foods, such as those high in FODMAPs.

• Organic Acids Test (OAT) will measure oxalate metabolites in the urine. Metabolites, also known
as organic acids, are products of the body’s metabolism. Your body doesn’t readily absorb
organic acids so they’re found in the urine in high amounts.
HEAL YOUR GUT
Once you’ve identified your food triggers, adjust your diet to avoid the offending foods. Consider partnering
with a nutritionist to customize your diet for your specific needs and health concerns.

Depending on what the underlying cause of your reaction is, it’s possible that you may not need to
eliminate them forever. The following steps have the potential to help heal the gut to the point where you
may be able to reintroduce eliminated foods.

Given what we know about the role of gut bacteria and food allergies or sensitivities, it’s not surprising
that researchers found that giving several species of bacteria – found in the human gut – to mice actually
protected against food allergies and reversed established disease. The microbes, in effect, reset the
immune system.

THUS, IT’S ESSENTIAL TO WORK ON HEALING YOUR GUT. CONSIDER

THE FOLLOWING STEPS TYPICALLY RECOMMENDED BY FUNCTIONAL
MEDICINE DOCTORS AND NUTRITIONISTS:

• Remove – Eliminate anything that negatively affects the gut, such as trigger foods,
parasites, yeast and bacterial overgrowth.

• Replace – Add items that may be deficient and that help with digestion, including digestive
enzymes, hydrochloric acid or bile acids.

• Reinoculate – Encourage the growth of beneficial bacteria with probiotic foods (such as yogurt,
miso and tempeh), probiotic supplements and prebiotics. Prebiotics feed probiotics and are
found in a fiber called inulin. For inulin, eat foods such as garlic, onions, artichokes, flax and oats.

• Repair – Next, heal the lining of the gastrointestinal tract with nutrients such as zinc, vitamins A,
C and E, fish oil and the amino acid glutamine.

• Rebalance – Balancing lifestyle factors such as sleep, exercise and stress helps you maintain a
healthy gut.
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CAN YOU REVERSE

REACTIONS?
Recent studies show there’s hope for those who have lost oral tolerance for certain foods, or the ability to
eat those foods without a reaction. Immunotherapy, or giving small doses of what a person is reacting to
under a doctor’s care, has been shown to reverse allergies in some cases [26].

As for sensitivities and intolerances, many find that gut-healing allows them to eat foods that they could not
before. Once leaky gut is healed, and food molecules no longer pass into the bloodstream, the body should
soon stop IgA and IgG reactivity.

Additionally, studies indicate that certain probiotics may alleviate the symptoms of lactose intolerance by
modifying the microbiota in the colon. In turn, these bacteria may even produce their own lactase enzyme
that aids in digestion [27]. 

SUMMARY
If you suffer from food allergies, sensitivities or
intolerances, take steps to understand the nature of
your reactions by trying an elimination diet, keeping
a food diary and running lab tests. Then work with
a practitioner to customize your diet, and ideally,
address any underlying causes. With time, there’s
hope that you may be able to, once again, enjoy
excluded foods.
HERE’S
TO HEALTH.
 19 HealthMeans

REFERENCES
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