Today I’d like to explore food allergies vs. intolerance vs. sensitivity. I think there is a lot of confusion around these terms and how, even if, they differ. The words are bandied about the news and Internet, along with fear-inducing warnings and questionable information. It seems more and more people have problems with certain foods, or claim they do, and it’s hard to know when the claims are serious. You may have been on an airplane where they announced “No peanuts today as there is a passenger with a peanut allergy on board.” Or maybe your child’s school sent a note prohibiting peanut-containing snacks or lunches. “Wow,” you may think, “is it really that dangerous?” For some people the answer is yes. So let’s outline the differences and similarities.

          An actual allergy to a food causes the body’s immune system to react, sometimes aggressively. The body views a protein in the food as an invader and attacks the invader with antibodies. You may be familiar with people taking an anti-histamine medicine when they have hives or itchy seasonal allergy symptoms – the histamine produced by the body in this fight against invaders causes those symptoms. However, a true food allergy can be much more serious, causing anaphylactic shock in some people. Other symptoms are less serious but can increase in severity if exposure continues. These could be skin reactions, like hives, swelling, and itching or digestive symptoms like vomiting, diarrhea, nausea, and stomach pain.

          A food intolerance does not involve the immune system. Intolerance most often means your body cannot break the food down properly in your digestive track. Milk intolerance is the most common, and is due to lack of the enzyme lactase needed to break down the lactose in the milk. Other causes of intolerance are certain food additives like sulfites or nitrites; extreme aversion to a certain food; and intolerance of naturally occurring substances like histamines. Generally the symptoms of food intolerance are gastrointestinal-related. Some blog articles point to skin disorders from intolerances but the medical sites did not list skin problems as related to food intolerance. Food intolerance will not cause anaphylactic shock.

          Food sensitivity is sometimes the term used for food intolerances, but where it is distinguished it refers more to the    discomfort some people may experience after eating spicy foods or acidic foods, or the faint mouth itchiness some people get after eating a banana but with no other symptoms. Food sensitivities also do not involve the immune system.

While allergies and intolerances share some symptoms, the main difference is the involvement of the immune system. Also, reactions from a food allergy generally begin immediately or within a short time of eating the food, where reaction from a food intolerance may not show up for hours or even a few days. An allergy causes a reaction from even a small amount of the food but intolerance usually flares up after eating a lot of the problem food. I am lactose intolerant but find I can have a small amount of cheese, for instance, without symptoms, especially if I indulge only on occasion. My experience highlights another difference – an allergy causes the reactions every time the offending food is eaten but a food intolerance often only flares up if the food is eaten often. Allergies can be life-threatening but intolerances are not.

Just as food allergies and intolerances can be outgrown or fade, we can also develop an allergy or intolerance as adults, even after eating the food for years without problems. This is very common for milk intolerance. Children with food allergies often outgrow them, especially milk, egg, and soy allergies, usually by age 6 or 10. It is less likely they will outgrow peanut, tree nut, or shellfish allergies.[1] The most common allergens, accounting for about 90% of food allergies, are: milk, eggs, fish, shellfish, peanuts, tree nuts, wheat, and soybeans. [Note that gluten is not listed here, even though it seems to be such a huge topic. You may think people with celiac disease(~ 1% of the US population) are allergic to gluten but it is not an allergy, rather it’s an autoimmune disease.  ‘Non-celiac gluten sensitivity’ is a fairly new disorder and one that is difficult to diagnose, as there is no test for it and removing gluten from the diet may also remove other causes of the symptoms.]

If you suspect you have an allergy to a food, you should avoid the food and seek testing to be sure. If it proves you are allergic you will need to continue to avoid the food, and other foods that may include it. If your symptoms are severe you should carry an epinephrine pen at all times.  If you suspect you have a food intolerance, the best way to be sure is to track what you’ve eaten when you experience the symptoms, and then try an elimination diet on the most likely culprits. This should tell you if you can eat a little on occasion or should just eliminate it for good. Remember to check on preparation when eating out – was the sauce made with shrimp stock and you are allergic to shrimp? I have a friend who is allergic to potatoes and has to be careful of fried foods, soups, breads, and sauces because they often have potato or potato starch, or were cooked alongside potatoes. Read labels, ask questions, and protect your health.

[1] http://blog.foodallergy.org/2013/09/13/who-is-likely-to-outgrow-a-food-allergy/

 

Considering that this time of year many people are doing or thinking about doing a ‘cleanse’ I thought I’d write about a ‘cleanse’ for pantry and fridge. After all, if you continue to have less-than-healthy food products around, the cleansing of you won’t have long lasting effects! I have a friend who dislikes using the word ‘clean’ when talking about food – he says he expects all the food he eats is clean, meaning not dirty. Of course, in the world of better eating/good nutrition ‘clean’ means something else and he knows that. I get his point but haven’t found a better word to describe what is meant. So I want to talk about cleaning your food choices up. Cleansing your kitchen may mean replacing some food with better choices, removing some altogether, and adding in some new items. It many also mean switching food storage containers to avoid certain elements.

So what is ‘clean’ food? Generally it means food as close to its origins as possible, optimally organically grown. Minimal processing, few added ingredients of unknown purpose. Raw, plain nuts rather than those covered with questionable flavor coatings. Applesauce made from apples, period; no need for sugar, salt, preservatives. Pure sea salt, not highly-refined salt with anti-caking additives and stripped of trace minerals.

Let’s start in the pantry. Because I like to cook my pantry has a lot of basic ingredients –nuts & seeds, various grains and beans, flour, cocoa, honey, oils, vinegars. Not too much in the way of prepared foods but a few things. If you are like me, there are products you grew up with, that your mom trusted to feed you and that you buy for your family. A certain peanut butter, specific saltines, a particular soup brand. Maybe you buy it just because of its history in your family, maybe you tried some other brands and they never lived up to the one. Even so, chances are the formulation of that tried-and-true brand is not the same as it was when you were 10. I know I have been disappointed when returning to an old favorite only to find it was very changed, or my tastes had outgrown it. Well, products can change and your tastes change too. So let’s look at what you have. Does the peanut butter contain palm or peanut oil? Sugar? Why? Don’t peanuts produce oil; is there a need to add oil? Why would sugar be added – to feed our addiction to sweet? Heck, you’re gonna put jelly on the sandwich anyway. (Just kidding, of course!) Look for a brand that is made from peanuts, maybe with salt. Personally I prefer it unsalted, but if you are more accustomed to salt in your peanut butter, go ahead and get that one. You can always ease into unsalted peanut butter. How about the salsa? (Yes, I know fresh, homemade is better, but it’s not always tomato season.) Is there sugar added to the salsa? Again, why? Isn’t salsa supposed to be spicy? The tomatoes have naturally occurring sugar; adding sugar just feeds the craving for sweet things, and increases the sugar load in your day. I just noticed the tomato soup I have in my pantry has added sugar! Had not looked at the list carefully, but guess I’ll re-think this brand in the future. At least it doesn’t have: High Fructose Corn Syrup, Potassium Chloride, Flavoring, or Monopotassium Phosphate like a common national brand. Do you buy canned tuna or salmon? Hopefully you buy it packed in water not oil. Fish has its own oil, doesn’t need vegetable oil for flavor or stability. Again, I like it without added salt but that can be hard to find. Do you make your own pasta? No? Neither do I! What’s in the packaged pasta you buy? More than the durum wheat or grain it’s made from, and water? That’s really all pasta needs. I grew up with what I think is an iconic saltine cracker – crumbled in tomato soup, buttered with chili, smeared with peanut butter. That brand at least has unbleached flour although it is enriched, meaning the wheat is stripped of the bran and germ so has to have nutrients added. Yet they use soybean oil (GMO?) and cottonseed oil. I never buy products using cottonseed oil as it is not a food crop so who knows what it was sprayed with? Have chips? Some are better than others as far as being clean; taste obviously is too subjective for me to make any claims on it. But if the chips you buy are made from corn or contain soy or canola, even as oil (“… and/or vegetable oil”), be sure they are organic chips to avoid genetically engineered ingredients. Whole grains or potatoes, oil, salt and maybe sugar – all that’s needed for tasty chips. Obviously your pantry may have more items than these few, but hopefully you get the idea of what to watch for. So take an hour or so to review what you have and which may need swapping for a better choice.

Turning to the refrigerator, what’s hiding in there? Mine is packed pretty full but I keep a pretty good mental inventory. Mostly right now, a few days after market day, it’s got a lot of produce. This I have to monitor carefully so it doesn’t spoil on me.  What’s the rest? Condiments, almond milk, soy creamer, white wine, and some jelly, among other things. What am I looking for in these products? For starters, I avoid carrageenan, which is prevalent in non-dairy products like plant milks and creamers. I don’t understand the need for sugar in most condiments, but confess that the ketchup and the barbeque sauce I have both have sugar added. I recall not finding a single offering of ketchup without sugar when I last looked, and do not feel like making my own! I do skip those that still use high fructose corn syrup, and would always stay away from any with artificial sweeteners.  See ‘Sweet Addictions’ for more on why. Currently there are no pickles in our fridge because I am on a quest for good tasting, well-made pickles with basic pickle ingredients – cucumbers, vinegar, spices. Some brands have so many preservatives, which is what I thought the process of pickling did – preserve foods. Why add chemical preservatives? If you buy cheese, be sure to get real cheese and not “processed cheese food”; if you buy non-dairy varieties watch for carrageenan and non-organic soy and corn (starch).

Last thing to think about, in both pantry and fridge, is the containers foods come in or that you use to store foods. Use glass bowls or jars to store extras or leftovers, or use stainless steel. Avoid canned foods unless the can is labeled ‘BPA-free’. Some companies have moved away from BPA linings in canned foods, which were put in to protect the food from corrosion on the metal can and extend its shelf life. While some claim there is little or no risk to humans from BPA, many studies point to it being an endocrine disruptor and possible cause of cancer. Not worth the risk when there are products without the risk. Avoid buying foods in plastic containers, especially numbers 3, 6, and 7. Avoid re-using plastic water bottles – invest in a stainless steel bottle you can refill as needed. Throw out your old plastic bowls that melted in the microwave and are flaking, and don’t heat food in plastic or covered with plastic wrap in the microwave. Also be careful of storing or cooking food in aluminum foil. I know, I know, we’ve all done it. But it can leach aluminum into the food, especially acidic foods or those cooked at high temperatures, and too much aluminum in our bodies is considered a health risk.

I am not telling you to throw away what you currently have on hand, but as you need replacements, keep this in mind. It could mean having raw ingredients on hand to make your own spaghetti sauce for instance, or being more discriminating when buying ready-made. Read the labels, and if you aren’t sure what an ingredient is, look it up. You may need to move on to a different choice. Even if you aren’t doing a ‘cleanse’ of your food intake, cleaning up what you keep around the house will help you stay healthier.

20160426_coach thyselfCoach, coach thyself. That’s what I told myself a couple of weeks ago. I had been having uncomfortable digestive issues for some time; not constant but getting more frequent and more annoying. I knew I needed to step back and reset my digestion but was reluctant to get started. Always an excuse – “I’ll be traveling” “We are going out with friends” “There’s a party in a few days” – and so on. Doing a reset on digestion meant changing what and how we eat – lighter foods and certain foods eliminated – at least for a time. This was complicated by the fact that my husband has great digestion and didn’t really need to reset, although he sometimes has concerns about gaining weight. Since I cook most of our meals, making separate foods was not something I looked forward to eagerly. But there came a day when I was simply tired of feeling off-kilter and he too was feeling a bit heavy, plus spring is a good time to cleanse. So we agreed to go for it and the planning began.

I decided the first week the focus would be on eating light foods and would be an elimination diet. This helps lighten the overall load on my digestive system, and provides a clean slate to test certain foods for intolerances. So I eliminated all meat, dairy, eggs, fermented foods, added sugar, alcohol, beans, wheat, caffeine, and soy. We also switched to having our larger meal of the day at midday rather than evening. This may have been the biggest challenge for us, since our lives are so accustomed to daytime activities – work, errands, exercising, play – where we’ll grab a simple lunch and then have a heavier dinner at the end of the day. Many cultures have the main meal of the day at midday and studies have shown it to be a healthier way to eat if weight control is a concern. The theory in this is that you are more active throughout the day and thus use up the calories better. Then in the evening when relaxing and preparing for sleep, a less substantial meal is eaten.

So what did we eat, after eliminating all those foods? Well, there’s a huge world of recipe ideas and I tried a number of them. The first few days our meals were all vegetables; later in the week I added some dishes with grains, although no wheat grains. We had several soups, like borscht, cream of celery, cream of carrot, and spinach soup. All of those were homemade versions, using fresh vegetables and no dairy milk or oils. I made several grain dishes, using rice, millet, or barley, with a variety of vegetables and seasonings. One day I made wraps using collard leaves as the wrappers and filling them with a cashew ‘cream’, carrots and cucumbers and daikon radish in matchsticks, and some parsley leaves. Served these with a simple lettuce and grape tomato salad dressed with a bit of olive oil and lemon juice. We had a couple of variations of this simple but refreshing salad several times during this week, usually as the evening meal. Breakfasts were oatmeal or barley as cereal, or veggie smoothies. No snacking! We drank lots of water and I had herbal teas that were soothing for my tummy.

The worst day for me was day three – it’s when all my cravings kicked in and I really wanted some of my favorite Late July chips and a glass of wine! I was pretty cranky that day, but was over it by the next morning and realized I was feeling much better in my gut too.

After the first week I was feeling pretty good, and I decided it was time to start testing for food intolerances. I already knew dairy and I don’t get along but wondered if any other foods were causing issues. If you know me, you know I really like breads – craft breads, muffins, crackers, etc. None of that white, fluffy stuff, but most any kind of whole grain goodness.  I was afraid wheat had become a problem for me. Not gluten, as I had been eating gluten-containing grains throughout the week and felt fine. So it made perfect sense to me to test wheat first. My belly was feeling fine, and if wheat was going to be a problem it should certainly show up now. Test one: a piece of my yummy homemade whole wheat bread, toasted, with coconut oil spread on lightly. Just one piece, then wait and see. Felt fine all day. Next day, same test. Still felt fine. Next day, pancakes. Still good!! What a relief!

Second test was caffeine. Now, I am not addicted to caffeine, don’t even drink it daily. But I do like the ritual of making coffee and sitting with a cup, and I was missing that. So I made some coffee, and as I expected, no reaction, no issues.

Note that during these test days, I added no other omitted foods. One at a time and give each some time to check for reactions. I gave each re-introduction of omitted foods about two days of watching. I have not added all items back in yet, but so far, so good. Dairy will stay out of my diet and meat will remain a minor part. We don’t eat of lot of sugar-laden foods anyway, so they too will be a minor part of our diet. We are still eating lighter meals for the most part.

It seems that since none of the omitted foods have caused me problems since consuming them again, it may be that my system simply was overloaded. Maybe I have been eating too often and too fast, and because my digestive fire is not as strong as some people’s it just couldn’t keep up. I don’t eat a lot at one sitting but I eat frequently, and sometimes I eat too fast. So I was also more careful to slow down and chew more thoroughly, and I feel this helped along with focusing on lighter foods for all my meals. Not only is the bloating and cramping gone, but I also lost some of the belly fat I’d recently started to collect. Not my aim, but obviously my body is happier with the changes.

This is an example of how paying attention to your body and its signals can resolve many ills without medication or extensive tests. If after this testing period I still did not feel right, I would see my doctor to rule out more serious issues. But your friendly, neighborhood health and wellness coach is a good first step. I can help you figure out where and how to start, provide support when the process seems difficult, and cheer you on to success and feeling better. Working as a team with my husband as we are going through the process has been a huge help for me.

 

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