This is the second part in a series of articles written by our nutritionist, Laura Palazzolo. In Part 1 , Laura taught us about the difference between food allergies and senistivities. The following article expands on Part 1 by how to address these senistvities and allergies with appropriate testing and diet changes.
Elimination Diet Part 2
Why do an elimination diet?
One thing I always stress with my clients is that there is not a “one size fits all” type of diet. Sure, there is a general template that works well for most people, but if you have unexplained symptoms, it could be related to food sensitivities. Through our study of celiac disease (an autoimmune condition, in which the body reacts to gluten), we’ve learned that symptoms of food sensitivities are not so cut and dry. Even if you do not have gastrointestinal symptoms (such as constipation, diarrhea, vomiting, bloating) it does not exclude you from having food sensitivities. Other symptoms could be attention problems, low mood, skin rashes, headaches or joint pain. It could even be a symptom that I have not listed here! Some research is focused on intestinal permeability (aka “leaky gut”). When there is intestinal permeability, intact food particles are able to pass into circulation, thus activating the immune system. This low level inflammation has been shown to be present in many chronic diseases (such as diabetes, heart disease and cancer) and many believe it is the underlying cause of chronic disease. Food sensitivities may also damage the gut over time, which leads poor nutrient absorption and suboptimal nutrition status. A lot about the area of food sensitivities is unknown, however, the elimination diet, when under the supervision of an experienced practitioner, offers a large potential benefit with little risk.
Type of food allergy testing
- Serum IgE test: A blood test which measures IgE response to specific foods, usually the most common food allergens. Should not be used as the sole diagnostic tool due to a variety of limitations.
- Skin prick tests: A small amount of the suspected food is placed on the skin and the skin is pricked to allow some of the solution to enter just below the skin. There are often false positives with this method (50-60%!).
- Medically supervised double-blind placebo-controlled food challenges: The gold standard for diagnosing. The food is hidden in another food or opaque capsule. A placebo capsule is also tested, while reactions are monitored.
- Serum IgG test: Not medically validated, but often used to identify non-IgE food allergies and food intolerances. Can be a useful tool if a standard elimination diet is done with no relief of symptoms. Needs a custom elimination diet based on results with a food challenge to identify offending foods. Many different companies provide this type of testing, with reports of varying reliability.
Elimination diets are effective
In my professional opinion an elimination diet is a useful tool for just about anyone to gain more information about their bodies and individual tolerances. Elimination diets have been best studied in eosinophilic esophagitis, an allergic and immune condition in which the esophagus becomes inflamed and have been shown to be effective in both adults and children to identify food triggers and reduce symptoms of the disease. Other diseases in which elimination diets and/or variations of this diet have been used are atopic dermatitis, irritable bowel syndrome and inflammatory bowel disease (Crohn’s Disease and Ulcerative Colitis)
In the last part of the series, I will review a standard elimination diet protocol, with mention of variations on the standard elimination diet.