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© 2019 Alpine Nutrition

  • Amanda Bullat MS RDN CD

Allergic, Sensitive, or Anxious?


Sunday...grocery shopping day. I'm minding my own business, trying to decide how much money I don't want to spend on some tahini to make a lemon tahini dressing, and I overhear a couple next to me...

Woman: we can't get nut butter this time. What to get instead?

Man: what's wrong with nut butter? We always get almond or peanut.

Woman: I can't eat those. My naturopath (ND, naturopathic doctor) said I have to stay away from them since they came up on my food allergy sensitivity test.

Man: I don't remember you having a reaction to nut butters in the past.

Woman: well according to this test I do. I don't know. There's so much on this do-not-eat list (looking at the list in her hand). What am I supposed to eat? It's so complicated...we can't even eat eggs any more. They're supposed to be bad for you too!

Man: That's ridiculous! You've never had a problem with eggs either. You can still have a hard boiled egg here or there. Maybe you need to run your own test...

Ok, I admit, I was eaves dropping. It's what we food neutral, anti-diet dietitians do. Ears wide open for any mention of wellness culture, orthorexic, bullshitery.

Honestly it infuriates me and makes me sad time to hear well intending medical professionals sending their patients down the rabbit hole of eliminating foods without 1.) providing well researched scientific proof of the need to do so (surprise, there's isn't much of that!) and 2.) not giving the patient options of what to replace the villanized foods with.

Example: Here's a list of all the foods that will harm you (based on this not-so-accurate blood test). Eliminate them for 2-3 weeks. You might be able to add some back in. But who knows. Be sure to write down everything you eat and all your symptoms after eating. Ok, good luck with that. See you in a few weeks!

Reality: Eating disorder in the making. Death sentence...literally if taken too far.

Let's be clear on something REALLY important...food allergies and sensitivities are NOT the same thing. A reaction from a true food allergy is usually instantaneous or happening within a couple of hours in many cases - such as anaphylactic shock, throat closing, hives, swelling with redness. These reactions require immediate medical attention and/or use of an Epi-pen to stop the reaction until further medical care is available.

Food sensitivities on the other hand, typically show up as much milder reactions such as digestive discomfort, head aches, mild rashes - usually after a delayed amount of time - a few hours up to a handful of days. While uncomfortable, food sensitivities aren't life threatening.

There are a number of tests on the market that claim to assess someone's sensitivity to foods. They can be done using samples of blood or stool and some utilize a skin prick method. Regardless if it's a test ordered by a medical professional or one you can do in your own home and send away the sample for results, there can be issues with accurate results.

In order for the tests to "work," you need to have been eating all the foods being tested regularly. The tests examine whether or not your immune system creates anti-bodies to the foods after they're broken down in your digestive system.

Now, just because your body makes anti-bodies to those foods, doesn't mean you'll have a reaction (false positive result). On the other hand, the test may show that a food is fine for you, but you already know through trial and error the food doesn't sit well with you (false negative result), so you choose not to eat it.

Pause. Wait what?

You could get a positive result (i.e. the food is harmful to you) from a food that you frequently eat and experience no negative physical reactions to? Yep. And you could get a negative result (i.e. the food is fine for you) even though you already know, based on experience, that you have a reaction after eating the food, so you don't eat it regularly? Yep. Confused? Yep, you and anyone else who's done a food sensitivity test. Myself included.

Suppose you take your well-intending Doc's advice and eliminate the "highly reactive" food on your test result list for 2-3 weeks. You start to feel better and immediately assume it's because you've eliminated these foods.

BUT, research shows that people who are doing these tests are already hyper aware of and practice fairly healthy habits. So, it's difficult to assume that the "feeling better" is actually coming from the food elimination.

There maybe a placebo effect going on. Elimination diets require more hands-on cooking with fresh ingredients and less eating out. Maybe you're feeling better because you're taking more time to prepare meals for yourself which is causing you to slow down in other areas of your life (i.e. not working as much or over committing to social activities). Maybe you're now consuming less sodium or sweeteners naturally by having to cook more from scratch. That will eliminate feelings of puffiness, bloating, and fatigue right there.

After your 2-3 weeks of elimination is complete, it's time to start adding back in the eliminated foods and note what reactions occur if any. The process can be problematic due to the nocebo effect - assuming that you'll experience a negative reaction to the food due to psychological or psychosomatic factors such as remembering the way your body felt prior to the elimination and assuming the same will happen again.

Do you see how this whole chain of events can be a hot bed for creating an eating disorder? How going down this rabbit hole under the assumption that food is to blame for all the negative sensations you experience in your body?

It's problematic and complicated to say the least. And if you toss in any mention of weight as well - now you have a opened not just a can but a whole freak'n case of worms!!

So, what's a better alternative? Stay tuned!

Next time we'll talk about what it looks like to do your own assessment of how foods feel in your body - similar to what the husband of the woman above was suggesting. It's all about interoceptive awareness.

Until then...Wishing you food peace & body liberation!

Note: special thanks to Fiona Sutherland at The Mindful Dietitian for the use of her word, bullshitery - so great and on point!

#wellnessdiet #nutritionmyths #eliminationdiets #disorderedeating