Food allergies, and food intolerances and sensitivities, can affect how you feel and lead to chronic symptoms, like stomach aches, fatigue or joint pain.
But it can be a challenge to determine exactly which foods aren’t sitting right with you.
Debra Bell, MD, takes on this topic to help us understand how to determine if our food is making us feel sick and what we can do about it.
Selected Podcast
Could Your Food Be Making You Sick?
Featured Speaker:
Debra Bell, MD – Integrative, Complementary Medicine
Debra Bell has more than 25 years of experience in conventional medicine, and complementary and alternative medicine. As part of her practice, she is skilled in the use of vitamin, nutritional and dietary supplements, and diet and lifestyle changes. She tells family and friends that the key to good health is paying attention to how you feel physically and emotionally, what you eat, and what gives you joy and meaning. In her spare time, she enjoys gardening, cooking, cycling, kayaking and being with family and friends. Transcription:
Melanie Cole (Host): Food allergies and food intolerant and sensitivities can affect how you feel and lead to chronic symptoms like stomachaches, fatigue, or joint pain. But it can be a challenge to determining exactly which foods aren’t sitting right with you. My guest today is Dr. Debra Bell. She’s an integrative medicine family physician at Allina Health Penny George Institute for Health and Healing. Welcome to the show, Dr. Bell. Tell us a little bit about food allergies. Is it pretty common these days? Is it getting more common?
Dr. Debra Bell (Guest): Well, the answer to that is that food allergy is a big word. In general, food allergies are specifically that a person has a reaction soon after eating a certain food, and that would be something that your immune system is overreacting. Those are becoming more common. People hear about people having peanut allergies or children having severe allergies, and those are more common. There are also things that many people call food allergies that are not the same as those kinds of food allergies where you would have a specific reaction right after eating, like trouble breathing or swelling or hives or something like that. So it’s a big category in terms of what people think of when they hear “food allergy.” But technically, we’re talking about immediate hypersensitivity reaction from the immune system is technically what a food allergy is.
Melanie: What are some of the most common causes of food allergies?
Dr. Bell: The most common causes would be things like nuts and certain fruits are the most common that people have. Some people will have food allergies also to dairy, and of course celiac disease is actually an immune sensitivity to gluten, which is what’s in certain grains.
Melanie: And we hear a lot more about as people get older they develop food allergies that they didn’t have when they were younger, or is that an intolerance to fish or shellfish, things like that?
Dr. Bell: Yes. There is what’s called the delayed hypersensitivity response food allergy, and that would be the kind of thing that would develop later in life. That would be the kind of thing that somebody might develop over time. For instance, celiac disease is actually a delayed hypersensitivity response. And so that can happen as we get older that basically, our immune system, there’s something else that’s going on in our body, other exposures or other things that are increasing inflammation that sort of turn the dial up so that we begin to have more reactions. Our immune system becomes more reactive. And then in the same way, there are food intolerances which are still creating an immune response but is a different kind of immune response than from specific food allergies, and those also can develop as we get older based on all the other things that are happening in terms of exposures and our digestion and things like that.
Melanie: You mentioned food allergies and it being an urgent situation. It can be. What kind of symptoms would someone have if they have a food intolerance or a sensitivity?
Dr. Bell: That can be very broad. One of the most common things for food intolerance or a food sensitivity would be gastrointestinal complaints. And so people might have bloating or nausea or abdominal pain or diarrhea. Those would be the most common. But people can also have broader things like skin rashes. They can have joint achiness. People can have depression or difficulty concentrating or what people might call brain fog. And also, people can have fatigue. Those are symptoms that can be associated with food intolerance.
Melanie: When we’re talking about food sensitivities, you mentioned celiac, and we hear about gluten so much in the media. Are people reacting to this? Is this an overreaction, or are we truly getting oversensitive to gluten?
Dr. Bell: Well, I think both. I think that people are overreacting. Anytime anybody has anything wrong with them, people will always say, “Oh, it’s from gluten.” But the fact is that most people tolerate gluten quite well. There are many complicating factors though. What is in our grain now in the American agricultural realm is actually quite different than what we might have had 50 years ago, and so some people speculate that some of the sensitivity and intolerance is not actually the gluten but is to the modified grains and the various chemicals and pesticides that are used to grow those grains. That’s something that sometimes causes people intolerance. And then again, because we have so many different kinds of exposures and our food chain is not as great as it used to be, there are people who are sensitive to gluten. And gluten is a protein that is in certain grains, and so there are more people who have celiac disease that they’re used to, but it’s a small number. And now there’s a group of people who have what would be called non-celiac gluten intolerant. There are many more people with that than there were 50 years ago, but it’s not nearly as many as you might hear in the media or the public that blames just about everything on glutens.
Melanie: If you have some of those symptoms you’ve described, Dr. Bell, if they suspect that their eating might be what’s causing this bloating or nausea or any of these symptoms, what’s the first thing they should do?
Dr. Bell: I actually think that if people are having symptoms, it’s not a bad idea actually to seek professional help and make sure that you don't have celiac and that everything else with your digestion is normal. And then under guidance of a professional, consider doing an elimination diet. And whether you’re just doing elimination diet with gluten or you’re doing elimination diet with gluten and dairy or you do a more extensive elimination diet would be something that you would work out with the professional that you are working with, and that would be a skilled nutritionist or an integrative medicine practitioner. Because I think that one thing that I'm finding is that there are some people now who are eating extremely restrictive diets and actually are not having the right nutrients that they need—they’re losing weight, they don't feel well, and it’s because they’re not getting nutrients from being too restrictive. So you really want to do it under guidance in a very systematic way. We have people eliminate just for two to four weeks and then do a very systematic re-challenge so that we can gather information about whether or not someone really does have the food intolerance.
Melanie: What else would you do if they have that food intolerance? How would you treat it if you find out that this is really something that they’re intolerant now? Do they have to stay away from that food permanently? Is reading labels going to be a big part of this, or can they gradually reintroduce that food?
Dr. Bell: Well, again, it depends on the person and the situation. Most people do need to eliminate it for one to three months. Now, again, in integrative medicine, we often think that sometimes somebody’s food intolerances have to do with the health of the digestive tract and the general health of immune health. And so we do many other things to improve that. We improve other aspects of the diet to avoid exposures of excess—excess sugars, excess fats, excess processed foods, which can also just heal the gut over time. We try and avoid unnecessary antibiotics. We pay attention to making sure people are having enough sleep, stress reduction, and then we sometimes will use probiotic capsules of very specific kinds of bacteria to help to rebalance the environment of the gut. So there are a lot of things that we do for gut health, immune health, stress reduction and general healthy nutrition that then help to improve things so that people may be able to tolerate the substance either in moderation, which would be once or twice a week, or gradually be able to reintroduce it back in their diet over a four- to twelve-month period.
Melanie: In just the last few minutes, Dr. Bell, if you would, what’s your best advice for people that might think that they’ve got food allergies or intolerance or sensitivities? And you can even include prophylactic probiotics, taking those. Just give us your best advice.
Dr. Bell: Sure. The first thing that I would recommend to people is to eat real food. I recommend that people read labels. If they can't pronounce a word on the ingredients or they don't recognize that word as a food, then they should put that back on the shelf. And they should attempt to really eat as much whole food as possible, shopping the perimeter of the grocery store and trying not to eat out of the box. That’s the first thing. Many people will eliminate all the processed foods and eat more of a whole food diet and their symptoms improve just from that. Then after that, taking a good quality refrigerated probiotic. And one way to know that it’s good quality is that it actually says on the label, “guaranteed until the time of expiration,” not just at the time of manufacture. And that’s also something that’s acceptable for people to do. The final thing is to try and keep a bit of a food and symptom diary and see if you do notice any direct associations of when you’re eating something and when you’re having a symptom. That’s a good beginning of just beginning to observe and watch and paying attention to our body. It can give us a quite a lot of information right from the start.
Melanie: Thank you so much. It’s really great information. You’re listening to the WELLcast with Allina Health. For more information, you can go to allinahealth.org, that’s allinahealth.org. This is Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): Food allergies and food intolerant and sensitivities can affect how you feel and lead to chronic symptoms like stomachaches, fatigue, or joint pain. But it can be a challenge to determining exactly which foods aren’t sitting right with you. My guest today is Dr. Debra Bell. She’s an integrative medicine family physician at Allina Health Penny George Institute for Health and Healing. Welcome to the show, Dr. Bell. Tell us a little bit about food allergies. Is it pretty common these days? Is it getting more common?
Dr. Debra Bell (Guest): Well, the answer to that is that food allergy is a big word. In general, food allergies are specifically that a person has a reaction soon after eating a certain food, and that would be something that your immune system is overreacting. Those are becoming more common. People hear about people having peanut allergies or children having severe allergies, and those are more common. There are also things that many people call food allergies that are not the same as those kinds of food allergies where you would have a specific reaction right after eating, like trouble breathing or swelling or hives or something like that. So it’s a big category in terms of what people think of when they hear “food allergy.” But technically, we’re talking about immediate hypersensitivity reaction from the immune system is technically what a food allergy is.
Melanie: What are some of the most common causes of food allergies?
Dr. Bell: The most common causes would be things like nuts and certain fruits are the most common that people have. Some people will have food allergies also to dairy, and of course celiac disease is actually an immune sensitivity to gluten, which is what’s in certain grains.
Melanie: And we hear a lot more about as people get older they develop food allergies that they didn’t have when they were younger, or is that an intolerance to fish or shellfish, things like that?
Dr. Bell: Yes. There is what’s called the delayed hypersensitivity response food allergy, and that would be the kind of thing that would develop later in life. That would be the kind of thing that somebody might develop over time. For instance, celiac disease is actually a delayed hypersensitivity response. And so that can happen as we get older that basically, our immune system, there’s something else that’s going on in our body, other exposures or other things that are increasing inflammation that sort of turn the dial up so that we begin to have more reactions. Our immune system becomes more reactive. And then in the same way, there are food intolerances which are still creating an immune response but is a different kind of immune response than from specific food allergies, and those also can develop as we get older based on all the other things that are happening in terms of exposures and our digestion and things like that.
Melanie: You mentioned food allergies and it being an urgent situation. It can be. What kind of symptoms would someone have if they have a food intolerance or a sensitivity?
Dr. Bell: That can be very broad. One of the most common things for food intolerance or a food sensitivity would be gastrointestinal complaints. And so people might have bloating or nausea or abdominal pain or diarrhea. Those would be the most common. But people can also have broader things like skin rashes. They can have joint achiness. People can have depression or difficulty concentrating or what people might call brain fog. And also, people can have fatigue. Those are symptoms that can be associated with food intolerance.
Melanie: When we’re talking about food sensitivities, you mentioned celiac, and we hear about gluten so much in the media. Are people reacting to this? Is this an overreaction, or are we truly getting oversensitive to gluten?
Dr. Bell: Well, I think both. I think that people are overreacting. Anytime anybody has anything wrong with them, people will always say, “Oh, it’s from gluten.” But the fact is that most people tolerate gluten quite well. There are many complicating factors though. What is in our grain now in the American agricultural realm is actually quite different than what we might have had 50 years ago, and so some people speculate that some of the sensitivity and intolerance is not actually the gluten but is to the modified grains and the various chemicals and pesticides that are used to grow those grains. That’s something that sometimes causes people intolerance. And then again, because we have so many different kinds of exposures and our food chain is not as great as it used to be, there are people who are sensitive to gluten. And gluten is a protein that is in certain grains, and so there are more people who have celiac disease that they’re used to, but it’s a small number. And now there’s a group of people who have what would be called non-celiac gluten intolerant. There are many more people with that than there were 50 years ago, but it’s not nearly as many as you might hear in the media or the public that blames just about everything on glutens.
Melanie: If you have some of those symptoms you’ve described, Dr. Bell, if they suspect that their eating might be what’s causing this bloating or nausea or any of these symptoms, what’s the first thing they should do?
Dr. Bell: I actually think that if people are having symptoms, it’s not a bad idea actually to seek professional help and make sure that you don't have celiac and that everything else with your digestion is normal. And then under guidance of a professional, consider doing an elimination diet. And whether you’re just doing elimination diet with gluten or you’re doing elimination diet with gluten and dairy or you do a more extensive elimination diet would be something that you would work out with the professional that you are working with, and that would be a skilled nutritionist or an integrative medicine practitioner. Because I think that one thing that I'm finding is that there are some people now who are eating extremely restrictive diets and actually are not having the right nutrients that they need—they’re losing weight, they don't feel well, and it’s because they’re not getting nutrients from being too restrictive. So you really want to do it under guidance in a very systematic way. We have people eliminate just for two to four weeks and then do a very systematic re-challenge so that we can gather information about whether or not someone really does have the food intolerance.
Melanie: What else would you do if they have that food intolerance? How would you treat it if you find out that this is really something that they’re intolerant now? Do they have to stay away from that food permanently? Is reading labels going to be a big part of this, or can they gradually reintroduce that food?
Dr. Bell: Well, again, it depends on the person and the situation. Most people do need to eliminate it for one to three months. Now, again, in integrative medicine, we often think that sometimes somebody’s food intolerances have to do with the health of the digestive tract and the general health of immune health. And so we do many other things to improve that. We improve other aspects of the diet to avoid exposures of excess—excess sugars, excess fats, excess processed foods, which can also just heal the gut over time. We try and avoid unnecessary antibiotics. We pay attention to making sure people are having enough sleep, stress reduction, and then we sometimes will use probiotic capsules of very specific kinds of bacteria to help to rebalance the environment of the gut. So there are a lot of things that we do for gut health, immune health, stress reduction and general healthy nutrition that then help to improve things so that people may be able to tolerate the substance either in moderation, which would be once or twice a week, or gradually be able to reintroduce it back in their diet over a four- to twelve-month period.
Melanie: In just the last few minutes, Dr. Bell, if you would, what’s your best advice for people that might think that they’ve got food allergies or intolerance or sensitivities? And you can even include prophylactic probiotics, taking those. Just give us your best advice.
Dr. Bell: Sure. The first thing that I would recommend to people is to eat real food. I recommend that people read labels. If they can't pronounce a word on the ingredients or they don't recognize that word as a food, then they should put that back on the shelf. And they should attempt to really eat as much whole food as possible, shopping the perimeter of the grocery store and trying not to eat out of the box. That’s the first thing. Many people will eliminate all the processed foods and eat more of a whole food diet and their symptoms improve just from that. Then after that, taking a good quality refrigerated probiotic. And one way to know that it’s good quality is that it actually says on the label, “guaranteed until the time of expiration,” not just at the time of manufacture. And that’s also something that’s acceptable for people to do. The final thing is to try and keep a bit of a food and symptom diary and see if you do notice any direct associations of when you’re eating something and when you’re having a symptom. That’s a good beginning of just beginning to observe and watch and paying attention to our body. It can give us a quite a lot of information right from the start.
Melanie: Thank you so much. It’s really great information. You’re listening to the WELLcast with Allina Health. For more information, you can go to allinahealth.org, that’s allinahealth.org. This is Melanie Cole. Thanks so much for listening.