33 million people in the U.S. struggle with food allergies, yet many remain undiagnosed and continue to suffer in silence. Recent studies estimate that up to 20% of the population struggle with some form of food intolerance, yet less than a third are formally diagnosed.

Part of the challenge is understanding the differences between the types of adverse food reactions and how they can affect our health! Imagine starting each day unsure of which foods will make you feel sick and tired. This is a frustrating reality for many individuals navigating the complex world of food allergies, sensitivities, and intolerances.

Our comprehensive guide aims to shed light on these situations, offering insights into identification, management, and relief. The ultimate goal is to ensure that food can once again be a source of pleasure rather than a cause of fear.

Understanding Adverse Food Reactions

The term “adverse food reactions” is the umbrella term that encompasses food allergies, sensitivities, and intolerances. We’ll briefly explore each, but the main difference between these categories lies in the chemistry of the immune system that is involved in each adverse reaction.

Food Allergies

Food allergies are the most “classic” food reactions that most people think of. There is an immediate, sometimes severe and life-threatening, reaction from the engaged immune system. These reactions usually manifest within seconds to minutes after consuming or contacting the food.

Common food allergies include immune reactions to peanuts and other tree nuts, shellfish, milk, eggs, and wheat. Food allergies most commonly manifest with classic allergic symptoms such as itching, hives, swollen tongue, vomiting, and difficulty breathing, such as with anaphylaxis.

Food Sensitivities

Food sensitivities are also characterized by an immune response but take place through a different mechanism. Rather than the immediate response of food allergies, food sensitivity reactions can take hours to even days to appear. This makes intolerances sometimes more difficult to identify.

Common food sensitivities include dairy, eggs, gluten, tree nuts, and soy. Symptoms of food sensitivities can vary widely and can include fatigue, depression, anxiety, joint pain, acne, rashes, migraines, and headaches.

Food sensitivities are often related to the gut-immune connection and conditions like leaky gut, which we’ll explore later.

Food Intolerances

A food intolerance is different from allergies and sensitivities in that these reactions do not involve an immune system response. Instead, intolerances involve the body not being able to properly break down and process the food item.

A classic example is lactose intolerance, which involves a deficient or defective lactase enzyme needed to break down lactose, the sugar in milk.

Common food intolerances include those to milk, citrus, chocolate, histamine in foods, alcohol, artificial colors, preservatives, and flavors. Symptoms can vary but often include flu-like symptoms, inflammation, and digestive discomfort.

What Causes Adverse Food Reactions?

Despite how relatively common food reactions are, the reason for their existence is poorly understood. This remains a common question in research, and several hypotheses have been explored though inconclusive.

Some theories that attempt to explain the increasing rates of food reactions include the following:

• The Hygiene Hypothesis - Contemporary living reduces the immune system’s exposure to microbes. Contributing factors include antibiotic use, more cleaning products, less farming, decreased outdoor play, and more!
• Vitamin D - Observations show higher incidence of food allergies the further one lives from the equator. Less sunlight exposure leads to lower levels of vitamin D, an important nutrient for the immune system.
• Early Immune System Development - Factors like breastfeeding, fewer vaginal births, and the timing of solid food introduction have been explored.

Leaky Gut and Adverse Food Reactions

The gut-immune connection deserves special attention when discussing food reactions! An estimated 70% of the immune cells in the entire human body reside in the gut. This makes the gut a crucial part of the puzzle in dealing with food reactions.

One hypothesis for the increasing rates of adverse food reactions is the concept of leaky gut, also known as intestinal permeability. Various factors like Stress, inflammatory foods, gluten, antibiotics, and over-the-counter painkillers can overwhelm the integrity of this important immune barrier.

Leaky gut occurs when the single-cell layer separating the inside of your digestive tract from your bloodstream is disrupted. This allows larger particles, such as undigested food, to enter the bloodstream and trigger an immune response.

Research in this area is ongoing, but it is practical to note that the more food sensitivities you have, the more likely it is related to an intestinal permeability issue. The leakier the gut, the more types of food particles are allowed through, and the more your immune system becomes sensitized.

One last thought to consider when navigating adverse food reactions: any whole food is not inherently “good” or “bad,” even though we often seek black-and-white answers in contemporary diet culture. Also, maybe it’s not the food’s fault at all - maybe it’s your gut.

Common Food Reactions

Before we dive into the most common triggering food, I want to highlight that many people do not experience reactions to these foods. Some do. It may be beneficial to work with a well-training nutritionist, dietician, or healthcare practitioner to help navigate these topics to avoid disordered eating and undernutrition.

The Big 5

Let’s first start with what I like to call, “The Big 5.” These are foods that most commonly cause food reactions. They are wheat/gluten, dairy, soy, tree nuts (especially peanuts), and shellfish. These five food groups are often part of an elimination diet plan and are a great place to start if you suspect adverse food reactions.

Nightshades

Nightshades are products of plants that come from the Solanaceae family that includes over 2,000 plants. Many of them are naturally poisonous and inedible, while others are able to be safely consumed by most.

Some of the most common edible nightshades are potatoes, tomatoes, eggplant, bell peppers, jalapenos, and chili peppers. Other products that contain some of the same problematic compounds as nightshades include ashwagandha, tobacco, and goji berries!

High Histamine Foods

Histamine is a compound naturally found in the human body and in many foods. It plays a role in coordinating allergic reactions, sleep/wake cycles, and stomach acid release among other things. In some, higher levels of histamine from increased intake or dysfunctional breakdown can trigger symptoms.

Common histamine-rich foods include alcohol, cheeses, spinach, sausage, pork, nuts, avocado, citrus, coffee, and chocolate. Histamine content rises as foods ripen or age, so it helps to eat freshly prepared food and promptly freeze or refrigerate leftovers.

Other Food Trigger Considerations

There are other classifications of foods that can affect some people, though much less frequently. I will briefly introduce some of them here:

• Salicylates, found naturally in many plants and alcohols, can trigger reactions in sensitive individuals when consumed in higher amounts.
• High tyramine foods, like aged cheeses and fermented products, can cause issues for those with tyramine sensitivity and those on medications such as MAOI antidepressants.
• Oxalates, present in foods like spinach and beets, may contribute to problems for individuals prone to kidney stones.
• Mold-containing foods, such as certain cheeses, dried fruits, and baked goods, can accumulate and be problematic for some.

While these triggers are generally less common, they can still significantly impact those who are sensitive to them. It's essential to be aware of these potential triggers and consult with a healthcare provider if you suspect any of these may be affecting you.

Symptoms Related to Adverse Food Reactions

Adverse food reactions are frequently part of the complex underlying picture of chronic health issues. Many people don’t realize how badly they feel or that specific foods are the cause until those trigger foods are removed. This is especially true with delayed sensitivity reactions.

Another difficult reality is that symptoms can include a range of mental, emotional, and physical symptoms, making them tricky to diagnose. Understanding the common symptoms is a crucial step toward healing.

Physical Symptoms:

• Brain & Head: Dizziness and headaches.
• Mouth, Nose, Throat, & Chest: Anaphylaxis, asthma, cough, difficulty breathing, runny nose or nasal congestion, sensation of a lump in the throat, swelling of the lips, face, tongue, and throat, tingling or itching in the mouth.
• Abdominal Region: Diarrhea, nausea, vomiting, indigestion, stomach pain, and cramping.
• Limbs, Hands, and Feet: Weakness, numbness, and joint pain.
• Skin: Hives, rash, itching, eczema, and discoloration of the skin.

Non-Physical Symptoms:

• Behavioral or Psychiatric Disorders: Hyperactivity, anxiety, depression, mood swings
• Reproductive Issues: Infertility, irregular periods
• Cognitive: Brain fog, fatigue

Recognizing these symptoms and their connection to food can help you identify and eliminate trigger foods, leading to significant improvements in your health and well-being.

Identifying and Testing for Food Triggers

Identifying food triggers is a crucial step in managing adverse reactions. It can also be challenging, but it’s worth the process and effort!

The gold standard for this process is the elimination diet, where you remove potential trigger foods from your diet for a period and then reintroduce them one by one. Then you carefully monitor any symptoms.

You can also test the immune system response through antibody testing. I generally suggest that such results should be taken with a grain of salt as they may not always be definitive and related to the actual expression of symptoms.

If you find yourself reacting to multiple foods, it might indicate broader gut or immune system issues. Remember, the problems aren’t always with the foods themselves. Working with a healthcare provider can ensure the systematic identification of food triggers, leading to a more balanced and symptom-free life.

5 Strategies for Managing Adverse Food Reactions

Finally, let’s look at five practical strategies to navigate food allergies, sensitivities, and intolerances. Hopefully, these form an empowered base for tackling the issues in a very noisy space.

1. Consult with Specialists: Seek guidance from allergists, immunologists, and gut health experts.
2. Mind Your Mental Health: Considering our diet culture and the complexities of navigating food triggers, seek counseling to help support your journey.
3. Consider Your Gut Health: Incorporate special testing or treatment for your gut and avoid inflammatory and processed food. You can even incorporate a high-quality probiotic supplement like the supplement we created called Horizon by Cielo.
4. Prioritize an Elimination Diet: Consider an elimination diet to identify and remove specific food triggers by methodically reintroducing foods and monitoring reactions.
5. Choose Fresh, Whole Foods: Opt for fresh, whole foods and cook at home to avoid hidden sources of common food triggers found while eating out.

Conclusion

Remember, navigating the world of food allergies, sensitivities, and intolerances can feel overwhelming. With the right information and support, it is possible to sort through the noise, find relief, and regain control over your health.

You’re not alone on this journey, and understanding the root causes and identifying symptoms is a powerful first step. On the other side of the effort, the goal is to transform your relationship with food from one of fear and uncertainty to one of enjoyment and nourishment.

For ongoing support and practical wellness tips, follow Cielo and Dr. Kenny on Instagram and stay connected for more empowering content.