14. Food Allergies, Sensitivities, and Intolerances
Did you know that children with autism are more likely to also have food allergies, sensitivities, and intolerances? While these words are often used interchangeably, they are all very different in how they present themselves, how we test for them, and how they can be treated!
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IN THIS EPISODE
Differences and similarities in food sensitivities, food intolerances, and food allergies
How to test for different types of food reactions
Where does celiac disease classify as a food reaction?
LINKS
Food Reactions in the Autism Nutrition Library
Join the Autism Nutrition Library
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TRANSCRIPT
Welcome to the Nourishing Autism Podcast where you take a deep dive into the research on autism and dietary changes, nutrition supplements, and lifestyle modifications. Every week, we break down nutrition topics and an easy-to-understand way for you to feel less overwhelmed and feel confident on your nutrition journey with autism.
Hi everybody, and welcome to the Nourishing Autism Podcast. I'm your host Brittyn Coleman, the Autism Dietitian. And today we are diving into all types of food reactions, including food allergies, food sensitivities, and intolerances. Really excited to talk about this because it is a very, very common topic in autism because we know that kids with autism are more likely to have different types of food reactions.
And oftentimes these words are used interchangeably, allergy, sensitivity, intolerance, and in fact, they couldn't be any more different. So we're going to dive into what each of these means. And also talk a little bit about the testing because it will be different for each of them. And really just how to group these into different categories so that you would be able to explain the symptoms that your child may be having and help your child get the best care.
So let's start off with food allergies because that is the most familiar food reaction to most people. So with a food allergy, typically we're thinking of common symptoms like anaphylaxis, hive, swelling, wheezing, or trouble breathing, tingling in your mouth, etc. And this typically happens instantaneously, or within 30 minutes of eating a food that the individual is allergic to. Now why this reaction is happening? When you start to have an allergic reaction, you have antibodies. And there IgE big I little G big E antibodies that are coming to the rescue.
And they are sending off this kind of inflammation and can cause this kind of reaction, your body is trying to protect you. What's happening is that your body flags, that food as inappropriate, that it shouldn't be there, and that it's harmful to your body. And so the rest of your body comes to the rescue and we have an allergic reaction.
A food allergy is often diagnosed by a skin prick test by an allergist or by something called RAST R A S T, which can be a blood draw. You can test for food allergens, you could test for environmental allergens, like mold or pollen or a dog dander, but typically in the nutrition world, we're talking about food allergies and there are top eight allergies that are commonly causing an allergic reaction. That's milk, wheat, eggs, soy, tree nuts, peanuts, fish, and shellfish. So a lot of people talk about some kind of food reaction just as a food allergy, but that's really not the case.
So let's dive into a food sensitivity so that you can tell the difference here. So a food sensitivity. First of all the symptoms are not as severe. Typically we're seeing symptoms like headache, brain fog, eczema, heartburn, bloating, irritability, gas, and cramps, and a runny nose. Even dairy sensitivity can show up as a runny nose.
Now on food sensitivities, the reaction timeline is a lot larger. We see reactions between 30 minutes and even up to 72 hours after consumption. So food allergies often go undiagnosed a lot of the time because we're looking at that immediate reaction. What did we just eat? In fact, it could be a few days later, they are actually having the symptoms of that reaction. So they can be really difficult to diagnose. Now in order to diagnose a food sensitivity, you can do an elimination diet. And I would definitely recommend doing that with the guidance of a dietitian or a healthcare professional to walk you through that, to make sure that we are identifying the foods that are causing an issue for your child you can also test for food sensitivities.
Now I want to be clear, there are so many food sensitivity tests out there. And many are not going to be very helpful or accurate. So a lot of times I know you're getting ads for different food sensitivities, and I'm sure you're probably gonna end up with an ad for some food sensitivity after listening to this podcast. Because that's the way it works. Right?
So a lot of times what they're testing for in food sensitivity testing is just antibodies. So if you remember, I talked about antibodies with food allergies and that antibody is called IgE. Now with food sensitivities, oftentimes our body puts out different antibodies like IgG, IgA, IgM to these food sensitivities, but it's not only just those antibodies. There's actually a lot of other cells involved here too. And a lot of the food sensitivity tests are only looking at that IgG antibody, which might not be a good representation because you can react to foods in different ways outside of just IgG.
There's actually even some evidence to show that if you've eaten a food recently, you may have increased levels of IgG. So proving some of those tests may not be fully accurate if that's only what they're testing for.
So there's a type of food sensitivity test that I use for my clients. And it's called the MRT and the MRT stands for the mediator release test. And what the MRT does it's a patent, a test and they look at the endpoint. It's an end-point test. What this means is that they're introducing, I won't go into all of the science on how they do it, but they introduce the sample of blood into these different proteins. And they measure the amount of inflammation that has occurred from those foods in the body.
So it's not just testing what is the IgG level of the food already in the blood? It's actually introducing the food proteins to the blood and measuring the amount of inflammation created. So they have a lot of information on the way that their test works on their website, which is now leap.com.
So I would encourage you to do that if you're interested in the science behind it, but that is the panel that I use for my clients. And I see it so incredibly helpful for kids who struggle with constipation, who struggle with gastrointestinal issues, headbanging, which may be a side effect of a headache or migraine, and honestly just helping kids feel their best. Sometimes we can't get to the root of why a child might not be feeling very well. And when we can locate the reason or a food that they're eating consistently, that is causing inflammation in their bodies over time, after removing that food, we can see they do so, so much better. So this is the test I use for my clients I've seen incredible successes over nearly past five years that I've been using this particular test with my clients.
And then lastly, let's talk about food and tolerance. So food intolerances, actually, aren't an immune reaction. So what food allergies and food sensitivities have in common is that they're both immune-mediated, meaning that your immune system is responding to that food and it's coming to the rescue for you.
So your immune system is responding. For a food intolerance, your immune system is not responding. It's more that you're missing a particular enzyme that breaks down a certain sugar protein. Typically, what we're thinking about is lactose intolerance and what lactose intolerance really is. Lactose is the sugar inside milk and your body needs an enzyme that breaks down that lactose. The enzyme easily it's called lactase, it breaks down lactose. Now some people do not have enough lactase in order to break down all of the lactose that's in milk, but when we can see some people still create some lactase but they could consume some food items that have little to no lactose in it, like fermented dairy. So for example, we have yogurt, we have Keefer, some of those fermented dairy products that don't have as much lactose in them.
People who are lactose intolerant can still get by with eating it because they still produce little levels of lactase. Now they can't consume a large glass of milk that has tons and tons of lactose in it because either they don't produce enough, or they're not producing that lactase at all. So this is not immune-mediated. It is more mediated by your digestion.
Typically, we're not doing a lactose intolerance test or some kind of testing for intolerances, but your physician may want to order one. If they do, it typically is going to be a hydrogen breath test. So you can have many other intolerances outside of just lactose. It could be sucrose. You could have a lack of sucrase.
So, if you were testing for lactose intolerance or sucrose intolerance, you would be ingesting a large amount of lactose or a large amount of sucrose or whatever it may be, and then testing that through that hydrogen breath test. But a lot of times we can go off of symptoms. If you notice you're having some severe diarrhea and gastrointestinal issues after consuming a glass of milk we can typically limit it down, but if you do want to do testing and pursue that you definitely can.
And so we can see there are very clear differences in between a food allergy, food sensitivity, and food intolerance.
Now those are the three typical food reactions that we're talking about. And I do want to bring up one last one, which is celiac disease. And celiac disease is different from all of these, in that it is a serious auto-immune condition. And what autoimmune conditions mean is that your body is basically coming and attacking itself in some kind of way. So for celiac disease, whenever you ingest gluten, which is the protein in many grains, like wheat, barley, and rye, and this triggers your immune system to attack itself. It attacks your small intestine and this can cause malnutrition or malabsorption of different nutrients. Typically the symptoms are diarrhea, stomach cramping, nausea, even vomiting short term. But long-term, you can have really pale, foul, smelling stools, the inability to gain weight, and malnourishment. So these reactions from a celiac response typically begin within 30 minutes but can happen up to two hours later.
Now testing for celiac disease is a lot different than testing for a food allergy or for food sensitivity. You have to go through a different set of testing. Definitely ask your GI doctor, if your child is experiencing these symptoms. So that they can do some simple blood work too. Rule it out. If they notice that lab work is abnormal. Then we can go through some more invasive testing, like actually doing a biopsy. So keep in mind that to test positive for celiac tests, you do have to be currently eating gluten. So if your child has been on a gluten-free diet for a few weeks now, or for a few months now, and you want to get tested for celiac disease, you would have to put them back on gluten in order to get an accurate result.
If you're interested in pursuing different testing, or just want to learn more about food reactions and autism. I do have a lot of information inside the Autism Nutrition Library and the food reactions note inside of the conditions tab. And if you scroll down, you can see some of the research that we've pulled aside that shows an increase in food, sensitivities, and allergies, and intolerance in autism. We do not see a known association between children with autism and having celiac disease.
There's so much more to talk about when it comes to food reactions. I definitely encourage you to speak with a healthcare provider who knows your child best in order to figure out if your child is having some kind of food reaction to help you test for that and figure out the next steps to help your child feel their best.
I do suggest working with a functional medicine practitioner who can do this testing for you, because if you do good. If you do go to an allergist's office, they are only going to test for food allergies. Same with your pediatrician.
So, if you're looking for additional testing outside of just allergy testing, you may seek the guidance of a functional medicine practitioner who can do these additional tests with you. And look at your child's health holistically and look at gut health and other pieces that may fit into that and why they may be having multiple food reactions. When we don't want to have food reactions, we're not supposed to react to tons and tons of foods. This may indicate something else like a leaky gut or some other inflammation inside the body.
Thanks, everybody for tuning in, and I will catch you next week as we take the guesswork out of Nourishing Autism!
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Transcribed by Descript
ABOUT Brittyn Coleman, MS, RDN/LD, CLT
I’m a Registered Dietitian, Autism Nutrition Expert, and the Creator of the Autism Nutrition Library.
I work with parents of children with autism to optimize their child’s diet, supplements, and lifestyle based on their unique needs. I help expand accepted foods for picky eaters, improve digestion and gut health, find the root causes of many symptoms, and ultimately help them feel their best so that they can do their best and be their best.
Not only do I relate to families on a professional level, but also on a personal level. I have been a part of the autism community for over 20 years, as my younger brother was diagnosed on the spectrum at a young age.
I look forward to working with you to uncover the root cause of your child’s symptoms and help your child be the best version of themselves!
