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Our body reacts to foods in many different ways. Imagine blindfolding a group of people and then asking them to describe an elephant. Each person would have a radically different description, depending on what part of the elephant they are describing. Although the description of the tail is radically different from that of the trunk, both are equally true and valid.
In this case, the “elephant” represents how our body reacts to food. Each food testing method describes a different “view,” a different part of the elephant. Some examples of these different types of food testing include the elimination diet, allergy testing, constitutional food intolerance testing, and ALCAT laboratory testing.
One food might test positive as an allergen, but not an intolerance, or vice versa. Again, these differences do not invalidate each other; instead they are different “views” of the elephant.
Food Allergies
Food allergies are caused when the immune system marks a food molecule as a “foreign invader” and begins to attack that particular food particle. Allergies can be either Immune globulin E (IgE) OR Immune globulin G (IgG) mediated reactions.
IgE food allergies are anaphylactic reactions and generally are quite obvious. Someone with a severe IgE reaction to strawberries, for example, would have throat swelling, hives and/or difficulty breathing within seconds of ingesting a strawberry.
IgG food reactions are delayed onset reactions. The body responds with less severe symptoms, from four hours to four days after the food is ingested. These allergic reactions are much harder to track, as someone may have eaten the offending food a few days before a reaction is evident. If you have an IgG (delayed onset) reaction to tomatoes, for example, you might not connect the headache on Thursday with the tomato soup you ate on Monday.
Food Intolerances
Food intolerances are other food reactions that may or may not be mediated by the immune system. Certain foods may cause inflammatory reactions in the body that have nothing to do with IgE or IgG pathways. Some physicians only pay attention to food allergies without understanding that foods can trigger other inflammatory pathways in the body.
Certain specialized laboratory tests have been developed to assess other types of inflammatory reactions in the body. I work with two types of food intolerance testing: constitutional food intolerance testing, also known as the “O.G. Carroll test”; and ALCAT Laboratory testing.
ALCAT Food Intolerance Testing
PreviMedica offers another form of food intolerance testing, the ALCAT Test. ALCAT uses a whole blood sample. The test examines the final common inflammatory pathway in the body. In other words, the test looks for any and all inflammatory reactions to foods.
The test reports assesses whether a food causes severe, moderate, mild or no reaction. The ALCAT test offers a much broader and more specific view of how we react to food than the constitutional food intolerance test. These test results can change over time, so you may want to repeat the test periodically to ensure that you are eating an optimal diet for your body at that time.
*note from the editor: more information regarding chronic inflammation, food intolerances, and health symptoms and conditions can be found at the here.
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You likely are very aware of the symptoms of acute inflammation. After falling on your knee, for example, you may experience pain, swelling, redness and heat in the area where you landed. These acute inflammatory symptoms are designed to protect the immediate area, walling off that region from further damage. Although these reactions are protective in the short term, they slow healing in the long run because they also impede the delivery of nutrients to repair the damaged area.
Chronic inflammation can be more difficult to detect. This low-level of inflammation may not be obvious using most clinical testing methods. Ongoing infection, repeated injuries, chemical exposures, irradiation, bacteria, viruses and fungi all can contribute to chronic inflammation. Another huge contributing factor that we will discuss in more detail below is the quality and quantity of food we eat.
Most physicians monitor severe inflammatory conditions, such as rheumatoid arthritis (RA), with a test called “sedimentation rate,” or “sed rate” for short. This test measures how quickly red blood cells in a test tube clot together and sink to the bottom of the test tube. The more inflammation in the body, the faster the blood cells clot and sink to the bottom of the tube.
When people suffering with Rheumatoid Arthritis go “into remission,” the periods between bouts of acute inflammation, the sed rate may be normal. Chronic, low level inflammation, however, continues to affect the body.
One of the primary tests used to track sub-clinical levels of inflammation (below the level most conventional tests would detect) is C-reactive protein (CRP). This test is an indirect measure of inflammation. Elevated CRP levels indicate increased inflammation in the body.
Over the past decade, conventional medicine has recognized that elevated CRP levels can contribute to a host of chronic conditions, including
· Alzheimer’s
· Asthma
· Heart Disease
· Diabesity (a combination of diabetes and obesity)
· Rheumatoid arthritis
· Osteoarthritis
· Inflammatory Bowel Disease (Ulcerative colitis and/or Crohn’s Disease)
Alzheimer’s Disease
For years researchers assumed age caused changes in brain tissue. Newer thinking points to inflammation as the cause of neurological changes that lead to Alzheimer’s.
Dr. Perlmutter first proposed the idea that inflammation, or “fire,” as he colorfully described it, was the primary catalyst for Alzheimer’s and other forms of dementia. Research demonstrated that patients who regularly used anti-inflammatory drugs had lower incidence of Alzheimer’s disease. Regular ibuprofen users reduced their risk for developing Alzheimer’s to only 40% of those who did not take ibuprofen. Aspirin users reduced risk by 26%. Acetaminophen users, however, had a 35% increase in their risk for developing Alzheimer’s, possibly because of the toxic metabolites which reduce glutathione.(1, 2, 3, 4)
Perlmutter emphasizes the best treatment is preventative, i.e. minimizing inflammation so that brain changes never begin. Reducing brain inflammation once it has begun is difficult, as cerebral inflammation tends to be self-perpetuating. (5, 6)
Lowering blood sugar levels is an extremely effective way of protecting the brain from age-related damage. A Dutch study revealed that type II diabetics taking insulin had four times the risk of developing dementia. Those who ate fewer calories had fewer free radicals, and therefore less damage. Lower glucose levels also means less glycosylation, i.e. protein damage caused by elevated glucose levels. (7)
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Alzheimer’s Disease
For years researchers assumed age caused changes in brain tissue. Newer thinking points to inflammation as the cause of neurological changes that lead to Alzheimer’s.
Dr. Perlmutter first proposed the idea that inflammation, or “fire,” as he colorfully described it, was the primary catalyst for Alzheimer’s and other forms of dementia. Research demonstrated that patients who regularly used anti-inflammatory drugs had lower incidence of Alzheimer’s disease. Regular ibuprofen users reduced their risk for developing Alzheimer’s to only 40% of those who did not take ibuprofen. Aspirin users reduced risk by 26%. Acetaminophen users, however, had a 35% increase in their risk for developing Alzheimer’s, possibly because of the toxic metabolites which reduce glutathione.(1, 2, 3, 4)
Perlmutter emphasizes the best treatment is preventative, i.e. minimizing inflammation so that brain changes never begin. Reducing brain inflammation once it has begun is difficult, as cerebral inflammation tends to be self-perpetuating. (5, 6)
Lowering blood sugar levels is an extremely effective way of protecting the brain from age-related damage. A Dutch study revealed that type II diabetics taking insulin had four times the risk of developing dementia. Those who ate fewer calories had fewer free radicals, and therefore less damage. Lower glucose levels also means less glycosylation, i.e. protein damage caused by elevated glucose levels. (7)
Heart Disease
For many years, total cholesterol levels and the ratio of LDL (“bad” cholesterol) to HDL (“good” cholesterol) were considered the best predictors of heart disease. In the early 1990’s, however, researchers began to recognize a stronger correlation between elevated homocysteine levels and heart disease than elevated cholesterol and heart disease. (8) High levels of homocysteine, an amino acid, are associated with a range of chronic inflammatory conditions including heart disease, arthritis, and osteoporosis.
Another study, released in 2002, further undermined the conventional medical world’s assumptions about heart disease. C-reactive protein, or CRP, was shown to be a better predictor of heart disease than cholesterol levels. In fact, even small, seemingly insignificant cholesterol plaques along blood vessel walls could “blow up” under the influence of CRP.
In a recent study, patients with low cholesterol levels were given Rosuvastatin, a statin drug. Although their cholesterol levels did not change, their CRP levels dropped by 37%! Most physicians have assumed the benefits of statin drugs were related primarily to their cholesterol lowering effects. This new study demonstrates that an even greater benefit may be from the CRP-lowering effects of the statin drugs. (9)
Blood sugar levels also directly impact blood vessel health. When blood sugar levels run high, nitric oxide (NO) levels plummet. Nitric oxide supports blood vessel elasticity and dilation, and therefore helps lower blood pressure levels. Recent research shows L-arginine, an amino acid, can increase NO levels. Save your money, though. Five different enzymes quickly break down L-arginine. You need to dose L-arginine every 4 -5 hours to maintain steady blood levels. Pomegranate juice protects against the break-down of L-arginine, thereby increasing NO levels. You also can increase NO (with no additional supplements!) by reducing calories and steadying blood sugar levels.
The bottom line: although cholesterol levels can dramatically affect blood vessel health, homocysteine and CRP levels are better predictors for heart disease.
Remember we can reduce CRP and homocysteine levels with nutrients and lifestyle choices, NOT just drugs.
Asthma
Usually allergic reactions trigger asthma, e.g. an allergy to pollen or dust. Exercise and cold exposure also can stimulate an asthma attack. Recent research shows roughly half of the asthma sufferers in the U.S. whose symptoms begin in adulthood have no allergic tendencies, but they do have significantly elevated CRP levels. I’ve worked with several patients who fall into this category. Some are diagnosed with “asthma” and other with “reactive airway disease,” or RAD.
Obesity + Diabetes = Diabesity
For years we have known that carrying too many pounds can increase insulin resistance. Newer evidence suggests that the cell receptors resist insulin because of inflammation triggered by fat cells. Fat cells release inflammatory cytokines which in turn trigger an inflammatory cascade in the body that inhibits cell response to insulin. (10, 11, 12)
Reduced response to insulin may continue for many years before someone is diagnosed with diabetes. This period of impaired blood sugar control has many names, including metabolic syndrome, insulin resistance, syndrome x, and borderline diabetes. People struggling with blood sugar regulation often have high triglyceride levels, reduced HDL (the “good” cholesterol), increased inflammation, three times the risk for heart attack, higher risk for stroke and diabetes.
Insulin is a vital hormone that “unlocks” cell walls so that blood sugar can enter. Imagine a long corridor in a hotel, with rooms on either side of the hallway. Each room represents a separate cell. Insulin “unlocks” the door so that blood sugar can enter the cell. Without insulin, blood sugar would continue to mill around in the hallway, waiting for a “door” to open.
Someone may produce enough insulin, but the insulin may fail to “unlock” the cell door. The cell “locks” are resistant to insulin’s effect, and blood sugar continues to circulate in the hallway while the cells are empty. In essence the cells are “starving in a sea of plenty."
Inflammatory bowel disease
The primary inflammatory marker associated with Inflammatory Bowel Disease is tumor necrosis factor-alpha (TNF-alpha). This tumor marker, produced by macrophages in the immune system, destroys and suppresses tumor cells. Researchers have discovered TNF-alpha is elevated with sepsis (systemic infection), autoimmune diseases (included rheumatoid arthritis), psoriasis, and inflammatory bowel disease.
Stress increases systemic inflammation
Recent research demonstrates that increased stress causes spikes in cortisol, which in turn increase inflammation in the body. Increased stress can contribute to Alzheimer’s disease, heart disease, blood sugar dysregulation and diabetes.
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Inflammatory and anti-inflammatory
pathways in the body
Most of the inflammatory reactions in our body are mediated by a group of fatty acids called prostaglandins. Our bodies have three prostaglandin pathways that either increase or reduce inflammation in the body:
PGE1 (prostaglandin 1)
· Reduces inflammation
· Decreases blood pressure
· Reduces allergic reaction
· Increases mucous production in the stomach
· Increases immune response
· Promotes nerve function
Food sources of PGE1: the body uses linoleic acid, an essential fatty acid, to make PGE1 in the body. “Essential” fatty acids must be consumed in our diets. We cannot produce them internally; hence, they are essential to include in our diet. Food sources of linoleic acid include safflower oil, sesame oil and seeds, evening primrose oil, black currant seed oil, borage oil, soy oil, corn oil, gamma linolenic acid (GLA), and breast milk.
PGE2
· Increases inflammation
· Suppresses immune function
· Promotes allergy response
· Increases platelet aggregation (how easily platelets in the blood stick together, forming micro-clots along blood vessel walls)
· Increases smooth muscle contraction/spasticity
Food sources of PGE2: meats, dairy products including human breast milk.
PGE3
· Reduces inflammation · Inhibits the release of PGE2
· Increases HDL, the “good” cholesterol
· Decreases triglycerides
· Decreases platelet aggregation
Food sources of PGE3: the body uses alpha-linolenic acid to make PGE3 in the body. Foods rich in alpha-linolenic acid include EPA (fish oil), DHA (fish oil), flaxseed oil (the richest natural source of omega-3 fatty acids), walnuts, pumpkin seeds, soybeans, and hemp seeds and oil.
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Some physicians consider the elimination diet the “gold standard” for identifying food reactions. The elimination diet involves eating a “hypo-allergenic diet” (foods that are considered non-reactive) for two weeks. After this two week “clearing” diet, the patient eats a suspected food allergen and waits up to four days for any sign of reaction. If she has no reaction within four days, she then eats lots of the food for a day and waits another four days for any symptoms to develop. If she has no reaction to this second “challenge,” then the food is considered safe to eat.
Although some patients have great success with this approach, many do not have the patience to stay on the hypo-allergenic diet and invest up to eight days to test each food. Thoroughly testing 200 foods, for example, would require up to 1600 days (over four years)!
Some people also react to the assumed “hypo-allergenic” foods, which skews the test results. Most elimination diets, for example, include lamb, pears, and rice. I know from other testing that I am severely reactive to pears and lamb. If I followed the classic elimination diet, I would never have a clear reading on the introduced foods, as I already would be reacting to the “hypo-allergenic” diet!
The elimination diet can be helpful if you want to test only a handful of foods. Keep in mind, though, that you may also react to some of the “hypo-allergenic” foods, and thus skew the test results.
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What other options do I have for reducing inflammation?
Dietary
• Reduce meat, dairy and eggs in your diet. These foods contain arachadonic acid, which runs the PGE2 inflammatorypathways in the body.
• Reduce simple carbohydrates such as sugar, white flour and white rice. These foods increase acidity in the body. The more acidic the body, the more inflamed it becomes.
• Steady blood sugar levels. The more blood sugar spikes you have, the more acidic the body becomes. See (Link Here) for more information about steadying blood sugar levels.
• Eliminate food intolerances. Unknowingly eating food intolerances also increases overall inflammation in the body. Even “healthy” foods may not be healthy for a particular person. Pears usually are listed on hypo-allergenic diets, for example, yet they are a severe intolerance for me, triggering severe inflammation in my body! A “healthy” diet is an individualizeddiet, one that suits your particular body.
• Increase fruits, vegetables, and other “alkaline-forming” foods. The more alkaline your body, the less inflammation.
• Add GLA, omego-3 and fish oil to your diet. These oils help run the PGE1 and PGE3 pathways, both of which support anti-inflammatory responses in the body.
• Add green tea to your diet (as long as this is NOT a food intolerance for you!). Research shows that theaflavin, a constituent in black and green tea, blocks the gene expression of cytokine interleukin-8 (IL-8).(13) Elevated IL-8 levels are associated with asthma, gum disease, inflammatory bowel disease, cancer, and cardiovascular disease. Both British and Japanese studies also demonstrated black tea reduces platelet aggregation, the beginning of the clotting cascade.(14, 15)
• Lose weight if you are overweight. Remember that fat cells release cytokines, which trigger inflammatory reactions in the body.
Reduce stress
• 10 deep breaths, 3 – 4 times a day. Deep breathing is one of the fastest, most effective ways of shifting the body from stress to relaxation.
• Meditation, at least 20 minutes once a day. Studies in the 1980’s demonstrated that regular meditators have higher DHEA levels, which in turn reduce PGE2 (inflammatory) activity. More time spent in meditation (and deep relaxation) increases DHEA and reduces inflammation in the body. (16)
• Guided deep relaxation – during the day and/or at bedtime.
Exercise
• “Uses up” cortisol and other stress-related hormones. Recent research comparing fit and unfit women found that women who exercised regularly released less cortisol in response to stressful events. (17) Remember that increased cortisol levels can contribute to Alzheimer’s disease, cardiovascular disease, diabesity, and a host of other chronic, inflammatory conditions.
• Reduces muscle tension
• Strengthens bones
• Improves sleep
Increase sleep
• A study published in the February 15, 2011 issue of the Journal of Cancer demonstrated that people sleeping six or less hours per night had a 50% increase in the risk of developing colorectal adenomas. Adenomas are growths in the colon that can become malignant, e.g. turn into colon cancer.
• Improves immune function
• Improves short term memory and concentration.
ENDNOTES
1. Alafuzoff I, et al. 2000. Lower counts of astroglia and activated microglia in patients with Alzheimer’s disease with regular use of non-steroidal anti-inflammatory drugs. J Alzheimer’s Dis 2:37-46.
2. Anthony JC, et al. 2000. Reduced prevalence of Alzheimer’s disease in users of NSAIDs and H2 receptor antagonists: the Cache County study. Neurology 54(11):2066-71.
3. Lim GP, et al. 2000. Ibuprofen suppresses plaque pathology and inflammation in a mouse model for Alzheimer’s disease. Journal of Neuroscience 20:5709-14.
4. MacKenzie IR, et al. 1998. Nonsteroidal anti-inflammatory drug use and Alzheimer-type pathology in aging. Neurol 50:986-90.
5. Teismann P, et al. Cyclooxygenase-2 is instrumental in Parkinson’s disease neurodegeneration. PNAS 2003; 100 (9):5473-5478.
6. Pompl PN, et al. A therapeutic role for cyclooxygenase-2 inhibitors in a transgenic mouse model of amyotrophic lateral sclerosis. FASEB J. 2003; 10.1096/fj.02- 0876fje
7. Ott A, Stolk RP, van HF, et al. Diabetes mellitus and the risk of dementia: The Rotterdam Study. Neurology. 1999 Dec 10;53(9):1937-42.
8. Lambert J. et al. Familial hyperhomocysteinaemia and endothelium-dependent vasodilatation and arterial distensibility of large arteries. Cardiovasc Res. 1999 Jun;42(3):743-51.
9. Ridker PM, Danielson E, Fonseca FA, et al. Rosuvastatin to prevent vascular events in men and women with elevated Creactive protein. N Engl J Med. 2008 Nov 9.
10. Schmidt MI, Duncan BB. Diabesity: an inflammatory metabolic condition. Clin Chem Lab Med. 2003 Sep;41(9):1120-30.
11. Weisberg SP, Leibel R, Tortoriello DV. Dietary curcumin significantly improves obesity-associated inflammation and diabetes in mouse models of diabesity. Endocrinology. 2008 Jul;149(7):3549-58.
12. Leiter EH, Reifsnyder PC, Xiao Q, Mistry J. Adipokine and insulin profiles distinguish diabetogenic and non-diabetogenic obesities in mice. Obesity (Silver Spring). 2007 Aug;15(8):1961-8.
13. Aneja R, Odoms K, Denenberg AG, Wong HR. Theaflavin, a black tea extract, is a novel anti-inflammatory compound. Crit Care Med. 2004 Oct;32(10):2097-103.
14. Steptoe A, Gibson EL, Vuononvirta R, et al. The effects of chronic tea intake on platelet activation and inflammation: a double-blind placebo controlled trial. Atherosclerosis. 2007 Aug;193(2):277-82.
15. Sugatani J, Fukazawa N, Ujihara K, et al. Tea polyphenols inhibit acetyl-CoA:1-alkyl-sn-glycero-3-phosphocholine acetyltransferase (a key enzyme in platelet-activating factor biosynthesis) and platelet-activating factor-induced platelet aggregation. Int Arch Allergy Immunol. 2004 May;134(1):17-28.
16. MacLean CR, Walton KG, Wenneberg SR, et al. Effects of the Transcendental Meditation program on adaptive mechanisms: changes in hormone levels and responses to stress after 4 months of practice. Psychoneuroendocrinology. 1997 May;22(4):277-95.
17. Traustadottir T, Bosch PR, Matt KS. The HPA axis response to stress in women: effects of aging and fitness. Psychoneuroendocrinology. 2005 May;30(4):392-402.
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What’s the correct ratio of Omega-6 and Omega-3 essential fatty acids?
Ideally we would eat four parts Omego-6 essential fatty acids to one part Omega-3. Most Americans, however, eat far too much of the Omega-6 fatty acids, often twenty times as much as the Omega-3’s.
You can help rectify this imbalance in two ways:
1. Reduce overall fat consumption. Most Americans eat 40 – 50% of their calories from fat. In contrast, most traditional Asian diets rely on fat for 10 – 20% of their calorie intake!
2. Increase foods rich in Omega-3 fatty acids: fish and fish oil; freshly ground flax seeds and flax oil; pumpkin seeds; freshly ground hemp seeds and hemp oil.
3. For more information about fats and oils, visit (LINK HERE this would be the extended article about fats and oils).
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Should I just eliminate wheat and dairy?
Wheat and dairy are two of the most common food intolerances and allergies in North America. Before devoting time and energy in changing your diet to eliminate these foods, however, you may want to invest in some specific food tests to determine whether these or other foods are contributing to your health problems. The tests may confirm your suspicions or direct you to eliminate completely different foods. With this knowledge in hand, you can invest your energy in making changes that are most likely to benefit you and your health.
Keep in mind that the body can react to a particular food in several different ways. Because so many patients are concerned about wheat, I’ll outline all of the different ways the body can react to wheat, gluten, and/or gliadan:
Celiac disease (also known as celiac sprue, gluten-sensitive enteropathy, and nontropical sprue) is an inherited genetic tendency. For someone with celiac disease, gluten -rich food triggers an auto-immune response when it enters the small intestine. This auto-immune reaction causes severe inflammation that, over time, compromises the small intestine’s ability to absorb any nutrients. As the condition progresses, someone with celiac disease becomes severely malnourished.
Those with celiac disease cannot eat any grain that contains gluten: wheat, barley, rye and oats. Proteins related to gluten also are found in triticale, spelt, kamut. Eating any of these gluten-containing grains can cause gas, bloating, and severe intestinal inflammation that over time can lead to poor absorption of all nutrients.
Your family doctor can order a specific test to determine whether or not you have celiac disease.
Wheat Allergy
An allergy is a specific Immune globulin reaction (see below) to particular foods. Someone with a wheat allergy, for example, might not react to other gluten-rich foods, such as oats or barley.
Wheat intolerance
Someone with wheat intolerance has an inflammatory reaction to wheat that may be mediated by any of the inflammatory pathways in the body. Like the wheat allergy described above, this person may react to wheat but not other gluten-rich grains.
Gluten intolerance
Someone who is gluten intolerant does not test positive for celiac disease. This person, however, may have an inflammatory response to gluten that is not as severe as celiac sprue.
What about an allergy to milk?
Just as with wheat, you can react to dairy in a variety of ways, outlined briefly below:
Dairy allergy
Allergic reactions are specific Immune globulin-mediated reactions (see below) to dairy products made from cow, goat and/or sheep. A true dairy allergy means you are allergic to any product made from that animal’s milk including cheese, cottage cheese, sour cream, yoghurt, kefir, or butter.
Dairy intolerancemeans dairy products cause an inflammatory response in the body that may be mediated by any of the many inflammatory pathways in the body. Someone with dairy intolerance may react to a certain animal milk (such as cow’s milk) but not another (such as goat or sheep). Someone with dairy intolerance generally will react to all forms of dairy products, e.g. cheese, milk, yoghurt, butter, kefir, casein, whey, and lactose.
Lactose intolerance means someone cannot tolerate lactose (milk sugar), but he is able to tolerate other components of dairy such as casein (milk protein) or whey (a protein-rich byproduct of cheese production).
Casein intolerance refers to a reaction to milk protein, but not necessarily lactose or whey.
Whey intolerance means someone has an inflammatory response to whey, but not necessarily to casein or lactose.
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Wheat and Dairy Allergies and Intolerances
Is an Elimination Diet right for you? 
Food Factors and Athletic Performance
