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Food intolerance

Most hypersensitive physical reactions upon food intake are caused by food intolerance and much more rarely by food allergy. Food intolerance is increasing in the westernised world and affects 10% of the whole population.

Food intolerance is a type of food hypersensitivity that is caused by a difficulty in digesting or processing certain foods. Food intolerance is not an allergy! Food intolerance differs from a food allergy because it generally requires a normal serving size to produce symptoms similar symptoms. Also, symptoms can arise from many different foods and symptoms of food intolerance usually present slowly, within hours or even days after food consumption.

Food intolerances are difficult to diagnose because food chemicals that cause food intolerance are found in a wide range of foods. Generally, food intolerance symptoms become stronger the more of the relevant food is eaten. If only a little amount of the relevant food is eaten the person might remain symptom free.

Types of food intolerances

Frequent types of food intolerances are:

• Lactose intolerance – dairy products
• Gluten sensitivity – wheat, barley (malt), oats, rye
• Histamine intolerance – many different (processed, fermented and old) foods
• Glutamate intolerance – against monosodium glutamate (MSG)
• Alcohol intolerance – by alcohol dehydrogenase deficiency or histamine liberation
• Salicylate intolerance –fruits, vegetables, spices, Aspirin

Other types of food intolerances are caused by food additives in processed foods, like:

• Artificial sweeteners – Sorbitol, Xylitol, Aspartam, Saccharin, Sucralose
• Artificial colouring – Especially carmine (red) and annatto (yellow)
• Emulgators
• Other flavourings

Symptoms of food intolerance

Signs and symptoms of food intolerances can vary greatly between different people and different types of food intolerances. Food intolerance signs and symptoms can affect the gastrointestinal tract, the respiratory tract, and/or –more rarely – the skin. Symptoms of food intolerances include:

• Gastrointestinal tract
• Abdominal cramps
• Mouth ulcers
• Nausea
• Diarrhoea, constipation, or bloating – intermittent
• Respiratory tract
• Asthma
• Cough (dry)
• Nasal congestion
• Pharyngeal irritations
• Sinusitis
• Skin
• Dermatitis
• Eczema
• Hives (urticaria)
• Skin rashes

Because physical health, social health and mental health are influencing each other, be aware that these physical symptoms of food intolerance may have a strong impact on our mental wellbeing as well.

Causes of food intolerance

Different types of food intolerances have different causes. Generally, causes for food intolerances can be:

• Absence or low activity of an enzyme
  • Lactose intolerance
  • Fructose intolerance (hereditary)
  • Galactose intolerance
  • Sucrose intolerance
  • Sorbitol intolerance
  • Gluten sensitivity
  • Histamine intolerance
• Damaged gut flora
  • Lactose intolerance
  • Gluten sensitivity
• Malabsorption
  • Fructose malabsorption
• Chemicals in foods and drinks
  • Salicylate
  • Benzoate
  • Amines
  • Caffeine
  • Nitrates
  • Sulfites
• Food additives from processed foods
  • Glutamate (monosodium glutamate) – Can cause headaches.
  • Sulfites – Can trigger asthma attacks
• Artificial sweeteners
• Artificial colouring
• Emulgators
• Other flavourings
• Irritable bowel syndrome
• Celiac disease
  • Lactose intolerance can be a secondary effect of celiac disease!

Foods that cause food intolerance

According to surveys in Germany, the following foods caused symptoms of food intolerance in more than 10% of persons:

• Beans and pulses
• Cucumber salad
• Fried foods
• White cabbage
• Carbonated drinks
• Kale
• Fatty foods
• Peppers
• Sauerkraut
• Onions
• Savoy cabbage
• Hard-boiled eggs
• Coffee
• Mayonnaise
• Smoked meat and fish

Treatment of food intolerance

There are three general lines of treatment

• Food exclusion diet
• Digestive enzymes
• Gut restoration

However, food exclusion diet and the use of enzymes are treatment options that only treat the symptoms of food intolerance. These treatment options require lifelong compliance and cannot lead to a cure. The only causative treatment for food intolerance, which only works for some food intolerances, is doing a gut restoration.

Food exclusion diet

The main treatment option for patients with food intolerance is to stick to a strict food exclusion diet. In contrast to the elimination diet ­– which is a diagnostic tool – food exclusion diet is the most important treatment option for patients with food intolerance.

Exclusion diet means total avoidance of the foods identified in the food elimination diet and oral food challenge. On an exclusion diet, symptoms should improve or even resolve completely, within days to weeks. Improvement of food intolerance symptoms usually occurs within 2 to 4 weeks.

A strict food exclusion diet can be challenging. As long as you are cooking for yourself you can succeed in entirely avoiding the foods you do not tolerate. But there are some food intolerances that involve substances which are found in many different foods, for example histamines. Another issue is processed foods. I am not talking only about ready-made meals and fast-foods, but also processed foods like mayonnaise or mustard.

That means whenever you use processed foods for meals and cooking, you need to read food labels! The main problem arises when you don´t have time to cook for yourself, are invited to eat with friends or simply like to eat in a restaurant. Same applies to entirely processed foods, like ready-made meals or fast foods. It is also problematic if you simply don´t have the time to cook for yourself, because you have to work or you are busy doing things.

For a range of food intolerance that lack a certain enzyme the of digestive enzymes is a supportive treatment options, allowing people to eat out.

If you want to know more about food exclusion diet, read more here

Digestive Enzymes

For people with food intolerance that lack a certain enzyme or whose enzyme has a low activity, there is an additional treatment option to exclusion diet in order to support improving their symptoms: the use of digestive enzymes. However, this treatment option is rather supportive and also not curative. The main benefit of using digestive enzymes is that it allows food intolerant people to eat out.

Digestive enzymes greatly help your digestion by breaking down food particles into smaller molecules that can be absorbed by our intestines. Digestive enzymes are involved in the chemical breakdown of all energy macronutrients, namely fats, proteins, and sugars.

Food intolerance people that have a lack of a certain enzyme or whose enzyme has a low activity, are mostly involved in the chemical breakdown of sugars (carbohydrates). Here is a list:

• Lactose intolerance
• Fructose intolerance (hereditary)
• Galactose intolerance
• Sucrose intolerance
• Sorbitol intolerance
• Gluten sensitivity
• Histamine intolerance

Lactose intolerance

The most prominent example of a food intolerance with an absence or a low activity of an enzyme is lactose intolerance. The four types of lactose all have a common cause: the lack of the enzyme lactase (lactase deficiency). The enzyme lactase catalyses the chemical breakdown of the disaccharide lactose into the simple sugars glucose and galactose. The degree of lactose intolerance depends on the total amount of lactase in our small intestine.

If there is not enough lactase in our small intestine, not all the ingested lactose can be enzymatically broken down and the remaining lactose causes the typical symptoms of lactose intolerance. People with lactose intolerance may experience symptoms like abdominal pain, diarrhoea, nausea, bloating, and farting upon the consumption of foodstuffs which contain lactose. Symptoms of lactose intolerance can be more or less pronounced depending on the degree of lactase deficiency.

Lactase enzyme supplements

Traditionally, management of lactose intolerance involves decreasing the amount of lactose in the diet by food exclusion diet. For some situations, like eating out, the use of lactase enzyme supplements can greatly improve symptoms of lactose intolerance.

Lactase enzymes are digestive enzyme supplement that should be taken at the beginning of each meal. If you are lactose intolerant and you eat lactose containing food, like dairy products, the lactase enzyme supplement will help you digesting lactose and you won´t have any symptoms of lactose intolerance.

Enzyme supplements for food intolerances

This is the theory. There are many different lactase enzyme supplements on the market. Some people claim they work perfectly, others say they don´t work at all.

And indeed, there are other enzyme supplements for food intolerances that lack of a certain enzyme or whose enzyme has a low activity. Today, there are enzyme supplements for lactose intolerance, fructose intolerance, sucrose intolerance, and histamine intolerance.

Whether these enzyme supplements work or not, one thing is for sure, they cannot lead to a cure of the underlying food intolerance.

Gut restoration

The only causative treatment for food intolerance, which unfortunately only works for some food intolerances, is doing a gut restoration. Again, the most prominent example of food intolerance with an absence or a low activity of an enzyme that can be improved by gut restoration is lactose intolerance.

Lactose intolerance

Several studies demonstrated that by increasing the amount of lactic acid bacteria in your gut flora, you can reduce the symptoms of lactose intolerance. In a study using a 2-week supplementation with lactic acid bacteria, lactose intolerance symptoms were significantly reduced. Furthermore, faecal β-galactosidase activity increased significantly after 2-week supplementation, suggesting the reduction in lactose intolerance symptoms was due to increasing β-galactosidase (lactase) levels.

Numerous studies have shown that fermented milk products containing lactic acid bacteria such as probiotic yoghurts and kefir can efficiently improve lactose digestion in people with lactose intolerance. The reason why can improve lactose intolerance is that lactic acid bacteria can 1. survive gastric passage and 2. Their bacterial lactase (β-galactosidase) supports lactose digestion in the small intestine.

Exactly this mechanism is used in the 30 DAYS GUT RESTORATION PROGRAMs on the website www.gutrestoration.com.

Performing a gut restoration

The best way to introduce probiotics into your intestines and sustainably change the composition of your gut flora is to do a gut restoration. Reasons for gut restoration are all kinds of gut flora related health issues, like for example food intolerances.

If you want to perform a gut restoration yourself, visit the website www.gutrestoration.com. On this website, you will find 30 DAYS GUT RESTORATION PROGRAMs for gut restoration, that exactly use those probiotic strains that have shown substantial beneficial effects in the treatment of certain gut flora related health issues.

Risk factors

Beside others, food intolerances are associated with:

• Chronic constipation
• Chronic hepatitis C infection
• Eczema
• Headache
• Inflammatory bowel disease
• Irritable bowel syndrome
• Respiratory issues, like asthma and rhinitis
• Intolerance to nonsteroidal anti-inflammatory drugs (NSAIDs)
• Like salicylates, Aspirin and Ibuprofen

Whether these risk factors are causative for food intolerances, a result of it, or just a coincidence is not established in each case.

Diagnosis of food intolerance

Diagnosis of food intolerance is generally difficult and strongly depends on the type of food intolerance. Diagnosis is usually based on a combination of different diagnosis, carried out by a qualified healthcare provider. This can be a competent physician, doctor or another medical practitioner.

The diagnosis usually involves physical investigation and laboratory tests. The most important diagnostic tools for food intolerance include food elimination diet and oral food challenges. If lactose intolerance or fructose malabsorption is suspected, a hydrogen breathing test can be performed.

Food intolerance is an exclusion diagnosis. To discriminate food intolerance from food allergy, a test for IgE-mediated allergic reactions should be performed. Because food intolerance is not an allergy, these IgE-based tests are negative in food intolerant people.

The final confirmation of food intolerance must be a double blind, placebo controlled food challenge (DBPCFC).

Diagnostic methods for food intolerance

• Medical history
• Food elimination diet – proves food intolerance or food allergy
• Oral food challenges – proves food intolerance or food allergy
• Skin-prick testing – to exclude food allergy
• Blood test – to exclude food allergy
• Specific tests
  • Hydrogen breathing test – For lactose intolerance or fructose malabsorption
  • Other specific tests for the suspected food intolerance
• Endoscopy, colonoscopy, and biopsy – for eosinophilic or non-IgE mediated allergic reactions

The different diagnostic methods are explained under “food allergy”.

If you want to know more about lactose intolerance, read more here

If you want to know more about food allergy, read more here