Wednesday, September 10, 2008

Back to Food Allergy Basics

Photo: My Food Scale

After being assigned to teach a basic nutrition class to some grade-schoolers at church this week, I found that my research has reminded me that I need to talk about food, allergies, and digestion here on the internets as well. I think we could all use a refresher. Don't you?

Basic Digestion
Put simply, humans eat food, which your body then converts to proteins and sugars to fuel, or give energy, to the rest of your body to operate the remaining bodily functions (i.e., thinking, walking, breathing). Your digestive system does all this work for you, so that the rest of your systems can keep operating.

As I understand it, digestion starts in your mouth, where you chew the delicious foods (and sometimes not so delicious: i.e., LIMA BEANS) and saliva helps to begin the break down the food. It slides down your esophagus to your stomach, where your stomach breaks food down further, leaving you full and satisfied, while your belly continues to gurgle with embarrassing noises. It then moves into the small intestines (22 feet long), your large intestines, and then on out the other end (you can fill in the blanks here).

During this process your liver, pancreas, and gall bladder mysteriously help to remove the toxins and aid in absorption of nutrients. You also have good bacteria living in your digestive system that help to break down the food. I know it's all a little icky, but it's a necessary part of our ability to keep our cute, little bodies movin' and groovin'.

It Ain't Workin' Right: Allergies/Intolerance
So what happens when digestion isn't so smooth, as is the case for me, and 12 million other Americans, who can't eat anything they want? What happens when nutrient rich foods make you feel awful, instead of delightfully full? Oh, those of you with allergies and intolerances (sometimes due to celiac disease), you know what I'm talking about: painful gas, the trots (it paints a nice picture in your head), headaches, nausea, rashes, respertory problems, tightening chest, heart palpitations, hot flashes, swelling, vomiting, itching, dizziness, weight gain/loss, fatigue, and all other sorts of unpleasant and sometimes frightening symptoms.

For those of us who suffer, we frequently can't quite put our fingers on what it is that is making us sick. We go to doctor after doctor, while they scratch their heads and act as though we've been taking a ride on the crazy train to stress town. "It's all in your head", they say, "Allergies are hard to diagnose, unless you do the elimination diet", they quip in disgust (the jury is still out on what is a true allergy and what is an intolerance). But then one day, you get your magical referral and you find yourself in an allergist's office, where the good doctor listens to every one of your crazy, mismatched symptoms, and says, "Let's do a scratch test and some blood work". Vualah! You've got your food allergy diagnosis in no time.

Life after Diagnosis
Now what? After learning that wheat had become my personal nemesis, I went home and discovered the only food in the house I could eat was ketchup. I panicked and thought I might starve to death inside of a week. I knew nothing about how to separate wheat from the rest of my diet. I ate steak and steamed veggies for two weeks. I lost 9 lbs. in seven days. Talk about instant, forced Atkins diet.

I wandered the grocery store for hours in a stressed out haze trying to find even one thing I could eat. I went to the hippy, natural grocery store two towns over and found a scant few wheat-free/gluten-free products, all of which I had to shell out a small fortune to try even once. Most of it was disgusting, and sat uneaten for years. I had to learn what all the ingredients in my food actually were. I had been eating a very unhealthy diet, and I had no idea because everything I ate previously had been labeled to appear as though it was health food.

After awhile reading labels got easier and the grocery store trips did not take three fruitless hours. I learned to cook from scratch, which I found out was not nearly as hard as I had feared. I had previously been a cook-from-the-box/bag kind of gal. Six years later, I feel like a pro (although I am constantly learning new ways to dealing with food allergies).

What About You?
Well, if you are still reading this post, you or someone you know, has had problems eating something, sometime that made them very sick, something that may have not been easy to identify. Food allergies are on the rise in the US, so much so that it is becoming an epidemic. Children and adults alike are being diagnosed with food allergies at alarming rates.

Food companies are catching on, and companies, like Whole Foods, have profited enormously from this epidemic. Allergen-free foods are really expensive, although increasingly easier to find. Smaller food companies specializing in allergen-free foods are exploding with each passing day, and larger companies, like General Mills are making great effort to create facilities that can handle the demands of keeping non-allergen-free foods completely separated from allergen-free foods (think Kosher).

The FDA is still not regulating this process well, but more and more companies, and some restaurants, are adhering to self-imposed strict standards. Some, however, are not and are claiming to, so buyers beware. You may not find out that the box advertising lied to you until you, or someone know, has swelled and vomited.

Why Does This Happen?
Well, there are many theories out there right now, but none of them have been validated with sound science yet, so the entire scientific and medical communities are shrugging their shoulders in a collective, "I dunno!" This is partially why it's so hard to get medical doctors to take their patients seriously (in my case years), why it's so hard to diagnose, and why it's so difficult to treat. As my neighbor, the nurse told me a few weeks back, the doctors have no protocols to follow, so they can't wrap their heads around the problem and patients suffer as a result.

As for the theories, my personal favorite is one that points a finger at environmental factors. If you look at the way instant and microwave food changed the way Americans eat in the last several decades, you'll begin to realize that our foods have been saturated with chemicals, preservatives, and genetically modified food stuffs to look and taste similar to the same foods cooked from scratch. At some point, some of us may hit a saturation point with certain foods. No longer are we eating many foods in season, and we rarely make a meal from fruits, vegetables, grains, and meats in their raw form. These instant foods have been filled with food products like wheat, soy, corn, dairy, and eggs without us ever being the wiser. When I started to read my labels, and really look at what I was eating, I found wheat in salad dressing, soda, and even oral medications. It is everywhere.

Another theory says we've become too clean as a country, giving our body no choice, but to start fighting foods instead of disease -- too much anti-bacterial living and not enough exposure to regular germs. Another is mutation of genes, or missing enzymes. They may all have merit, or none at all. This epidemic is still too new and too unknown to be certain. In the meantime, the only alternative is to abstain from eating those foods.

Navigating Life Without: Tips for the Newbie
My good friend's father always says, "If it hurts when you go like this (arm waiving), don't go like that". Good advice to follow where food and digestive problems occur. Despite what well-meaning citizens might tell you, eating more of what makes you sick will not make it go away, it will make you feel worse. Just say no!

  • If you're suspicious that food is making you sick, demand a referral to an allergist until you get one
  • Once you've gotten to an allergist, ask for scratch and blood tests to look for allergies to foods
  • If you get a diagnosis, go home and look up all the ingredients that this food is called or made into
  • Start reading all of your labels (grocery shopping gets less overwhelming over time, and remember aim for six ingredients or less)
  • Make yourself a set of food allergy business cards telling medical personnel and restaurant staff exactly what it is you can't have with every possible ingredient listed (remember that if you didn't know what stuff was, neither do they)
  • Alert all medical personnel that you come in contact with of your allergies, many medicines, as well as IVs, have food additives that you may not be aware of (beware of all dyes and iodine if you have a shellfish allergy)
  • When filling prescriptions at the pharmacy, ask to speak to the pharmacist so that you can personally check all active and inactive ingredients in the drugs you are taking (be sure to check ALL over the counter drugs as well)
  • Search bookstores and websites for cookbooks and recipes for your specific allergy or intolerance
  • Learn how to cook, especially with substitutions (going allergy-free does not mean going without the foods you love, there's always a way to make your favorite dishes)
  • Don't eat prepared foods at bake sales, potluck suppers, gifts from friends and neighbors, or any other unlabeled food unless you have personally seen every ingredient that went into the dish -- a lot of well-meaning people will assume that their food is safe for you because they made it and they do not understand how food allergies work
  • Most importantly, DO NOT CONSUME ANYTHING THAT MAKES YOU SICK, although people have been known to "outgrow" their allergies and intolerances, many people get sicker and sicker with every bite
**Addendum** For the Joseph the Food Scientists perspective on food allergies, click here. It will be worth your while, I promise.


karin said...

I have issues with tree nuts (which is nothing compared to wheat) but I am amazed at how many things were packaged in a facility with nuts.

Very informative.

EMama said...

Lovely refresher. You are my allergic friend. I have bragged a few times that I'm able to prepare gluten-free foods because of you.

David & Lisa said...

you hit several issues here...even those of us w/out allergies need to be aware of all of the processed crap out there that we are consuming daily. Any ideas of what to do with a very picky 4 year old who only wants pizza and chicken nuggests, etc? Even buying the "whole food" versions is not teaching healthy habits i know. If left to starve, he would.

Heather said...

Great article.

Parker has had a little trouble with an iron deficiency (with the non gluten and since most 4 year olds aren't very fond of broccoli and other dark green leafy veggies.) I do have to stand my ground and threaten him to make him eat sweet potaotes, cantalope, raisins, and rice but still have to give him MyKidz iron drops now and then to ward off anemia. You know how I can tell? - this is kinda gross, but his #2 gets pale and anemic looking. The first time this happened I took him to the doctor (he was 3) and told them and they said "It's probably just something he ate." I was like, um, no I don't think so. And then I said that I heard this could be a symptom of anemia and asked for a blood test. They were very doubtful but I insisted and he was anemic. MyKidz iron drops even actualy taste good!!!

You really have to fight for your own healthcare sometimes....

I will now check out Joseph the Food Scientist's article

Heather said...
This comment has been removed by the author.
AJ said...

I always thought it was "scratch and sniff," not "scratch and blood." If it starts to bleed, you're probably scratching too hard.