How do food allergies relate to your gut?
May is Food Allergy Action Month, and in honor of this we want to talk about how food allergies are important to understand, address, and how they are related to other gut disorders!
According to Food Allergy Research and Education (FARE), food allergies affect 32 million Americans, including one in every 13 children. A food allergy is a serious and possibly life-threatening medical condition that occurs when an individual’s immune system overreacts to a generally harmless food protein (known as an allergen). This is not to be confused with food intolerance (digestive problems that occur after a certain food is eaten), although both conditions share very similar symptoms.
What might cause a food allergy?
It’s still unknown why people develop food allergies, but both genetic disposition and environmental factors can influence whether one will develop. Most children that have food allergies will have experienced eczema during infancy: the earlier it starts or the more severe, the more likely they are to have a food allergy. In the most common type of food allergy, an antibody called immunoglobulin E (IgE) mistakenly targets an otherwise harmless protein as a threat. This reaction causes several chemicals to be released, the main one being histamine. Histamine causes small blood vessels to expand (making skin appear red and swollen), affects nerves (causing itchiness) and increases the amount of mucus in the lining of your nose, which may cause a burning sensation. In anaphylaxis, large amounts of histamine are released by the immune system in the blood, which can possibly cause unconsciousness or even death.
What are the most common food allergens?
The Food Allergen Labeling and Consumer Protection Act of 2004 identified 8 foods as major food allergens as these accounted for 90% of food allergies. According to section 203, which explains the rules around labeling, the common or usual name of the ingredient is required to be used in the ingredients list as well as the name of the food source where this major allergen is derived from. This is done to provide extensive safety and allow consumers who have an allergy to correctly identify and avoid it. The common names are as listed below:
Milk
Egg
Peanut
Tree nuts
Soy
Wheat
Fish
Shellfish
Sesame
Now you might find yourself wondering why there are 9 foods on the list above. Sesame has been identified as the 9th most common allergen in April of 2021 and in accordance with the FASTER (Food Allergen, Safety, Treatment, Education and Research) act of 2021, sesame will be added to the list as the 9th major food allergen on January 1st, 2023! Sesame is a common ingredient in many foods including hummus. Although it does not need to be listed as an allergen currently, that will soon change.
What is the difference between allergies and SIBO or other gut dysfunction?
Food intolerances can sometimes be mistaken for food allergies due to similarities in symptoms, such as stomach pain, diarrhea, nausea, vomiting, or eczema/rash flare ups. Food allergies (though they may have these common symptoms) can be much more acutely life threatening than other gut dysfunction, and need to often be treated immediately if a flare-up occurs. It does depend on the severity of the allergy, but generally allergies have to do with larger immune responses, and generalized gut dysfunction can have a variety of causes, and they are not as immediately life-threatening.
Food intolerances (or symptoms and gut issues that are often mistaken for food allergies) usually develop as a result of untreated SIBO, since it causes damage to the cells of the gut wall in the small intestine. SIBO, IBD, and other gut disorders are chronic, and often lead to longer-term harm to the body. Emerging evidence also suggests that the gut microbiome contributes to the development and manifestation of atomic disease. The microbiome affects food tolerance via the secretion of metabolites and the expression of microbial cellular components. In other words, the microbiome can secrete compounds and express genes that can impact whether or not our guts will tolerate certain foods– these little bacteria have a big impact! This is why understanding the biology of the microbiome and how it interacts with the gut is helpful in developing smart therapies and treatments.
What can my care team do to support me with potential food allergies?
If you suspect you have a food allergy, there are several ways it can be diagnosed. You should see your general practitioner, and if necessary they can refer you to an allergy clinic for testing. If the symptoms developed quickly, they will administer a skin prick or blood test. If symptoms developed more slowly or are more mild, you will most likely be put on a food-elimination diet.
If it is a severe food allergy, treatment involves using an auto-injector of adrenaline in the case that you are exposed to the allergen. If it is a more mild food allergy or food intolerance, your care team must treat the cause (including SIBO treatment), coupled with gut healing interventions and eliminating the foods causing unwanted reactions. Something a dietician can help with is improving the function of your MMC, or Migrating Motor Complex, which refers to the periodic mobility pattern that occurs in the upper gastrointestinal tract.
Consulting with your care team is important when you suspect a food allergy or intolerance; allergies can be life threatening, and though intolerances and allergies may share some of the same symptoms, it is important to understand the distinctions between them.
If you are interested in why a dietitian on your care team matters, why a plant-based dietitian can help you with your health journey, and how IBS can impact your life, you can find out more on the Married to Health website!
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References
Center for Food Safety and Applied Nutrition. (n.d.). Food allergen labeling and consumer protection act of 2004. U.S. Food and Drug Administration. Retrieved May 5, 2022, from https://www.fda.gov/food/food-allergensgluten-free-guidance-documents-regulatory-information/food-allergen-labeling-and-consumer-protection-act-2004-falcpa
Center for Food Safety and Applied Nutrition. (n.d.). Food allergies. U.S. Food and Drug Administration. Retrieved May 5, 2022, from https://www.fda.gov/food/food-labeling-nutrition/food-allergies
Common Allergens - Peanut, Egg, and Sesame Allergies | FARE. (2022). Retrieved 2 May 2022, from https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/common-allergens
Food allergy - Causes . (2018). Retrieved 3 May 2022, from https://www.nhs.uk/conditions/food-allergy/causes/
Iweala, O. I., Choudhary, S. K., & Commins, S. P. (2018). Food Allergy. Current gastroenterology reports, 20(5), 17. https://doi.org/10.1007/s11894-018-0624-y
Nance, C. L., Deniskin, R., Diaz, V. C., Paul, M., Anvari, S., & Anagnostou, A. (2020). The Role of the Microbiome in Food Allergy: A Review. Children (Basel, Switzerland), 7(6), 50. https://doi.org/10.3390/children7060050
What Is a Food Allergy?. (2022). Retrieved 2 May 2022, from https://www.foodallergy.org/resources/what-food-allergy