The Food Intolerance Bible: A nutritionist's plan to beat food cravings, fatigue, mood swings, bloating, headaches and IBS

food additives, preservatives, colouring agents and flavour enhancers (this chapter)

eating too quickly (Chapter 4 (#uaca3f800-00eb-5007-b966-b0b60cb5a863))

maldigestion (low stomach acid levels, low levels of pancreatic enzymes) (Chapter 4 (#uaca3f800-00eb-5007-b966-b0b60cb5a863))

imbalanced intestinal ecology: an overgrowth of yeast, bacteria or parasites (Chapters 5 (#litres_trial_promo), 6 (#litres_trial_promo) and 7 (#litres_trial_promo))

prescription and over-the-counter drugs (Chapter 8 (#litres_trial_promo))

weak intestinal immunity and improved hygiene (Chapter 9 (#litres_trial_promo))

excess stress (Chapter 10 (#litres_trial_promo)).

The above list will have relevance to some people but not to others. For those of you for whom these factors are relevant, it is vital to address them in order to escape a vicious cycle involving food intolerances. I have had many patients tell me that they have followed an elimination diet to improve their symptoms. However, the reason they have come to see me is that, while the diet worked for a number of months, they ultimately ended up with the same symptoms, in spite of continuing to avoid the original culprit foods. Upon retesting we have learned that these patients were now suffering from new food intolerances. What is going on here is that the underlying causes are continuing to cause problems. In this way, food intolerance can be ‘upstream’ of a number of other problems – though it is worth bearing in mind that it can be ‘downstream’ as well.

This is the primary reason why you need to be aware of the associated and underlying causes of food intolerance. To help you to determine which of the seven most common causes of food intolerance may be relevant to you, each will be discussed in turn – where appropriate, questionnaires are provided to narrow down the potential culprits.

The diagram above shows the various factors that can contribute to food intolerance. Often there is one cause that you need to address.

Eating Too Much of the Same Food Too Often

Of the estimated 195,000 edible plants on the planet, we tend, in the Western world, to obtain most of our calories from fewer than 20 foods. Indeed, most people tend eat the same 10 foods every day (and this would most likely include wheat and dairy products). This predisposes you to having an altered immune reactivity to these foods. It also means that the variety of nutrients you derive from food will also be limited, which may have other effects on your health.

A simple seven-day food diary would highlight whether you are eating a predominance of only a handful of foods. Simply list the foods you eat every day for a whole week, and then check your list for the number of different food groups – for example, don’t forget that most breakfast cereals, bread and pasta are all made from wheat. The higher the number of foods you eat in a typical week the better, and the more variety you have, the better. If you can identify that two or three foods comprise the bulk of your caloric intake, then these need to be suspected as possible culprits. You then have the option of eliminating these foods for a trial period and monitoring your symptoms.

You could also compare, as you may already have done, your typical food intake with the list of Usual Suspects, and especially the top five on that list.

Particularly if you have digestive symptoms, you should also follow the Digestive Support Plan for at least one month.

Food Additives, Preservatives, Colouring Agents and Flavour Enhancers

It is believed that the relatively recent plethora of food additives, colourings and preservatives in our diet has increased the risk of our immune system reacting against them, and this has been shown in at least one formal research study. It is also the subject of the Feingold Diet, which was named after Dr Ben Feingold of San Francisco, who proposed that additives and other naturally-occurring chemicals in food cause hyperactivity and other problems in children.

The Feingold approach is well known in the nutritional arena. His approach of avoiding food additives can produce a dramatic difference in some children, and more moderate improvement in others. For example, the consumption of ‘yellow sunset’ colouring and tartrazine can have marked effects on some susceptible children’s behaviour, and therefore their avoidance can result in a total lack of such symptoms.

Feingold believed that the naturally-occurring chemicals in foods called salicylates, which are found in a wide array of foods, are also implicated in causing behavioural changes. However, it would appear that salicylates are not the lone culprit, because there are other offending agents at work, including solvent chemicals, that contribute to the children’s symptoms.

Since food additives and preservatives are found primarily in pre-prepared foods, it should be fairly easy to spot when you might be consuming these artificial additives. However, even foodstuffs such as bread can contain additives. Therefore, anything that comes in packaging potentially has something artificial added to it. Start checking your labels and choose as much food as you can that is in its whole and natural state.

It is possible to test for an intolerance to additives – see Appendix II for more information.

A Note on Salicylates

This book does not provide you with salicylate-free recipes, but they are free of all additives, colourings and preservatives, and should contribute in a positive way to reducing your risk of adverse immune reactions within your Gl tract. A list of foods containing salicylates is provided in Appendix V (#litres_trial_promo).

Relevant Tests: IWDL’s Additives FACTest

4 Digestive Difficulties (#ulink_d346f50c-83d6-564a-9265-e14ac2a35215)

Eating Too Quickly

When you eat too quickly, food does not get chewed and broken down properly, so that when it reaches the stomach it is not in the ideal form for optimal digestion. This means the stomach acid and digestive enzymes are unable to digest this food, no matter what it is, and as a consequence intact proteins may be absorbed through the intestinal lining, setting up an immune reaction that can lead to the development of food intolerance. Eat more slowly and chew food thoroughly before swallowing it!

Chewing food well also helps stimulate protection within your intestinal lining, in the form of something called Epithelial Growth Factor (EGF). EGF helps support cell growth in the intestines. Chewing also lets your digestive system know that something is coming so that it can prepare itself, whereas bolting your food can be a shock to your digestive system. Can you remember how many meals you have eaten in the past week when you chewed your food thoroughly?

When your mind is preoccupied while you are eating, your digestive system switches off. Your mind is giving your body the message that it is engaged in something, and this is not conducive to optimal digestion. Remember, if you cannot digest your food properly, it sets the scene for food intolerance. Typical examples are when you eat at your desk while working. Or eating while on the move. Or while watching TV. It is best to concentrate on the food you are eating to help your digestive system work at its best. The ritual of saying grace before a meal, for example, is an excellent means of setting the scene for your digestion. I’d encourage you all to ‘give thanks’ for the food you are about to eat, if only because it is one means by which you can improve your digestion.

COELIAC DISEASE

Coeliac disease is another name for a gluten allergy (also called gluten-sensitive enteropathy) – which is not the same thing as a gluten intolerance. What happens in coeliac disease is that the gluten proteins yield toxic fragments, or peptides, that damage the delicate cells of the intestinal lining. Over time, the surface area of the small intestine becomes damaged, causing a flattening or atrophy of the microvilli (tiny hairs that help with the transportation of food through the intestine). This leads to malabsorption of all nutrients (vitamins, minerals, fats, proteins and carbohydrates) and, typically, weight loss, although many other conditions can ensue as well.

The reason this occurs is not wholly understood, but one theory is that there is a lack of appropriate digestive enzymes. Another theory is that the immune system perceives a part of the gluten protein to be ‘foreign’ and attacks it. In the ensuing battle, the immune system inadvertently damages the intestinal lining.

The symptoms include bloating, diarrhoea, foul-smelling stools, pale stools, and poor growth in babies and children. In adults there can also be pain, malaise, weakness and weight loss. Fatigue and irritability are also common. The skin and tongue may appear pale due to a lack of the normal red pigment found in blood. Bone problems may occur, such as deformity, pain or propensity to fracture.

Since nutrients are incompletely absorbed, increased bowel frequency, with the passage of bulky, pale stools, may occur; there may be associated abdominal pain and/or distension. However, many sufferers experience no bowel disturbance, and may be constipated rather than suffer diarrhoea.

It is likely that many people with gluten sensitivity have few or no symptoms, so the condition can remain unrecognized.

How Common Is It?

In Britain, the condition affects approximately 1 in 1,000 people. If one family member is affected it is more likely that others in the same family will have it as well. The frequency of gluten sensitivity is greater than among the general population in people with certain other disorders, particularly those with the type of diabetes that requires insulin.

Although not backed by solid research evidence, one estimate puts the figure at much higher than 1 in a 1,000, and more like 1 in 200. This is consistent with the suggestion that for every coeliac known there are five others who have yet to be identified. Perhaps with the wider recognition and acceptance of food intolerances, these individuals will either come forward or be identified by a practitioner, and we will have a better idea of how widespread this problem is.

How Is It Treated?

Treatment involves avoiding all gluten foods – namely wheat, rye, barley and oats. Once the intestinal lining has been damaged, however, it can take some time to repair itself, and usually the individual needs to replenish nutrients either intravenously or orally. In many cases there are a host of other foods to which the coeliac sufferer is intolerant (soy and milk, for instance) due to the damage done to the intestinal lining, which often means that even if they avoid gluten their health does not immediately return to normal.

What Complications Can Arise?

Women with untreated gluten sensitivity can experience infertility, though this reverses itself once glutens are withdrawn from the diet. Before and during pregnancy, women with gluten sensitivity should be particularly careful to take a supplement of folic acid, as advised for all women.

Thinning of bones (osteoporosis) may be more common among people with coeliac disease than in the general population.

Dermatitis herpetiformis

People with an itchy, blistering skin eruption affecting the knees, elbows, buttocks and back, called dermatitis herpetiformis, almost always also show evidence of gluten sensitivity on intestinal biopsy. Zinc deficiency may also be a significant nutritionally-related issue with this condition, for which zinc supplements are needed.

Coeliac Disease and Mental Health

Interestingly, many people with coeliac disease also suffer bipolar disorder, highlighting the connection not only between the intestines and the brain but between gluten intolerance and brain functioning. Symptoms associated with gluten intolerance (rather than coeliac disease) include altered behaviour, depression, irritability and a short attention span.

An Inherited Disposition

It would appear that coeliac disease is at least partly an inherited disposition, because it runs in families. It is a condition that does not have to be present at birth to later reveal itself. One belief is that coeliac disease is a manifestation of humans’ inability to adapt to wheat, which has only been available to humanity over the past 10,000 years – the blink of an eye in evolutionary terms. However, this does not explain the prevalence of wheat intolerance, the most likely cause of which is the sheer repetition and high doses that we consume, possibly at every meal and snack.

Coeliac Testing