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Functional Medicine Registered Dietitian Brigid Titgemeier has weighed in on some of the most important nutrition topics of 2020-21 with us. As founder of My Food is Health, Brigid is aware of wellness trends on both a macro level and a micro level down to each and every individual patient she sees… 

What Are Food Sensitivities?

Food sensitivity tests have become all of the rage with more and more companies offering direct-to-consumer at-home testing.. But you may be wondering if it’s worth all the hype?

Food sensitivities are not the same as food allergies. Food allergies that are provoked by an IgE immunological response can often manifest in anaphylaxis or other severe allergic reactions. Food sensitivities on the other hand are caused by an IgG/IgA immune response to foods that can lead to more subtle, chronic symptoms overtime. Unlike most food allergies, food sensitivities will often fluctuate with time. Food allergies are more legitimized by the conventional medical community whereas food sensitivity testing is not. While food sensitivity testing can be very beneficial when used appropriately, there is not widespread standardization in the testing procedures and there is a lack of research demonstrating the benefits. Despite the fact that food sensitivity testing is not as well validated, people can still experience a dramatically lower quality of life when eating foods that they have known sensitivities to.

Separately, some people may also have food reactions, which is when you react adversely to foods even though you do not flag for food allergies or sensitivities. In my experience, paying attention to your food reactions can tell you so much about how you are digesting and absorbing the foods you are consuming. More on this point later.

What Does it Mean if I Have a Lot of Food Sensitivities?

It’s not uncommon for people to get food sensitivity results back with 20 different foods that are flagged high. Before you feel overwhelmed and contemplate removing all 20 foods from your diet at once, it’s important to highlight two facts. One is that not all food sensitivity testing companies are created equal. It is difficult to find companies that have high sensitivity, specificity, reproducibility and individual cut offs for each individual food being tested. The second is that results that show a lot of food sensitivities are a larger indication of a leaky gut, otherwise known as increased intestinal permeability or an unhealthy gut lining. If that’s the case, then removing the said flagged foods does not address the root cause of why you may be experiencing a sensitivity to a particular food in the first place. The root cause is the need to repair your gut lining so that your tolerance to food improves.

All Health Begins In the Gut

A healthy gut lining is critical to overall health. Intestinal permeability refers to the lining of the gut that surrounds your microbiome. Think of the gut lining as a cheesecloth, able to keep your microbes, pathogens or even food from entering your bloodstream or the outer layer. If your foods are not traveling outside of your intestine through a leaky gut (which would essentially equate to holes in your cheesecloth) then your immune system will not be tagged to determine whether the food is a friend and can stay—or a troublemaker and needs to be attacked. Having an intact cheesecloth significantly lowers food sensitivities, the body’s response to foods, and risk of developing an autoimmune disease,

A gut barrier that’s not intact is referred to as a “leaky gut”. Research shows that leaky gut occurs when there are separations in the gut lining or tight junctions that decrease the body’s ability to effectively defend against pathogenic microorganisms. Which means that if you have a leaky gut, you’re at an increased risk of food sensitivities, allergies, inflammatory bowel disease (IBD), autoimmune conditions (such as multiple sclerosis, type 1 diabetes and lupus), and inflammation.

Gluten: Food Sensitivity or Not?

Gluten or wheat is one that often shows up as a food sensitivity on many of these at home tests. At the same time, it’s important to note that gluten may also contribute to a leaky gut in people who are predisposed to gut imbalances. If you have done a food sensitivity test and reacted to a lot of foods, I often recommend removing gluten and the top foods that you had the highest reactivity to in the food sensitivity test for a short-term period, such as six weeks. The goal is to remove foods that are contributing to GI issues for a short period of time while increasing nutrients, and sometimes supplements, that help to support the lining of the gut and then reintroducing those foods one at a time. Some people who have severe autoimmune diseases may need to remove foods for a longer period of time, such as one year, but these elimination diets are not meant to be followed long-term. Often when people reintroduce foods into their diet, they will identify that a certain food continues to trigger certain symptoms that they were not experiencing while following their elimination diet. And in this instance, avoiding that specific food may be a good idea long-term. If you are eliminating foods I recommend working with a practitioner to ensure you are not experiencing nutrient deficiencies.

Why Do The Foods I Eat Most Often Show Up As A Sensitivity?

Though the evidence on this is limited, it is thought that repeated exposure to certain foods can trigger food sensitivities. This is another limitation of food sensitivity testing: overconsumption of one particular food can trigger an elevation in your IgG immune response in a similar way that food sensitivities can. This is commonly seen when following restrictive diets such as keto or paleo where you may over consume specific foods in many different sources such as almonds, coconut or avocado. When you have very few foods in your diet, it can increase the risk of developing sensitivities to those foods. Try to avoid overconsuming any one particular food (especially almonds which are easy to consume now as almond milk, almond butter, almonds, almond yogurt, almond flour cookies, etc.). Regardless of the diet that you adhere to, incorporating as much variety in your food intake is absolutely key for supporting the diversity in your gut microbiome and decreasing the risk of developing additional food sensitivities.

Should I Avoid These Foods for the Rest of My Life?

Food sensitivities change overtime. If you completed a food sensitivity test two years ago and you repeated the test today, the results will look different. There is no reason to remove these foods long-term unless you notice adverse symptoms from one specific food each time that you reintroduce it into your diet. My goal is always to help people identify their non-negotiable foods based on their personal reaction rather than removing several categories of foods from the diet that they may not need to avoid. It’s a very delicate balance to remove the specific foods that are provoking symptoms without restricting foods unnecessarily.

When you eat a variety of foods, you are feeding the bacteria in your gut a variety of foods and nutrients. This is good news because when you provide your gut bacteria with diverse food sources, you create greater diversity of bacteria. In fact, a 2016 study in twins found that the twins who consumed a greater diversity of food also had more diverse species of bacteria in their gut, leading to better health outcomes. Many connections have been made between increased gut diversity and improved health, with those who have greater species diversity experiencing lower rates of chronic diseases such as type 2 diabetes and inflammatory bowel disease.

Is There a Better Assessment?

For many people it is more effective to focus on improving the lining of your gut health. Doing an elimination diet without strategically incorporating nutrients to support the lining of the gut or the microbiome is not overly effective! Before ordering a food sensitivity test, I encourage people to use my free Food Symptom Tracker to pay close attention to foods that are creating adverse reactions. It may feel like you are constantly bloated but if you record your food intake and symptoms for several weeks, you will likely identify patterns you never realized before. There is so much power in identifying your own food triggers. Remember, food reactions are clues to how you are digesting and absorbing the foods you’re eating. Tracking how you feel after consuming foods is invaluable and can really start to uncover answers to your health. The second step is to focus on healing the lining of the gut because this is where food sensitivities begin!

Interested in Learning More About Gut Health?

I created a two week online course that helps you stop the guesswork and gets to the root cause of your food symptoms. In the course, I outline my roadmap to support a healthy gut lining and decrease food reactions. I walk you through how to create your own personalized nutrition plan based on your specific health so that you don’t have to just eliminate foods endlessly. It’s one thing to learn about gut health in a podcast; it’s another to take action and assess your own personalized nutrition needs.

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