Food Intolerances – The Quiet Culprit

Regardless of time, geography or ethnicity, food is something that bonds us all. It is varied in taste, quality and ingredients and is paramount for our survival, but it is not without the potential for issues in certain individuals. Many people suffer various ailments when they consume different foods such as allergies to particular foods or components of foods, irritable bowel disorder, and food intolerances.

What is food intolerance?

As opposed to a food allergy which has a true, measurable immunological component such as an antibody-dependent allergy response, a food intolerance is more nuanced and difficult to definitively diagnose, as it is not characterized by an immune response. Food intolerance, also referred to as non-allergic food hypersensitivity, is a broad set of disorders related to the intake of various food items and the response of the digestive system to certain chemicals or constituents of foods. As opposed to a food allergy where any quantity of the offending food item will elicit an allergic reaction, a food intolerance seems to be dose-dependent, which is highly individualized to the sufferer. Symptoms of food intolerances can include:

• Malaise
• Bloating, belching and flatulence
• Diarrhea
• Constipation
• Gastrointestinal (GI) discomfort and pain
• Nausea and vomiting
• Flushed appearance
• Hypotension
• Headache
• Rarely joint pain

What causes food intolerance?

The pathophysiological mechanisms that underlie the manifestation of these diverse and encompassing conditions are many and some are poorly understood.

Enzyme deficiencies and transporters

Some causes of food intolerance can be due to enzymatic deficiencies for individuals who are lactose intolerant and have a complete or partial lack of sufficient levels of lactase to catalyze the breakdown of the lactose disaccharide into its component monosaccharides resulting in excessive colonic bacterial fermentation of lactose, bacterial overgrowth with resulting formation of gases that cause flatus, diarrhea and pain. This lactase deficiency can be primary and genetic, or secondary as lactase levels drop naturally when an infant is weaned or from an underlying GI disease.

Another cause of intolerance and subsequent discomfort and osmotic diarrhea is a lack of certain glucose transporters in the intestine that result in the malabsorption of fructose.

The excessive consumption of polyols or sugar alcohols such as sorbitol, can also cause nasty GI symptoms and osmotic diarrhea, as these solutes pass undigested to the colon where they attract inordinate quantities of water in the bowel.

Another enzyme deficiency (amine oxidase) relates to the degradation of histamine naturally occurring in some foods and may also cause non-specific GI and systemic cardiovascular and respiratory symptoms such as flushing, dizziness, rapid breathing and low blood pressure.

Food components and FODMAP

Other potential causes of intolerances include various additives or intrinsic food components such as sulfites, the amino acid glutamate, caffeine, salicylates and wheat (non-celiac wheat sensitivity).

Diets high in FODMAP’s, which is an acronym for various carbohydrates, may be maldigested and a trigger in some persons with food intolerances and IBS (irritable bowel syndrome). Foods containing FODMAP’s include fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols. These naturally occurring, fermentable carbohydrates can be difficult for some people with the functional irritable bowel syndrome to digest, as it may trigger:

• Gut pain
• Abdominal distension
• Flatulence
• A mix or preponderance of either diarrhea or constipation.

The pathological underpinning of this plethora of gastrointestinal misery, seems to be a combination of alterations in the colonic microbiota, excessive gas production from the prebiotic (fiber) fermentation of some of these short-chain carbohydrates, inordinate visceral sensitivity, altered (too slow or fast) gut motility and osmotic diarrhea.

Common food culprits

The presence of food intolerances is highly individualized, and not every food or component of food will be a trigger for all persons suspected of suffering a food intolerance. Nor will a particular offending food item elicit the same degree of an unpleasant response for the same quantity of food consumed for all people. Here follows a list of some potential offending foods:

• High FODMAP foods: wheat, pitted fruits, artichokes, leeks, onions, garlic, cruciferous vegetables like cabbage and broccoli, apples, beans and other legumes, barley, rye and sugar alcohols
• Salicylates: coffee, tea, plums, peas, citrus etc.
• Lactose: dairy products, with lower amounts of lactose in butter, probiotic yogurts and hard cheeses.
• Fructose: high fructose corn syrup, honey, molasses and fruit with rich amounts in apples and pears.
• Histamine: avocado, dried fruits, cured meats, citrus, smoked fish, fermented foods etc.
• Caffeine: tea, coffee, dark sodas and chocolate.
• Salicylates: spices, coffee, tea, produce, honey and nuts.
• Sulfites: These are added to preserved and pickled fruits and vegetables, beer and wine.
• Others: MSG, eggs, aspartame and yeast.

Treatment options

The diagnosis of a food intolerance is challenging, as there is murky and unsubstantiated evidence that support conventional biological parameters assessed on lab tests as being valid and reliable. Therefore, both diagnosis and treatment are centered around trial and error through an elimination diet and the adoption of a food diary that includes qualitative entries about symptoms following food consumption. The keeping of a food diary and employing an elimination diet with subsequent reintroduction of food into one’s diet, can identify foods to be avoided or consumed in limited amounts.

As seen above, food intolerances include a broad range of food groups and items that many people particularly enjoy eating or drinking, and which are often high in fiber and essential nutrients. Diligent and detailed food diaries are pivotal for these persons to maximize the variety in food selection and minimize restrictions to foods consumed.

If you are someone that is a concurrent sufferer of joint pain from arthritis or injury who is interested in taking supplements or special diets to help alleviate joint inflammation, degradation and pain, some of these foods and ingredients can simultaneously exacerbate symptoms of food intolerance. Fortunately, JointFuel360 capsules are free of active or filler components that trigger symptoms of food intolerance, and contain antioxidative, anti-inflammatory ingredients (resveratrol, turmeric and Boswellia serrata extract), and joint-rebuilding hyaluronic acid and hydrolyzed collagen type 2 fibers.

 

 

 

References

Brazier, Y. (2020). Food intolerance: Causes, types, symptoms, and diagnosis. Medical News Today. Retrieved January 3, 2022, from https://www.medicalnewstoday.com/articles/263965

Gargano, D., Appanna, R., Santonicola, A., De Bartolomeis, F., Stellato, C., Cianferoni, A., Casolaro, V., & Iovino, P. (2021, May 13). Food allergy and intolerance: A narrative review on nutritional concerns. Nutrients. Retrieved January 3, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8152468/

Kubala, J. (2018, January 25). The 8 most common food intolerances. Healthline. Retrieved January 3, 2022, from https://www.healthline.com/nutrition/common-food-intolerances#TOC_TITLE_HDR_12

Lomer, M. C. E. (2014, December 3). Review article: The Aetiology, diagnosis, mechanisms and clinical evidence for food intolerance. Wiley Online Library. Retrieved January 3, 2022, from https://onlinelibrary.wiley.com/doi/full/10.1111/apt.13041

Thomas, D. L. (2019, February 27). Food intolerance. News. Retrieved January 3, 2022, from https://www.news-medical.net/health/Food-Intolerance.aspx