Tuesday, March 29, 2011

Food Sensitivity Testing - let's talk about your options!

So as promised in the last posting, today I'll give you a little more information about testing for Food Sensitivities.  And just to backtrack a little .. food sensitivities happen when the body reacts to proteins in specific foods and the immune system is activated by those proteins in much the same way as it is activated by proteins on bacteria.  A reaction is mounted by the immune system and can cause inflammation both at the gut level but also systemically.  Because of the complexity of the immune reaction, food sensitivities are often one of the key triggers for many different complaints.  I almost always think about them when dealing with three key complaints including: skin conditions like eczema or psoriasis, GI upset including anything from heartburn to diarrhea, and behavior difficulties in kids (ADHD, temper or Autism Spectrum Disorder).  And  many people with autoimmune disorders and arthritis or migraine benefit from knowing if there are any food triggers aggravating their symptoms.

So we know its important to check for food sensitivities but how do you do it?  There are three different testing choices available to identify food sensitivities. Please note, that food sensitivities are very different from food allergies and the following testing methods are not adequate to diagnose food allergies. The gold standard is an Elimination and Challenge test.  In this case, we limit the diet to a very restricted set of hypo-allergenic foods (usually foods that are outside the normal diet) for a good period of time (usually 3-6 weeks).  The goal is to allow the body a chance to heal up as we take away any provoking foods.  Then we slowly add one food type at a time and gauge for reactions.  For example, we might do our elimination for 3 weeks and eat only lamb, pear and brown rice, then introduce dairy products for a few days while we watch for skin or tummy symptoms.   This type of diet needs a lot of planning and commitment and, because it is so limited, it should not be done without the supervision of a qualified practitioner.  And it should be mentioned that challenging with foods can cause quite a pronounced reaction and should be done exceptionally carefully with asthma or autoimmune conditions.

The next type of testing is called EAV testing, which is also known as Biomeridian or VEGA testing.  This testing evaluates the energy in specific acupuncture meridians and how that energy reacts when challenged with foods.   It sounds a little odd but is really very effective for many complaints.  The advantage to this is  that it can be done quickly and in-office and is non invasive.  It does require that the patient be able to sit relatively still for a period of time, so it can be difficult with younger kids or kids with restlessness/hyperactivity.  On the down-side, the testing isn't well accepted by conventional medical practitioners and so isn't my first choice when we are also working with an allergist or other specialist.

The last type of testing and the only one that can allow us some information about food allergies is called ELISA testing.  ELISA testing is a specific testing procedure that measures how much (if any) of an antibody (immune) reaction there is to specific food proteins.  There are many lab companies in North America that offer this testing and they have widely variable pricing and reliability of their tests.  Most have different food lists available that can be chosen specific for the patient's needs (ie. vegetarian panels or specific testing for food allergies).  This testing does require a blood sample, but depending on the type of tests, it is either with an arm drawn sample or more commonly a dried blood spot taken using a finger stick.  Most kids find the finger prick quick and easy, enough that they don't complain.. at least not much.  I find this to be the best choice for most people as the company I use has excellent pricing and turn-around time and has a choice for an expanded panel with many extra spices and foods.  In addition, ELISA testing is a common procedure and one that is being used by conventional allergists to explore food allergies.  So as a testing method, it is one that conventional physicians can identify with.

For patients coming into my office, I always suggest we discuss your complaints and talk about the testing options to figure out which, if any, is the best choice.  This might depend on your financial situation, time goals and the condition itself.  Most Naturopathic Physicians have done a good investigation into the testing options available in your area and can give you good guidance.  To find a Naturopathic Physician in Canada go to http://www.cand.ca/index.php?findnd&L=0 to find one in the US try http://www.naturopathic.org/AF_MemberDirectory.asp?version=1  .

Tuesday, March 15, 2011

Gluten Sensitivity, its not just a myth!

Finally, some research has illustrated what so many of us knew:  Even with a negative celiac test it is still possible to have a dramatic sensitivity to gluten proteins.

Have a quick look at this article from the Wall Street Journal "Clues to Gluten Sensitivity" from March 15th, 2011 publication by Melinda Beck.

Lisa Rayburn felt dizzy, bloated and exhausted. Wynn Avocette suffered migraines and body aches. Stephanie Meade's 4-year-old daughter had constipation and threw temper tantrums.

All three tested negative for celiac disease, a severe intolerance to gluten, a protein found in wheat and other grains. But after their doctors ruled out other causes, all three adults did their own research and cut gluten—and saw the symptoms subside.

A new study in the journal BMC Medicine may shed some light on why. It shows gluten can set off a distinct reaction in the intestines and the immune system, even in people who don't have celiac disease.

"For the first time, we have scientific evidence that indeed, gluten sensitivity not only exists, but is very different from celiac disease," says lead author Alessio Fasano, medical director of the University of Maryland's Center for Celiac Research. (Click here for the full article).

There are testing options available to confirm a gluten sensitivity.  They include an elimination and challenge, EAV testing or antibody tests (IgG and IgA).   In the next blog, we'll discuss these three options and the differences between them.

Thursday, March 10, 2011

Holey Protein Bagels, Batman!

If I had to name my top nutrition tip it would be to focus on protein throughout the day.  Not low fat or low sodium, probiotic foods or alkaline diets. No, for most of the people I see day to day, definitely protein.  While the other diet suggestions are key in some circumstances, the average person has a busy stressful day and most of us (yes me too!) are so rushed with meals.  Breakfast (if it happens) is a banana and toast or maybe just coffee as you rush the kids to school.  Lunch is soup or a salad, as we escape work for a few minutes.  Then dinner is the bigger focus, but really when you get home and get the kids organized who wants to cook something elaborate? Evenings? Yes, this is when we snack. This is when the cookies call to us from the cupboards and the treats look so inviting.  After all, that was a really long day!

And that was a really good day!  There were three solid meals, nutritious even!  Maybe a little snacking but well deserved.  But that's a pretty healthy diet.  True enough.. except for the protein. The problem is that we ask ourselves to be "on" and alert all day, ready to meet any challenge at work or to tackle any kid emergency at any moment.  And by maintaining that level of stress, we need our adrenal glands to produce cortisol at a slighly higher level throughout the day.   After a while of producing that slightly higher level of cortisol, our adrenals just run out of steam a little.  Nothing horrible, but just a little and enough that the body conserves its cortisol production.  At the end of the day, the normal energy slow down may turn into an energy crash.  You might notice that is takes longer to get going in the morning and, perhaps, little more irritability and moodiness? 

Ok, and what does that have to do with eating?  Cortisol also has influences on metabolism, weight distribution and, most important, blood sugar control. After longer periods of stress many (especially women) notice that they start to store weight right on their bellies, they may crave sugar and have trouble skipping meals.   Keeping a focus on protein at every meal and every snack helps to keep blood sugar stable.  And that removes one big stress to the adrenals and decreases the amount of cortisol we need to keep up our energy.  It doesn't have to be much protein either.  Adding some nuts to a snack, or switching to a higher protein bread  for sandwiches or toast can make a huge difference for overall energy and sugar cravings. Check out SilverHills bagels, they have an astounding 15g of protein each!  An easy option for lunches is to plan to keep leftovers from every dinner.  Our Magnificent meat loaf  makes a great lunch for adults and kids.  Adding a handful of beans to pasta dishes or a stirfry is a fantastic and inexpensive choice and can be pureed for the picky kids.  So, planning to have a little protein at every meal and supporting the body with small snacks with a little protein is the best start for overall fatigue and stress management.

Stay tuned for more health tips and please feel free to email if you have any questions you'd like to see answered here.

~ Dr Kellie