Why is food intolerance summarily ignored?

The insufficiency and misguided direction of our health care system is well documented. The failure to address major public health issues with preventive measures has deeply affected our well being, physically and financially. One glaring omission from the mouths of public health decision makers is food intolerance. The question is, why?

The 2010 Report of the Dietary Guidelines Advisory Committee is a perfect example. They dedicated almost nine pages to discussing food allergies, yet only the following for food intolerance:

"Before addressing some essential and often complex food allergy-related questions, it is important to facilitate a basic understanding of food allergies. Fundamentally, there are two types of food sensitivities or adverse reactions associated with exposures to food allergens. Those types involve the consumption of the triggering component(s) or inhalation of the causative agent(s). Sensitive individuals may present overt food allergy symptoms, or present symptoms associated with food intolerance.

According to the National Institute of Allergy and Infectious Diseases, the human body’s adverse response to food can be caused by several by two fundamental mechanisms. Those mechanisms either involve the immune system or numerous systems outside of the immune system, typically the digestive system. The latter is often referred to as food intolerance. A classic example of food intolerance is lactose. Other possible food intolerances perceived by consumers and may be clinically identified include strawberries, mushrooms, chocolate and raspberries. Yet, many individuals can present food allergy symptoms with these same foods."

This is a pretty significant statement, given the fact that most of the nation consumes lactose products on a daily basis and sixty percent of adults are believed to be intolerant. Lactose and gluten (which is affecting more Americans each year), while major reactors, only are two of hundreds of intolerant foods, which include some of the most common things we eat daily. Many experts believe up to 72 million Americans have food intolerances, most of which go undiagnosed.

Great Britain recently incorporated food intolerance testing into the health screening vernacular. Yet, even as the National Institute of Allergy and Infectious Diseases admits that food intolerance exists, most allergists and physicians in the United States do not acknowledge it. Research funding has suffered because of it. Despite the dearth of research, the data that exists is convincing.

Here are the three reasons why we believe food intolerance is ignored:

1. Difficult to Diagnose.
   Unless anaphylactic reactions occur, patients are often diagnosed with food allergies when they may really be food intolerances. Allergists do not have a protocol to discern between the two. According to Marc Riedl, MD, MS, section head of clinical immunology and allergy at UCLA, patients with non-specific symptoms, such as a rash or digestive troubles, and positive skin-prick or blood tests actually have less than a 50 percent chance of having a food allergy. In order to make a proper diagnosis, they pointed out, physicians need to evaluate the data within the context of a patient's history and have a great understanding of symptoms consistent with true food allergy. "I frequently see patients in my clinical practice who have food intolerance, but have previously had inadequate or inappropriate evaluation and been told they have a food allergy. This causes a great deal of unnecessary anxiety and concern for the patient." Our response: as Dr. Riedl alluded to, it is not that difficult to diagnose if using the proper screening methodology and an expert in food intolerance can analyze the results.
   
2. Allergists Are Averse to Change.
   Our response: maybe so, but look at how many more patients they could add to their practices.
   
3. Denial.
   There are so many foods that our digestive system may deem toxic that to individualize one's food intolerances is a daunting task. Our response: if insurance would cover intolerance screenings as much as they do lipid panels, this would not be an issue. Insurance could also reimburse allergists the same amount for educational consultations as they do allergy shots.
   

Until public health experts get their act together to acknowledge food intolerance, all we can do is continue to shed light upon the issue by screening our clients who we suspect have food intolerances, see them heal, and have them share their results with everyone they know.

For detailed data on food intolerance, go to Food's Toxic Effects Parts One and Two

For Future Consideration:
B-Cell activating factor (BAFF) is an exciting possibility as a mediating mechanism in testing via serum and gut lavage fluid for food intolerance. In a Alimentary Pharmacology and Therapeutics study, subjects with self-reported food intolerances had much higher BAFF levels than in subjects who did not report food intolerances. We will be tracking this testing methodology for future consideration.