Does this sound like you? You’ve had a love-hate relationship with food for a long time. In fact, for as long as you can remember, you’ve always loved food more than food has loved you. Once you made the decision to give up gluten you dedicated yourself to reading labels, and swapped out all of your foods to ones that are certified gluten-free. Things may have started to look up, but now your GI pains are back and you are not sure why. It is possible you could have additional food intolerances.
Food Intolerance, or “non-allergic food hypersensitivity” (NAFH) as it is sometimes called, is an additional challenge that many Celiac and gluten-sensitive individuals face. Unlike a food allergy that triggers a response from the immune system, the symptoms of food intolerances are the digestive system’s response to a particular food – through possible damage, an enzyme deficiency, or a food effect. The real challenge an individual faces is trying to distinguish between the two types of gluten sensitivity. Currently there are around 250-different symptoms associated with celiac disease and gluten-intolerance, which can present from joint aches, to migraines, to diarrhea or constipation.
While individuals with both gluten-intolerance and celiac disease tend to share similar symptoms of abdominal pain, bloating, intermittent diarrhea and others, “why” the body is in pain is rather different. In celiac disease it is the immune system causing the raucous. Those same helpful antibody agents that keep our body free of everything from the common cold to mumps and measles turn against our intestines in the presence of gluten. The small intestine is slowly damaged over time until we can no longer digest and absorb some foods easily. Symptoms from gluten sensitivity come from the intestine’s ability to digest and absorb some foods. Think of that classic children’s toy of the wooden shape-sorter, where our infants and toddlers strive to find the right sized hole for the triangle, square and circle shaped blocks in their hands. Just as their eager pounding and slamming of mismatched shapes provides little more than frustration, so too do our intestines search for the right shaped nutrients to absorb. If our body has triangle shaped holes dedicated to absorb digested-gluten, but lacks the enzyme to turn our large square gluten molecules into smaller, more easily absorbed triangles, there is bound to be some side negative side effects.
While true celiac disease is estimated to affect as much as 1% of our population, as of yet we do not have clear understanding of how many Americans are affected by NAFH. The National Institute of Health has estimated that it could be anywhere between 12-19% of all individuals; but it could likely be higher in individuals with a gluten allergy. Foods that people are frequently intolerant of are substances that naturally occur in foods, arise in food processing methods, or are added during processing.
Intolerance of Lactose, the sugar found in milk, is a common type of food intolerance. It occurs when your body stops producing enough of the enzyme Lactase to digest all of the Lactose in your daily diet. While this deficiency is more common as we age, it can also happen when there is significant damage to our intestines, like after bowel surgery or as a result of chronic inflammation related to gluten-intolerance or allergy. These types of injuries can also make it difficult to digest some foods with large sugar molecules, histamines, nitrates, MSG, or even other foods like eggs, corn, or soy. Sometimes adding digestive enzyme supplements like lactase, beano or diamine oxidase can reduce symptoms like cramping, bloating, intermittent diarrhea or constipation, skin rashes, joint pains or headaches. However sometimes it is necessary, as with gluten, to remove those foods from your diet.
It is important not to try to indentify these possible triggers alone. While some foods may cause symptoms relatively quickly after consumption, others may take up to three or four days before causing a reaction – which can make identifying the trigger food confusing. A Registered Dietitian can help you find foods that you may be sensitive to, and show you the best way to avoid them without risking your overall nutritional health. You can work with your insurance provider to find a Registered Dietitian near you, or find one yourself with the Academy of Nutrition and Dietetics free online tool: http://www.eatright.org/programs/rdfinder/ .
If you have given up gluten, and you do not seem to be feeling much better, you may have undiagnosed food intolerances. Food hyper-sensitivity is often “masked” or covered up by food allergies. If you have removed gluten completely from your diet and still find yourself suffering, it may be time to work with a Registered Dietitian to figure out which other foods you may be sensitive to. No one should remove or restrict large portions of their diet without the supervision of a qualified professional, but everyone should be able to enjoy a large variety of healthy and delicious foods without the pain or discomfort associated with food sensitivities.
Adam Pazder, RD CD is a consultant dietitian and Chef for Nutrition Authority; a western-Washington based outpatient nutrition firm. Adam is part of a team of Credentialed Nutrition Educators who ‘coach’ people to a healthier life by applying basic nutrition principles to better manage disease states and for disease prevention. To find out how you can sit down face to face with your own ‘personal nutritionist’, or receive the very best nutrition coaching through Skype or via the telephone, go to: www.nutritionauthority.com or call 253.227.8284.