Why is Dairy Inflammatory?

DairyIf you’ve read about dairy at all on the internet, no doubt you will read in countless blogs and articles about how dairy is one of the top 10 inflammatory foods. It’s ALWAYS on the list. But why is that? What is it inherently about dairy that makes it so inflammatory. The particular proteins? The processing? The cows themselves? I would imagine many of you have no definitive answer, and yet we believe the inflammatory food lists without even thinking. If you are curious, let’s investigate.

Civilizations began drinking the milk of animals between 9000 and 3000 BC, once they were less nomadic and began to farm and raise animals in one location. Mainly it was given to children because, interestingly enough, during those times most adults lacked the enzyme, lactase, to break down milk lactose. Eventually people started making cheeses and curds which reduced the lactose sufficiently for adults to consume. In more recent times a mutation occurred which allows lactase production into adulthood, allowing many adults to consume milk on a regular basis.

Milk production and consumption was quite fortunate, actually, as for many civilizations milk (and fermented beverages like wine) was safer than the questionable water sources. At least this source was non-alcoholic! It also provided a ready source of calories if for any reason food should become scarce.

This milk was, of course, raw and fresh. I am sure there were occasionally issues with hygiene and foodborne illness as there is with any fresh animal product but for the most part, as mentioned previously, it was considered safer than the drinking water. Apart from the occasional illness, however, there does not seem to be the same links between dairy and inflammation that we see today. What changed?

Processing: Pasteurization and Homogenization

One of the first ways we treated milk in modern times for safety reasons was with pasteurization. This was meant as a way to prevent illness and death given the often unsanitary methods of collection, storage and distribution that started to occur in modern times. It wasn’t until 1860’s that pasteurization was first utilized and it became standard practice in the 1890’s.

There are currently several approved methods of pasteurization. The original method was to heat milk to 145 degrees F for 30 minutes. Newer methods use much higher heats for a shorter duration of time. The high-temp, short time method (HTST) sees the milk heated to 161 F for 15 seconds, and the ultra high heat method gets the milk up to 280 F for just a couple of seconds. There are other variations of heat and time as well, but the main point is that the milk is heat treated to kill pathogens. Presumably this is a good thing as no doubt it has prevented deaths from contaminated milk, but we will see that this has some unfortunate consequences as well.

Just like breast milk from humans, the milk from animals is “alive.” What do I mean by that? There are delicate proteins, enzymes, immunoglobulins, vitamins and minerals all present in fresh, raw milk. Heat can damage or denature these elements, rendering them inactive or potentially harmful. Every parent knows you cannot heat breast milk or you take away its nourishing properties. When we do this to animal milk, we dramatically reduce its ability to work with our body. It is not the intact fluid it once was. While it still can provide helpful nutrients and protein, it may also be harming our body at the same time.

In an article Dr. Mercola wrote on the very same topic, he noted that first of all heat kills the Vitamin C naturally present in raw milk. It also converts the lactose into another form, called beta lactose, which is more rapidly absorbed and may adversely raise blood glucose levels. Pasteurization also destroys some of the naturally occurring iodine as well as alters the Calcium (the very thing we typically drink it for) into a form that is hard to absorb. Many of the natural enzymes are denatured as well, potentially making it harder to digest. While pasteurization may help keep us from falling ill, it seems to produce a product that is nutritionally inferior. Pros and cons, I guess.

The next way we treat milk is with homogenization. This is not for safety concerns but merely for desired consistency. In its natural state, milk is composed of fat and water. When left to sit, this fat will rise to the top. Once milk became commercialized, this was undesirable, and so manufacturers sought a way to prevent this from occurring. Homogenization was born. There are various mechanical methods to do this, but the end goal is to break up the fat globules and prevent them from clumping together. This practice appears to be harmless, however some have noted that during this process some of the proteins (whey and casein) become reassembled with the fats. It believed that these now protein-heavy fat globules may decrease absorption and increase risk for allergies, however there are few studies to back this up. For now it seems homogenization may be the least of your worries when it comes to milk consumption.

Nutrient Profile

The nutrient profile of milk has also changed over the years. Obviously when humans first began consuming milk, all of the cows were grass fed and raised on open pastures. Nowadays, as we all know, most cows are kept in close confines and fed a varied diet, usually consisting of a mixture of grains, dried grass, and random leftovers such as canola meal, almond husks and citrus pulp. This has an effect on the fats, vitamins and minerals that can be found in the milk we end up consuming.

Grass-fed cows, for example, produce milk that is higher in anti-inflammatory Omega 3’s, Vitamin E, beta carotene, phytochemicals/antioxidants and conjugated linoleic acid. Cows that are fed more varied diets produce milk with higher levels of inflammatory fats and lower levels of vitamins and antioxidants. Remember, we are what we eat, and this same saying applies to the cow as well. Now, while grass-fed milk might seem more healthy after saying all of that, remember if its pasteurized, many of these beneficial properties may be neutralized as we discussed previously. Just something to ponder given the plethora of organic and grass-fed milks on the store shelves these days.

Apart from diet, the type of cow can also have a significant impact on the nutrients in the milk. Most dairy cows in the US are of the Holstein variety. This variety in particular tends to produce larger amounts of milk than their cousins and hence has been the cow of choice. However, this brings up the A1 vs A2 debate. The A-what? Apparently all cows originally produced A2 protein in their milk, a type of beta-casein that makes up about 30% of the protein in milk. Several thousand years ago a mutation occurred that changed the beta-casein slightly, which we then dubbed A1. Most of the European dairy cows, including Holstein, predominantly produce A1 proteins. It has been purported by several researchers that A1 milk is harder to digest and has been linked to increases in heart disease, Type 1 Diabetes, and leaky gut syndrome. Whether this is indeed true or not is yet to be proved, but it may be another reason why some people have a harder time with milk products than others.

If you want to look for A2 milk, you are in luck. The Jersey, Guernsey and Normande cows produce mostly A2 milk. Some stores carry these varieties and some milks in other countries are even starting to be labeled as “A2.” Personally I have Guernsey cow milk and yogurt in my fridge right now. For someone such as myself with a history of dairy issues, it seems to be, at least for now, more digestible.

Hormones

We likely have all heard about the issues with hormones in cow’s milk. But where are those hormones coming from? First, there are natural hormones that pass into the milk from pregnant cows. The later in pregnancy the cow is, the more hormones she passes. One researcher noted that 60-80% of the natural estrogens we consume are from dairy. This can have implications when it comes to cancer. Also, the higher the fat content of the diary product, the higher the amount of estrogens.

In 1993, the FDA approved the use of genetically engineered recombinant growth hormone (rBST) to increase milk yield. Many studies and reviews have shown rBST to be safe, mainly in that it cannot be absorbed by humans via milk consumption. Despite those studies many countries, including Canada, Australia, New Zealand and all of the EU have banned it. The main reasons for this involve animal welfare, namely referring to increased illness and infections amongst animals injected with rBST. More antibiotics are then needed, increasing the risk for antibiotic resistance, and these antibiotics may pass into the milk as well. Yet one more thing to consider.

Conclusions? Maybe you, like me, are just as confused as before. The government tells me milk is healthy and beneficial, but health websites are telling me that milk is inflammatory and best avoided …. What is one to do?

First, I think it’s safe to say that raw milk from grass-fed Guernsey or Jersey cows would be the ideal choice. Of course, there are risks to unpasteurized milk that need to be taken into account. Also there is the problem of finding those types of milk on a regular basis, not to mention the cost. The presence of hormones would also still be a concern. Additionally, even if you find the most perfect milk on the planet, the proteins may still set off your immune system and cause inflammation. Any food can be inflammatory if your immune system chooses to react against it.

The next best choice would be pasteurized milk from organic, grass-fed cows, however again there is potentially an availability issue for some and also cost concerns. Also the allergy issue remains and may even be more of a problem as the milk has lost some of the elements that improves and supports digestion.

The least favored choice would be non-organic, ultra high heat pasteurized milk that is treated with rBST from very pregnant cows (but how would you know this!). Unfortunately this is the most common milk on the shelf and therefore what most Americans are consuming. This IS inflammatory for all of the reasons described and I would highly recommend to avoid. If this is your calcium source, there are far better ways to get this mineral than milk. Do a quick google search and you can easily find great lists of non-dairy foods rich in calcium. If you drink milk simply because you like it, try one of the better options discussed above. You may want to drink less of it due to cost, but at least you will be consuming a healthier beverage.

We all have been taught that milk does a body good, but now we know this might not be the case. Do what is right for YOUR body and make your choices regarding dairy accordingly.

For Further Reading:

A1 vs A2 milk

Hormones in Milk Can Be Dangerous

Grass Fed Milk

Dr. Mercola on Milk

 

A Guide to Food “Allergy” Etiquette

food-allergies-matLikely you’ve noticed, but there are a growing number of people with food “issues.” It might be a food intolerance, a food sensitivity, or even a very serious, life threatening food allergy. I’m one of them. Maybe you are too.

But maybe you are not. And maybe you are now daily exposed to people talking about their food avoidances in the work place to stores promoting the latest in allergy-free products, and are even told not to bring your favorite foods to schools or potlucks for the sake of a small minority that might have an adverse reaction to such foods. SO annoying, right? But seriously, does this make you angry?

Just let me tell you, no one chooses to have food issues. Parents do not choose for their sons or daughters to go into anaphylactic shock when exposed to peanuts, dairy or any other random foods that might normally seem completely benign. In fact, it’s something all of us parents fear. While you are grumbling about peanut butter, can you imagine the fear of that parent praying their child does not accidentally ingest or even come in contact with the food that could land them in the hospital, or worse, while they are at school or out in the world? In a far less serious example, I did not choose to break out in painful acne all over my back every time I eat dairy. And others did not choose to experience terrible gas and bloating when eating foods with gluten, sugar, soy, etc. I know sometimes it may seem that people are using food avoidance as a diet or other regimen apart from a true food allergy, but give them the benefit of the doubt. All of us in a second flat would choose to be able to eat anything we desired if given the ability. Oh how I would LOVE to eat a piece of cheesecake without paying a price. Or really, just to have a simple latte. Or buy a thick chocolate chip cookie full of high quality butter. Great, now my mouth is watering, and I digress.

You may be wondering what the differences between food allergies, food intolerances and food sensitivities are, anyway. Let me break it down real quick so you can a better sense of where people are coming from.

Food Allergy: This is by far the most serious. This is an immune-modulated reaction related to the IgE antibody. These reactions usually occur within minutes of eating a food and can range from something as simple as a mouth rash to more serious symptoms such as hives, vomiting, or anaphylactic shock.

Food Sensitivity: These reactions are modulated by non-IgE antibodies or T-cell reactions and are typically delayed in nature. The reactions may occur hours after eating a food up to 3 days later. It can be extremely frustrating to figure out which foods are the actual culprits so have some patience with your poor friends or family members who are still trying to sort it out. Better yet, tell them about Mediator Release Testing. In these cases the symptoms are rarely life threatening but can include things such as digestive issues/IBS, headaches/migraines, body aches, fatigue, eczema, and a host of other ambiguous symptoms that might equate to “feeling lousy.”

Food Intolerance: This is the result of the body’s inability to correctly break down a food due to some deficiency in an enzyme or other body process that would normally allow you to digest and assimilate that food in a normal manner. The easiest example is lactose intolerance. When the enzyme Lactase, produced in the small intestine, is lacking, people cannot break down the lactose in dairy products efficiently. The undigested lactose goes into the intestines and then produces unpleasant gas and bloating. Avoiding dairy or taking oral Lactase usually solves the problem.

Celiac Disease: I feel the need to mention this one here because it is none of the above but commonly encountered. You may know that those with Celiac Disease must be on a gluten free diet, but that is not because gluten is an allergy. It’s because gluten causes an autoimmune disorder. The presence of gluten signals certain antibodies to damage the villi of the small intestine, making it an attack against “self.” The destruction of these villi, which are the absorptive surfaces of the small intestine, eventually produce malabsorption of nutrients and a host of co-morbidities. Even the smallest trace of gluten can trigger these events.

Irregardless of the type of food issue a person has, I think the common frustration among folks is what to do about it or how to help. Well first of all, there is nothing you can do about it. People’s food issues are people’s food issues. What you can do to help is be accommodating.

Do you know how many times I’ve heard people say to me in my office, “Danielle, I just don’t want to be a burden to anyone.” So then they’ll go, eating the food of family and friends, that they know will make them sick. What I’m saying is that many people would rather make themselves sick than have you think ill of them for bringing up a food issue. I know it may seem easy to just not eat, but have you ever seen someone give you the eye for not eating anything at a party? It’s even worse if you are thin. And doubly worse if it’s around family. People hate the non-eater. It’s a no-win situation.

Being accommodating to food sensitivity/food allergy/food intolerance sufferers first requires you to ask. When was the last time you asked on an invite or in a group if there were any food allergies to be aware of? And even if you did, have you ever though that a large majority of them don’t even mention their avoidances simply out of politeness?

Secondly, do a little research on these food groups. How many people do you know that are gluten free? Check out your grocery store for gluten free options and products. Do a little reading online about common foods to avoid. Discuss the issue with these particular friends to learn a little more. Trust me, they will appreciate you asking and might even share why they are avoiding certain foods in the first place.

Thirdly, take it seriously. Remember that even a little bite of allergenic foods for some people can provoke serious symptoms. As I mentioned before, sufferers of Celiac Disease, for example, can have NO gluten. Even the contamination from foods processed in the same facility as wheat can cause malabsorption and inflammation in their small intestine. Over time this sort of damage can lead to vitamin/mineral deficiencies and even cancer. It’s serious. Other people with gluten sensitivity may be able to get away with a touch of gluten here or there. You just never know the severity, so ask.

Lastly, try not to be offended. Even if the dish you so carefully created for your allergy-suffering friend seems perfect in every way, try not to take offence if they still can’t eat it. I’ve been there, in both respects. I’ve had people create dairy-free meals for me only to have seemingly forgotten that butter constitutes dairy (admittedly I still eat it and suffer the consequences). On the flip side I’ve created meals or baked goods for others where I may have remembered to accommodate a few of their allergies but unfortunately forgot about one. It happens. Get over it and enjoy the company.

Now I know this is no perfect science and there will still be frustration, anger and annoyance when dealing with people’s food issues, but hopefully we can all get along a little bit better just by being more aware and sensitive to those around us. Next time you bring a dish to your work potluck or church event, consider making something gluten free. Maybe prepare something Vegan. The options are endless. Take stock of those around you and think about how you can be more accommodating. You will be amazed how much your efforts are appreciated.

As a Dietitian, What Do MY Kids Eat For Breakfast?

BreakfastAs a Dietitian, I know people are constantly scrutinizing what I and my family eat. I’m not complaining; I get it. It’s no different than when I examine the outfit of a personal stylist or the teeth of a dentist. We all have to represent our brand. In my case, however, it’s not always easy to categorize food as “healthy” and “unhealthy.” Certain foods have certain meanings or connotations to different people and can easily be judged as “bad” by one group and yet “good” by another. It can be so confusing!

I try not to judge people’s foods choices (for the most part, I’m human), but I will admit I sometimes feel sad when I see the foods kids are accustomed to eating. I know in many cases it just happens; a few well-meaning trips for Happy Meals turn into a demanded lifestyle, for example. I remember all too well the WIC mom telling me all her kid would eat was McDonalds Chicken Nuggets and French fries. That must have required so many painful trips to the Golden Arches. But we as parents have a huge amount of control over what our kids eat. I think parents forget that. Heck, even I forget at times and let things go that I would rather not. We all do it.

Now, I have had the advantage of a lot of training in the area of childhood nutrition, so I knew early on that when I had kids I would be introducing a variety of healthy, whole foods and avoiding exposure to the unhealthy stuff as much as possible. That being said, do we have sugar in our house? Most certainly. Do we even have sugar-containing beverages from time to time? You better believe it. They had half an Odwalla smoothie and a smidge of Ginger beer today. Granted it has been an unusually warm week here in Seattle, so we let a few cold beverages slide. But thankfully that is not the norm and the kiddos know that.

My point is this: kids will eat healthy foods given the right structure and parental modeling. I’m not talking about kids with clear texture aversions or other conditions that cause anxiety or distress around certain foods. I’m talking about “most” kids that are simply taking advantage of their parents’ lack of knowledge or willpower when it comes to diet.

So I know, you are still wondering, what do MY kids eat for breakfast. First, let me tell you what we don’t eat. It’s pretty simple. We don’t eat cereal (yep, no Frosted Flakes around here), “white” bread products (bagels, English muffins, Wonder Bread, pancakes/waffles with white flour, etc), sugary yogurts, anything with artificial sweeteners, cereal bars, Pop Tarts, and heavily processed meats (sausage patties, cheap bacon, etc.). Another thing we don’t eat at breakfast? Vegetables. Uh oh, I know! We just don’t eat veggies in the morning. I pick my battles and forcing savory fritattas and quiches is just not one of them. Believe me I’ve tried. It often works for lunch but not for breakfast. I try not to lose sleep over it.

Here’s a list of what we DO eat:

  • Whole grain waffles. I make buckwheat waffles with coconut oil almost weekly. They keep nicely in the fridge and we eat these for days. A little work up front and you have quick and easy breakfasts for days.
  • Whole grain pancakes. Also often made with buckwheat flour or a mixture of non-gluten grains. For the record we aren’t gluten-free or anything, I just like the variety.
  • Oatmeal with hemp and flax seed, maybe some blueberries thrown in. Oh yes, I buy the packets, but I embellish them with these add-ons to boost the protein and healthy fats. Costco often sells the jumbo pack of gluten-free oatmeal packs, just so you know.
  • Organic Greek yogurt with fruit, hemp and/or flax seeds, plus nuts and/or granola. Again, adding some protein and healthy fat in there, along with a smidge of fiber.
  • Other “yogurts.” Sometimes I make a big batch of coconut milk yogurt or rice milk yogurt cultured in my yogurt maker. This is mostly for me and the little one. He will eat anything. That being said, I have nothing against alternative yogurts sold in the stores. I just don’t like paying for it.
  • Chia “yogurt.” This is a new one for us, but me and the little one love it. Soak coconut milk overnight with chia seeds, then add peaches and toasted nuts the next morning. SO good. The older one poo poo’d it, but whatever. Money-saving hint: get your canned coconut milk at Trader Joe’s for ninety nine cents. Can you make breakfast any cheaper?
  • Whole grain toast (usually Dave’s Killer Bread) with almond butter and jam.
  • Eggs. We eat a LOT of eggs. It’s possible we could save a lot of money if we raised chickens. Unfortunately I refuse to have any animals. Isn’t child caretaking enough?
  • Bacon! My husband usually finds good quality bacon from our local butcher and the kids love it. It’s more of a rarity, but certainly something we love to have on occasion.
  • Fruit. Who doesn’t love fresh fruit in the morning?

So there is a sampling of what we eat. Often we create different combinations of the items listed above. It has become what my husband now calls “breakfast extravaganza.” He is pretty sure very few are putting as much time and effort into breakfast as we do (although I bet some of you do, right?), but clearly the kids love it and need it. Breakfast is by far their biggest meal of the day. It’s satisfying to know we are starting their day off right. Did I mention my kids are the in the 75th percentile for height? Maybe it’s due to breakfast … just a theory.

Now that I’ve shared these delicious ideas with you, please help me expand my breakfast repertoire. What healthy foods do your kids eat for breakfast?

photo credit: Dazed81 via photopin cc

Book Review: The Virgin Diet by JJ Virgin

Elimination DietIt seems that amongst the continual slog of new diet books coming on the market, more and more of them are touting programs that resemble the classic elimination diet. Given that I do not recommend elimination diets that aren’t tailored and unique to each person for many reasons, I thought I would review one of these new books to see if it proves a good guide for helping people change their diet and lose weight or is just another fad. One of the most popular of these books on the market right now is The Virgin Diet by JJ Virgin.

The promises of the book start right on the cover. “Why Food Intolerance is the Real Cause of Weight Gain,” and “Drop 7 Foods — Lose 7 Pounds — Just 7 Days.” Alright, I’m hooked. Let’s start reading.

The premise of her book is that hidden food sensitivities are the real reason you can’t lose weight. When your immune system is continually taxed and overburdened, the body is less able to shed unneeded weight and instead wants to hold onto fat. I am not sure this is scientifically supported, but I understand what she is trying to say. It tends to make sense and coincides with what I have seen in my own clients. Also, some of the “weight” is actually water weight as the body seeks to dilute the problematic foods by making you bloated. In more ways than one, food sensitivities are making you fat.

She then dives into what food sensitivities are and how they differ from allergies and food intolerances. All good stuff you need to know. She educates on how food sensitivities cause ongoing inflammation and how that negatively affects your health overall… not just your weight. In fact, while the cover touts all the weight loss benefits of her diet, much of the book discusses how you will alleviate many other symptoms such as fatigue, acne, indigestion, diarrhea, and constipation, just to name a few.

She also provides some great education on how different types of sugars, especially fructose, are so damaging to our bodies, mainly in how they raise insulin and throw off our fullness/hunger cues. She is spot on in how these sugars make us gain weight, deplete our energy, and increase our hunger.

Another area she touches on is leaky gut. I will say, I do agree that leaky gut is real. Many health professionals, especially doctors, would disagree. The premise is that for some people the lining of our small intestine becomes compromised, allowing food particles to get into the bloodstream and attacked by the immune system. This sets us up for food sensitivities. While there is some science to back up what she is saying, the issue is still hotly debated. In any case, she provides a decent discussion on the topic so you get an understanding of why gut health is so important.

Virgin then divulges how her diet plan works. It’s really simple actually. Eliminate the seven most reactive foods from your for several weeks, then reintroduce each food one at a time and see if your body has a negative response. Then avoid those problematic foods for a good long while. Her “diet” ends up being a modified version of the classic elimination diet, or as she has coined it, the Virgin Diet.

The next part of her book gets into the nitty gritty of the Virgin Diet. She has a section on each of the seven foods she recommends eliminating along with great information as to why they are problematic and where these foods are often found in our diets. She even gives tips on hidden sources of these foods, especially for soy, corn and wheat, which tend to be found in almost every processed food on the shelf these days. I think this section is particularly helpful as it does provide a good education on why these foods could be messing with your health and how to successfully avoid them.

The downside of the Virgin Diet? It comes back to the classic elimination diet. The problem with these diets is that there is no clear way to know which foods to leave in the diet and which ones to take out. Yes, we can take out the “seven” most allergenic foods and hope for the best, but what about those that react to other foods? If leaky gut is real, why can’t other types of food particles slip through the cracks so to speak as well? It seems she has just taken the seven most common problematic foods into account without addressing the possibility there could be others.

That leads me to her section on “healing foods” that she highly encourages you to eat throughout this process. Those foods? Coconut, aloe, flaxseed, apples, cold water fish, garlic, onions and oregano. Yes, all foods known to have healing properties, EXCEPT if you react to them. I have clients that cannot eat these foods. I have one that will get terrible diarrhea if he eats apples. This would be devastating to his progress if he were to follow the diet as recommended. For people such as him, this diet will just be more time and money wasted.

What disturbs me most about this book is how Virgin insists that you will see amazing and life-changing results by following this plan. I know this is going to devastate many people when their efforts are not rewarded as promised. They may even start to believe that food sensitivities are not their problem when in fact they are just eliminating the wrong foods.

Then there are all the “products” that get promoted along with the book. If you go on her website and sign up for any of her freebies, you will be forever inundated with emails touting her shakes, bars, supplements, and even exercise equipment. How do I know this? My in-box bears the proof. If you thought you were going to buy this book to lose weight without the expense of professional help, you might fall into the trap of shelling out all your money right to Virgin yourself. Nothing wrong with this, of course, but just beware. In my opinion authors become less credible when the healthy values they promote become wrapped up with multiple add-on products and programs. It can easily become a giant money pit for someone desperate to feel better.

Now all that being said, I still would recommend the book as a good guide on healthy diet principles. It provides education into what food sensitivities are, how to avoid certain foods known to be unhealthy for us, and how to have a better relationship with food overall. The last section of her book talks more about how to be a mindful eater, how to add moderate exercise to your lifestyle, and tips for maintaining your new healthy lifestyle. All valuable information presented in an easy-to-read format.

So there is my take on The Virgin Diet. Apart from the actual elimination diet, the book can be quite helpful for better understanding your body and taking better care of yourself. If you are truly suffering from food sensitivity issues, consult a professional for a personalized plan to get you better, and ideally get yourself tested for food sensitivities with the right blood test (www.foodsense.net/leap-mrt/). Otherwise you will likely fail to get the results you are looking for.

Elimination Diets: The Gold Standard for Food Sensitivities?

ID-100141638Have you ever gone through the rigor of an elimination diet to see if there are foods in your diet that are causing unpleasant symptoms? Many of us have, or at the very least thought about it. The classic Elimination Diet is still the gold standard for uncovering food sensitivities. It was originally invented and popularized by Dr. Albert Rowe in his book Elimination Diets and Patient’s Allergies, written in 1941. We are still using his concept to this day. Many healthcare practitioners, even medical doctors, recommend these diets on a routine basis. They too know that IgG tests, as I wrote about previously, are fraught with errors and are frankly unreliable.

So what does an Elimination Diet entail exactly? As aptly named, this type of diet seeks to eliminate many of the known common allergens (or as they should be more appropriately called, sensitivities) from the diet for a set period of time, usually 3 or 4 weeks. This gives the immune system enough time to calm down, so to speak, and ample time to see a reduction in symptoms. When foods are reintroduced, the symptoms they provoke are typically obvious and more severe than previously experienced. This makes it much easier to pinpoint the culprit foods.

Here are the foods typically eliminated on a basic elimination diet:
Wheat
Gluten
Corn
Soy
Dairy
Nightshades
Eggs
Peanuts
Alcohol
Caffeine
Cane Sugar
Artificial Sweeteners

Other foods eliminated on stricter plans:
Beans, peas, lentils
All seeds and nuts
ALL sugar (including maple syrup, honey, etc)
Beef
Chicken
Pork
Shellfish
Certain chemicals (tyramine, phenylethylamine, nitrates, MSG, etc)

As you can imagine, these diets are clearly no walk in the park. They are typically only suggested for patients that are willing and able to follow the protocol with the strong suggestion that the diet be guided by a trained practitioner. The rigor of the diet can be a hurdle for some, but this can be overcome with proper education, advice, and support. Most of us Dietitians have had training and practice during our schooling and are well qualified to walk patients through the process.

While you know now that elimination diets have been around for some time, you may have noticed they have started to become re-popularized lately, almost faddish in nature. Nowadays there seems to be countless books hitting the shelves talking about anti-inflammatory diet plans and specialized eating plans that claim they will help you shed weight, increase your energy, and even make you look years younger. What do all these diets have in common? They are based on the classic elimination diet!

As noted previously, these diets can be moderately restrictive or very restrictive based on what criteria you follow. That criteria is usually decided upon by you and your practitioner and what foods they seem to think are likely problematic in your particular case. While guided, informed and well-meaning, it’s essentially a guessing game. Similarly when you follow the plan put out by some author who has never met you and certainly doesn’t know your history or symptoms, it is an even greater guessing game.

And there you have the number one problem with our “gold standard.” How in the world do we know what to eliminate and what to leave in? Why are we never recommending someone take out apples, for example, or quinoa, or other “healthy” foods that could be equally problematic. If you are one of the lucky few that reacts to only one or two of the common allergens, then this diet works great for you. Problem solved! I’ve met these people and the elimination diet has been a miracle. For others, however, it ends up being just another plan that didn’t work. Clearly elimination diets can be helpful, but they just aren’t the answer for everyone. I know this first hand because elimination diets never worked for me.

As I mentioned previously, there are several authors and experts that are now recommending different elimination diets as the miracle plan to cure your ailments and help you shed stubborn weight. Even Dr. Oz has an elimination diet plan! Knowing what you know now, you can immediately ascertain that this may hold true for a select few. For many, these diets won’t address all of the problematic foods and you just spent money on yet another book or wasted weeks of hard work for little reward.

All that being said, I do think elimination diets have their place. I have had clients who were unable or unwilling to spend money on food sensitivity blood testing (the only one I recommend is Mediator Release Testing by Oxford Biomedical) and we successfully found an elimination diet plan that worked for them. This is the minority, however. We guessed and won. That doesn’t always happen. Most clients who have already tried everything typically come to find out, through blood testing, that no one figured out they were reacting to random healthy foods (ie fruits, vegetables, gluten-free grains, etc) and therefore they fell through the cracks. There is where elimination diets show their limitations and knowing the right blood test to use is crucial.

The best use of an elimination diet is with a trained medical practitioner, particularly one that knows your entire health history and can help you devise the best diet plan. A book, a TV show, or an online guide is not the way to go. Sure, those avenues have obviously helped some, but a carefully tailored plan is the best option, especially for those with more severe and chronic conditions. Of course blood testing is even better and more targeted if you can find a practitioner, such as myself, offering Mediator Release Testing. Educate yourself on all the options before starting or otherwise all that hard work may be for naught.

In my next post I will review one of the current popular elimination diet books, The Virgin Diet by JJ Virgin. Stay tuned!

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Friend Don’t Let Friends Do IgG Testing

ID-10044134Are you like me? Did some well-meaning practitioner at some point recommend IgG testing as a means to find out if you have food sensitivities? Maybe you had nagging digestive issues, body aches, fatigue, or unexplained migraines. A blood test, they said, could help us see what foods your body doesn’t work well with. Not knowing any better and desperate to get better, you fork over the money. A lot of it.

And are you also like me in that when you got the results back and took out those foods … nothing happened. Ok, maybe you felt a little more energetic by cutting out wheat or in my case, had significantly less skin inflammation by cutting out dairy, but nothing else resolved. Over time you resumed eating anything you wanted and were the same as before, minus a couple hundred bucks. So what gives?

For many years now IgG testing has gone mainstream and has especially become prevalent with many naturopaths and integrative health care practitioners. When food sensitivities are suspected, many turn to these tests without much knowledge as to how they work or their limitations.

So what is IgG testing? It’s a blood test that measures the level of IgG present in the blood in response to different types of foods. The more IgG, the more reactive your immune system is to that food, or so the theory goes.

The main problem with this? Well, IgG is not the only antibody involved in food-immune reactions. By measuring IgG, we are only capturing a piece of the immune puzzle. So even if IgG tests were accurate, we would be missing large part of the picture.

That brings me to accuracy. As I alluded to, unfortunately IgG tests are just not all that accurate. They may on occasion capture true food sensitivity reactions, but the other interesting thing is that they may be showing you foods that you have developed a good tolerance to. Tolerance you say? Isn’t that exactly the opposite of what we are testing for? Indeed. Research has shown that in many cases those with high IgG responses to certain foods are actually showing a strong tolerance for that food. It’s almost a protective mechanism, of sorts.

Now, I am certainly not the first to raise questions about the validity of these IgG tests. In fact, faculty from my own Alma Mater, Bastyr University (where I first got my IgG test done, mind you) has even written on the topic (http://www.tldp.com/issue/174/IgG%20Food%20Allergy.html). In their article they discuss the reliability and validity of IgG tests. They submitted multiple samples from the same person to several different labs that offer IgG tests. They found that 2 of the 3 labs had results that were different enough amongst the samples to be unreliable. There were too many variations in IgG levels for the same food with the same blood specimen to yield any clinically significant result. Surprising, isn’t it?

The next consideration is validity. What basis or standard are we using to judge whether a particular IgG level is correlated with signs and symptoms of food sensitivity? Unfortunately, no standard has been determined. What one lab may deem as a high IgG level might only be moderate to another. Each lab can determine their own standard and make clinical judgments accordingly.

The last area of concern raised by the author of this article pertains to the use of therapeutic diets that correspond with the results. Often these tests come with suggested diet plans that propose elimination and rotation diets. As we have seen previously, clearly these are based on questionable results. Also they rarely take into account “untested” foods, so there is more guesswork in terms of what foods should and should not be included in the diet. This is just one more way in which IgG tests will very likely waste a lot of your time and money.

So don’t be like me. Don’t let you or someone you know waste their money on expensive food sensitivity testing that yields questionable results at best. All those colorful graphs should go straight into the recycle bin if you ask me. Unfortunately many practitioners see it as an easy way to show or prove to their patients on paper that they need to change their diet. There are much better ways, friends.

Mediator Release Test by Oxford Biomedical is by far the best blood test out there. You can read more about that on my web site and why I recommend it exclusively. If your practitioner isn’t aware of it, tell them to check it out or simply contact me for more information.

Like I said, friends don’t let friends do IgG tests. That’s why I’m telling you.

Stay tuned for my next post on the pros and cons of elimination diets!

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The LEAP Diet: The Ultimate Food Sensitivity Diet Plan

ID-100209374Food sensitivities seem to be on the rise. Whether the symptoms are finally being recognized or the incidence in truly on the rise, more and more people are determining they have one or more food sensitivities. I deal with food sensitivities every week in my practice. It’s impossible to ignore as a dietitian. It was out of frustration with the standard elimination diet and its ineffectiveness for some of my clients that I stumbled upon MRT, Mediator Release Test. Many of you already know about MRT. For those of you who don’t, it’s the most accurate food sensitivity test on the market that I recommend exclusively for my clients. You can read more in-depth about it at Oxford Biomedical’s website. It’s gaining in notoriety and popularity. I’m actually becoming more and more surprised how many people are already knowledgeable about the test. What surprises people most often, however, is that the test is just a small fraction of the whole equation. The “diet” protocol is the real key to getting well. To get the best possible outcome (complete resolution of symptoms) you have to follow this diet protocol to a “T.” This is the main reason why LEAP clients are so successful. I’ve said it before and I’ll say it again. Over 90% of my clients see dramatic results using MRT + the LEAP diet protocol. It astounds me every time but it works.

But why LEAP? LEAP stands for Lifestyle, Eating, and Performance. It’s a protocol tailored specifically for each unique person and their unique test results. No one’s food sensitivities are the same, so no one’s elimination diet should be the same. That’s why I have such a problem with those books that that tell people to eliminate the top allergenic foods and all your problems will go away. While it may work for some, for many it just doesn’t solve the problem. The elimination diet should be tailored specifically for each person, their symptoms, and in the case of those who do MRT, their test results.

Let me take you through the process that I walk every one of my client’s through. First thing we sit down and review what came back as high reactive (red), moderate reactive (yellow), and non-reactive (green). Based on that we devise a Phase I diet. You only consume the very lowest reactive foods for the first week. As you can see, this can be both challenging and boring. A limited diet is no fun and makes for much more work in the kitchen, but it’s doable. I assist by brainstorming meal and snack ideas, offering specific food suggestions, and helping my client make a plan for implementation. Planning is SO important, both mentally and physically. Preparing your mind and your cupboards will set you up for success.

After Phase I we meet again. If everything is going as planned we move on to Phase II. In this phase we start adding back the rest of the “green” foods. We simply add back the rest of the non-reactive foods in a methodical manner to continue to calm the immune system and add more variety back into the diet.

Now Phase II can take a couple weeks. There are quite a few foods to add back in. Once that process is complete and presumably you are feeling great, we move on to Phase III. Of course if you are not feeling amazing for any reason then that is where I help troubleshoot, but for the sake of simplicity let’s say everything is progressing as expected. Phase III is where we test back “untested” foods, namely all those foods that aren’t included with the MRT test. MRT tests for 150 different foods and chemicals, so clearly it is not exhaustive. We need to have a way to know if any untested foods are causing immune reactions as well. This is another long process but one in which the diet gets progressively more and more inclusive. Oftentimes at this point you take the ball and run. You typically don’t need much more help from me except maybe one additional check in or even just a quick email should random questions come up. The process is nearing completion and you have a good idea of what foods you can handle and which you can’t.

Of course throughout this time as well we are working on gut healing protocols and considering additional supplementation, if necessary. It all just depends on your unique symptoms and conditions. It’s such an extremely tailored process that again, a book or website alone often does not meet the needs of someone with serious food sensitivities.

I’m not bashing on all the books, though. They can be a great guide and motivator and provide some helpful tools and resources to get started on a new diet lifestyle. I’m reading a few right now (which I’ll be reviewing, stay tuned!) and they have some fantastic tips and ideas that many people could employ. Just remember to seek expert help when needed instead of shelling out money for more books that only Band aid the problem.

Book pic

So there you have it. This is a basic summary of the process I use when guiding someone through an elimination diet using MRT that consistently yields positive results. Now compare this to elimination diets you’ve read about in books or have been suggested to you by other practitioners and you can see why they don’t address the entire picture. A one-size-fits-all approach just doesn’t work for everyone. Something to think about if you or someone you know is dealing with ongoing food sensitivity reactions.

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