Accounting for food allergy
A recent paper in the Journal of the American Medical Association on the prevalence of food allergies in the U.S. spawned headlines in opposing directions.
Some media outlets emphasized that many fewer people have food allergies than believe they do, and thus implied that the problem has been exaggerated. Others noted that the numbers affected — nearly 11 percent of the surveyed sample of 40,000 adults intended to reflect the general population — were high just the same.
I side with the latter.
An allergic reaction to food affecting more than one in 10 of us is a substantial public health problem, not diminished in my view by the fact that almost twice as many thought they had food allergies. And quite frankly, they may be right — because the study was limited to a short, stringent set of specific allergic responses — including such entries as hives, tongue swelling, trouble breathing and vomiting.
Of those reporting food allergies that did meet the researchers’ criteria, almost 40 percent reported at least one emergency department visit as a result. This is an alarmingly high number: roughly one in 10 of us reports a food allergy potentially severe enough to warrant a trip to an emergency department, and of this group, four in 10 wind up making such a trip.
I’m impressed. If we add intolerances to overt allergies — intolerances of lactose, lectins, gluten, FODMAPS, etc. — the numbers affected go up substantially. If we allow for the less discrete symptoms some food sensitivities induce — from bloating to brain fog — the numbers go up substantially. Add them all up, and this is a bona fide crisis of public health nutrition and modern epidemiology. Food is supposed to nourish and sustain us — not trigger the immune system like a bee sting or poison ivy.
Why is this problem so prevalent? There is no single, definitive answer — but there are some rather obvious and widely acknowledged explanations. They come in two basic flavors: what we are doing to our food and what we are doing to ourselves.
Regarding food, we have altered it radically and cumulatively over recent decades. The specifics include the routine substitution of formula for the first, best, native food for Homo sapiens like other mammals: breast milk.
They include food chemicals, such as artificial flavorants, artificial colorants, preservatives, miscellaneous additives (often as texturizers), sugar substitutes and more. They also include trace, or maybe at times not so trace, amounts of herbicides, pesticides, hormones and antibiotics.
They include novel combinations of compounds that don’t occur in nature; sometimes it is compounds in combination rather than in isolation that trigger the immune system to strike back. They include genetically modified food products
as well. While genetic modification can be useful and safe, it is nonetheless subject to the law of unintended consequences. If novel proteins, for instance, are introduced into foods — new allergies and intolerances are likely to result.
Regarding ourselves, our various immune reactions to food relate to both the health and balance of our immune responses in general, and the integrity of gastrointestinal lining.
Stress and sleep deprivation are generally inflammatory. Importantly, modern diets tend to be inflammatory due to excesses of saturated fat, refined carbohydrate, added sugar and perhaps to a lesser extent, omega-6 fats, along with relative deficiencies of omega-3 fats, fiber and diverse antioxidants from plant foods. This creates an obvious feedback loop: inflammatory modern diets heighten immune system responses, including to compounds delivered by that very diet.
Disturbances directly affecting the gastrointestinal lining may be of even greater concern. Inflammation of the gastrointestinal tract resulting from various sensitivities can cause socalled “leaky gut” which increases the likelihood of heightened immune responses to compounds in food. Modern living and the modern diet are known to damage the microbiome, which is a key contributor to our healthy digestion.
Generally, the only safe approach to an established, severe allergy is avoidance. But viewing the problem more generally and with prevention in mind, the triggering faults lie within our modern food supply and within our bodies. We have means at our disposal to ameliorate both beginning with: eating genuinely wholesome foods, in sensible, balanced assemblies. It’s never too late, nor too early, to start.