The fields of medicine and nutrition are changing in how they perceive and treat food allergies, and are exploring the link between food sensitivity, allergies and obesity. Studies in the last several years by the Centers for Disease Control and Prevention (CDC) and the Journal of Allergy and Clinical Immunology have found a definitive link between food allergies and obesity, particularly in children. Two experts were interviewed for this article: August McLaughlin, health and sexuality writer and nutritionist in Los Angeles, and Dr. James Fondren, doctor of internal medicine in Newport Beach.
McLaughlin has noticed an increase in food allergies in recent years. “Food allergy prevalence in kids in the U.S. rose from 3.4 percent to 5.1 between 2009 and 2011 alone, according to the National Center for Health Statistics, which is a big jump.” In her own research, she has noticed a significant increase in food sensitivities and intolerances, particularly in self-diagnosed cases. McLaughlin believes “numerous factors contribute to the increases, though the definite causes haven’t been fully sorted out.”
“The typical Western diet, high in added sugars, processed food and genetically-modified ingredients, may contribute. Industrialized countries tend to have more food allergy cases than less developed countries.” McLaughlin believes the discrepancy might derive from “the measures we take to control infectious diseases. They also keep us from being exposed to bacteria that might prevent us from developing allergies. Low exposure to potential allergens can also contribute. Some research shows that mothers who avoid peanuts during pregnancy, for example, are more likely to have children with peanut allergies; avoiding a food can lead to an inability to tolerate or digest it properly.”
Dr. Fondren says, “Doctors are told wheat allergies are highly under-diagnosed, and may be roughly 10 percent of the general population. I don’t diagnose it in 10 percent of my own patients so it is likely being under-diagnosed in my practice as well.” Based on empirical evidence, Fondren believes other non-wheat related allergies have “about the same prevalence now as they did 10 to 15 years ago.”
McLaughlin stresses that more education and diagnostic tools are imperative to pinpoint and effectively treat allergies. “It is so important to make education and testing available to all families, particularly lower-income families, who are more likely to experience food allergies and less likely to gain treatment than higher-income families. Low-income families are also more likely to eat a low-nutrient, processed diet and have a higher incidence of obesity and heart disease.”
Non-profit group Food Allergy Research and Education (FARE) sees food allergies as “a growing health concern across all racial groups.” In fact, new studies show children of certain ethnicities such as African-American or Asian have significantly higher odds of having a food allergy than Caucasian youngsters. African-American children are two times as likely as Caucasian children to have an allergy to peanuts and milk. In addition, they are four times as likely to be allergic to shellfish. Children tend to outgrow many allergies but allergies to, for example, shellfish and peanuts are more likely to persist into adulthood which means the person may in fact be at risk for an allergic reaction throughout adulthood. Additionally, between 1997 and 2007, Latino children had the greatest increase in parent-reported food allergies, compared with kids from other ethnic groups.
According to McLaughlin, “early testing is crucial when a food allergy is suspected.” Unlike food sensitivities, which cause milder symptoms, such as bloating and gas, allergies can cause serious health problems and become fatal. “When a food allergy is present, your body releases antibodies known as IgG and C-reactive protein (CRP), which is a marker of inflammation. Inflammation contributes and derives from unhealthy weight gain and related health problems, such as high blood pressure and heart disease. Some experts believe that the allergies actually cause the inflammation, making added pounds a given. Research conducted in Europe showed that overweight kids had significantly higher IgG and CRP levels than normal weight kids, which supports this idea.”
Two key ways people discover the food culprit in their diet is by doing allergy or blood tests for food allergies and sensitivities. Skin and blood tests, the most commonly used today, are considered safe and effective. Because allergies can be very serious, avoiding the suspected culprit is important. McLaughlin recommends speaking to a physician or nutritionist before making any significant dietary changes. “Some tests require that you have the suspected food in your digestive system, so finding out the testing requirements before making the changes is key. Also elimination diets work best when they are guided by a professional and combined with proper testing.” She stresses that “all omitted foods should be replaced with equally nutritious alternatives.”
After reviewing McLaughlin’s answers, Fondren agreed but added, “the blood testing is more prevalent nowadays. But at the end of the day allergy testing, whether it is the blood testing or the skin testing, is not perfect.” He believes the clinical diagnosis often holds more weight than the allergy tests. “There are many doctors who think there is a link between obesity and gluten sensitivity. The science may lag behind our thoughts. There are articles for and against the gluten sensitivity issue so it is controversial. Many of my patients feel better on a gluten-free diet.” Fondren believes there is “a clinical entity that is not celiac disease, as he sees many patients who have definite sensitivities to wheat or gluten, with symptoms that disappear with gluten removal.” He disagrees with the recent articles suggesting gluten intolerance does not exist, but understands that “research ebbs and flows.”
Regarding other food allergies, new blood tests are emerging that help determine whether a person has outgrown an allergy over time, which happens often. The test requires building up immunity first, then re-adding the food in small amounts over time. McLaughlin believes this should always be done under the care of a physician. She also recommends “avoiding tests you can find on the internet, such as hair tests. Many of these tests are simply money-making schemes with little evidence of effectiveness. For example, McLaughlin is not a fan of the ELISA/ACT test, usually conducted by a chiropractor. Although she believes “the test can determine immune system responses, she does not believe those responses are linked with the hundreds of foods and nutrients the patient is being tested for.”
As a nutritionist, McLaughlin believes “obesity is very complex, and involves the whole self.” She recommends that individuals consider all underlying issues, including emotional issues. Her questions includes items like the following: “Are you under intense stress? Sleeping enough? Happy in your professional life? If you aren’t taking good care of yourself, why is that the case?” McLaughlin says, “determining these answers can go a long way. It’s important to change your negative beliefs about yourself and your habits.” Fondren’s dietary and lifestyle recommendations “depend on whether the patient appears diabetic on the labs, or just appear to be eating too much in general.”
Both professionals interviewed believe that “a healthy, consistent sleep routine and a whole foods-based diet are key, as is regular exercise.” McLaughlin adds, “you don’t need to hit the gym to stay fit. And, as unrelated as it may sound, it’s important to pursue your passions in life. The more emotionally fulfilled we are, the more likely we are to take care of ourselves.” Obesity has been linked to inflammation, illness, food allergies and unhealthy habits, but these recent studies offer hope for those who have changed their unhealthy habits with no decrease in weight. As Fondren says, “the research will continue but there may be no definitive answers for the time being.”
Interview by Jenny Hansen