Food sensitivities can be confusing at times. We know that symptoms can be more problematic at certain times depending on where we are with our IBD. For some, there may be an increase in gluten and dairy sensitivity during a flare versus other times such as remission. For others, there is a consistent sensitivity to gluten despite not having celiac disease. Regardless, it’s important to know what food sensitivity is and how we acknowledge these sensitivities in practice.
What is food sensitivity?
It’s important to note that food sensitivity is NOT the same as a food allergy. This is because food sensitivity does not involve the immune system, unlike a food allergy. Food sensitivities are not considered to be dangerous to the body according to the American Academy of Allergy Asthma & Immunology.
Research has shown that up to 20% of the population has a food intolerance. Food intolerances can be defined as lacking an enzyme or chemical and displaying difficulties digesting certain foods which are sometimes interchangeable with food sensitivities.
Since food sensitivities are not immune-mediated, meaning, they do not involve the immune system, there are no definitive tests to measure a spectrum of foods including carbohydrates, spices, and beverages.
What about food sensitivity testing?
If you’ve heard of food sensitivity testing, you may be wondering if these tests are validated and if you should be utilizing them. Let’s take a deeper look into these tests.
Food sensitivity tests use total immunoglobulin G (IgG) antibodies to measure possible food sensitivities in 90-100 different foods. These tests indicate that having a higher IgG antibody level to a certain food item would indicate an intolerance to that particular food. The downfall of these tests is that they are not reliable since there is no current data showing the reliability or validity of these tests.
There is also no specific diagnostic tool for food sensitivities and having higher IgG antibody levels can actually indicate a tolerance to these foods according to the American Academy of Allergy Asthma & Immunology.
It is important to note that most people create IgG antibodies after food consumption. The frequency of consuming a food item can alter testing, making a food sensitivity test unreliable. There are, however, tests that can measure intolerances like lactose intolerance and fructose intolerance that are performed with breath tests (1).
Symptoms of food sensitivity or intolerance can include:
- Abdominal pain
- Headache/brain fog
- Excess gas
- Visceral hypersensitivity (pain within the organs)
What are examples of food sensitivity?
Food sensitivities can occur for many reasons including a change in the microbiota, intestinal permeability, enzyme deficiency, and dysbiosis (imbalance of healthy bacteria in the gut).
Environmental factors can also play a role. Fermentable oligo-di-mono-saccharides and polyols, also known as FODMAPs, represent a cluster of certain foods that can cause food intolerances and sensitivities in individuals with irritable bowel syndrome (IBS).
Another type of food sensitivity is non-celiac gluten sensitivity (NCGS) which is characterized by a person experiencing gastrointestinal symptoms or symptoms that can occur outside of the GI tract (extraintestinal symptoms) after consuming gluten or wheat-containing products.
Symptoms are not driven by an allergy to wheat and can occur in patients who do not have celiac disease.
Research has shown other factors, including amylase-trypsin inhibitors (also referred to as ATIs), contribute to the production of wheat and can be harmful to consume for patients with celiac disease and can cause gastrointestinal symptoms in those with NCGS. FODMAPs can also cause sensitivities to those who have NCGS.
What is the treatment of food sensitivity?
Depending on the specific food(s), the treatment for food sensitivity is to reduce the intake of these foods or eliminate them entirely for a specific amount of time and then reintroduce them slowly into the diet.
The low FODMAP diet, for example, utilizes a 3-phased approach where higher FODMAPs are decreased or eliminated for 2-6 weeks, until symptom improvement is reached, and are then reintroduced slowly and checked for tolerance.
When utilizing the low FODMAP diet, there is not one specific food group that is eliminated. Currently, there are no cures or diagnostic tools to assess food intolerances but we know they can improve overtime as the gut environment improves.
Furthermore, using food sensitivity kits can create more harm than good since they can create fear of consuming foods without validation.
At this time, there is no definitive diagnostic tool that is used to test for food sensitivities. These tests can be expensive and are also unreliable. When measuring a food tolerance through IgG testing, outcomes can do more harm than good since they can create unnecessary fear.
When IgG testing is performed, elevated levels of a food item are indicative of an intolerance. However, elevated IgG antibodies can actually be a sign of tolerance to these foods. When in doubt, please consider speaking to an allergist to assess your symptoms.
- Gargano, D., Appanna, R., Santonicola, A., De Bartolomeis, F., Stellato, C., Cianferoni, A., Casolaro, V., & Iovino, P. (2021). Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns. Nutrients, 13(5), 1638. https://doi.org/10.3390/nu13051638
- Lavine E. Blood testing for sensitivity, allergy or intolerance to food. CMAJ. 2012 Apr 3;184(6):666-8. doi: 10.1503/cmaj.110026. Epub 2012 Mar 19. PMID: 22431905; PMCID: PMC3314037.