You Are Unique: Food Intolerance Handbook

Pages 10-26 from The Food Intolerance Handbook
Copyright (c) Sharla Race. All rights reserved.

1 YOU ARE UNIQUE

Yes, you are unique and in more ways than you can probably imagine. We live in an era that accepts differences in height, weight, body shape and personality without question yet assumes we all need the same type of food and the same amount of nutrients, to be healthy.

Biochemical individuality

In 1956, Dr Roger Williams, who discovered pantothenic acid (B5) and folic acid, coined the term “Biochemical Individuality”. Biochemical individuality means that not only do we have a unique physical appearance but that internally we are also very different from each other.

Our internal organs are different sizes and the way they function varies. Some of us are deficient in certain enzymes such as those needed for digestion whilst others have these in abundance. Our ability to resist and fight disease varies. Some of us require vast amounts of certain nutrients whilst others don't, some feel pain more than others do and some of us are more likely to develop food intolerance and allergy problems than others.

Our genetic inheritance defines not only how we look but also how our bodies function internally at the level of every single cell. Before you start blaming your genes on everything, remember that other factors will also affect how healthy you are; these include your lifestyle, what you eat, the amount of exercise you take and your environment. But these only strengthen the argument for viewing each individual as exactly that—an individual.

So, although we are able to say that the body requires protein, minerals and vitamins we cannot say that you will function well on the same diet as me. Your needs will differ from mine and my needs will differ from yours. It is this fundamental uniqueness that provides the key to unravelling many baffling health problems.

The first step on the road to health is to embrace the idea that you are unique and that you may need to be treated differently than others with the same or similar symptoms. My focus in this book is to introduce you to the idea that eating the wrong diet could be impairing your physical and mental health.

The fact that you may have a problem with wheat, milk or a food chemical, such as salicylate, does not mean there is anything “wrong” with you. It is simply part of who you are—part of your own unique biochemical make-up. You may not find a cure but you will be able to find a solution by eliminating the food or reducing the amount that is consumed.

The myth of the healthy diet

It is a myth to suppose that there is such a thing as a single healthy diet that works for all. A healthy diet is a diet that works for you. You are unique and if you eat the wrong diet for you, even if it follows all the current healthy diet guidelines, you will not experience good health and you will probably have weight problems.

The current healthy diet guidelines generally suggest that you:

Eat a variety of different foods.
Eat the right amount to be a healthy weight.
Eat plenty of foods rich in starch and fibre.
Don’t eat too many foods that contain a lot of fat.
Don’t have sugary foods and drinks too often.
Don't eat too much salt.
Look after the vitamins and minerals in your food.
If you drink alcohol, drink within sensible limits.

The guidelines tend to focus around concepts of food pyramids, plates or tables which generally suggest that:

Oils and fats should be used sparingly.
Protein and dairy products should be eaten in moderation.
At least five portions of fruit and vegetables should be eaten each day, with slightly more vegetables than fruit.
Bread, cereal, rice, pasta and, sometimes, potatoes, should be the major part of the diet.

As a general guideline this may be adequate but it can never work for everyone. You could in fact follow these guidelines and be very unhealthy. For example, if you are intolerant of milk, gluten or wheat then you would not be able to eat the portions recommended in the dairy and grains sections without becoming seriously ill.

The detail within these guidelines changes virtually every year. I found it quite disconcerting that, at one point in the UK, the grains section included breakfast cereals, teacakes, crumpets and crackers all of which are potentially high in sugar, salt, refined grains and food additives. In the final analysis, these broad sets of guidelines can only ever be seen as that—broad guidelines. You will always need to adapt them to your own individual needs.

Do not see any dietary guidelines, unless they are avoiding an allergen that could kill you, as being cast in stone. Not only do the guidelines change virtually every year, the information we have on what is healthy and what isn’t also changes. For example, evidence on dietary fat which has caused so much concern over the last few decades is contradictory. There have been times when all forms of fat were seen as potentially bad and whilst there is now more of a distinction between good and bad fats people remain confused and often interpret “low fat” as “no fat” which is potentially hazardous to their health.

Benton took a random sample of 7,076 British people and divided them into three groups depending on the amount of fatty foods that were eaten. The findings showed that reaction times of those eating higher amounts of fatty foods were quicker. The results did not differ across different age, sex or occupation groups.[Benton D. Lipids and cognitive functioning. In: Hillbrand M and Spitz R T (eds). Lipids and Human Behaviour. American Psychological Assoc 1996.] Dr Ronald Krauss, chairman of the American Heart Association said that studies in healthy people show genetic differences in their response to low fat diets. It would seem that two thirds of the population would show only minimal benefit from a low fat diet and that for some it would be harmful.[BMJ News. Very low fat diets may harm some people. BMJ 1998;316:517.]

The focus on obtaining calories and nutrients from grains, meat and dairy products has also been called into question by the latest wave of interest in vegan diets and in raw foods. We all need protein, energy and nutrients from our food but how we obtain these will vary enormously. No single diet can be right for everyone.

Over the last forty years there has been an explosion of diets not just aimed at people wanting to lose weight but for general good health. They all come with the most amazing claims but if any of these worked for all of us wouldn't we all be healthier, and slimmer, than we currently are? By all means investigate the different diets on the market but don't be fooled into thinking that any one of them is 100% the right diet for you.

Success with some of these diets is often due to finding, by luck, one that excludes the foods that cause you a problem or provides you with the missing foods your body needs. For example, macrobiotic diets have worked wonderfully for some people but this could be because they have a sensitivity to the food chemical “solanine”. All vegetables in the deadly nightshade family are excluded on a macrobiotic diet and all of these are high in solanine. Also, the diet relies on fresh food and has no preservatives and additives which further removes potentially troublesome elements from the diet.

The raw food diets work well for some because they increase the alkalinity in the body and make you feel great. For many they are a serious problem as most vegetables and fruit contain naturally occurring chemicals, such as salicylate, that some people are sensitive too. Stone Age diets remove grains, and often dairy products, from the diet as do many low carbohydrate diets. Could not the success of these be due to eliminating, two of the most common trouble makers, milk and wheat?

Weight loss diets that increase the fibre content of the diet may work because they are helping the individual to balance their blood sugar more and so prevent over eating. But for those with a grain sensitivity they do not work at all and in some cases lead to weight gain. Some people thrive on vegetarian diets whilst others become ill not because of the lack of meat protein but because they are consuming more dairy products than they can tolerate, have a sensitivity to lectins in beans, or are intolerant of certain grains or vegetables.

No “off the shelf” diet is going to work for everyone. Please do not think I am knocking these diets. I think the variety of them is a good thing and they are very useful for the people who can use them. But failing to improve, lose weight or being able to maintain one of these diets is not necessarily a sign that you have done something wrong, it is more likely that you have quite simply been trying to follow the wrong sort of diet for you.

It is strange that at this point in history we need guidelines on what to eat. Perhaps the greater choice and greater availability of food have clouded our own innate judgement as to what is healthy for us and what isn't but sadly guidelines can only ever be part of the story. You are going to have to take responsibility for your own diet.

If food was my problem surely I'd know, wouldn't I?

How I wish this could be true.

To doubt that there is a link between what you eat and your mental and physical health is a natural response. After all you eat food every day surely you would have noticed if you had a food related problem and surely, if it was a possibility, your doctor would have said something. If only it was that easy...

You could go throughout your whole life with your health being impaired without knowing that food was your problem or your doctor even suggesting it. The reason for this is the body's amazing ability to keep on going against the odds. Sadly, when the problem is not identified early on, the symptoms in the long term become more and more debilitating leading to depression, anxiety, fatigue and overall ill health. I shall try explaining what happens in a little more depth.

Your immune system is highly complex and amazing. It has many different layers of defence which are all designed to protect your body from harm whether it be from bacteria, viruses, parasites or toxins. It is a system that is spread throughout your body and it serves you well but it can get overworked. An exhausted immune system will not be able to protect you as well as it should.

One of the ways this exhaustion can come about is by a daily assault from food that is not right for you. Hans Selye in his book "The Stress of Life" describes how our bodies deal with prolonged bouts of stress. The description below is based loosely on his ideas.[ Selye H. The Stress of Life. McGraw-Hill rev ed, 1984.]

Stage One
At first, when it receives the food you have a problem with, your body will let you know that there is a problem—some symptoms will appear but these are often ignored, not noticed or happened when we were children so we don't remember them.

Stage Two
The body then goes into an acceptance phase. It adapts to the toxin and does its level best to keep you going. You may not experience very good health but you are managing.

Stage Three
Eventually it will reach the point of exhaustion. It can no longer deal with the onslaught and your health begins to break down. Mystery viruses, fatigue, minor problems, loss of zest etc... all begin to appear and you just never seem to feel well.

When stage three takes place will vary from individual to individual. For some it will take place in childhood, in others much later in life or as a result of illness or trauma. It is also not a one-off process. You may find that you become so ill that you have to rest for weeks or months and then you seem to be okay but actually you have returned to stage two and sooner or later will revisit stage three again.

The difficulty is that when stage three is reached you are often presenting a puzzling array of seemingly unrelated symptoms and it is not easy for any medical practitioner to recognise that food intolerance may be the root of the problem. This form of delayed hypersensitivity can involve a whole-body response involving several organ systems and leading to a chronic illness with recurring flu like symptoms. The array of resulting symptoms can be extremely puzzling. By my mid thirties I had such a long list of symptoms that I never presented them to a doctor for fear of being labelled a hypochondriac.

This breakdown in health does not take place overnight but can take a life-time to evolve. Usually in childhood there are symptoms of colic, eczema, nasal congestion, recurring ear infections and “growing” pains. The child seems fully well for only short periods of time. The pattern continues into adulthood with recurring bouts of a variety of symptoms such as nasal congestion, sore throats, generalised muscle aches and stiffness, abdominal pain and bloating, fatigue, weakness, an inability to think clearly and problems concentrating.

It is often the case that no specific physical cause can be found. People at some point acquire a label, either one of a number of syndromes such as chronic fatigue, fibromyalgia, irritable bowel, depression, panic disorder, or a single aspect is identified as the main problem such as migraine, rheumatic disease, asthma, Crohn's disease, urticaria, or arthritis. The presence of the hidden food problem is not identified and the individual continues to suffer.

Doctors, including Rowe and Randolph, have also identified a tension-fatigue syndrome, characterised by sensory and motor hyperactivity and/or sensory and motor fatigue, linked directly with food sensitivities. Once again, this condition does not appear overnight but at first occasionally bothers the individual then increases in occurrence and intensity leading the patient and doctor to a sense of desperation as nothing can be found to be wrong. The symptoms increase—tiredness after a full night's sleep, tiredness when not being particularly active, mental sluggishness, an inability to concentrate or get oneself going, possible depression, aching and sore muscles, bloating and so on. Studies by doctors who have accepted the existence of this syndrome have shown that the symptoms most generally go into remission when the offending foods are removed from the diet.

Food intolerance can occur at any age. It can be a short-term problem or a lifelong condition. If not identified early on it can lead to more serious problems in later life: for example, colitis in a child, which is caused by milk intolerance, can lead to Crohn's disease in adulthood.

It is also the case that any food can cause problems. Although some foods, like wheat and milk, have been identified as most likely to cause problems they are not the only culprits. Any food can cause your body and mind to be ill. You can be intolerant of any of the following:

A complete food such as milk, soya, carrot, egg, pork, wheat, mushroom, chicken, apple.
A naturally occurring chemical such as salicylate in many herbs, fruit and vegetables; tyramine in aged meat, cheeses and wine; purines in protein foods; amines in cooked foods; solanine in vegetables; or naturally occurring MSG (monosodium glutamate).
An added ingredient that does not occur naturally in the food—such as a preservative, artificial sweetener, colouring, flavour or antioxidant.
In a complex food, i.e. any processed food, you could be sensitive to any one of the ingredients. For example, in bread it is possible to react to wheat, preservatives, yeast, or flour improving agents.

Proven by many, not accepted by the majority

As you will discover, in the next chapter, there is an overwhelming amount of evidence that demonstrates how food can make you ill. So, why is the link between food and health, proven by many doctors, not accepted by the majority? I put forward the following answers not as excuses but as a way of explaining the mechanism at work in traditional western medicine.

Accepting food as a cause of illness is seen as too simplistic and would contradict accepted theories of disease causation put forward by highly respected members of the profession.
There is always another promised wonder drug around the corner that, with media hype and marketing, overshadows research on links between food and illness.
Increasing specialisation means doctors focus on a single set of symptoms rather than on the totality of the person.
Treating symptoms rather than looking for causes is what doctors are taught to do.
Doctors receive virtually no training in nutrition. The ones that come to accept the links between food and illness have often seen the effects of food intolerance on themselves, a relative or patient.
The range of symptoms that can be caused by food intolerance is so vast that food intolerance would nearly always have to be considered and this is not seen as a valid use of a doctor's time—it is far easier, and saves time, to treat the symptom than to assist the individual in finding the cause.
Assessing food intolerance is not something that can be done solely by the doctor—at some stage control must pass to the individual.
There is still little understanding of how food intolerance and allergies can cause so many symptoms and this is unsettling to doctors used to relying on weighty tomes of scientific evidence.
Little funding is available for research into the relationship between food and health. Drug research is more readily funded as pharmaceutical companies have a vested interest in the results. There is, quite simply, no profit to be made from understanding food intolerance.
Research that requires the comparison of identical cases is virtually impossible in the area of food intolerance as what causes one individual to have, for example, migraines, will not necessarily cause migraines in another individual. Case studies are seen as being too individual specific and therefore are often ignored as evidence.

One of the other reasons is that doctors do not learn from their patients. Dr Mansfield, an advocate of the link between nutrition and arthritis, states that people who have had spectacular improvement in their arthritis have been met by disbelief when reporting their success with a change in diet to their GPs and rheumatologists. Their improvement in virtually all cases has been put down to “spontaneous remission”. Dr Mansfield says: "These physicians, amazingly, seem uninterested by the patient's offer to re-eat the ‘bad’ foods and demonstrate an abrupt end to this ‘spontaneous remission’ for a few days."[Mansfield J. Arthritis, Allergy, Nutrition and the Environment. Thorsons 1995.]

Other doctors, including Philpott, Mackarness, Mumby, Randolph, and Rowe, have been equally amazed at how findings on links between nutrition and health have, rather than being embraced, been ignored. Professor Jonathon Brostoff, Professor of Allergy and Environmental Health, University College, London, said that re-education of doctors was essential. "The education system does not even mention nutrition, let alone food intolerance. We do not have a body of doctors who have learned about the role of food and diet in health."[Brostoff J. BBC News on-line Tuesday October 13 1998. http:\\www.bbc.co.uk.]

During the course of the research for this book, I have come to appreciate the difficulty faced by doctors and researchers in scientifically establishing the role of food in illness. Thankfully, with appropriate tests, allergies can now be more easily recognised but food intolerance continues to cause problems. This will become easier when the various mechanisms by which food affects individuals become known and defined. Research in the area of food additives and the problems caused by naturally occurring food chemicals is taking place but is fraught with difficulties for the following reasons.

Little is still known about why some individuals have problems with eliminating these substances from their bodies.
Most of these substances are cumulative in the body and this can make testing extremely difficult.
The symptoms produced vary in type and intensity from individual to individual.
Tolerance levels are individual specific.
Challenging with a single dose often produces a negative result.

This inability to explain why food “x” causes symptom “y” and the fact that any food can cause any symptom leaves many doctors sceptical and resistant to exploring food intolerance as the cause of illness. Scepticism is healthy but total dismal is ignorance and the result is that millions of people are denied the help that they need. Suffering continues and the cost of health care keeps on rising.

It was interesting reviewing the research more than ten years after this book was first published as nothing had changed:

Scepticism about the role of food intolerance in causing health problems remains quite common
Medical journals still contain case studies presented by doctors who are astounded that for at least one of their patients food was actually the cause of their illness.
Research papers are still being written that describe how some individuals make amazing recoveries when their diets are changed and that perhaps other doctors should consider testing for food sensitivities.

What has changed is the way each of us, as individuals, can access information. The internet has enabled us to explore and find out more about a diagnosis we have been given and to discuss with others ways forward that might help us.

One cannot fault the drive for medical advances to prevent or cure diseases that cause so many deaths such as cancer and heart disease but ignoring the host of more minor complaints that people continuously suffer from is criminally insane. It is time health organisations and professionals recognised that avoiding certain foods and additives can greatly improve, even cure, a person’s condition, improve their quality of life and help prevent more serious illness.

As Gaby in his paper on the role of hidden food allergy and food intolerance in chronic diseases says: "Food allergy is an important and frequently overlooked cause of (or triggering factor for) a wide range of chronic, physical and mental disorders. Routine use of elimination diets in clinical practice can greatly increase the response rate in many difficult-to-treat medical conditions."[Gaby AR. The role of hidden food allergy/intolerance in chronic disease. Altern Med Rev 1998;3(2):90-100.]

Doctors’ indifference to the role of nutrition in illness is perhaps nowhere best seen than in the disregard for evidence that shows that hospitalised people are frequently provided with nutritionally deficient diets. A few examples follow:

Todd et al found that the daily energy, protein, iron and vitamin intake of people on different wards of an English hospital were less than those recommended for healthy adults.[Todd E A et al. What do patients eat in hospital. Human Nutr Ampi Nutr 1984;38A:294-97.]
Allison found that treatable malnutrition could be occurring in up to 25% of hospital patients and that nutritional status may also deteriorate during a prolonged stay. Suggestions were made that hospital managers had a positive policy towards nutritional care, that catering services recognised and addressed the problem and that, for optimal success, a skilled nutrition team was necessary and cost effective.[Allison SP. The management of malnutrition in hospital. Proc Nutr Soc 1996;55(3):855-62.]
Nevett found that malnutrition is a common problem amongst hospitalised people and that this leads to an increased risk of mortality and morbidity.[Nevett G. Malnutrition of the hospitalised patient-assessment of provision of diet and dietary intake. EDTNA ERCA J 1997;23(4):22-4.]
The development of malnutrition whilst in hospital is the result of changes in diet, nutrition not being seen as a high priority, common hospital practices, and lack of knowledge of people's previous nutritional state is the conclusion reached by Edwards in a comprehensive overview of malnutrition in hospital people.[Edwards SL. Malnutrition in hospital patients: where does it come from? Br J Nurs 1998;7(16):954-8,971-4.]

I find these type of studies distressing. Surely, during a stay in hospital, you should be able to expect the best possible care and that this should include an adequate and nutritious diet.

In 1999, a study by the Nuffield Trust in the UK, found that 40% of adults in hospital were undernourished and many others become so during their time in hospital. The report recommended that food provision be considered as part of clinical care rather than a “hotel” function.[Davis AM, Bristow A. Managing Nutrition in Hospital. Nuffield Trust Report, 1999.] The situation did not improve and in 2008 a report warned that malnutrition was still common in NHS hospitals and that the problem had increased by 85% over the past 10 years. By the way, this problem isn’t restricted to the UK—surveys elsewhere consistently find that about 20% of patients in general hospitals are malnourished.[Lean M, Wiseman M. Malnutrition in hospitals. BMJ. 2008 Feb 9;336(7639):290.]

The role of food in health is being overlooked by those very people responsible for our health and who produce the guidelines for healthy eating. Just what message are they sending out if their healthy eating guidelines are not implemented in hospitals?

By ignoring nutrition and the role that food intolerance plays in illness, doctors are closing the door on health for a great many people. If someone presents at a doctor's surgery with a recurring rash and headaches that individual’s body is undergoing stress and if it is not dealt with adequately their immune system will suffer. If an ointment and pain relief are prescribed then the symptoms may abate but the problem will still remain—prescribing a different ointment and higher strength pills will still not solve the problem.

The more stress and damage we do to our finely tuned immune systems the harder it will be for them to deal with an invasive disease or illness. Modern medicine has become focused on signs and symptoms, and drugs and treatments to “cure” them. The approach by doctors has become standardised and narrow, overlooking (usually not even considering) the unique aspects of an individual's condition.

Finding appropriate help has become expensive and exhausting and it is a tragedy that many people are unable to get the help they need. The food we eat, and the environment we live in, can never be ignored. For many people, an exploration of these would lead to an end to unnecessary suffering. And food intolerance does cause suffering—not just rashes and headaches but, if not identified, a lifetime of chronic ill health can ensue.

If doctors can't help us we need to educate ourselves and force them to “hear” us. I know you may have great difficulty finding appropriate help but at least through this book, and others, you will have more information to guide you and help you guide your helpers. We need to take more responsibility for our own health.

Why you need to involve your doctor

You may be asking yourself why I insist on you involving your doctor when so many have little experience of this field. Quite simply—illness is complex and has many causes and I do not want you to undergo any additional unnecessary suffering. If all other causes of your problem have been eliminated and your doctor does not want you to try dietary changes you can always change doctors.

As awareness increases more help will become available and there are, currently, doctors who are experts in this field and others who have a more open mind than some of their colleagues. It is important to obtain the appropriate help as testing for allergies is always safest when carried out by trained medical staff—anaphylactic reactions can lead to death.

I must stress that involving your doctor is even more important if you are suffering from any mental health problems, whether diagnosed or not, as the reactions that can take place when testing foods can be extreme. In these instances, testing of foods must be done with medical supervision.

Next - 2.1 food can make you ill