2.3 FOOD CAN MAKE YOU ILL
Gastrointestinal Problems
Gastrointestinal symptoms including diarrhoea, nausea, abdominal cramping, and gastrointestinal bleeding are frequently associated with food sensitivity.[James JM, Burks AW. Food-associated gastrointestinal disease. Curr Opin Pediatr 1996;8(5):471-5.] In a study of seventy one children with chronic abdominal pain, Ignys et al found that food allergies were implicated and that many improved after being placed on an elimination diet.[Ignys I, Bartkowiak M, Baczyk I, Targonska B, Krawczynski M IV. Food allergy in pathogenesis of chronic abdominal pain in children. Pediatr Pol 1995;70(4):307-11.]
Pelto et al hypothesised that milk hypersensitivity in adults may be the cause of gastrointestinal disorders. From the people they tested they did find a link that was not always associated with lactose intolerance and did not always show up as an actual allergy. They concluded that milk hypersensitivity in adults, occurring as gastrointestinal reactions, may be more common than previously thought.[Pelto L, Salminen S, Lilius EM, Nuutila J, Isolauri E. Milk hypersensitivity-key to poorly defined gastrointestinal symptoms in adults. Allergy 1998;53(3):307-10.]
Read et al studied twenty seven people with severe chronic diarrhoea for which no diagnosis had previously been found. For one of the people the cause turned out to be an allergy to beef.[i] In a study of fifty people with ulcerative colitis, food allergy was found to be the cause in 67% of them.[ii]
[i] Read NW, Krejs GJ, Read MG, Santa Ana CA, Morawski SG, Fordtran JS. Chronic diarrhea of unknown origin. Gastroenterology 1980;78(2):264-71.
[ii] Andersen AFR. Ulcerative colitis: an allergic phenomenon. Am J Dig Dis 1942;9:91-98.
[i] Read NW, Krejs GJ, Read MG, Santa Ana CA, Morawski SG, Fordtran JS. Chronic diarrhea of unknown origin. Gastroenterology 1980;78(2):264-71.
[ii] Andersen AFR. Ulcerative colitis: an allergic phenomenon. Am J Dig Dis 1942;9:91-98.
Rowe and Rowe reported that nearly 50% of one hundred and seventy people with ulcerative colitis needed no medication as their condition could be managed successfully with anti-allergy therapy alone.[i] Rider and Moeller tested twenty people with ulcerative colitis for wheat, egg and milk intolerance; fourteen of them experienced complete remission or significant improvement.[ii]
[i] Rowe AH, Rowe A Jr. Chronic ulcerative colitis: atopic allergy in its etiology. Am J Gastroenterol 1960;34:49-60.
[ii] Rider JA, Moeller HC. Food hypersensitivity in ulcerative colitis: further experience with an intramucosal test. Am J Gastroenterol 1962;37:497-507.
[i] Rowe AH, Rowe A Jr. Chronic ulcerative colitis: atopic allergy in its etiology. Am J Gastroenterol 1960;34:49-60.
[ii] Rider JA, Moeller HC. Food hypersensitivity in ulcerative colitis: further experience with an intramucosal test. Am J Gastroenterol 1962;37:497-507.
Wright and Truelove placed fifty people with ulcerative colitis on a milk-free diet or a control diet for one year. During the follow-up period, 38% of those on the milk-free diet remained free of relapses, compared with 21% of those on the control diet.[Wright R, Truelove SC. A controlled therapeutic trial of various diets in ulcerative colitis. Br Med J 1965;2:138-141.]
Food protein-induced enterocolitis syndrome (FPIES) in very young children leads to a range of symptoms including gastrointestinal distress, malabsorption, diarrhea, pain, and failure to thrive. Cow's milk and soya are the most common causes of FPIES, but cereal grains (rice, oat, and barley), fish, poultry, and vegetables can also cause the condition. In most cases, the problems have gone away by the time the child reaches the age of three.[Nowak-Wegrzyn A, Muraro A. Food protein-induced enterocolitis syndrome. Curr Opin Allergy Clin Immunol. 2009 Aug;9(4):371-7.]
See also Coeliac Disease, Colic and Colitis, Crohn’s Disease, Irritable Bowel Syndrome.
See also Coeliac Disease, Colic and Colitis, Crohn’s Disease, Irritable Bowel Syndrome.
Glaucoma
In a review of the research, Mindell found that glaucoma can be caused by long term use of steroid drugs or by "over consumption of optic nerve toxins like aspartame and MSG (monosodium glutamate)".[Mindell EL, Hopkins V. Prescription Alternatives: Hundreds of safe, natural, prescription-free remedies to restore and maintain your health. Keats 1999.]
Head and Neck Pain
Seltzer reviewed the existing literature to uncover the existence of head and neck pain syndromes caused by foods, and food and drug combinations. They found at least twenty five such syndromes including those induced by colourings, flavours, chocolate, coffee and tea, and foods containing tyramine.[Seltzer S. Foods, and food and drug combinations, responsible for head and neck pain. Cephalalgia 1982 Jun;2(2):111-24.]
Hemiplegia
Staffieri et al reported on a case of right sided hemiplegia that took place immediately after a meal. It was associated with angioedema, urticaria, purpura, and eosinophilia. A wheat elimination diet resulted in a clearance of the symptoms within a few days.[i] Cooke reported on a case of transient third cranial nerve palsy associated with hemiparesis, followed by an episode of contralateral blindness and paresthesia in a food allergic patient. Symptoms were resolved with avoidance of beef and pork.[ii]
[i] Staffieri D, Bentolila L, Leuit L. Hemiplegia and allergic symptoms following ingestion of certain foods. Ann Allergy 1951;10:38-39.
[ii] Cooke RA. Allergic neuropathies. In: Cooke RA ed. Allergy in theory and practice. WB Saunders, 1947, 325-36.
[i] Staffieri D, Bentolila L, Leuit L. Hemiplegia and allergic symptoms following ingestion of certain foods. Ann Allergy 1951;10:38-39.
[ii] Cooke RA. Allergic neuropathies. In: Cooke RA ed. Allergy in theory and practice. WB Saunders, 1947, 325-36.
Hypoglycaemia
Blood sugar problems are usually linked with diets that are high in refined carbohydrates such as white bread and sugar. The advice is to avoid refined carbohydrates and to switch to a high carbohydrate/high fibre diet or a high protein/low carbohydrate diet. However, for many people neither of these will work as their blood sugar problems are caused by a food sensitivity. Breneman identified food sensitivities as the cause of blood sugar problems in 75% of those with the condition.[Breneman J. Basics of Food Allergy. Charles C Thomas 1978.]
Irritable Bowel Syndrome (IBS)
Petitpierre, Gumowski, and Girard investigated food hypersensitivity as a cause of irritable bowel syndrome. They found that one or several foods or food additives could induce the typical symptoms of IBS and that adequate exclusion diets could result in dramatic clinical improvements.[Petitpierre M, Gumowski P, Girard JP. Irritable bowel syndrome and hypersensitivity to food. Ann Allergy 1985;54(6):538-40.]
Nanda et al had people with irritable bowel syndrome placed on an elimination diet for three weeks. The diet excluded dairy products, cereals, citrus fruits, potatoes, tea, coffee, alcohol, additives, and preservatives. Improvement was experienced by 42.8%. Some were intolerant of only one food and others had multiple food intolerances, the maximum being nineteen. The most common problem foods were dairy products, onions, wheat, chocolate, coffee, eggs, nuts, citrus fruits, tea, rye, potatoes, barley, oats, and corn.[Nanda R, James R, Smith H, et al. Food intolerance and the irritable bowel syndrome. Gut 1989;30:1099-1104.] Antico et al concluded that food additives may be a major factor in the development of irritable bowel syndrome.[Antico A, Soana R, Clivio L, Baioni R. Irritable colon syndrome in intolerance to food additives. Minerva Dietol Gastroenterol 1989;35(4):219-24.]
Joint Pain
In cases studied by Novembre et al, tartrazine and benzoates were linked with causing joint pain.[Novembre E, Dini L, Bernardini R, Resti M, Vierucci A . Unusual reactions to food additives. Pediatr Med Chir 1992;14(1): 39-42.] Golding reported that nine individual’s attacks of joint pain and associated swelling were triggered by certain foods or associated with allergic manifestations.[Golding DN. Is there an allergic synovitis? J R Soc Med 1990;83:312-4.]
A naturopath and orthomolecular nutritionist, Alexander writes that he has found "70 per cent of the people he treats for joint pain and stiffness and/or muscle pain have a sensitivity to the nightshade group of plants". His experience led him to write that an “important part of the treatment of arthritis is the removal of this food group from the diet".[Alexander P. It could be ALLERGY and it can be CURED. Ethicare Pty Ltd 1990.] Solanine is a naturally occurring chemical that is found in these plants and is dealt with in a later section.
See also Arthritis.
See also Arthritis.
Mekersson-Rosenthal Syndrome
Food allergy and intolerance to food additives have been implicated in Mekersson-Rosenthal syndrome. Mckenna et al report on the case of a thirty-four year old man whose symptoms were triggered by sodium benzoate and tartrazine.[McKenna KE, Walsh MY, Burrows D. The Mekersson-Rosenthal syndrome and food additive hypersensitivity. Br J Dermatol 194;131:921-22.]
Memory Loss
Impaired memory is a not uncommon symptom of food intolerance but it is rarely one that is studied in isolation as it invariably comes in tangent with other symptoms. Randolph and Moss present the case of a woman who had an excellent memory and then began to experience memory loss. Initially her problem was thought to be psychological in origin but was found to be caused by a susceptibility to wheat, corn and, especially, oats.[Randolph TG, Moss R W. An Alternative Approach to Allergies: The new field of clinical ecology unravels the environmental causes of mental and physical ills (revised edition). Perennial Library, Harper & Row 1990.]
Dr Mandell refers to a condition known as “allergic amnesia” in which the allergy sufferer often lashes out verbally, has irrational outbursts, and may be aggressive but later has no memory of the incident. He also cites cases of memory loss caused by food intolerance: one of a woman with periodic memory lapses, the other of a boy who after eating chocolate suffered from an impaired memory.[Mandell M, Scanlon L W. Dr Mandell's 5-Day Allergy Relief System. Thomas Y Crowell 1979.]
Meniere's Disease
Derebery and Berliner found that 40.3% of seven hundred and thirty four people with Meniere's disease had or suspected they had food allergies.[i] In a different study, Derebery concluded that people with Meniere's disease can show improvement in their symptoms of tinnitus and vertigo when receiving specific allergy therapy.[ii] Haid et al in a study of five hundred and seventy four individuals suffering from Meniere's disease found that, amongst other factors, allergy may trigger the disease.[iii]
[i] Derebery MJ, Berliner KI.. Prevalence of allergy in Meniere's disease. Otolaryngol Head Neck Surg 2000;123(1Pt1):69-75.
[ii] Derebery M J. Allergic management of Meniere's disease: an outcome study. Otolaryngol Head Neck Surg 2000;122(2):174-82.
[iii] Haid CT, Watermeier D, Wolf SR, Berg M. Clinical survey of Meniere's disease: 574 cases. Acta Otolaryngol Suppl 1995;520 Pt 2:251-5.
[i] Derebery MJ, Berliner KI.. Prevalence of allergy in Meniere's disease. Otolaryngol Head Neck Surg 2000;123(1Pt1):69-75.
[ii] Derebery M J. Allergic management of Meniere's disease: an outcome study. Otolaryngol Head Neck Surg 2000;122(2):174-82.
[iii] Haid CT, Watermeier D, Wolf SR, Berg M. Clinical survey of Meniere's disease: 574 cases. Acta Otolaryngol Suppl 1995;520 Pt 2:251-5.
Migraine
Migraines have over the years been linked with a wide range of foods. Some studies also link them with naturally occurring food chemicals such as histamine and tyramine.
Food allergy as a cause of migraine is mentioned in the scientific literature as early as 1930 when Blayeat and Brittain published the results of their study of fifty five migraine sufferers. In that study, 52.7% achieved complete or near-complete freedom from symptoms by avoiding allergenic foods; a further 38.2% had some degree of partial improvement.[Balyeat RM, Brittain FL. Allergic migraine. Based on the study of fifty-five cases. Am J Med Sci 1930;180:212-221.]
Speer found that foods such as milk, chocolate, cola and corn, were common triggers for migraine. [Speer F. Allergy and migraine: a clinical study. Headache 1971;11:63-67.] A study by Grant of sixty people with a history, some as long as twenty two years, of frequent and recurring migraines had 85% of them become headache-free after following an elimination diet. The number of headaches in the group fell from four hundred and two to only six per month. The commonest foods causing reactions were wheat (78%), orange (65%), eggs (45%), tea and coffee (40% each), chocolate and milk (37% each), beef (35%), corn, cane sugar, and yeast (33% each).[Grant EC. Food allergies and migraine. Lancet 1979;1(8123):966-9.]
Scheife and Hills found that amongst the most common precipitating factors for migraine were foods and drinks including coffee, tea, and cola beverages, chocolate, cheese, and alcohol.[Scheife RT, Hills JR. Migraine headache: signs and symptoms, biochemistry, and current therapy. Am J Hosp Pharm 1980;37:365-74.]
Merret et al tested to see if food allergy was a major cause of migraine. Their findings were that allergies could not often be detected and concluded that the food intolerance associated with migraine headaches was not related to the conventionally defined allergic mechanism.[Merrett J, Peatfield RC, Rose FC, Merrett TG. Food related antibodies in headache patients. J Neurol Neurosurg Psychiatry 1983;46(8):738-42.] Mansfield noted that clinical observations and studies support the role of food in causing migraine and sinus headache and clearly makes the point that the benefits of an avoidance diet include the need for fewer medications.[Mansfield LE. Food allergy and headache. Whom to evaluate and how to treat. Postgrad Med 1988;83(7):46-51,55.]
Lucarelli et al studied ninety two children affected by migraine. Forty nine had positive skin tests to one or more foods and forty of these improved after following an elimination diet for four to six weeks.[i] Elimination diets worked for migraine sufferers in a study by Mylek. The food most usually implicated was cow's milk but other problem foods included cabbage, eggs, preservatives and colours, some cheeses, and chocolate.[ii]
[i] Lucarelli S, Frediani T, Zingoni AM, Ferruzzi F, Giardini O, Quintieri F, Barbato M, D'Eufemia P, Cardi E. Food allergy and infantile autism. Panminerva Med 1995;37(3):137-41.
[ii] Mylek D. Migraine as one of the symptoms of food allergy. Pol Tyg Lek 1992;20-27;47(3-4):89-91.
[i] Lucarelli S, Frediani T, Zingoni AM, Ferruzzi F, Giardini O, Quintieri F, Barbato M, D'Eufemia P, Cardi E. Food allergy and infantile autism. Panminerva Med 1995;37(3):137-41.
[ii] Mylek D. Migraine as one of the symptoms of food allergy. Pol Tyg Lek 1992;20-27;47(3-4):89-91.
A study by Wantke using a histamine free diet had considerable success for some migraine sufferers.[i] Leira and Rodriguez reported that some foods in our diet can spark off migraine attacks in susceptible individuals. They identified a number of food based triggers for migraine including individual foods such as cheese, citrus fruits, nuts, tea, coffee, pork, chocolate, milk, vegetables, and substances within food such as tyramine, phenylalanine, phenolic flavonoids, alcohol, caffeine, food additives including sodium nitrate, monosodium glutamate and aspartame.[ii]
[i] Wantke F, Gotz M, Jarisch R. The histamine-free diet. Hautarzt 1993;44(8):512-6.
[ii] Leira R, Rodriguez R. Diet and migraine. Rev Neurol 1996;24:534-8.
[i] Wantke F, Gotz M, Jarisch R. The histamine-free diet. Hautarzt 1993;44(8):512-6.
[ii] Leira R, Rodriguez R. Diet and migraine. Rev Neurol 1996;24:534-8.
Mouth Ulcers (Aphthous Ulcers)
Wray reports on a study in which twenty individuals who had suffered from recurrent aphthous ulcers, some for more than eleven years, were given a gluten-free diet to follow. Five (25%) became ulcer free and when challenge tested with gluten the ulcers returned.[Wray D. Gluten-sensitive recurrent aphthous stomatitis. Dig Dis Sci 1981;26:737-740.]
A study by Hay and Reade placed seventeen individuals with recurrent aphthous ulcers that had not responded to conventional therapy on an elimination diet. Of the twelve people who followed the diet for six to eight weeks, four became symptom-free and one had marked improvement. In four of these cases a particular food was identified which, when eliminated from the diet, led to marked improvement or complete resolution of the ulcers.[i] Similar results were found by Wright et al.[ii]
[i] Hay KD, Reade PC. The use of an elimination diet in the treatment of recurrent aphthous ulceration of the oral cavity. Oral Surg 1984;57:504-507.
[ii] Wright A, Ryan FP, Willingham SE, et al. Food allergy or intolerance in severe recurrent aphthous ulceration of the mouth. Br Med J 1986;292:1237-1238.
[i] Hay KD, Reade PC. The use of an elimination diet in the treatment of recurrent aphthous ulceration of the oral cavity. Oral Surg 1984;57:504-507.
[ii] Wright A, Ryan FP, Willingham SE, et al. Food allergy or intolerance in severe recurrent aphthous ulceration of the mouth. Br Med J 1986;292:1237-1238.
Movement Disorders
Gerrard et al present three cases where individuals had episodic movement disorders triggered by foods or components of the diet. In one person, the movement consisted of shaking the head from side to side and was triggered by milk and a number of other foods. Repeated shrugging of the shoulders, in another, was triggered by egg and coffee. Rhythmic contractions of the arms and legs, in the third individual, were triggered by aspartame. Their observations led the researchers to conclude that foods can trigger movement disorder by acting on dopamine and other neurotransmitter pathways in the brain.[Gerrard JW, Richardson JS, Donat J. Neuropharmacological evaluation of movement disorders that are adverse reactions to specific foods. Int J Neurosci 1994;76(1-2):61-9.]
Multiple Sclerosis
Dr Mandell describes the case of a woman who had been diagnosed with multiple sclerosis. After extensive allergy testing it was found that most of her symptoms were in fact caused by food sensitivities.[Mandell M, Scanlon L W. Dr Mandell's 5-Day Allergy Relief System. Thomas Y Crowell 1979.]
Murray and Pizzorno note that "the consumption of two common allergens—gluten and milk—have been implicated in MS”.[i]
Kruger and Nyland have proposed that "multiple sclerosis arises due to the effect of various mediators (histamine and protease) released from the perivascular mast cells after stimulation by some diet factor."[ii]
[i] Murray MT, Pizzorno JT. Encyclopaedia of Natural Medicine. Rocklin, CA: Prima Publishing; 1998.
[ii] Kruger PG, Nyland HI. The role of mast cells and diet in the onset and maintenance of multiple sclerosis: a hypothesis. Med Hypothesis 1995;44(1):66-69.
Kruger and Nyland have proposed that "multiple sclerosis arises due to the effect of various mediators (histamine and protease) released from the perivascular mast cells after stimulation by some diet factor."[ii]
[i] Murray MT, Pizzorno JT. Encyclopaedia of Natural Medicine. Rocklin, CA: Prima Publishing; 1998.
[ii] Kruger PG, Nyland HI. The role of mast cells and diet in the onset and maintenance of multiple sclerosis: a hypothesis. Med Hypothesis 1995;44(1):66-69.
Nephrotic Syndrome
Nephrotic syndrome is a condition marked by very high levels of protein in the urine, low levels of protein in the blood, swelling especially around the eyes, feet, and hands, and high cholesterol. It can occur with many diseases but some causes are unknown. The following studies all demonstrate how in some of these cases the problem can be food intolerance.
Sandberg et al studied six children, aged between ten and thirteen, who all had nephrotic syndrome of unknown origin. Drug treatment was stopped and a diet that avoided milk was prescribed. Once the protein in the urine had dropped to a certain level, within three to ten days, the children were challenge tested with milk. The milk challenge resulted in a return of significant amounts of protein in the urine and oedema in four of the children.[Sandberg DH, McIntosh RM, Bernstein CW, et al. Severe steroid-responsive nephrosis associated with hypersensitivity. Lancet 1977;1:388-391.]
Gaboardi et al outlined the case of a six-year old girl with dermatitis herpetiformis, coeliac disease, and nephrotic syndrome. All three conditions disappeared when she was placed on a gluten-free diet.[Gaboardi F, Perletti L, Cambie M, Mihatsch MJ. Dermatitis herpetiformis and nephrotic syndrome. Clin Nephrol 1983, 20: 49-51.]
Lagrue et al tested thirty four individuals with idiopathic nephrotic syndrome. Five foods were tested—wheat flour, cow's milk, whole egg, beef and pork. The tests were positive in twenty two of the individuals.[i] Various other studies have confirmed that for some individuals there is a link between food sensitivities and idiopathic nephrotic syndrome. [ii],[iii],[iv],[v],[vi]
[i] Lagrue G, Heslan JM, Belghiti D, Sainte-Laudy J, Laurent J. Basophil sensitization for food allergens in idiopathic nephrotic syndrome. Nephron 1986;42(2):123-7.
[ii] Howanietz H, Lubec G. Idiopathic nephrotic syndrome, treated with steroids for five years, found to be allergic reaction to pork. Lancet 1985;2:450.
[iii] Lagrue G, Laurent J, Rostoker G. Food allergy and idiopathic nephrotic syndrome. Kidney Int Suppl 1989;27:S147-51.
[iv] Laurent J, Lagrue G. Dietary manipulation for idiopathic nephrotic syndrome. A new approach to therapy. Allergy 1989;44(8):599-603.
[v] Laurent J, Rostoker G, Robeva R, et al. Is adult idiopathic nephrotic syndrome food allergy? Value of oligoantigenic diets. Nephron 1987;47:7-11.
[vi] Laurent J, Wierzbicki N, Rostoker G, Lang P, Lagrue G. Idiopathic nephrotic syndrome and food hypersensitivity. Value of an exclusion diet. Arch Fr Pediatr 1988;45(10):815-9.
[i] Lagrue G, Heslan JM, Belghiti D, Sainte-Laudy J, Laurent J. Basophil sensitization for food allergens in idiopathic nephrotic syndrome. Nephron 1986;42(2):123-7.
[ii] Howanietz H, Lubec G. Idiopathic nephrotic syndrome, treated with steroids for five years, found to be allergic reaction to pork. Lancet 1985;2:450.
[iii] Lagrue G, Laurent J, Rostoker G. Food allergy and idiopathic nephrotic syndrome. Kidney Int Suppl 1989;27:S147-51.
[iv] Laurent J, Lagrue G. Dietary manipulation for idiopathic nephrotic syndrome. A new approach to therapy. Allergy 1989;44(8):599-603.
[v] Laurent J, Rostoker G, Robeva R, et al. Is adult idiopathic nephrotic syndrome food allergy? Value of oligoantigenic diets. Nephron 1987;47:7-11.
[vi] Laurent J, Wierzbicki N, Rostoker G, Lang P, Lagrue G. Idiopathic nephrotic syndrome and food hypersensitivity. Value of an exclusion diet. Arch Fr Pediatr 1988;45(10):815-9.
Oral Allergy Syndrome
Oral allergy syndrome refers to symptoms that arise as a result of direct contact of the oral mucosa with the offending food. Symptoms are usually in the form of oral itching and lip swelling. It has been frequently associated with sensitisation to fresh fruits and vegetables in those with a pollen allergy. Bircher et al found that about 35% of people allergic to pollens showed allergic symptoms to fresh fruit and vegetables.[i] Oral allergy syndrome has also been described in cases of egg and shrimp allergy.[ii] Adults seem to be more likely to develop oral allergy syndrome to fresh fruit and vegetables than children.
[i] Bircher AJ, Van Melle G, Haller E, Curty B, Frei PC. IgE to food allergens are highly prevalent in patients allergic to pollens, with and without symptoms of food allergy. Clin Exp Allergy 1994;24:367-74.
[ii] Amlot PL, Kemeny DM, Zachary C, Parks P, Lessof MH. Oral allergy syndrome (OAS): symptoms of IgE mediated hypersensitivity to foods. Clin Allergy 1987;17:33-8.
[i] Bircher AJ, Van Melle G, Haller E, Curty B, Frei PC. IgE to food allergens are highly prevalent in patients allergic to pollens, with and without symptoms of food allergy. Clin Exp Allergy 1994;24:367-74.
[ii] Amlot PL, Kemeny DM, Zachary C, Parks P, Lessof MH. Oral allergy syndrome (OAS): symptoms of IgE mediated hypersensitivity to foods. Clin Allergy 1987;17:33-8.
Pre Menstrual Syndrome
Although it is unlikely that PMS is as such “caused” by food intolerance, reactions to problem foods can be exacerbated in the pre-menstrual phase and may mimic PMS symptoms. Abraham found that symptoms of the pre-menstrual syndrome could be reduced or eliminated by changes in the diet—either by eliminating/reducing certain foods or increasing supplementation of certain vitamins.[i],[ii]
[i] Abraham G E . Nutritional factors in the etiology of the pre-menstrual tension syndrome. Journal Reprod Med 1983;28(7):446-64.
[ii] Abraham G E. Management of the pre-menstrual tension syndromes: Rationale for a nutritional approach. In: Blond J (ed). 1986 A Year in Nutritional medicine. Keats 1986.
[i] Abraham G E . Nutritional factors in the etiology of the pre-menstrual tension syndrome. Journal Reprod Med 1983;28(7):446-64.
[ii] Abraham G E. Management of the pre-menstrual tension syndromes: Rationale for a nutritional approach. In: Blond J (ed). 1986 A Year in Nutritional medicine. Keats 1986.
Wurtman et al found an association between changes in mood and eating carbohydrates. They found that women who reported having pre-menstrual symptoms increased their intake of carbohydrates when feeling depressed. They speculate that this is an attempt to increase serotonin production and hence improve mood.[Wurtman JJ, Brzezinski A, Wurtman RJ, Laferrere. Effect of nutrient intake on premenstrual depression. Am J Obst & Gyn 1989;161:1228-34] It seems possible that certain foods will “agree” or “aggravate” more at certain times in the menstrual cycle.
Psoriasis
Skin conditions are frequently linked with contact or food sensitivities and psoriasis is no exception. Douglas reported on people with psoriasis improving after eliminating certain foods. The foods varied from individual to individual but included citrus fruits, nuts, corn and milk. Others noticed improvement when eating a diet low in acidic foods such as coffee, tomatoes, soda and pineapple.[i]
Michaelsson et al found that a gluten-free diet was helpful to some people with psoriasis.[ii]
See also Eczema, Urticaria.
[i] Douglas JM. Psoriasis and diet. Calif Med 1980;133:5.
[ii] Michaelsson G, Gerden B, Hagforsen E, Nilsson B, Pihl-Lundin I, Kraaz W, Hjelmquist G, Loof L. Psoriasis patients with antibodies to gliadin can be improved by a gluten-free diet. Br J Dermatol 2000;142(1):44-51.
Michaelsson et al found that a gluten-free diet was helpful to some people with psoriasis.[ii]
See also Eczema, Urticaria.
[i] Douglas JM. Psoriasis and diet. Calif Med 1980;133:5.
[ii] Michaelsson G, Gerden B, Hagforsen E, Nilsson B, Pihl-Lundin I, Kraaz W, Hjelmquist G, Loof L. Psoriasis patients with antibodies to gliadin can be improved by a gluten-free diet. Br J Dermatol 2000;142(1):44-51.
Recurrent Otitis Media
Inflammation of the middle ear is a common childhood complaint. In 1994, Nsouli et al evaluated one hundred and four children, with recurrent serious otitis media, for food allergy by means of skin testing, specific IgE tests, and food challenges. Children who had evidence of allergy eliminated the suspected offending foods for sixteen weeks, after which individual food challenges were done.
Eighty one (78%) of the children had evidence of food allergy, and elimination of the allergens resulted in significant improvement in 86 percent of the children. The problem foods were cow's milk, wheat, egg white, peanut, soya, corn, orange, chicken and apple. They concluded that considering food allergies in children with these problems "might prevent surgery and might prevent permanent damage".[Nsouli TM, Nsouli SM, Linde RE, et al. Role of food allergy in serious otitis media. Ann Allergy 1994;73:215-219.]
Viscomi presents an approach to allergic management for use in cases of children with otitis media arguing that there is often a history of allergy. Fifty allergic children with recurrent secretory otitis media, despite conventional surgical therapy, were treated for inhalant and food allergy for one year. There was a significant reduction in the recurrence of the condition.[Viscomi GJ. Allergic secretory otitis media: an approach to management. Laryngoscope 1975;85:751-758.]
A study by Bernstein et al of 100 children with recurrent otitis media with effusion tested for six inhalant and two food allergens. They concluded that allergic reactions may play a role in otitis media with effusion in about 23% of young allergic patients. One wonders if the percentage would have been significantly higher if a greater range of foods had been tested.[Bernstein JM, Lee J, Conboy K, Ellis E, Li P. Further observations on the role of IgE-mediated hypersensitivity in recurrent otitis media with effusion. Otolaryngol Head Neck Surg 1985;93(5):611-5.]
Rousquet et al reported that between 7 and 29% of asthma sufferers have a milk sensitivity. They also found it was often a cause of rhinoconjuctivitis in young children and may be implicated in serious otitis media.[Rousquet J, Chanez P, Michel F-B. The respiratory tract and food hypersensitivity. In: Metcalfe DD, Sampson HA, Simon RA. (eds) Food Allergy: Adverse reactions to foods and food additives, 2nd ed. Blackwell Science 1997.]
Restless Legs Syndrome
In a study of people with restless legs syndrome, Lutz found many improved on a caffeine free diet.[Lutz E G. Restless legs, anxiety and caffeinism. J Clin Psychiatry 1978; 693-8.]
Rhinitis
Rhinitis is a symptom usually associated with hay fever but studies, including those carried out by Pelikan,[i] Pastorello,[ii] and Freedman,[iii] have shown that when food, including additives, are tested there is a surprisingly high number of patients who have some degree of intolerance, sensitivity or allergy
[i] Pelikan Z, Pelikan-Filipek M. Bronchial response to the food ingestion challenge. Ann Allergy 1987;58:164-172.
[ii] Pastorello E et al. Evaluation of allergic etiology in perennial rhinitis. Ann Allergy 1985;55:854-56.
[iii] Freedman BJ. Asthma induced by sulphur dioxide, benzoate and tartrazine contained in orange drinks. Clin Allergy 1977;7:407-415.
[i] Pelikan Z, Pelikan-Filipek M. Bronchial response to the food ingestion challenge. Ann Allergy 1987;58:164-172.
[ii] Pastorello E et al. Evaluation of allergic etiology in perennial rhinitis. Ann Allergy 1985;55:854-56.
[iii] Freedman BJ. Asthma induced by sulphur dioxide, benzoate and tartrazine contained in orange drinks. Clin Allergy 1977;7:407-415.
Sampson and Eigenmann estimate that the prevalence of food-induced allergic rhinitis, even among patients referred to allergy clinics, appears to be less than 1 percent, although 25 to 80 percent of patients with documented IgE-mediated food allergy have nasal symptoms during oral food challenges.[i] Cinqi et al note that food-induced allergic rhinitis frequently occurs together with other food allergy symptoms such as asthma, eczema, oral allergic manifestations, urticaria, and gastrointestinal symptoms.[ii]
[i] Sampson H, Eigenmann PA. Allergic and non-allergic rhinitis: Food allergy and intolerance. In: Mygind N, Naclerio R, eds. Allergic and non-allergic rhinitis. Copenhagen: Munksgaard, 1997.
[ii] Cingi C, Demirbas D, Songu M. Allergic rhinitis caused by food allergies. Eur Arch Otorhinolaryngol. 2010 Sep;267(9):1327-35.
[i] Sampson H, Eigenmann PA. Allergic and non-allergic rhinitis: Food allergy and intolerance. In: Mygind N, Naclerio R, eds. Allergic and non-allergic rhinitis. Copenhagen: Munksgaard, 1997.
[ii] Cingi C, Demirbas D, Songu M. Allergic rhinitis caused by food allergies. Eur Arch Otorhinolaryngol. 2010 Sep;267(9):1327-35.
Kok et al involved six hundred and eighty individuals who were receiving treatment for allergic rhinitis in a study in which they were tested for various food allergies. Common positive foods were tested, including hidden ingredient foods such as soy, wheat and malt. Twenty one per cent reported poor to slight improvement, 29.4% reported better improvement, and nearly 50% reported good to very good improvement. Three of the most common allergens were egg, milk, and wheat. The study authors concluded that strict diet control without pharmacotherapy is effective in the management of patients with food-induced allergic rhinitis.[Kok YO, Yeoh KH, Wang DY. Effect of Diet Control in Food-Induced Allergic Rhinitis. Otolaryngol Head Neck Surg August 2010 vol. 143 no. 2 suppl P273-P274]
Raphael et al explores “gustatory rhinitis”, a form of rhinorrhea caused by spicy foods in which the reactions are not immunological ones, being influenced rather by neurologic mechanisms.[Raphael G, Raphael MH, Kaliner M. Gustatory rhinitis: a syndrome of food-induced rhinorrhea. J Allergy Clin Immunol 1989;83(1):110-5.]
Sexual Dysfunction
Armani et al had seven young men eat seven grams of liquorice each day for a week, They found that after four days their testosterone levels had dropped by an average of 44%. These findings led them to suggest that doctors should consider liquorice as a potential culprit when treating men with sexual dysfunction.[Armanini D, Bonanni G, Palmero M. Reduction of serum testosterone in men by licorice. N Eng J Med 1999;341(15):1158.]
Sinusitis
Allergy was demonstrated to be an underlying factor in 40 to 67% of people with chronic sinusitis and is present in as many as 80% of people with bilateral sinusitis according to Spector.[Spector S. The role of allergy in sinusitis in adults. J Allergy Clin Immunol. 1992;90:518-520.]
Mansfield noted that clinical observations and studies support the role of food in causing migraine and sinus headache and clearly makes the point that the benefits of an avoidance diet include the need for fewer medications.[Nsouli TM, Nsouli SM, Linde RE, et al. Role of food allergy in serious otitis media. Ann Allergy 1994;73:215-219.]
Sleep Disorders
Okudaira et al found that ingestion of xanthines such as theophylline and caffeine in coffee, tea, colas, and chocolate could contribute to some sleep disorders.[Okudaira, H; Ito, K; Miyamoto, T et al. Evaluation of new system for the detection of IgE antibodies (ImmunoCAP®) in atopic disease. Arerugi; 1991;40(5):544-545.]
Kahn et al in a study of one hundred and forty six children referred for sleep disturbance identified fifteen whose sleep problems were resolved within five weeks of starting a diet free from cow's milk. In a subsequent challenge, the sleep disturbances returned within four days of reintroducing the cow's milk.[Kahn A, Mozin MJ, Rebuffat E et al. Milk intolerance in children with persistent sleeplessness: a prospective double blind crossover evaluation. Pediatrics 1989;84:595-603.] Food chemicals, such as salicylate, have also been implicated in sleep disturbances.
Tinnitus
Tinnitus is an accepted symptom of salicylate toxicity as has been frequently shown in various studies. For example, Brien's review of toxicity associated with salicylates cites tinnitus and hearing loss, usually reversible, with acute intoxication and long term administration of salicylates such as aspirin.[Brien J A, Sigma. Ototoxicity associated with salicylates: A brief review. Drug Saf 1993;9(2):143-8.]
And, Cazals notes that tinnitus may be the first subjectively recognised symptom of salicylate toxicity and presents evidence going back to 1877 which shows links between salicylates and tinnitus. The dose of salicylate medications, for the treatment of rheumatoid arthritis, was often set below the point at which the individual started to experience tinnitus. [Cazals Y. Auditory sensori-neural alterations induced by salicylate. Prog Neurobiol 2000;(6):583-631.]
Although these studies have focused on manufactured forms of salicylate there is also evidence that dietary salicylate, in a sensitive individual, may also lead to tinnitus. DeBartolo reported that over a twelve year period they had identified individuals who were sensitive to salicylates and had improved or relieved their tinnitus with a salicylate free diet.[deBartolo H M Jr. Zinc and diet for tinnitus. Am Journal Otol 1989;10(3):256.] Shulman in his book on the diagnosis and treatment of tinnitus includes one of the potential triggers as being foods high in salicylate.
Urticaria
Atherton writes that food has been demonstrated to play a major role in urticaria. In some people whealing occurs within minutes of ingestion of the problem food, in others the reaction can be much slower and less easy to identify. It is not only foods that cause these reactions but food additives, especially azo dyes, have been implicated.[Atherton DJ. Diagnosis and management of skin disorders caused by food allergy. Ann Allergy 1984;53(6Pt2):623-8.]
Swain et al found that eighty six out of one hundred and forty children with recurrent urticaria improved significantly on a salicylate free diet. They also observed reactions to preservatives, azo dyes and brewer’s yeast.[i] Juhlin also found that many sufferers of urticaria improved on a diet free from additives.[ii]
[i] Swain A , Dutten SP, Truswell AS. Salicylates in Food. J Am Dietetic Assoc 1985;85(8).
[ii] Juhlin L. Additives and chronic urticaria. Ann Allergy 1987;59:119-23.
[i] Swain A , Dutten SP, Truswell AS. Salicylates in Food. J Am Dietetic Assoc 1985;85(8).
[ii] Juhlin L. Additives and chronic urticaria. Ann Allergy 1987;59:119-23.
Henz and Zuberbier reported that in the majority of cases of urticaria the symptoms were provoked, and sustained, by food ingredients. On a diet largely avoiding preservatives, dyes and natural pseudo allergens, 73% of people experienced remission of more than six months duration, starting within the first three weeks after starting the diet (the spontaneous remission rate is 14%). Eighteen per cent reacted to food preservatives and dyes, and 71% to pureed tomatoes. [Henz BM, Zuberbier T. Most chronic urticaria is food-dependent, and not idiopathic. Exp Dermatol 1998;7(4):139-42.]
Zuberbier et al had success in identifying food additives as the cause of urticaria in some people and improvement in the symptoms of others.[i] Verschave et al used an elimination diet for additives and tyramine with sixty seven individuals with chronic urticaria; 55% reacted favourably.[ii] Rudzki et al placed one hundred and fifty eight people with chronic urticaria on a diet free of salicylates, benzoates and azo dyes—fifty were found to be sensitive to food additives.[iii]
[i] Zuberbier T, Chantraine-Hess S, Hartmann K, Czarnetzki BM. Pseudoallergen-free diet in the treatment of chronic urticaria. Acta Derm Venereol 1995 ;75(6):484-7. And Zuberbier T, Czarnetzki BM. High response rate to additive-free diet in chronic urticaria. Br J Dermatol 1996;134(6):1159.
[ii] Verschave A, Stevens E, Degreef H. Pseudo-allergen-free diet in chronic urticaria. Dermatologica 1983;167(5):256-9.
[iii] Rudzki E, Czubalski K, Grzywa Z. Detection of urticaria with food additives intolerance by means of diet. Dermatologica 1980;161:57-62.
[i] Zuberbier T, Chantraine-Hess S, Hartmann K, Czarnetzki BM. Pseudoallergen-free diet in the treatment of chronic urticaria. Acta Derm Venereol 1995 ;75(6):484-7. And Zuberbier T, Czarnetzki BM. High response rate to additive-free diet in chronic urticaria. Br J Dermatol 1996;134(6):1159.
[ii] Verschave A, Stevens E, Degreef H. Pseudo-allergen-free diet in chronic urticaria. Dermatologica 1983;167(5):256-9.
[iii] Rudzki E, Czubalski K, Grzywa Z. Detection of urticaria with food additives intolerance by means of diet. Dermatologica 1980;161:57-62.
Thirty per cent of individuals with chronic urticaria and angioneurotic oedema, in a study by Montano et al, were found to be sensitive to sodium benzoate, tartrazine or sodium metabisulfite.[Montano Garcia ML, Orea M. Frequency of urticaria and angioedema induced by food additives. Rev Alerg Mex 1989;36(1):15-8.]
See also Eczema, Psoriasis.
See also Eczema, Psoriasis.
Vasculitis
Veien and Krogdahl reported on the case of a twenty-four year old woman with leukocytoclastic vasculitis. She experienced a severe eruption of vasculitis after a placebo controlled oral challenge with 50mg of ponceau (E214, a red colour dye). She followed an additive free diet and, after two months, the vasculitis was found to have faded.[Veien NK, Krogdahl A. Cutaneous vasculitis induced by food additives. Acta Derm Venereol 1991;71(1):73-4.]
Buscino et al described the cases of two children with food induced vasculitis. In an eight-year old girl, the vasculitis was found to be caused by a sensitivity to cow's milk and also to eggs. A twenty-three month old girl with vasculitis was found to be sensitive to chocolate: the vasculitis went into remission when chocolate was avoided and only returned after accidental ingestion of products containing cocoa.[[i] Businco L, Falconieri P, Bellioni-Businco B, Bahna SL. Severe food-induced vasculitis in two children. Pediatr Allergy Immunol. 2002 Feb;13(1):68-71.]
Vertigo
Dunn and Snyder presented information on three children who were found to be milk sensitive. Their vertigo attacks were eliminated by removing milk from their diets and reappeared with milk challenges. Chocolate was suspected in another child but could not be confirmed.[i] Duke reported on a case of adult vertigo in Meniere's syndrome that improved on an elimination diet.[ii]
[i] Dunn DW, Snyder CH. Benign paroxysmal vertigo of childhood. Am J Dis Child 1976;130:1099-100.
[ii] Duke WW. Meniere's syndrome caused by allergy. JAMA 1923;34:645-47.
[i] Dunn DW, Snyder CH. Benign paroxysmal vertigo of childhood. Am J Dis Child 1976;130:1099-100.
[ii] Duke WW. Meniere's syndrome caused by allergy. JAMA 1923;34:645-47.