Written by Eris Rolves, SLU Dietetic Intern
I frequently get targeted
advertisements all over my Facebook and Instagram accounts for services that
provide home food sensitivity tests. Oh, the joys of being an RD to be – your search
history from academic research and Googling of medical terms easily spills over
into your personal Internet browsing! Like the ad intended, it caught my eye
and convinced me to stop scrolling, but not for the reason you may think. I
examined the ad with skepticism instead of intrigue.
These home food sensitivity tests
are marketed as an easy and cost-effective way to pinpoint what foods you are supposedly
intolerant to. For those of us who frequently experience unexplained
gastrointestinal distress, this appears to be the answer to our prayers at
first glance. No doctors appointments, invasive procedures, or additional
suffering? Just fork over a couple hundred dollars to have a company analyze my
blood, saliva, or hair sample and return a list of foods that make my belly
hurt? Seems like a straightforward, easy solution. However, it also seems too
good to be true, and I hate to be the bearer of bad news, but these home food
sensitivity tests most definitely are. Allow me to dig into the details of why.
Defining “Food Sensitivity”
It’s important to keep in mind that
“food sensitivity” is not a medical diagnosis. This means that there are no
formal criteria for identifying a food sensitivity, so the term isn’t really
recognized in medicine. What can be diagnosed, though, are food intolerances
and food allergies.
A food intolerance is developed
when your digestive system is unable to properly digest or absorb a certain
food, causing pain or damage to the GI tract. Gluten and lactose intolerance
are two common ailments that fall into this group. Chances are, your adverse
reaction to a certain food is related to intolerance, not an allergy.
A food allergy is significantly
more severe and stems from the immune system. In a food allergy, your body
reacts to a certain food through the digestive system, respiratory system, and
the skin. Anaphylaxis can even occur, which is a life-threatening side effect that
can include difficulty breathing, dizziness, and/or loss of consciousness. Food
allergies are serious and should be diagnosed by a physician, not a home test.
https://www.aaaai.org/conditions-and-treatments/library/allergy-library/food-intolerance
https://www.mayoclinic.org/diseases-conditions/food-allergy/expert-answers/food-allergy/faq-20058538
Why can’t food sensitivity tests
diagnose a food intolerance or allergy?
These home tests and diagnostic
medical tests are not looking for the same thing. Let’s have a quick science
lesson: Your immune system protects you by developing antibodies in response to
outside invaders it comes in contact with. The antibodies are custom-made by
your body to fight off specific invaders, and there are several types of
antibodies, called immunoglobulins (abbreviated Ig). Food allergies are
measured and diagnosed by the presence of IgE antibodies. It’s not entirely clear
why, but IgE antibodies are made in response to proteins in certain foods that
your body deems to be a threat, resulting in an extreme immune response when
that food is eaten (cramps/diarrhea, vomiting, hives, swelling, anaphylaxis). Home
food sensitivity tests measure the presence of IgG antibodies, which can be
made in response to any food and doesn’t necessarily result in that extreme
reaction from the immune system. Again, it isn’t clear why IgG antibodies are
made in the first place, but most people have IgG antibodies for quite a few
foods.
By measuring the presence of IgG
antibodies in your sample, the test is likely to return to you a laundry list
of foods you are “sensitive” to – and on top of that, foods that you probably
eat regularly. This leads to people following an unnecessarily restrictive diet.
Anyone with a diagnosed food allergy or intolerance can attest that having to
bend over backwards to avoid their trigger foods is not enjoyable. Why do that
if you don’t have to?
A more in-depth explanation of why
home food sensitivity tests are not effective can be found here: https://www.jaci-inpractice.org/article/S2213-2198%2817%2930704-3/fulltext#sec2
https://www.istockphoto.com/photo/antibody-immunoglobulin-gm1219978307-357047077
If food sensitivity tests aren’t
accurate, why do people feel better after following the results?
If you read the comments on the social
media ads for the food sensitivity tests, you’ll scroll through hundreds of
comments of people saying that the test was “the only thing that helped them
figure out what was wrong with them” and they’ve “never felt better” since
cutting out all the foods on their results list. How can this be? One might
feel this way for a couple of reasons. First, the placebo effect. Someone who
is well aware that they are trying out this new diet that’s supposed to
completely alleviate their symptoms may be convinced that it’s working for a
while until proven otherwise. Second, that long list of trigger foods the test
generated probably did contain a problematic food or two for them, and they are
successfully avoiding them along with a dozen others.
There is really no advantage to
avoiding foods that do not cause an adverse reaction. Like I mentioned, these tests
tend to implicate foods that you eat often, so it would be a major adjustment
to remove them from your diet, and a disappointing one at that. Unless your
favorite food happens to be the trigger food, a diet without the joy it brings
is not recommended, nor is it a healthy one.
Additionally, eliminating too many
foods from your diet can result in nutrient deficiencies, ultimately leading to
more health problems. That means doctors appointments, procedures, medications
to take – all of the results you were trying to avoid in the first place by
taking a seemingly harmless home test. These tests market a solution to your
suffering, but what you are really buying is more stress, confusion, and
complicated mealtimes.
Other factors to consider…
Keep in mind that your headaches,
stomach aches, GI symptoms, lethargy, and mental fog may have nothing to
do with your diet. Many of these home tests market themselves as answers to
general physical ailments like these. But there could be a lot of reasons you
feel this way that aren’t food related. Stress from work, school, life, and
major events like a global pandemic can cause you to feel less like yourself,
especially when that stress is chronic. Additionally, sudden changes in
lifestyle like staying at home most of the time and being less physically
active can impair digestion. Sudden changes in diet can also have repercussions
for your stool patterns, like an increase in fiber or caffeine intake. And, if
you are having significant abdominal pain upon eating, it could be indicative
of a more serious GI condition like an ulcer, an H. pylori infection, or
gallstones.
What should I do instead to get
to the bottom of my food issues?
If you think you are having an
adverse reaction to food, the best solution is to visit your primary care
physician or a registered dietitian. Your physician can refer you to an allergist
to determine if you have an allergy based on clinical testing. Registered,
licensed dietitians are the only healthcare providers who are able to
effectively help you identify intolerances and navigate an elimination diet to
narrow down any trigger foods you might have. Their goal is to find what
bothers you without unnecessarily cutting out too many foods or even entire
food groups.
I know that getting help from a
dietitian seems like the long way to a solution and quick answers are much more
attractive, especially when you’re in so much discomfort when you eat. Having
digestive issues is not fun! But, think of working with an RD as “food
therapy”. Working out what foods are bothering you and how to build your
diet/lifestyle around that is going to take time. Anyone or anything that says
otherwise should be approached with a healthy dose of skepticism. Just like you
wouldn’t believe a mental health counselor who says they can cure your
depression with one session, or a physical therapist that says they can relieve
your pain with one exercise, or a doctor that says they can cure your cancer
after just one appointment – don’t believe someone who says they can solve your
stomachaches overnight.
http://www.carlehealthfitness.com/wp-content/uploads/2018/07/dietician.jpg
