Food Reactions
What are Food Reactions?
Food reactions happen when our bodies are allergic, sensitive, or intolerant to a food.
While the terms food allergies, food sensitivities, and food intolerances are often used interchangeably, they are actually different in the way your body responds to a food. The ultimate treatment for all is the removal of the food.
Food allergies and food sensitivities are our immune system responding to a food, while food intolerances do not involve our immune system.
The most common food reactions are to the “Big 8”, which include:
Cow’s Milk
Wheat
Eggs
Soy
Tree Nuts
Peanuts
Fish
Shellfish
Different Food Reactions
This is where it gets tricky! Each food reaction has different antibodies and cells involved, different reaction times, and varying levels of symptom severity.
Food Allergy
Antibody Involved: IgE
Common Symptoms: Anaphylaxis, hives, swelling, wheezing or trouble breathing, tingling in mouth, etc.
Typical Reaction Timeline: Typically instantaneous or within 30 minutes
How to Test: RAST or Skin Prick Test (SPT) by an allergist. This is also often called IgE Food Allergy testing.
Food Sensitivity
Antibody + Mechanism Involved: IgG, IgA, IgM, T-Cells
Common Symptoms: Headache, brain fog, eczema, heartburn, bloating, irritability, gas or cramps, runny nose, etc.
Typical Reaction Timeline: 30 minutes – 72 hours
How to Test: Since many antibodies can be involved with food sensitivity reactions (IgG, IgM, IgA, etc), it’s best to use an end-point test rather than just an isolated antibody test (like an IgG Food Sensitivity Test). We prefer the Mediator Release Test (MRT). If you are wanting to use the MRT, be sure you are in the care of a Registered Dietitian who is also a CLT. The next best option is a test that measures both IgG and IgA. My preferred panel is through Vibrant America, though you will have to have a healthcare provider order it for you.
Food Intolerance
Antibody Involved: None. Involves the lack of a digestive enzyme (i.e. lactase, sucrase, etc)
Common Symptoms: Diarrhea, stomach cramping, nausea, sometimes vomiting
Typical Reaction Timeline: 30 minutes – 2 hours
How to Test: Breath testing can be helpful depending on what you’re testing for, but food intolerances are often just measured by symptoms
Celiac Disease
What is it? Celiac disease is a serious auto-immune condition in which the ingestion of gluten causes damage in the small intestine. Celiac Disease may cause malnutrition and/or malabsorption in children and can “pop up” at any time.
Symptoms:
Short term: Diarrhea, stomach cramping, nausea, and even vomiting.
Long term: Pale, foul-smelling stools, inability to gain weight, malnourishment
Typical Reaction Timeline: May begin within 30 minutes or up to 2 hours later
How to Test: There are many ways to test for risk or active celiac disease. Learn more about this process from the Celiac Disease Foundation.
DISCLAIMER: Before starting any supplement or medication, always consult with your healthcare provider to ensure it is a good fit for your child. Dosage can vary based on age, weight, gender, and current diet.
Food Reactions & Autism in the Research
While we still need more research, there are interesting research studies that show us food reactions in autism are increased, with the most evidence supporting food sensitivities.
Food Sensitivities & Autism
In one study by Jyonouchi in a Pediatric Allergy/Immunology Clinic, they suggest that practicing physicians should be aware of the potential impact of allergic diseases on behavioral symptoms and cognitive ability in children with ASD and that certain “IgE allergies” may not be allergies at all, they may be non-IgE mediated causes (suggesting food sensitivity) [1].
Another study looks at the overlap of gastrointestinal symptoms with ASD core symptoms that include pathways in the gut-brain access, which contribute to alterations in behavior and cognition, including IgE mediated and/or cell-mediated GI food reactions and gluten-related disorders (celiac disease, wheat allergy, non-celiac gluten sensitivity) [2].
Food Allergies & Autism
Food allergies are prevalent in up to 30% of the general population and seem to be increasing in developed countries [1].
In a 2018 national study, a “significant and positive association of common allergic reactions, in particular food allergy, was found” [3].
Food Intolerances & Autism
As food intolerances often are caused by the absence of a digestive enzyme, it’s important for us to look at many digestive enzymes, not just the most common lactase. One study reported that decreased disaccharidase activity (including lactase, maltase, sucrose glucoamylase, and palatinase) associated with functional GI abnormalities was reported in children with autism [4]. Other studies suggest that Elastase-1 is an important pancreatic enzyme that is important to take into consideration for autism [5].
Celiac Disease & Autism
There is no known association between a child with ASD having Celiac Disease [6], however we do see that maternal autoimmune disease is significantly associated with modest increase in odds of developmental disorders overall [7].
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[1] Jyonouchi H. Autism spectrum disorders and allergy: observation from a pediatric allergy/immunology clinic. Expert Rev Clin Immunol. 2010;6(3):397-411.
[2] Wasilewska J, Klukowski M. Gastrointestinal symptoms and autism spectrum disorder: links and risks - a possible new overlap syndrome. Pediatric Health Med Ther. 2015;6:153-166.
[3] Xu G, Snetselaar LG, Jing J, Liu B, Strathearn L, Bao W. Association of Food Allergy and Other Allergic Conditions With Autism Spectrum Disorder in Children. JAMA Netw Open. 2018;1(2):e180279.
[4] Saad K, Eltayeb AA, Mohamad IL, et al. A Randomized, Placebo-controlled Trial of Digestive Enzymes in Children with Autism Spectrum Disorders. Clin Psychopharmacol Neurosci. 2015;13(2):188-93.
[5] Sanctuary MR, Kain JN, Angkustsiri K, German JB. Dietary Considerations in Autism Spectrum Disorders: The Potential Role of Protein Digestion and Microbial Putrefaction in the Gut-Brain Axis. Front Nutr. 2018;5:40.
[6] Juneja M, Venkatakrishnan A, Kapoor S, Jain R. Autism Spectrum Disorders and Celiac Disease: Is there an Association?. Indian Pediatr. 2018;55(10):912-914.
[7] Lyall K, Ashwood P, Van de water J, Hertz-picciotto I. Maternal immune-mediated conditions, autism spectrum disorders, and developmental delay. J Autism Dev Disord. 2014;44(7):1546-55
