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I'm Allergic... What Should I Eat, Then?

For those of us who find pleasure in eating, it seems like a daunting task to have to avoid a food that we've enjoyed in the past. However, many of my patients feel so much better health- and energy-wise after eliminating the food allergen that they feel it is a worthwhile trade.
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"Nothing would be more tiresome than eating and drinking if God had not made them a pleasure as well as a necessity." -- Voltaire

Some of us think of food as the former part of this quote from Voltaire, that food is just a necessity, and we eat when we need to for energy and functioning. For those of us who believe the latter part of this statement, that eating is indeed a pleasure as well as necessity, finding out that we have allergies to foods we enjoy can be a life-altering event.

Many of my patients who come to me with questionable food allergies are inevitably anxious to find out if they are indeed sensitive to the food in question or not. Usually, the food sensitivity is revealed because it is a food they enjoy eating. So, when patients find out they are indeed allergic to the food, they are usually devastated and initially have a difficult time coming to terms with the information. However, once their questions have been answered and the dietary changes have been established, patients feel much better, associated symptoms improve, and are able to maintain the dietary changes without difficulty.

For those of you wondering whether you have food allergies or not, let's address some common questions I am frequently asked by my patients.

1. What are the most common food allergies? And if I am wondering if I have a food allergy, what should I do?

Some of the most common food allergies are to lactose, dairy (casein in dairy), nuts, seafood, and gluten. There are of course other food allergies, but these food sensitivities are more common in the general public.

If you think you may have an allergy or sensitivity to any of these, you should ask your primary care doctor or allergist for food allergy testing. However, even if the tests are negative, if you know that you have symptoms that flare when you've consumed a specific food, the positive association of symptom with a food is still the gold standard for establishing food sensitivities. That's why even if my patient's test negative for celiac disease from blood work, if they have a clear cut history of having symptoms with gluten, they are still gluten sensitive; they just have not developed antibodies to the gluten yet to fall into the category of celiac disease.

Remember that many medical situations are not black and white, where patients either have it or they don't. There is such a thing as a spectrum of disease where your gradation of being sensitive to a food may not place you within the category of a specific disease, but you are still sensitive to the food such that you have symptoms when you consume it. That's why the gold standard for establishing food sensitivities is an elimination diet of about 3-4 weeks. By eliminating the food from your diet, you can see if symptoms improve off the food or if symptoms worsen once you resume consumption of the food.

2. What can I do once I know I have a food allergy?

When you have a food allergy or sensitivity, your body actually becomes inflamed with consumption of any foods containing that ingredient. Chronic exposure to inflammatory triggers of the body is not beneficial. Even if the symptoms you get from eating the food are not severe, you should avoid the food anyway. Over time, chronic exposure to a food that leads to inflammation in the body may lead to other health issues, because chronic inflammation is harmful to the body.

Therefore, the first thing to do once you know you have a food allergy is to avoid that food. You should eliminate that food from your diet. If you are not sure how to do that, you should ask your physician for a referral to a nutritionist who can help you to establish a new diet regimen around your food allergies so that you can still enjoy your foods, while avoiding ingredients that have a negative impact on your health.

3. Can my food allergies change throughout the course of my life?

Generally, once you have a food allergy, that allergy is going to be an issue for the duration of your lifetime. If you have anaphylactic reactions to a food, then that needs to be taken seriously and you should never be exposed to or consume that allergen. If it is a mild food allergy, the symptoms may vary in intensity throughout your life. However, no matter how mild the symptoms may be, exposure to the allergen may still have undesirable inflammatory effects on your body.

For example, when you eat an ingredient you are sensitive to, consumption of that food may still lead to subclinical levels of inflammation even if your clinical symptoms are insignificant. So, for those of you who have only mild food sensitivities or allergies to certain foods, you should be aware that these foods may still be causing some damage even if your symptoms are not severe.

My general recommendation is that once you know you are allergic to a certain food, you should always avoid exposure to it if your reaction is severe and you should also carry an Epi-Pen with you in the event that you have an inadvertent exposure.

If your reaction to a food is mild, you should still try to avoid it as much as you can because there is a chance that chronic exposure to an allergen may put you at an elevated level of chronic inflammation that is not beneficial to your health.

For those of us who find pleasure in eating, it seems like a daunting task to have to avoid a food that we've enjoyed in the past. However, many of my patients feel so much better health- and energy-wise after eliminating the food allergen that they feel it is a worthwhile trade.

If you have a food allergy and you are struggling with the idea of changing your diet, once you've been able to establish a new dietary regimen of foods you enjoy in place of the allergen and you start to benefit from the health improvement from elimination of that allergen, you may find that the trade is worthwhile to you as well.

Consider this... what we found pleasurable in hobbies in prior years may not be what we enjoy now. We are, as human beings, nothing if not malleable creatures that are resilient and persistent in our attempts to find pleasure in life. Similarly, given time for adjustment, you may find your new dietary regimen equally pleasurable, if not more so, because you feel better without the constant exposure to a pro-inflammatory food allergen.

As Voltaire wisely implied in his statement above, for those of us who enjoy food, food is one part necessity and one part pleasure. So, you may have initially changed your diet to avoid a food allergen out of necessity. But, for those of us who find pleasure in food, your body will adapt to the new diet and find pleasure in it just as you have learned to enjoy new hobbies in other aspects of your life throughout the years. So, just see this as a new challenge you need to take on out of necessity. Take heart in knowing that you will adapt and find pleasure again in this change, just as you have done so in the past in other aspects and times in your life.