Saturday 17 March 2018

Follow your gut instinct

Many people believe they have a food allergy, but there are usually other reasons behind intolerances

KNOW YOUR SYMPTOMS: Skin rashes and swollen lips are usually an indicator of a food allergy, not the runny nose of allergic rhinitis
KNOW YOUR SYMPTOMS: Skin rashes and swollen lips are usually an indicator of a food allergy, not the runny nose of allergic rhinitis
Dr Ciara Kelly

Dr Ciara Kelly

'COULD it be a food allergy doctor?" I get asked about 10 times a week, often by people with symptoms that bear little relation to either food or allergies. And who could blame them? When we hear so much talk about it – it's an epidemic.

Up to a third of the population believe themselves to have a food allergy, when the actual figure is closer to four per cent. People ascribe all sorts of problems to food allergies, from gastrointestinal upset to more esoteric complaints such as fatigue and stress. And there's a whole industry which feeds (see what I did there?) – on the notion that we're allergic to various food groups.

I've yet to meet the patient who goes to alternative nutritionists who isn't told that they're allergic to wheat and dairy. And I have a significant number of patients who've had their 'allergy' diagnosed by a person dangling a crystal over them. Of course, because the area of nutrition is unregulated, a nutritionist, much like a counsellor, can be anyone who has used Google. They're a far cry from the recognised professions of dietitian and psychologist.

True food allergy generally causes skin rashes and or swollen lips in those affected, and sometimes difficulty breathing. It's not the same as the runny nose of allergic rhinitis on eating certain foods. And it's a far cry from food intolerance, which is an upset stomach, often with bloating or cramping, after eating.

Many of my patients present to me having already been advised elsewhere to cut out certain foods from their diet as a trial, to see if they feel better off them. Many of these patients see it as confirmation of their intolerance when, on reintroduction of the food after abstinence, they develop gastric symptoms. However, in actuality when you stop eating certain foods for a period of time, you stop producing the gastric enzymes necessary to digest them. So if, for example, an established vegetarian suddenly decided to eat two T-bone steaks it's a given they'll get stomach cramps! Not because they've a true 'meat intolerance' but just because they haven't eaten it for ages! So diets of exclusion actually cause transient food intolerances. This can be overcome simply by reintroducing the foods you've been excluding, slowly and in small amounts.

The fact that so many more people believe themselves to have a food allergy, than actually have one, leads me to think that either there's some vested interest at play encouraging people to believe this. Or perhaps that people in fact want to have them in a kind of Woody Allen-esque type neurosis. Perhaps it's simply that people believe them to be far more common than they are.

We're basically doughnut-shaped organisms with our digestive tract being the central hole. Perhaps the reason why so many people's guts are playing up is somewhat more prosaic. Perhaps it's to do with the increasingly large volume of food passed through our GI systems and also with the high-fat, low-fibre diets that are so prevalent today.

We're omnivores. The very best diet we can have is a varied one. The wider the variety of food, the better. The more colours, textures and groups you eat, the more likely your diet will fulfil all your nutritional needs, avoid any kind of deficiencies and reward you with good digestive health.

Some foods such as fats and sugars should be eaten in real moderation but for most people no food group should left out. There is nothing inherently bad about carbohydrates eaten in the correct quantity and type – wholegrain being the best kind. And despite the fashion for high protein diets, in general they are not superior to a well-balanced diet that allows you to eat all kinds of everything. Diets tend to follow fashion but our guts are as old as time. Basic food sense remains a constant.

  • Dr Ciara Kelly is a GP in Greystones, County Wicklow

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