TANIA TYLES DEMPSEY, M.D.
FOUNDER, AIM
AIM FOR RESULTS
The Role of Food Sensitivities on Health and Obesity.
Tania Tyles Dempsey, M.D.
Founder- Armonk Integrative Medicine
Cornell University 1988-92 B.S. Biological Sciences
The Johns Hopkins University School of Medicine 1992-96 M.D.
New York University/ Bellevue Hospital 1996-99 Primary Care/Internal Medicine Residency
Board Certified in Internal Medicine since 1999
Vanguard Endocrinology Certification 2011
Member of The American College of Physicians and The Institute of Functional Medicine
Reactions to Food
Allergy
Intolerance
Sensitivity/ Hypersensitivity
Food Intolerance or Sensitivity
Autoimmune Disease Celiac- Gluten Intolerance
Non-IgE mediated food hypersensitivity IgG delayed reaction (Type II)
Type III hypersensitivity
Contact dermatitis
Enzyme deficiency Lactase deficiency causing Lactose Intolerance
Inability to digest Fructose
Reaction to a chemical in the food Salicylates
apples, citrus fruits, strawberries, tomatoes, cherries, and wine
Chronic activation of the innate immune system
Symptoms of Food Sensitivity
Gastrointestinal Bloating, diarrhea or constipation, irritable bowel syndrome, colitis Malabsorption/ Nutrient Deficiencies
Iron, B12, vitamin D deficiency (osteoporosis)
Respiratory Asthma, chronic cough, sinusitis
Dermatologic eczema, psoriasis, keratosis pilaris (bumps on the sides of arms, legs)
Neurologic Migraine, behavioral problems, ADHD, memory, mood, sleep issues
Symptoms of Food Sensitivity
Musculoskeletal Arthritis, stiff joints, tendonitis
Endocrine Infertility, irregular periods, weight gain or weight loss,
thyroid disease, osteoporosis
Immune System Allergies, ability to fight infections, autoimmune disease
Food Intolerance is Multi-Factorial
Susceptibility is dependent upon many factors
Genetics
The integrity of the natural barrier of the gut wall (“leaky gut”)
The viability of phase I and phase II detoxification pathways
The presence or absence of other co-factors
The amount of the food
The combination of foods
STRESS with increased cortisol levels
Protective secretory IgA antibodies in the gut decrease in response to stress.
Undigested food macromolecules invade the bloodstream and activate the immune system.
Food Sensitivities- Why?
“Advances" in food technology, including methods of processing, preserving, and flavoring, with the use of dyes, pesticides, and fertilizers, has altered food to the point that these additives, in addition to food’s natural components, can cause a disruption to the immune system.
Genetically modified food also exposes us to new proteins never before seen in our diet.
Food Sensitivities- Why?
Further complications arise from the overuse of antibiotics coupled with an increased consumption of simple sugars /refined flours (very common in a food sensitive patient's diet) thus causing an imbalance in the flora of the intestinal tract and an overgrowth of yeast (candida).
Yeast overgrowth affects the mucosal lining of the intestines, contributing "leaky gut syndrome"
Non-fully digested food proteins to enter the blood where they can trigger immune reactions and the release of chemical mediators of inflammation.
Approach to the patient with suspected food sensitivities
First, determine which foods are causing the problem
Elimination diet
IgG testing
ALCAT
Other labs
Elimination Diet
Elimination diet without lab testing involves avoiding the most highly allergenic foods and watching the response. Gluten, Dairy, Eggs, Corn, and Soy
Traditionally, 4 weeks is often thought of as sufficient to see results, however, food molecules incorporate into our cells and can remain there for a long period of time. Eliminate these foods for 6 months or more
Testing for IgG Food Sensitivity
Blood test (Metametrix)
Looks at levels of IgG to each individual food
IgG levels may be higher in foods that also have high IgE associated with it.
Some people will have high IgG to a food without obvious symptoms
Most of the time the IgG is directed to foods that are eaten very frequently.
IgG or Type II Reactions
A 25 year ongoing study reveals that 95% of the population has what is known as a Type II toxic reaction or IgG response to common everyday foods that you eat regularly.
IgG or Type II reactions are delayed reactions to the offending food.
They can be difficult to diagnose without specific blood tests because the reactions can occur hours to days after the food is eaten.
ALCAT Test- A Different View
Antigen Leukocyte Cellular Antibody Test
Does not measure immunity
Reproducibly measures the final common pathway of all pathogenic mechanism; whether immune, non-immune, or toxic.
It is the only test shown to correlate with clinical symptoms by double-blind oral
challenges, the gold standard.
www.alcat.com
Results
Color coated chart reveals 4 different categories of reactivity:
Red- Severe Intolerance
Orange- Moderate Intolerance
Yellow- Mild Intolerance
Green- No Intolerance
Results
Separate section for Casein and Whey sensitivity
Gluten and Gliadin reported
Reaction to Candida Albicans (Yeast)
ALCAT for Weight Management
Baylor study using ALCAT for weight management This study showed that 98% of the subjects following the
ALCAT plan either lost scale weight or improved their body composition.
Another study using ALCAT Dr. J.R. Cabo-Soler, Chief of Biochemistry at the University of
Valencia, reported that iso-caloric food elimination diets, based on ALCAT test results, promoted enhanced weight loss, comprised more of adipose tissue, rather than muscle mass, as determined by DEXA studies in a population of refractory weight loss subjects.
Food Sensitivity and Effect on Weight
After eating an offending food, blood level of the neurotransmitter, serotonin, goes down.
Ingestion of highly-refined carbohydrates and sugar cause a rapid release of insulin, increasing blood levels of tryptophan, a precursor of serotonin.
In order to compensate for lower brain levels of serotonin (caused by eating offending foods) food sensitive people crave foods which will increase serotonin in the brain.
Inflammation
“Leaky gut” allows food particles to be exposed to the gut’s immune system.
Triggers a system-wide immune response
Leads to inflammation
Causes insulin resistance and more fat storage
Gut flora can also induce insulin resistance apart from the above immune response.
Changes in the gut flora can increase the rate of absorption of fatty acids and carbohydrates, and increase the storage of calories as fat.
Obese people have a greater proportion of micro-flora from Firmicutes, which includes Bacilli and Clostridia.
Case #1
65 year old female presents with a history of : Irritable bowel syndrome
Migraines
Prediabetes
Peripheral neuropathy from chronic L5-S1 nerve impingement following spinal fusion surgery
Suspected food intolerances to milk/dairy for years, anaphylaxis to scallops
Seasonal allergies and reactive airways/asthma
Recent onset of alopecia and weight gain
Osteoporosis Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other scientific data and should not expect the same results as those found in case studies alone.
Case #1 Continued
Treated for years with the following meds: metformin
topiramate for prevention of migraine
triptans prn for migraine
montelukast (Singulair®) for asthma and allergies
Inhaled steroids prn for asthma exacerbations
proton-pump inhibitor
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other scientific data and should not expect the same results as those found in case studies alone.
Case #1 Continued
She recently went on a Gluten free diet after several family members were found to have a “sensitivity” to gluten; but she denied a family history of Celiac.
Some improvement in symptoms, but short-lived; her symptoms started to return after a few months.
She then tried a dairy free diet. For years she had suspected dairy sensitivity or “lactose intolerance” but was able to tolerate certain types of dairy products so continued to consume these.
Again there was some improvement but after several weeks some of her symptoms returned.
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other scientific data and should not expect the same results as those found in case studies alone.
Case #1 Continued
She underwent testing that included the following: Thyroid function- including TSH, Free T4, Free T3
and Thyroid Antibodies
Hemoglobin A1c, Glucose, Insulin, Lipids
Vitamin/Mineral levels- B12, Folate, 25-OH vitamin D, Ferritin, and Iron
She opted to not get food sensitivity testing at this time due to cost.
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other scientific data and should not expect the same results as those found in case studies alone.
Case#1 Continued
Results are as follows: Hemoglobin A1c 5.8% (on Metformin)
TSH= 2.86, Free T4 =1.0 (normal 0.8-1.6), Free T3 =2.5 (normal 2.3- 3.98)
Normal thyroid antibodies
Total Cholesterol 238, HDL >60, LDL 144
Very low Ferritin level=10, low B12 328
Normal Vitamin D level on supplementation
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other scientific data and should not expect the same results as those found in case studies alone.
Case #1 Continued
Treatment “Paleo-diet”- low carb, high fat/protein
Armour thyroid
Activated B vitamins
Iron not supplemented due to side effects
Probiotics 100 billion
S-acetyl glutathione for Peripheral neuropathy
Alpha lipoic acid
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other scientific data and should not expect the same results as those found in case studies alone.
Case #1 Continued
Follow-up Hair stopped falling out
4 lb weight loss
TSH levels improved
Lipids improving- LDL 130
IBS still present, migraines better but not resolved
Neuropathy manageable with S-acetyl glutathione
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other
scientific data and should not expect the same results as those found in case studies alone.
ALCAT
She finally agreed to ALCAT testing
Despite some improvement globally, her bowel symptoms were still severe and she did see some correlation between symptoms and food intake.
She was compliant with a low carb, diary-free, gluten-free diet.
ALCAT- Severe Intolerance
GARLIC
HADDOCK
ANCHOVY
CARDAMOM CATFISH CUMIN
KALE
NECTARINE PEACH
RASPBERRY SEA BASS SPELT SPINACH SQUID SWISS CHARD TAPIOCA
VENISON
ALCAT- Moderate Intolerance
ALCAT- Mild Intolerance
ACORN SQUASH*
APRICOT*
BAKER'S YEAST*
BLACK BEANS*
BLACK CURRANT*
BLACK PEPPER*
BOK CHOY*
CINNAMON*
FIG*
FRUCTOSE (HFCS)*
KIWI*
LAMB*
LENTIL BEAN*
MUSSEL*
NUTMEG*
OKRA*
ORANGE*
OYSTER*
PARSNIP*
PINE NUT*
PINEAPPLE*
PISTACHIO*
PORTOBELLO MUSHROOM*
ROSEMARY*
SESAME*
SHRIMP*
TUNA*
VEAL
Additional Reactions
Mild reaction to Gluten/Gliadin Wheat
Barley
Rye
Malt
Oat
Mild reaction to Whey Cow
Sheep
Goat
Treatment
Elimination of all reactive foods
4 Day Rotation Diet provided by ALCAT
Only ate “Green” foods
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other scientific data and should not expect the same results as those found in case studies alone.
Follow-Up
Within 1 week bowel symptoms started to subside
At 1 month bowel symptoms were resolved.
After 1 month she added her “Yellow” foods back in a 4- day rotation. She did notice that certain foods on that list caused some mild
symptoms during the reintroduction phase so she continues to avoid those
She is still Gluten and Dairy-Free
10 lb. weight loss in 4 weeks
Migraines are improved 1 Migraine recently when she “cheated” on the diet
Medications are slowly being weaned off.
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other scientific data and should not expect the same results as those found in case studies alone.
Case #2
25 year old female presents with a history of : Anaphylaxis to all fish and seafood
Suspected food intolerances- possibly dairy
Irritable bowel syndrome
Eczema
Seasonal allergies and reactive airways/asthma
Polycystic Ovarian Syndrome
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other scientific data and should not expect the same results as those found in case studies alone.
Case #2 Continued
Initial workup with IgE and IgG testing confirmed: IgE/Type 1 reaction to fish and seafood
IgE reaction to milk/casein, some nuts/peanuts, and many other foods
IgG reactivity to many of the same
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other scientific data and should not expect the same results as those found in case studies alone.
Case #2 Continued
Treated with elimination diet for 3 months.
She reported some improvement in IBS after 1 month but still considerably symptomatic Abdominal pain and cramps at least 3 days a week.
She started noticing more eczema and fatigue after about 6 months.
Eczema did not respond to topical steroids given to her by her dermatologist.
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other scientific data and should not expect the same results as those found in case studies alone.
ALCAT
She agreed to ALCAT testing which showed additional food sensitivities.
Gluten sensitivity confirmed
Oats
Casein and Whey sensitivity confirmed
A variety of other foods that she thought was “healthy” such as kale, millet, beets, broccoli, etc.
ALCAT- Severe Intolerance
BRAZIL NUT
FLOUNDER
KALE
MACKEREL
MILLET
BAKER'S YEAST BLUEBERRY BOK CHOY BUFFALO CARAWAY CATFISH CELERY CINNAMON CUCUMBER DATE FENNEL SEED GINGER GRAPEFRUIT JALAPENO PEPPER LAMB LENTIL BEAN LOBSTER MUSTARD ORANGE PEACH SAFFRON TILAPIA TUNA VENISONANCHOVY
ALCAT- Moderate Intolerance
ALCAT- Mild Intolerance
BEET*
BELL PEPPERS*
BLACK BEANS*
BROCCOLI*
CARDAMOM*
CASHEW*
CHAMOMILE*
CHICKEN LIVER*
CHILI PEPPER*
DUCK*
EGG WHITE*
FAVA BEAN*
FLAXSEED*
MACADAMIA*
MUNG BEAN*
MUSSEL*
ONION*
PEANUT*b
PEAR*
PINE NUT*
PLUM*
PORK*
PORTOBELLO MUSHROOM*
RED/GRN LEAF LETTUCE*
ROSEMARY*
SOYBEAN*
SWEET POTATO*
SWISS CHARD*
WHITE POTATO*
WILD RICE*ACORN SQUASH*
Follow-Up after ALCAT Diet
Within 2 weeks bowel symptoms completely resolved.
More energy apparent after a few days.
5 lb. weight loss after 1 month.
Eczema initially resistant to treatment and diet Review of skin care products revealed multiple ingredients on her
ALCAT list as well as known irritants/toxins:
Wheat germ
Soy
Oats
Parabens
Eczema responds dramatically after changing skin care products.
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other scientific data and should not expect the same results as those found in case studies alone.
Case #3
70 year old female with a past history of Multiple Sclerosis (diagnosis in question)
Migraine
Hypertension
Hyperlipidemia
Hypothyroidism
Metabolic syndrome X- Insulin resistance
Osteoarthritis- s/p right knee replacement
Nephrolithiasis
Small vessel cerebrovascular disease with mild memory loss
Depression
Breast cancer
Multiple vitamin deficiencies- B12, D
Case #3
She complained of persistent headaches, fatigue, insomnia, depression, diffuse joint pain
Blood work continued to show vitamin D deficiency, elevated hemoglobin a1c, low HDL, elevated homocysteine.
Heavy metal testing revealed cadmium toxicity
Organic acid testing
Adenosylcobalamin insufficiency
Tetrahydrofolate deficiency
Renal ammonia overload
Deficiency in ATP production
Bacterial and yeast overgrowth
Inflammatory cytokine production
Case #3
Diet was reviewed and contained processed, refined carbohydrates, sugar and very little protein.
She also reported a binge eating problem for years.
Several attempts to change her diet could not be sustained.
She agreed to ALCAT testing.
ALCAT- Severe Intolerance
BOK CHOY
CLOVE
DATE
FIG
LEEK
LIMA BEAN
PAPRIKA
ALCAT- Moderate Intolerance
APRICOT
BASIL
BAY LEAF
BLACKBERRY
CHERRY
CLAM
CODFISH
CUMIN
ENDIVE
HOPS
MALT
ORANGE
PORTOBELLO MUSHROOM
PUMPKIN
RASPBERRY
RED/GRN LEAF LETTUCE
SAGE
SEA BASS
SOLE
SWISS CHARD
THYME
TROUT
ALCAT- Mild Intolerance
*
BLACK BEANS*
BLUEBERRY*
*
CARROT*
CELERY*
*
CRAB*
DUCK*
EGG YOLK*
FENNEL SEED*
HONEYDEW (MELON)*
KELP*
KIDNEY BEAN*
LAMB*
MILLET*
MUSSEL*
MUSTARD*
NAVY BEAN*
OKRA*
*
PAPAYA*
PARSLEY*
PEPPERMINT*
PORK*
ROSEMARY*
SAFFRON*
SALMON*
SARDINE*
SCALLIONS*
SESAME*
SQUASH (Yellow)*
SWORDFISH*
TAPIOCA*
TUNA*
TURMERIC*
VANILLA*
WILD RICE*
ZUCCHINI SQUASH
Follow-up after ALCAT
Followed rotation diet strictly for 1 month with one deviation.
During that time she had only 1 migraine for the entire month compared to her usual 2-3 per week.
The migraine occurred right after she “cheated” on the diet.
She felt less foggy overall and had more energy.
Her binge eating / food cravings decreased.
It became clear to her that her original diagnosis of MS was based on symptoms that may have been due to food sensitivities, as many of these same symptoms were slowly improving after 1 month.
Closing Remarks
Food plays a significant role in our health.
“We are what we eat.”
We are being exposed to things in our environment and in our food supply that we have never been exposed to in the history of mankind and it is affecting out bodies.
More and more people, as they age, are experiencing food sensitivities.
INFLAMMATION is known to be at the root of all chronic health conditions, including obesity and one major cause of INFLAMMATION is food sensitivity.
What can you do?
If you or any of your patients have signs or symptoms of food sensitivity or intolerance consider the ALCAT test.
Follow the rotation diet as recommended by ALCAT
Even with negative testing consider gluten intolerance as a major contributor to obesity and other chronic diseases.
Eat Organic Food
Avoid Genetically-Modified food (corn, soy, wheat, etc.)
Take care of the “gut”