the role of food sensitivity and food intolerance tests

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.


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.


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


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


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


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.


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


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


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.


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.


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



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.


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.


BOK CHOY

CLOVE

DATE

FIG

LEEK

LIMA BEAN

PAPRIKA


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


*

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”

the role of food sensitivity and food intolerance tests

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