West, here is a little info from Berardi on the subject, which might be useful to you…
Food Intolerance/Allergy Screening
I just received this note from a colleague:
We are trying to put together a food allergy screen or questionnaire for players to use to help identify problems with their diet. What are your guys thoughts on this and do you know of any well researched evaluations for food allergies?
Another colleague responded with this note:
Food allergies are over-promoted as a problem. While some suffer with them, they are not a likely problem for most individuals.
Back in the late 1970's and early 80's a researcher name Buiserret (sp?) who pretreated subjects with an NSAID prior to feeding them an offending food. There was no allergy response with such pre-treatment. NSAIDs are prostaglandin inhibitors, suggesting the allergy response was an inflammatory response.
All foods are antigens, so the test above suggest that our immune system is overactive prior to receiving the food. This suggests we should endeavor to reduce the pro-inflammatory immune system with an anti-inflammatory diet and supplements.
Grains on the other hand are likely to drive inflammatory states in the gut - Cordain reviewed this lit back in 2000. He looked at the gut inflamming nature of lectins from grains and legumes.
There is really just no good data for picking on foods in the average person as part of a general screen or wellness approach. Tests are questionable and questionnaires are spurious at best.
And here’s my response:
The deflaming guidelines are right on. And the idea of dampening down the flames of an overactive immune system or an excessive inflammatory response is important for managing not only food allergy / intolerance, it's also important for the management of other inflammation-related discomforts and diseases â?? everything from acute joint pain to chronic osteoarthritis to cardiovascular disease â?? and more. Truly, combating inflammation is of utmost importance in the modern dietary landscape.
Speaking to the idea proposed in the original email â?? screening for food allergy â?? I actually would like to establish an important distinction.
When speaking of â??food allergyâ??, weâ??re technically discussing severe allergic reactions to food â?? most often manifesting in anaphylaxis (HUGE immune response, vasodilation occurs, blood pressure drops, throat swells closed, etc.) In this scenario you can think peanut allergy. If a child eats peanuts and has a true peanut allergy, without medical assistance, they could die due to this anaphylaxis. So food allergy is typically a severe condition with severe consequences.
Now, in the general population, it's estimated that 3-7% of children suffer from food allergy while only 2% of the adult population suffers from food allergy. This makes food allergy, as suggested, way over promoted. Plus, if someone has a food allergy, they likely already know it and don't need a test for it. If they drink cow's milk, eat peanuts and tree nuts, and/or eggs, shellfish, or soy (the most common allergens), they experience symptoms based on the magnitude of their allergy. And again, most folks KNOW when they have an allergy.
However, this doesn't disqualify the idea of food allergy screening. Here is why.
Beyond allergy, there is another class of food difficulty called food intolerance. Food intolerance is much more common and occurs as a result of either improper digestion of food and/or more mild inflammatory response mostly due to the foods indigestibility. Symptoms of food intolerance are much more mild than food allergy and include gas, diarrhea, stomach cramping, stuffy nose, mucous production, etc. Think lactose intolerance here. If a child drinks milk, depending on the severity of his/her intolerance, they'll be gassy, bloated, and uncomfortable.
Now, intolerances to lactose, gluten, fructose, and yeast (most common intolerances) are much more prevalent than food allergies and because the symptoms are more mild, often people are unsure as to which foods are causing the problem. That's why food intolerance testing is becoming so common in athletic circles.
In my experience, nearly all of my athletes experience one or more food intolerances and their dietary needs have to be adjusted based on these. Importantly, I donâ??t actually do any biological allergy or intolerance testing because most of the current biological testing methods are expensive, unreliable, and invalid. I've seen the same sample, sent to 3 different labs, come back with 3 different profiles. Further, I've seen the same sample sent to the same lab twice and the results come back different both times.
As a result, I arrive at food intolerances based on food response logs that the athletes fill out. Based on knowing the common foods that cause problems - plus these food response logs - we typically can find the offending foods quickly and remove them. When the offending food isn't easily identified, we typically have a specific protocol based on the symptoms. These protocols typically involve the use of probiotics, digestive enzymes, and food rotation in series. And by the time we get to food rotation, about 90% of our athletes are doing better.
(Importantly, all of our athletes have diets rich in anti-inflammatory foods from the start so we are sure that these bases are covered).