Food intolerance: Who does not need gluten and lactose
Increased fatigue, pruritus, bloating and abdominal pain after eating - in the hope that it will “go away by itself”, unpleasant symptoms can be ignored for years. Why the body does not take any healthy food, we understand together with doctors: an expert of the Center for Molecular Diagnostics (CMD) of the Central Research Institute of Epidemiology of Rospotrebnadzor Marina Vershinina, candidate of medical sciences, psychotherapist, author of the method of correction of eating behavior and weight loss Mikhail Gavrilov and an allergist-immunologist at the clinic "Medicine" Ekaterina Koroteeva.
How food intolerance is different from allergies
The symptoms of allergy and food intolerance are usually very similar - itching of the skin and mucous membranes, rash, abdominal discomfort, stool disorders, but they have different mechanisms. An allergic reaction to a product is the body’s immune response to a stimulus; at the same time, the immune system perceives food proteins as foreign and produces protective antibodies - immunoglobulins E (IgE). The latter provoke an allergic reaction - most often to derivatives of milk, eggs, fish and seafood, wheat protein, nuts, or soy. As soon as the contact with the allergen stops, the immune system calms down - and the symptoms of allergy disappear.
In the case of food intolerance (it is also called "pseudoallergy"), a hyperreaction of the immune system does not occur. It is sometimes said that this condition is associated with the production of type G immunoglobulins (IgG), but Marina Vershinina notes that, unlike IgE, allergy markers, class G antibodies are the result of a normal reaction of the immune system, that is, an indicator that the body has become acquainted with or another food product and is not going to react to it. The doctor emphasizes that laboratory tests for the determination of IgG are expensive, but by itself the detection of such antibodies does not allow conclusions to be made to sensitivity to some products.
If a small amount or even one odor of an allergen is enough for the onset of allergy symptoms, then it is more and more difficult with food intolerance. In the case of pseudo-allergy, the reaction of the organism is often delayed (sometimes for several days), and the manifestations are blurred. For example, abdominal pain may be accompanied by fatigue or nasal congestion - all this can be easily attributed to fatigue or cold. At the same time, according to the doctor Mikhail Gavrilov, in adults, food intolerance is much more common than food allergy. At risk are those who have metabolic problems or diseases of the gastrointestinal tract, as well as smokers and people who move a little.
Where does pseudo-allergy come from
According to Marina Vershinina, a separate disease “food intolerance” does not exist at all - but there are many diseases and conditions against which intolerance of certain substances in food can appear. This may be due to malfunctions in the production of enzymes that digest a particular component (for example, if there is a shortage of the enzyme lactase, the body does not process lactose, milk sugar). The reasons may be inflammation of the intestinal mucosa with infections, and autoimmune processes, and the toxic effect of some products or drugs. Hypersensitivity to chemical food additives - preservatives, dyes, emulsifiers - is also not uncommon.
Most often, failure occurs due to the fact that certain enzymes are not produced enough. Usually in children this is due to the immaturity of the gastrointestinal tract, and in adults, for example, with inflammation of the pancreas. Lactose intolerance, as a rule, appears in adults and is considered a normal age process. Whole milk is the basis of nutrition at an early age, but over time the production of an enzyme that breaks down milk sugar decreases. According to Mikhail Gavrilov, almost a third of people over the age of twenty-five years old have worsened condition after a glass of whole milk, although they have never had a similar problem before. Fructose intolerance develops because of a violation of absorption - this breaks down the work of the so-called fructose carriers, that is, the molecules responsible for the passage of the substance through the intestinal wall. Its symptoms - nausea, vomiting, flatulence, diarrhea - are reminiscent of poisoning.
How to be treated
According to the allergist-immunologist Ekaterina Koroteeva, detecting and curing food intolerance is not an easy task: there are no reliable clinical and laboratory criteria for pseudo-allergy. Therefore, when diagnosing, doctors use the exclusion method, first of all noting food allergies and celiac disease (gluten intolerance, which is based on genetic and autoimmune factors). To confirm the intolerance of lactose or fructose, fecal analysis and the hydrogen breath test can help - it reveals violations of the breakdown and absorption of carbohydrates, which often lead to bloating and diarrhea; but in this case the diagnosis will be only preliminary.
The doctor will advise you to keep a food diary, noting the foods that you eat in a day, and your health after breakfast, lunch and dinner. The next step is an elimination (i.e., product exclusion) diet. The specialist removes one "suspicious" component from the diet; if after six weeks of the diet the condition improves, it means that the forbidden food is the cause of poor health. After that, such a product can be introduced into the diet, but in small portions and with an awareness of the consequences. If there is no improvement, then you need to try another option.
What to do to protect yourself
The best prevention of food intolerance, experts believe a balanced diet. Vegetables, fruits, nuts, various cereals, many varieties of fish and meat - the more varied the diet, the better. It is also advisable not to get involved in ready-made store products and in time to solve problems with the stomach and intestines, if they arise.
Who will help popular diets
Gluten-free products are becoming more and more - and although marketers are actively convincing of their benefits, doctors are sure that not everyone needs this benefit. Gluten-free diet prescribed for relatively rare autoimmune disease - celiac disease, and this is a serious limitation. According to Marina Vershinina, keeping a gluten-free diet for prevention is like standing on crutches beforehand for fear of breaking your leg. To begin with, it is important to confirm the diagnosis (the examination includes a biopsy of the small intestine) and obtain appropriate recommendations from your doctor. Another popular diet - nutrition according to the blood group - is completely unsafe: it has no evidence, and therefore the result may not be good.
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