Modern diets have made food sensitivities increasingly complicated and, unfor-tunately, very common. Not to be confused with food allergies, which usually occur within minutes of exposure to the food and cause anaphylactic shock or hives, food sensitivities involve a wide range of responses. Symptoms of food sensitivities can even be delayed for up to three days. Most people know that they have a food allergy because of the severity and immediacy of the reaction, but people with food sensitivities are often unaware of the cause of their discomfort.
   Food sensitivities are difficult to diagnose and involve complicated immunology because different parts of the immune system respond to them. Some of the most common symptoms of food sensitivities include dark or puffy circles under the eyes, a runny or stuffy nose, ear infections, swollen glands or tonsils, asthma, rashes, headaches, dizziness, muscle or joint soreness, mental “fog,” depression, anxiety, attention problems, insomnia, fatigue and all kinds of digestive problems including bloating, gas, diarrhea and constipation. Allergists and the medical establishment rarely recognize the subtle and complicated existence of food reactions, known as “delayed” or “hidden” hypersensitivities.

How Food Sensitivities Develop
   The digestive system takes foreign material (food), breaks it down, absorbs it and ultimately converts it into structural building blocks or energy. In order to do this, the body differentiates between unwanted material (such as toxins and pathogens), and desired, nutritious substances. When the body mistakenly identifies a food substance as unwanted, a food sensitivity develops.
   A range of factors increases the chances of developing a food sensitivity. Some people inherit food sensitivities, while others may develop them as a result of stress or anything else that damages the digestive system, such as overuse of pain medications, acid blockers, antibiotics or steroids. Overeating may contribute as well. When the digestive system is impaired, foods pass through and remain only partially digested. If certain foods reach the bowel undigested or only partially digested, they can cause irritation which will trigger an inflammatory response. This irritation can cause “intestinal hyper-permeability” or “leaky gut syndrome,” a condition in which the intestine develops minute holes through which undigested proteins pass into the blood stream and cause a strong immune response. The immune system has a good memory, so the next time it detects the same undigested proteins in the bowel, it promptly labels them as unwanted and a swift attack upon them is ordered. Proper digestion, therefore, is very important in preventing and repairing food sensitivities.

Determining Food Sensitivities: The Elimination Diet
   Food reactions can widely differ from person to person, so it is essential for us to become our own personal detectives, paying close attention to our bodies, following up on clues and taking the time necessary to determine what foods or substances are causing our symptoms. Anyone with chronic health problems can benefit from ruling out or eliminating reactions to food sensitivities. And most people can benefit in general from avoiding certain foods; the trick is to figure out which ones.
   The elimination diet makes us detectives in order to gather the information necessary to determine if we have food sensitivities and identify the offending substances. To conduct an elimination trial, a hypoallergenic diet is followed for seven to ten days (usually lamb, rice, pears, water and possibly a few other foods). Then other foods are reintroduced to the diet one at a time on an empty stomach. Food sensitivity reactions are often delayed, so the first two days are crucial to observing any unusual symptoms that appear after reintroducing a food. It is also crucial that new food is not introduced more often than every two days. A less restrictive version of this plan simply eliminates the most likely (food) suspects for seven to ten days and reintroduces them, one every two days. The elimination diet is not easy, so it is better to choose a time when it will be easier to control the diet. Even the tiniest bit of the wrong food can skew the results, so eating out is not recommended. Still, this method is recommended over other testing methods available which are both expensive and largely unproven. And the elimination diet, as well as being the most reliable, is free.
   But be warned: the foods often most difficult to give up, those that cause the most cravings and binge behavior, tend to be the ones causing the sensitivities. Some people go through withdrawal-like symptoms on the first few days of the elimination diet because food sensitivities can cause addictive-like symptoms and behavior. Although this seems counterintuitive, there actually is logic to it. When experiencing the effects of food sensitivities, to cope with the discomfort associated with the body's attack response to a food substance, it sends out a group of chemicals called opioids, natural narcotic, pain-relieving substances. This in turn causes a brief physical and mental boost or “high.” Unfortunately, as soon as this “high” wears off, the person is left feeling worse than before they ate the offending food. This dynamic can lead to a vicious cycle of craving the very foods that cause harm. Sometimes these cycles are so short that they go unnoticed, and often people never realize how much better they could feel without the offending food.
   Most people eat a repetitive diet, consuming the same foods almost daily. The most commonly abused and sensitizing foods today include wheat, dairy, soy, corn, eggs, citrus fruits, artificial sweeteners and MSG, just to name a few.

Remove, Repair, Replace & Rotate
   Once a sensitivity has been identified, there are a number of measures to take in order to feel better and in some cases restore regular immunity or get rid of the sensitivity. The integrative medical approach is commonly called the Three Rs: remove, repair and replace.
   During the “remove” phase, the sensitizing food is eliminated as well as anything else that causes damage to the digestive or immune system. This involves total avoidance of foods identified as sensitizers as well as any known inhaled allergies like pollen, pet dander or molds, which can also lower the immune system's threshold and cause it to go on high attack. This regime also includes removing as much stress as possible as well as chemicals or medications that may be damaging the digestive system (this should only be done with the consent and monitoring of a physician).
   The digestive system can then go under the “repair” phase. This can involve adding soothing, nutritive and/or anti-inflammatory substances such as aloe vera gel, slippery elm bark, marshmallow root or DGL licorice, which aid in healing the sensitive digestive lining and reducing the minute holes that lead to hyper-permeability.
   In the “replacement” phase, missing elements that comprise a healthy digestive system are restored. This often means adding a pro-biotic supplement containing strains of acidophilus and/or bifidus bacteria to the diet. This step may also include digestive aids such as hydrochloric acid (which must be initiated with care and taken according to the directions) or digestive enzymes to help ensure proper digestion. These digestive aids and gut-repairing substances can all be found at local health food stores.
   In addition to the three Rs, some people may need to institute the fourth phase, the “rotation diet.” For those who are highly sensitized to a large number of foods, or whose sensitivities seem to change often, a rotation diet may help prevent and eventually heal this. A rotation diet consists of only eating each type of food every two to four days so that there is a greater variety in the diet. This has been shown to help reduce the probability of highly sensitive individuals from developing new sensitivities.
   Many allergists and internists are not aware of the types of immune responses associated with food sensitivities and, furthermore, have no effective means to test for them or treat them; however, people should still inform their clinicians of any food sensitivities of which they are aware, and the measures being taken to deal with them. The medical community is becoming more aware of this issue, and the sharing of food sensitivity experiences helps raise awareness for this increasingly common problem. The physicians who take the time to discuss food sensitivities with their patients are getting remarkable results with many chronic, difficult conditions. Although it takes more time, and there is not always a quick fix, the pay-off for the patient can be profound.


Rachel Pritzker Hunter is a Certified Nutritionist who has lectured on Herbal Medicine and Nutrition at Case Western Reserve University Medical School, the University of Maryland, John's Hopkins School of Public Health, and others. She was cofounder and Associate Director of the first Master's degree program in Botanical Medicine at the Tai Sophia Institute in Laurel, Maryland where she also maintained a private nutrition practice until recently moving to Cleveland.