Michelle's blog

Food allergy and food intolerance, freefrom foods, electrosensitivity, this and that...

Allergy versus intolerance – again…

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Today’s excellent coverage of ‘freefrom food’ – a fab, in depth investigation on Radio 4’s Food Programme (you can ‘listen again’ or download a podcast here) and a short item on BBC 1’s Breakfast this morning –  were, on the whole, pretty balanced, but they have caused the usual rumbles of discontent amongst both the food allergic and the food intolerant community. It is a difficult subject and one that does call for more understanding from both sides than is sometimes given.

Very briefly…

A food allergy causes an immune reaction, normally almost immediate and varying in severity from quite mild symptoms (hives, itching,vomiting, diarrhoea etc) to life threatening anaphylaxis. It can be diagnosed relatively reliably via skin prick and blood tests, and reliably through food challenges, and there is an accepted way of treating it – by avoidance and the prescription of life-saving adrenaline (Epipens) in the event of anaphylaxis. Approximately 2% of the population suffer from food allergy.

In food intolerance, one or a number of foods disagree with you but none of them cause an immune reaction. However, ‘disagreeing’ can range from giving you stomach cramp, a headache or making you feel unreasonably tired to making you so ill that you are unable to work and are often forced to restrict your diet dramatically because you feel so unwell when you eat a wide range of ‘normal’ foods.

But while for some people just one or two foods do turn out to have been the triggers for their unwellness, very often a food intolerance is a ‘whole body’ illness in that it is inextricably bound up with the person’s general health and well being. If they are stressed, run down, have suffered from a trauma, viral illness or a serious stomach upset or are in any other way emotionally or physically in poor shape, their digestion will almost inevitably  be in poor shape too. This means that  the gut wall or lining of their intestine may have become porous allowing partially digested food proteins through unto the bloodstream (where they have no business to be), they will be unable to absorb nutrients from their food, their bowels may have got blocked up so that they cannot dispose of waste which becomes toxic when trapped in the system etc etc etc… Their digestions may simply not be able to cope with an ever increasing number of foods so the only apparent option is to exclude them.

The corollary to this is that if the person’s general health can be improved, especially their digestive health, then they will be to eat, process and digest a much wider range of foods and hopefully, in due course, return to a ‘normal’ healthy diet. And one way to help their digestive health to improve is to restrict their diet, in the short term, to foods that they are able to eat without feeling ill and thereby stressing their system even further. No one is suggesting that a severely limited diet is a good idea in the long term – we are, after all, omnivores – but if, in the short term it reduces the stress on their whole body system, then the benefit outweighs the reduction in nutritional options offered by a wider diet, which will probably not be absorbed anyhow.

The problem is that every body is different, as is every digestive system, so there is no one test which can be given to everyone complaining of a food intolerance. Moreover, because everyone is different, there is no one treatment which will work for everyone either.

Which is why complementary therapists who take a more holistic approach to their patients (looking at not only their whole body but their emotional/psychological health as well) seem able to offer more help to those suffering from food intolerance than allopathic doctors who look for a single or organic disease or cause – and when they cannot find one have little to offer.  (Although, as was made clear in both of today’s ‘freefrom’ programmes, the understanding of food intolerance in primary care is, very gradually, beginning to improve.)

But, by definition, a food intolerance is a horribly woolly condition not only leaving more conventional medics struggling but offering endless opportunities to all of those ‘dietary charlatans’ that main-stream medics and dietitians get so exercised about. And, of course, there are charlatans out there and there  are people who end up on horribly restricted diets which could further compromise their health, but one charlatan does not a crooked industry make, to coin a phrase, and for every charlatan flogging dodgy tests there are many hundreds of nuritionists, nutrional therapists, naturopaths and other therapists doing a very responsible job in trying to resolve their patients’ dietary issues.

The difficulty here is that dietitians (such those quoted in today’s programmes) tend only to see those very few patients who have gone to extremes in terms of exclusion diets – they do not see the many thousands who have adopted exclusions diets which seemed appropriate for thier particular problem and whose health has, as a result, improved, so they tend to get a slightly unbalanced view of what is going on out there.

And, to wave a few more controversial flags while I am at it……. The vast majority of the foods which are excluded by most ‘food intolerance’ tests are dairy products or gluten-containing products – eg wheat.

But, despite the claims of the Milk Marketing Board, do we really need dairy products in our diet? Far better sources of calcium are to be found in green leaves, nuts, pulses, fish and many other foods.  And what animal – apart from the human animal – continues to drink milk after it is weaned and, even more bizarrely, chooses to drink the milk of a quadruped with four stomachs which was designed for young quadrupeds with four stomachs, not for humans with two legs and one stomach?….

As far as wheat is concerned, those dietitians that claim that wheat is a very nutritious grain full of vital B vitamins, are absolutely right, but…. The wheat they are talking about is the stuff that our grandparents used to eat. The wheat used for commercial breads today has been bred to have an extra high gluten content, milled to exclude the nutritious wheat germ and then baked into breads with excess quantities of enzymes and of yeast that has not been allowed (thanks to the Chorley Wood Bread Processing Method) to prove properly so continues to do so in our stomachs.

Does anyone actually need either of them?

It is very understandable that parents who could lose their child any day to a chance encounter with a peanut butter sandwich should feel that those who ‘only’ suffer from a food intolerance which makes them feel rather unwell should not have the same  standing in the allergy world – but it is equally understandable that someone whose life has been put on hold by the fact that nearly everything they eat makes them feel so ill that they are unable to function normally, should get enormously frustrated when their condition is not taken seriously.

Both are serious conditions and both deserve the utmost sympathy and understanding from those of us who are lucky enough to be able to eat what we want when we want without fear of ill-health or even worse. And, much more importantly, both deserve respect and what help it is possible to give from the medical professional that they consult.

 

Judging the 2012 FreeFrom Food Awards – fascinating and rewarding

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Kate  Hawkings (food writer) and Louise Marchionne (allergy therapist) ‘working on’ category 12 – scones, sweet tarts, sweet biscuits, cookies etc. 

Like last year’s, this year’s judging for the FreeFrom Food Awards was a thoroughly enjoyable, if somewhat exhausting, experience! Made so by the range and quality of the entries, the enthusiasm and interest of our splendidly eclectic collection of judges and the superb efficiency with which Cressida, and her ‘kitchen assistant’, Katherine managed us all.

And managing us all, not to mention all the samples, is no mean feat.  We run two judging rooms, alternating between them and, in each, timed to the minute, we need not only the samples (some hot, some cold, some frozen, some fried) but an endless supply of bowls, plates, spoons, rubbish bins, water – and tea/coffee to revive flagging judges.

This is all made infinitely more complicated by the fact that all entries are judged blind, judges only seeing the packs at the very end after they have made their choices – just in case their chosen winners have committed some packaging or labeling howler which would effectively, disqualify them. It has happened. But from an organisational point of view it means that every product and every tasting sheet has to be meticulously numbered – and that those numbers must tally or we are all in serious trouble!

Our judging process comes in two parts. Part one is delightfully silent. Judges look at, sniff, taste and assess each of the products laid out or presented to them, make their own notes on the relevant judging sheet and give the product a guide mark out of 10. The judging sheet will have all the information about the product (ingredients, freefrom claims, directions for storage/preparation, availability, cost etc) except the brand name and who makes it.

They are asked to bear the following criteria in mind when assessing each product:

  • Quality of product based on appearance, aroma, texture, flavour
  • Usefulness – does it fulfil a really useful purpose for someone on a freefrom diet?
  • Cleverness – is it doing something which is really difficult to do in manufacturing terms?
  • Nutritional profile
  • Labelling – is the ‘on pack’ information that it gives clear & accurate?

 

 

Debbie of the Who says coeliacs can’t eat cake? blog checking out an entry.

We are very insistent that they do not talk to each other while doing this bit and that they at least try to keep their faces expressionless while they are tasting so as not to influence the fellow judges (either positively or negatively) who may not yet have tried that particular entry. Once they have all done their initial assessment, I ask them to draw up a shortlist and I note all their shortlist choices which will be used as a basis for a discussion of the potential winners.

At that point I ‘open the floor’ to discussion and, maybe because they have had to keep silent for so long – in virtually every category a very lively discussion ensued. This is mainly thanks to the diverse make up of the judging panels all of which include at least one nutritionist/dietitian, one foodwriter/chef/cook/’foodie’, one coeliac, one allergy sufferer (nuts, dairy, egg, celery, tomatoes etc) and one ‘normal’  non-foodie, non’freefrom’ person to benchmark the foods against non-freefrom food.

John Burke of GFLifeIreland, Hulya Erdal of Made by the Chef and chef Frank Bordoni working on their shortlists before the final discussion.

Coming from such very diverse backgrounds, the judges have very different ‘takes’ on what a constitutes good ‘freefrom’ product and the battle of nutritional content versus taste/quality, versus ‘Ohmigod –  you mean this really is a dairy and gluten free quiche that I could eat’ can rage quite fiercely!

We were very lucky this year also to have a lot of ‘dual’ experts, nutritionists/dietitians such as  Christine Bailey or Tanya Wright who not only have professional expertise in their area but are allergy sufferers themselves (Christine, dairy and gluten free, Tanya anaphylactically allergic to milk and eggs), chefs and food professionals such as Jane Milton, Hulya Erdal or chef Frank Bordoni who have also either had food problems themselves or been closely involved with some who had – and of course our new crop of ‘blogging judges’ all of whom have had very personal experience of living freefrom – and are delightfully vocal on the subject!

And what of the entries? Well, for obvious reasons, I cannot say much about them – except that there were some really exciting new products this year. Exciting not only in terms of flavour and texture (although some certainly were in those terms too) but in terms of going where no freefrom product has gone before!

Although you will have to wait till April to get the full story of who has won what, the shortlist will be out very soon so at least you will now what is in the running! Watch this space.

And meanwhile, thank you very much, again, both to all of those wonderful judges (for a full list of who they were see here on the FreeFrom Food Awards site) and to our amazing ‘in house team’ – seen below: Cressida, Katherine – and Daisy, who  behaved immaculately throughout, merely waking every now and then for a quick look around and a little nosh!