Junkfood Science: <i>Junkfood Science Special:</i> Fears of foods, contaminants and modern life

February 12, 2007

Junkfood Science Special: Fears of foods, contaminants and modern life

Shinga at Breath Spa for Kids continued her investigation into the Allergy UK's promotion of food allergies and intolerance in the UK with an excellent post “On Wanting to Vent My Rage Following Sloppy Journalism: Food Allergy and Intolerance.” This is such an important issue that affects every aspect of health and well-being and I would like to expound upon it and add the American perspective.

You may remember that Allergy UK, as part of their Food Allergy and Intolerance Week, released the results of a survey, The Stolen Lives Report. In it, Muriel Simmons, Chief Executive of Allergy UK wrote:

It is generally accepted that 2% of the population suffer from IgE-mediated food allergy and anything up to 45% suffer from some form of food intolerance. In our survey of 5,200 people it emerged that 59% of the people responding reported regarding themselves as having a food intolerance and 41% considered that they had classical food allergy.

So more than half of the population is supposed to be suffering from intolerances to food, with their symptoms even appearing two days after eating the offending food. The symptoms attributed to food intolerance, according to Allergy UK, include:

Aches and pains 6.1%

Bloating, indigestion, diarrhea 19.7%

Rashes 5.7%

Lethargy and anxiety 11.9%

Coughing and wheezing 8%

Headaches 5.6%

Runny or stuffy nose 6%

Suffering more than one symptom 37%

Everyone can find their own experiences in this list, which makes virtually all of us recommended for testing. But these nondescript symptoms will also be recognized by healthcare professionals as common effects of stress and anxiety. Such ordinary symptoms often defy medical diagnosis or pathology and there is little that doctors can do. They are also the symptoms that people manifest with nocebo (discussed here) — the amazing array of symptoms that people can experience after eating certain foods or being exposed to things they simply believe to be bad for them — including headaches, chest pain, nausea and indigestion, rashes, cough, and weakness and fatigue.

Clinical ecology and food intolerance diagnosis

The sad aspect of nocebo and our everyday normal aches and pains, is that some practitioners will use them to frighten people into believing they have actual health problems. Hence, the growing numbers of people who doctors call “the worried well.”

As Dr. Nortin M. Hadler, MD, FACP, FACR, FACOEM, professor of Medicine and Microbiology/Immunology at the University of North Carolina, Chapel Hill and rheumatologist, wrote in a recent Journal of Rheumatology:

If questioned closely, nearly all of us can recall low back pain last year, a third of us recall pain at the shoulder, hand or wrist, and 15% of us at the elbow. These memorable episodes last at least a week and often are recurring. Regional musculoskeletal pain is an intermittent and remittent predicament of normal life. Feeling "well" demands the sense of invincibility that we can cope with our next musculoskeletal morbidity. Being well symbolizes our triumph that we had the wherewithal to cope with the last episode for as long as it took for that episode to remit, to cope so well that the episode is barely memorable, if at all. Being well does not mean avoiding the challenges of regional musculoskeletal disorders; that is not possible. These challenges are as much a part of life as heartache, heartburn, headache, and the like. Therein lies the enigma of health.

Advocates of clinical ecology (also called environmental illness) claim that common symptoms are indicative of health problems brought on by even the smallest exposures to foods or toxins among sensitive people. They give more than a hundred different diagnoses to these presumed afflictions, even when there are no clinical indications of pathology, such as food intolerances and allergies, candidiasis, chronic fatigue, multiple chemical sensitivities, irritable bowel, hyperactivity, etc.). Hence, worried people will find a diagnosis to validate their symptoms, which can in turn accentuate their beliefs they are sick and escalate their symptoms.

Dr. Hadler is not alone in expressing concerns that people are also learning to be patients and that labeling them as diseased reinforces a medicalization of normal. “I would suggest that the treatment acts, dripping with empty promises of elucidation and unproved promises of palliation, are iatrogenic,” he said. “I would further suggest that these circular treatment acts will exacerbate whatever mood or thought disorder is complicating the plight of these patients....[C]hronic persistent pain is an ideation, a somatization if you will, that some are inclined toward as a response to living life under a pall, and not vice versa....[T]hese people choose to be patients because they have exhausted their wherewithal to cope.”

This is an incredibly difficult idea to share with people, especially those caught up in believing they are actually sick, because it goes against what they have truly come to believe they are experiencing and it questions fears about modern life that they have become convinced are true. Yet, medical authorities have repeatedly found (as reviewed here) clinical ecology to be invalid, without plausible, rational explanations in proven biophysical science and with no credible evidence to support it.

Several medical societies and organizations have issued position statements pointing out the shortcomings of clinical ecology diagnoses, the unreliability and misuse of certain diagnostic procedures, and the lack of scientific support, according to AAAAI. These professional groups that have examined the evidence include the American College of Physicians, American College of Occupational and Environmental Medicine, the Council on Scientific Affairs of the American Medical Association, the Ministry of Health of the Province of Ontario, the California Medical Association., the U.S. National Academy of Sciences, the World Health Organization, the International Society of Regulatory Toxicology and Pharmacology, and the Royal College of Physicians and Royal College of Pathologists in Great Britain.

The American Academy of Allergy, Asthma and Immunology (AAAAI), the nation's largest group of allergists, reviewed the controversy and various theories surrounding clinical ecology, including many claims of food intolerances, in its most recent scientific position statment on clinical ecology. It found no evidence of pathology or physiologic dysfunction and no evidence that these patients have any immunologic or neurologic abnormalities. “In addition, no form of therapy has yet been shown to alter the patient’s illness in a favorable way.”

In Shinga’s initial story, she noted that there is “a lot of scepticism about the reported high prevalence of food intolerance as an explanation for feelings of tiredness, malaise and other symptoms that lack a medical diagnosis.” In this second installment, she quotes Alison Williams, an NHS chief dietician based in Dunfermline, who explained: “There is a lot of misunderstanding about allergies and intolerance....and there is a big discrepancy between the number of people who think they have a food intolerance or allergy, and those that actually do.”

To briefly explain, food intolerances, unlike true allergies, do not involve the immune system. Certain digestive and physical conditions, such as lactose intolerance, can produce gastro-intestinal symptoms of legitimate food intolerance but, while more common than allergies, they are still rarer than popularly believed and people with food intolerances can still usually eat small amounts without suffering symptoms. Actual food allergies are exceedingly rare and only occur in about 1-2% of adults, according to the FDA, and most people are allergic to fewer than four foods. And allergic reactions are pronounced and unmistakable — swelling of tongue and throat, difficulty breathing, hives, vomiting, abdominal cramps, diarrhea, drop in blood pressure, loss of consciousness and even death — and appear within minutes to two hours after eating the allergen and can be life-threatening.

Food tolerance testing

Shinga did some digging into the study behind the high incidences of food intolerance being purported in the UK. Her indepth review of the claims and the study behind them is worthwhile reading. She found the statistics “seem to have been drawn from a postal survey of people who had already had IgG testing from York Test...a food-specific IgG enzyme-linked immunosorbant assay blood test.” As a result of these tests, people are given a list of foods they are supposedly allergic or intolerant to and must avoid, are prescribed a strict dietary regimen which includes that they should only eat certain foods every 4-5 days, and they are given a year’s membership to Allergy UK.

Readers may be interested to learn that this exact same scheme is also rampant here in the United States. Since the early 1980s, “food cytotoxic blood tests” have been promoted by storefront clinics, laboratories, nutrition consultants, chiropractors and doctors, claiming to detect food allergies, according to Dr. Stephen Barrett, M.D. in “Allergies: Dubious Diagnosis and Treatment.” Controlled studies, however, have never demonstrated their reliability and they are not supported by well-controlled studies and clinical trials, he said.

These tests, such as the ELISA/ACT developed by Serammune Physicians Lab of Reston, Virginia, claim to identify hidden or delayed allergies and food intolerances that result in unexplained fatigue and other symptoms. They also claim that even 60% of illnesses are due to these offending foods. But, as Dr. Barrett notes, these symptoms are unrelated to allergy:

Advocates claimed it could determine sensitivity to food, which they blamed for acne, anxiety, arthritis, asthma, back pain, baldness, bedwetting, conjunctivitis, constipation, depression, diarrhea, eczema, excessive sweating, fatigue, headaches, hearing loss, hoarseness, hypertension, hyperactivity, insomnia, learning disorders, nosebleeds, obesity, rashes, sinus trouble, stomach disorders, susceptibility to cancer, and other problems.

In an article on cytotoxic testing, Dr. Barrett reviewed the findings of the AAAAI which concluded that cytotoxic testing is incapable of diagnosing food allergies. Their review of the research found that white cells react no differently in these tests when exposed to substances that were known allergens for patients as those who were not sensitive; that different results were repeatedly obtained on the same patients and even varied from day to day; and double-blind, placebo-controlled clinical trials found positive test results were claimed for foods that produced no clinical symptoms.

After an extensive review of the research, Blue Cross Blue Shield released its policy on the efficacy of cytotoxic testing last May which stated “No randomized controlled trials have established the efficacy for cytotoxic food testing in the diagnosis of food allergies.” These tests had not been shown to improve health outcomes.

The FDA issued its updated determination in 1995 that “there is no FDA-regulated product on the market that has been demonstrated to be effective in cytotoxic testing” and that it remains an unproven procedure. Paul C. Turkeltaub, M.D., associate director of the division of allergenic products and parasitology at FDA's Center for Biologics Evaluation and Research urged consumers: “Be very wary of claims of food allergy to explain chronic, common complaints.”

One of the ELISA food intolerance testing labs operating in the United States with a visible internet presence is Optimum Health Resource Laboratories, based in Hollywood, Florida. It is the U.S. branch of York Nutritional Laboratories described in Shinga’s report. [Note both URLs take you to the same website.] In sharp contrast to known science, it says:

76-80% of the population as being effected by what are known as delayed food allergies (food sensitivities, food intolerances, etc.), there is an extremely good chance your nagging ill-health conditions are being caused and/or complicated by IgG-mediated (delayed) food allergies. In fact, out of thousands of individuals who have tested through our office, over 98% were found to be IgG reactive to foods!

So now, 8 out 10 of us have food allergies and virtually everyone they tested had a problem in need of intervention! Among the conditions they tell consumers could be related to food allergies or food sensitivities are:

feeling bloated, stomach cramps, constipation, wheezing, breathing difficulties, sinusitis, tension, nausea, hives, rashes, itching, Fibromyalgia, loss of appetite, panic attacks, loss of energy, headaches (including migraines), muscle & joint pain, diarrhea, arthritis, Rhinitis, asthma, hyperactivity, multiple sclerosis, Urticaria, eczema, premenstrual symptoms, irritable bowel syndrome, schizophrenia, anxiety, epilepsy, fatigue, myalgic encephalomyelitis, depression, infantile colic, colitis, recurrent infections, learning disabilities, dyslexia, conceptual difficulties, celiac disease, fluid retention, weight problems, Crohn’s Disease, psoriasis, mouth ulcers, gastric ulcers, Otitis media (ear infections), plus many more!

Dr. Raymond G. Slavin, M.D., former president of the AAAAI, described what happened when even his wife, who had no allergies, received test results from Bio-Health Centers of Huntington Beach, California, another cytotoxic laboratory. She was told she was allergic to 25 foods — even sugar, corn, beef, potatoes and milk — and needed to avoid them for 8 weeks. Luckily, she didn’t buy into it, but countless others have.

Food intolerance diets

Of course, the ELISA food intolerance tests are followed by nutritional recommendations that typically include avoidance of the “reactive” foods in an elimination diet “to lessen food intolerance antibodies” and a rotation diet in which individual foods are rotated every four days. The dietary prescripts are complicated and those from Dr. Braly’s Allergy Relief, also based in Hollywood, Florida, are an example. They’re the same as those being promoted by the British Allergy Foundation practitioners.

Sadly, these people’s lives become consumed in trying to follow the limiting, constrained eating regimens given them in a 30-page Food Sensitivity Guidebook, that include expensive all-natural, organic foods. Saddest of all, people are left afraid to eat or enjoy a host of perfectly safe, healthy foods. They cannot dine with friends or family because of their extremely restrictive diets. They don’t participate in celebrations or even allow themselves to enjoy a piece of their own birthday cake.

The UK and United States aren’t the only countries where clinical ecology and alternative allergy tests and treatments are being promoted. The Australasian Society of Clinical Immunology and Allergy recently published a comprehensive position paper on non-conventional approaches to common conditions that claim to have an allergy base but actually “have no scientific rationale and have not been shown to be reliable or reproducible when subjected to formal study.” In advising against use of these tests for diagnosis or treatment they said:

These philosophies use terminology loosely, blur and confuse the distinction between the terms "fatigue" and "immunity," and blend concepts of immunology, neurology and spirituality to explain the nature and causes of disease.

This paper is invaluable reading for a review of the most common unorthodox food allergy and intolerance practices and can help protect consumers from spurious practitioners. Of note to healthcare professionals, it also reviews the harmful consequences of these dubious tests and treatments. Not only can they lead to expensive interventions that are ineffective and may delay more effective care, they said, but:

Sometimes harmful therapy may result, such as unnecessary dietary avoidance and risk of malnutrition, particularly in children. For example, Rona and Chinn found that around one half of parents who thought that their child was food allergic or intolerant altered their child's diet, but only one third sought medical advice, and that some children were 4 cm shorter than controls. Unnecessary environmental and chemical avoidance, creating a perception of organic illness where none exists, or advising physical interventions when psychosocial factors are the source of symptoms, can impact on employment and social functioning. Claims of being able to “cure” food allergies have potentially dangerous consequences for those with true life-threatening reactions. Similarly, substitution of homeopathic “vaccines” for those with proven effectiveness has both individual and public health implications.

Some mainstream medical practitioners believe there is no harm in promoting alternatives, even if they only work by the placebo effect. Except, bad outcomes are real. Some of those were discussed in Healing Waters. There are other adverse effects of encouraging people to wrongly believe that common health complaints are due to foods and contaminants. It fosters a culture of fear that leads more people to worry that every minor complaint they experience is a serious health problem. The stress of this anxiety and an illness mindset is costly.

That Allergy UK report illustrated this problem when it said 62% of the consumers who had come to believe they had food intolerances said they visited their doctor at least six times a year about their symptoms; 14% at least 12 or more times.

Some experts suggest that anxious people who’ve gotten taken up in these beliefs constitute a large percentage of Americans frequenting clinics and hospitals, imposing a strain on health care costs and resources. Stress that’s transformed to physical symptoms afflicts ten percent of American adults, according to Steven Locke, M.D., a Harvard Medical School psychiatric researcher. These anxious people see doctors more often, accounting for up to one-third of all primary care calls, and result in healthcare costs 14 times higher than average. His research has estimated $30 billion annually in our country is spent in unnecessary medical costs resulting from people who fear being sick or believe they’re at risk.

The tragic human toll of these fears is a loss in the pleasures of the table and enjoyment of food, along with all of the social and bodily benefits that food brings to our lives. The sad human toll of these fears is losing a sense of well-being and a full enjoyment of the pleasures of life.

© 2007 Sandy Szwarc

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