By Mark Hyman, M.D.
Nowhere in medicine is there more controversy, superstition, confusion and religious fervor than there is surrounding the subject of food allergy and illness. Conventional allergists and immunologists generally confine all interactions between food and the immune system to the Type 1 hypersensitivity, IgE-mediated response.
Practitioners of integrative and alternative medicine have long recognized the limitations of this point of view, yet have failed to produce a viable alternative clinical model with which to test and assess interventions based on complex dietary manipulations.
However, an increasing body of literature illuminates the potential for more subtle interactions between the gut, food and illness. (1,2,3) Despite the limitations of the assessment tools (electrodermal screening) and the lack of a control group, the small sample size, the lack of a standard, validated assessment tool for measuring outcomes, Taylor, et. al, break ground in this pilot study. (4)
While cognizant of the limitations of their methodology, the authors demonstrate that alteration of the diet to reduce its antigenic load is correlated with a reduction in symptom severity in a condition that has no known conventional treatment (multiple chemical sensitivity).
Certainly conventional medicine has recognized that food can harm. Doctors have recommended avoiding certain foods to treat common conditions. Low-fat diets for the prevention of cardiovascular disease, bland diets to treat ulcers, low-salt diets to treat hypertension, once medical dogma, now are relegated to the pile of unnecessary or harmful advice.
Yet while medicine embraced these ideas, it has resisted the concept that changes in diet can not only prevent disease, but can be used as a therapeutic tool, often where no other exists.
The need to critically assess the role of diet as a therapeutic tool in disease cannot be overstated. The need for a healthy diet is well recognized in the prevention of chronic illness such as cardiovascular disease, diabetes, obesity and cancer.
The Healing Power of Food: Largely Unexplored
The use of nutritional therapy in illness stops there. Using food as a therapeutic tool in illness is a vast unexplored area of medical science. The power of food as medicine lies in the exact domain where current medical practice is weakest--in the chronic immune, endocrine and degenerative diseases that afflict modern civilization.
However, the emerging science of nutrigenomics highlights the complex role of macronutrients, micronutrients and phytochemicals in altering endocrine, immune and metabolic responses that regulate the subtle balance between health and illness.
The mechanisms whereby food acts to alter patterns of gene expression, regulate complex immunological signals and shift endocrine responses are being clarified.
The old idea that food is simply a vehicle for delivering energy in the form of calories is giving way to a new model of food--food as information. Our evolutionary adaptation to a particular diet has perhaps set the conditions that alter gene expression patterns to trigger illness, rather than support health in the context of an unfamiliar landscape of fast nutrient-poor food, increasing sedentary behavior and incessant stress. (5)
R.D. Laing said that, "Insanity is a sane response to an insane world." (6) Perhaps, the disease is a normal response to a diseased world (and a toxic diet).
As a species, we once ate a complex unrefined wild diet consisting of a wide variety of plant and animal foods rich in phytonutrients, fiber and omega-3 fatty acids. Now, our monotonous diet triggers different and diseased patterns of gene expression. The USDA reports that the top nine foods eaten by Americans are:
- Whole cow"s milk
- 2 percent milk
- Processed American cheese
- White bread
- White flour
- White rolls
- Refined sugar
- Ground beef
All of these foods are foreign to our genome that evolved on a Paleolithic diet. This mono diet creates altered patterns of gene expression that lead to disease, including food allergy or sensitivity. (7)
Dairy and gluten are two generally well accepted food antigens responsible for an array of complex disorders including autoimmune diseases, digestive disorders, endocrine disturbances and neurologic and behavioral disorders. (8,9) These data must be the wedge into a new framework for thinking about the relation of food, illness and health.
While many hurdles remain in the designing, funding and the interpretation of research on the interaction between food and health, it must be an area of highest research priority.
Food is our greatest ally in helping to prevent and treat illness, and to help our patients to create health. We must separate religion from science and assess the role of food as medicine, particularly in chronic illness where current pharmacologic approaches fall short.
Clinical experience treating chronic conditions such as IBS, IBD, migraines, autoimmune diseases, CFIDS, FMS, MCS, psoriasis, eczema, urticaria, arthritis, and respiratory illness, enuresis and cystitis with elimination diets must be translated into research protocols that illuminate individual differences in response to dietary antigens and their relation to diseases. This research will yield critical new insights into the role of food as slayer and food as healer.
Mark Hyman, M.D., serves as editor-in-chief of Alternative Therapies in Health and Medicine and is a medical editor of Alternative Medicine Magazine and has his own web site at www.drhyman.com.
1. Lindqvist U, Rudsander A IgA antibodies to gliadin and coeliac disease in psoriatic arthritis, Rheumatology (Oxford). 2002 Jan;41(1):31-7.
2. Hafstrom I, Ringertz B, Spangberg A , A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford). 2001 Oct;40(10):1175-9.
3. Riordan AM, Rucker JT, Kirby GA, Hunter JO, Food intolerance and Crohn"s disease, Gut. 1994 Apr;35(4):571-2.
4. Alternative therapies article – Taylor.
5. Eaton SB, Eaton SB 3rd, Konner MJ. Paleolithic nutrition revisited: a twelve-year retrospective on its nature and implications, Eur J Clin Nutr. 1997 Apr;51(4):207-16.
6. R.D. Laing [1959 / 1965]. The Divided Self -- An Existential Study in Sanity & Madness. Pelican Books.
7. Hunter JO, Food allergy--or enterometabolic disorder?, Lancet. 1991 Aug 24;338(8765):495-6.
8. Saukkonen T, Virtanen SM, Karppinen M, Significance of cow"s milk protein antibodies as risk factor for childhood IDDM: interactions with dietary cow"s milk intake and HLA-DQB1 genotype. Childhood Diabetes in Finland Study Group. Diabetologia. 1998 Jan;41(1):72-8.
9. Farrell, RJ, Kelly C, Celiac Sprue, NEJM 2002 346 (3):180-188.