Food intolerances, myth or reality?of Nutrition Plans
For many years, many therapists and nutritionists have supported the idea that various health problems can come from food intolerances. These food intolerances would be responsible for many diseases, ranging from eczema, migraine to fibromyalgia. Food intolerance tests (IgG) have been marketed and are even available on the Internet. Some people end up with diets of multiple exclusions that are difficult to manage. If food intolerances are the cause of many health problems, then one may wonder why food intolerance tests are not requested by most doctors and why most allergists or immunologists do not accept the validity of these tests. Would doctors be blind or misinformed? We will see that this is far from clear and that the usefulness of intolerance tests is far from proven. There is a special case with gluten intolerance, including celiac disease and gluten sensitivity, which will be discussed in this article.
Food intolerance, what are we talking about Nutrition Plans?
Food tolerance corresponds to an acceptance or more precisely to a non-action of our immune system towards correctly digested food molecules. In fact, it is our microbiota that promotes food tolerance. Indeed, when our ecosystem is balanced with good microbial biodiversity, friendly bacteria inform our immune system that everything is fine. There is nothing to declare. The immune system remains alert, but does not react. When our microbiota is disrupted, communication between the microbiota and the immune system is impaired, thereby promoting food sensitization that can progress to food allergy (1). Food allergies are therefore partly the consequence of a loss of oral tolerance to food following a modification of the microbiota. This is why the management of the microbiota is increasingly taken into account as a therapeutic strategy in allergies.
Nutrition Plans , the subject of this article concerns food intolerance. A concept far from clear. Theoretically, intolerance to a food is the consequence of incomplete digestion of food by digestive enzymes, which means that the food is not degraded to its simplest level of monomer (glucose, amino acid or fatty acid). The best known example is lactose intolerance which does not allow lactose to be split into glucose and galactose because of lactase deficiency, resulting in well-known digestive disorders.
However, when we talk about food intolerances, we most often refer to class 3 hypersensitivity reactions. It should be noted that allergists generally only take into account class 1 reactions, which correspond to an aggressive immune reaction to the allergen. While class 3 is a hypersensitivity that involves only class G (IgG4) memory antibodies. The presence in the blood of IgG antibodies against food primarily means that there has been contact between the food antigen and the immune system. This does not mean that there is any allergy or intolerance. There was just a contact. And that's where the differences exist. Allergists believe that the presence of IgG antibodies against food has no special significance, especially since many studies have shown no correlation between diseases and the presence of these antibodies (3-6) . In addition, the presence of IgG antibodies to foods is common in both healthy and disease-affected individuals (6). Despite the lack of clear evidence, some nutritionists believe that the presence of these anti-food antibodies is evidence that the offending foods maintain the diseases or symptoms complained of by the patient. Studies in this direction, however, remain anecdotal (7,8).
In fact, what is really important to understand is that the presence of IgG antibodies to food seems to indicate above all an increased intestinal permeability, because normally the intestinal mucosa is impermeable and should not allow contact between molecules. food and the immune system.
If we understand this, we can consider that the management of these so-called food intolerances does not necessarily go through exclusion regimes, but by the correction of intestinal hyperpermeability that requires, among other things, microbiota and the intestinal barrier.
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