As a child, you loved eating ice cream cones and drinking glasses of cold, delicious milk. Today, those same dairy treats leave you feeling gassy, bloated, and miserable. Could you be lactose intolerant?
You might be. Up to 20 percent of Americans live with intolerances to ingredients found in foods, most commonly the lactose in milk and the gluten in wheat and other grains. Even foods you ate with ease when you were younger can begin bothering your digestive system as you get older.
“Our bodies do change over time, and people can go many years without a food intolerance or allergy and then develop it,” says Dr. Michelle Hauser, a certified chef and nutrition educator and clinical fellow in medicine at Harvard Medical School.
Got Milk Discomfort?
Lactose intolerance, in particular, becomes more of a problem with age.
“It’s something that’s progressive through your life. What happens is, the gut loses its natural lactase enzyme as we age,” explains Dr.Stanley Rosenberg, assistant professor of medicine at Harvard Medical School.
Lactose is a sugar found in milk and other dairy foods. Normally, when you eat dairy, the lactase enzyme, which is produced in your small intestine, breaks lactose down into simpler sugars–glucose and galactose–so your body can digest it. When you have lactose intolerance, your body doesn’t produce enough of this enzyme, so you have trouble digesting dairy products. Bacteria that live in your gut feast on the undigested lactose, producing the hallmark symptoms of lactose intolerance–gas pain, bloating, nausea, and diarrhea.
What to do: Try switching to dairy products that are easier for your body to digest, such as lactose-free milk, hard cheeses, and yogurt. You can also take lactase supplement pills or drops (Lactaid, Lactrase) before eating dairy to help your body break down lactose. Make up for the milk you’re missing by eating other calcium-rich foods, such as spinach, salmon, and sardines, or by taking a calcium and vitamin D supplement.
Going Against the Grain
Celiac disease is an immune reaction triggered by gluten, a protein found in wheat, rye, oats, and barley. If you have celiac disease and eat a piece of wheat bread, your immune system attacks, going after the tiny fingerlike projections called villi in your small intestine that help you absorb nutrients from food. This damage may lead to intestinal complaints, such as diarrhea and abdominal pain, as well as to iron and calcium deficiencies.
About 2 million Americans have celiac disease, but researchers are finding that just as many have intestinal symptoms of gluten sensitivity without qualifying for a celiac diagnosis.
“There has been recent acceptance by the medical community that gluten causes symptoms in people who don’t have celiac disease, although the mechanism isn’t clear,” Dr. Rosenberg says.
What to do: If you have celiac disease, going gluten-free can relieve your symptoms, but that’s easier said than done. You not only have to avoid gluten-containing dietary staples like pasta, cereal, and bread, but you also can’t eat any foods that were prepared on the same surfaces as gluten-containing foods. Gluten can also hide in places you’d least expect it, including soy sauce, instant coffee, salad dressing, and even some of the medicines you buy at your local pharmacy.
Supermarkets today are devoting increasing amounts of shelf space to gluten-free breads, cereals, and other products, which makes shopping easier for people with celiac disease. Yet there’s no need to go gluten-free if you aren’t sensitive to the protein. In fact, you could be shortchanging your body of essential nutrients by doing so.
“A lot of these gluten-free products are highly processed,” Dr. Hauser says. “They’re not using whole grains. They have basically no fiber. And they get rid of the B vitamins and magnesium that would be in the wheat flours.” If you do cut back on gluten because you’re sensitive to it, do it in a healthy way by eating nutritious gluten-free grains, such as brown rice and quinoa.
Other Troublesome Ingredients
Certain preservatives can trigger a reaction if you’re sensitive to them. Sulfites, which are found in wine, dried fruits, and certain medicines, can cause symptoms ranging from flushed skin to wheezing. If you’re trying to avoid sulfites, watch out for names like sulfur dioxide, sodium bisulfate, and potassium bisulfite on food labels.
Monosodium glutamate (MSG)–which is sometimes added to enhance the flavor of Asian restaurant meals, and is used as an additive in other foods–is another ingredient many people claim gives them symptoms ranging from heart palpitations to numbness and headaches.
This so-called “Chinese restaurant syndrome” has been controversial, because studies haven’t been able to confirm its existence. But if MSG seems to bother you, avoid foods containing MSG, glutamic acid, and its salts–which can include hydrolyzed vegetable proteins, hydrolyzed yeast, soy extracts, and protein isolate. Chicken or beef flavorings, bouillon, broths, and soup and rice mixes with flavor packets are some common MSG-containing foods.
Some foods just have a natural proclivity to make us feel uncomfortable. Take beans, for example.
“Those are naturally gas-producing foods,” Dr. Rosenberg says. Taking a product such as Beano before eating a bowl of baked beans or other high-fiber food can help your body digest the complex carbohydrates, making them easier to tolerate.
Artificial sweeteners such as mannitol and sorbitol have a tendency to produce diarrhea–in fact, they’ve been used as laxatives. The simple solution if they bother you is to cut back on or avoid sugar-free chewing gums and other foods in which they’re ingredients.
Food Intolerance or Allergy?
If you have a reaction after eating a specific food, you might describe it as a “food allergy.” Yet it’s very possible that what you have is actually a food intolerance. Sometimes it’s hard to tell the difference.
“The problem is, an allergic reaction and an intolerance have a lot of overlapping symptoms,” Dr. Hauser explains.
Here’s how to distinguish a food intolerance from a true allergy:
Food allergy refers to an immune response to a particular protein in the food. Depending on the extent of the allergy, even a small amount of a food can lead to a severe and life-threatening reaction, called anaphylaxis, which requires immediate medical attention. Your doctor or allergy specialist can use a blood test or skin test to check for this immune response.
Food intolerance is sensitivity to or difficulty digesting a particular food. The symptoms are uncomfortable but not life-threatening. Examples of food intolerances include lactose intolerance, sensitivity to food additives such as sulfites or MSG, and food poisoning.
Sometimes the cause of your food intolerance is clear. You drink a glass of milk, and 30 minutes later you’re doubled over on the toilet. Or, every time you eat a piece of bread you feel sick to your stomach. But if you aren’t sure what’s causing your symptoms, it can help to try an elimination diet.
Start by keeping a food diary. For each day of the week, write down what foods you eat, at what times of the day.
“Record next to each meal and snack if you have any symptoms, and what they are,” Dr. Hauser recommends.
Once you have a general idea of which foods coincide with your symptoms, cut them all out of your diet for two weeks. Then slowly add one food back in every couple of days. When your symptoms return, you know you’ve found the culprit.
Don’t go through this process alone. Talk to your doctor–and possibly a dietitian–before embarking on an elimination diet to ensure you’re not shortchanging your body of essential nutrients while you’re avoiding certain foods.
To find out more about food sensitivities and how to deal with them, visit: www.livingwithout.com/.
– Harvard Women’s Health Watch
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