SHOW NOTES NOTES

What is the difference between a food intolerance and food allergy? [0:20]

• Intolerance in an inability to tolerate a specific food
• Classic/common food intolerance is lactose intolerance
  • Lack enzyme called lactase to digest lactose
  • Can be lactose intolerant, or could be dairy intolerant (different)
• Another example of an intolerance: gluten causes digestive stress
  • Bloating, gas, stomach distention, acne
• Intolerance & food sensitivity definitions and languages are evolving
  • Patient is “sensitive immunologically” to [food]
• Food intolerances are not life threatening
• Food allergy = immunological reaction
  • Immunoglobulin IGE response
    • Immunoglobulin = immune system regulator, different types
    • IGE is an immediate reactive immunoglobulin that can bind to a food substance a person is allergic to
    • Forms an antigen-antibody complex that stimulates symptoms
      • Anaphylaxis can be life or death
  • A measurable/proven true immunoglobulin reaction
  • Happening more frequently than governing bodies report
• Allergies do not always cause anaphylaxis
  • Large range from mild seasonal allergies & sinus congestion, all the way to severe anaphylaxis
  • Studies & research are still coming out

• Dr. Pastore’s patient had very high blood pressure, underlying cause was true food allergies. Removed the food, no longer needed medication for blood pressure
• Lexie’s client allergic to dairy
  • Removing dairy has eliminated all asthma symptoms
  • Accidentally exposed & gained 5lb of fluid retention
• “The solution to pollution is dilution”
  • Consuming an allergen causes the body to take fluid from between cells & floods area to “put out an immunological fire”
  • Causes water retention (not fat gain)
  • Effort for the body to dilute the negative immune response

• Consumer study showed that every 3 minutes, a food allergy sends someone to the emergency room [8:00]

What are the top 9 most common food allergies? [8:20]

• 9 major foods for IGE allergy responses
• Not limited to just these 9 things, could be any
• Majority of people react to:
  • Milk
  • Eggs
  • Wheat
  • Fish
  • Shellfish
  • Peanuts
  • Tree Nuts
  • Soy
  • Sesame
• Most processed foods have at least 2 of the most common allergens
• Food labels aren’t disclosing enough information for those with true allergies

• Dr. Pastore has yet to identify an individual who has anaphylaxis to one food and doesn’t react to another food
  • Will have more than one food allergy
  • Triggers & contributes to the anaphylaxis
  • Could cause an entirely different subset of symptoms

• Allergy is typically a poly-phenomenon, meaning more than one food

How many people have food allergies? What age do these allergies appear? [10:45]

• There is no set age for when a true food allergy transpires
  • Diagnosed in children or as an adult
  • Even if you never had symptoms or reacted before
• Can come on at any day at any age

FARE (Food Allergy Research and Education Organization) study [12:15]

• Approximately 32 million people in the US that have a true food allergen or allergies (meaning to more than one food) and are at risk for anaphylaxis
• From 2007 and 2016, the rate of food allergies increased by 377%
  • Tripled in 9 years
• 1 in 13 children have a true food allergy
  • Roughly 2 per classroom

Food allergy symptoms can mimic symptoms of other medical conditions [13:40]

• Genetic risk factor - if someone related to you is allergic to a food, you’re at a greater risk of developing an allergy to it oo
  • 1st degree relative with a true food allergy means you likely have an allergy or sensitivity to foods (may not be the same foods)
• Find the true cause of the symptoms, remove the allergen, symptoms go away
  • Elevated blood sugar due to food allergy due to inflammation, regardless of carbohydrate consumption
    • A pro-inflammatory response has been associated with the resistance of a cell’s ability to utilize insulin & glucose
      • Accelerates gluconeogenesis (making glucose from non-glucose sources in the body, driven by the liver)
      • Gluconeogenesis uses amino acid alanine to produce glucose, but body strips alanine from existing muscle tissue & causes decrease in muscle mass
      • Hyper-gluconeogenesis leads to visible muscle mass reduction in large muscle groups (quads, lats)

How do you get diagnosed with a true food allergy? [16:50]

• Give your doctor a detailed health history - past and present (as a child & adult)
  • Symptoms and if possible any knowledge about foods you may have eaten that cause problems
    • Even if you “outgrew” it
    • Could be a component of the Allergy March (atopic march)
      • Refers to allergic diseases/reactions can manifest over one’s life time for example someone can have eczema, allergic rhinitis, asthma and food allergies in any order of progression
      • The progression of allergy based conditions that transpire over years in any order and lead up to the manifestation of a serious food allergy, including anaphylaxis
  • History of eczema or skin rashes
  • Asthma (as a child or adult)
  • Allergic rhinitis or sinusitis (sinus congestion & sneezing)
    • Food is often behind environmental allergies

• Childhood allergy that you “grew out of”
  • Example: peanuts causes anaphylaxis as a child, but you “outgrew it” and now have asthma
  • Allergy is still there, just changed the way it manifested, have new symptoms when consuming peanuts (like asthma)
  • When we mature, immunology changes
    • Hyperpermeability of intestines (ability to absorb) is higher as a child, decreases as we age
    • Children absorb more & better with digestion than adults do

• Include your family history
  • List all blood relatives with known or suspected food allergies and environmental allergies.

• Have a detailed physical exam covering head to toe

To be diagnosed, request your doctor to run [20:00]

• A skin prick test
  • Stimulates to see if there is a histamine response

• A total IgE
  • To ensure you have enough IgE to test for
  • If your body is not producing enough IgE, can lead to false negatives
  • Total IgE = how much IgE you produce at any given time, you should be producing some
  • Cutoff is 187, if less than 5 means you may be IgE deficient

• IgE food allergy blood test against specific foods
  • IgE panel should be aggressive as possible, as many foods & environmental allergens as possible
  • Definitely run for the top 9 & any other suspected foods

• If something was flagged, practice an elimination diet for at least two weeks
  • Then, if symptoms are not as severe as anaphylaxis, in the presence of your physician attempt an oral food challenging
    • Eating the suspected allergen to see if it causes a direct response
  • NOT appropriate for everyone, but is definitely helpful in revealing cause and effect

What are the signs, symptoms & risk of having a food allergy? [25:15]

• Genetics/family members
• Itching in your mouth that passes when the food is swallowed
  • Histamine release occurred
• Gastrointestinal upset - could be more than a food intolerance
• Hives or skin rashes
• Anaphylaxis

Anaphylaxis  [26:30]

• Life threatening reaction to an allergen
• Negatively impact breathing and circulation
• Classically this transpires minutes after eating the offending allergen

• Rare form called biphasic anaphylaxis
  • Anaphylaxis that transpire hours or even DAYS after eating the offending food

• The pathophysiology of anaphylaxis:
  • An antigen (substance body perceives as harmful) binds to IgE
  • The antigen-antibody response stimulates immune system in negative way
    • Causes the release of cytokines Interleukin 4 (IL4), Interleukin 13 (IL13) causing a pro-inflammatory responses
    • Which stimulates other inflammatory mediators that communicate with cells to activate a type of white blood cell called a basophil
    • This causes a histamine release
    • Which increases bronchial muscle contraction and causes heart to slow - heart muscle depression

• Because of this, the symptoms of anaphylaxis include
  • Difficulty breathing
  • Reduced blood pressure leading to loss of consciousness
  • A weak pulse
  • Skin rashes, swollen lips, vomiting, diarrhea, severe intestinal pain or cramping due to histamine reaction

What is the treatment for anaphylaxis? [29:00]

• Epinephrine pen
  • Improves cardiovascular rhythm and circulation
  • Bring heart back to normal rhythm
  • Help you breathe better
  • Can counteract chemical effects of an allergic reaction
  • Does not shut off allergic reaction, but can save a life
  • EpiPen, Teva’s, Auvi-Q, Symjepi brands
• Antihistamine and/or steroid medication
• Strict food-allergy elimination diet
  • Peanuts are the ONLY one of nine major allergens to have a treatment
    • Microdosed peanuts to ignore immune response
    • Done in physician/allergist office ONLY
  • For the other 8, strict allergen avoidance is the only treatment

Can you outgrow a food allergy? [32:45]

• Very rare
• In thousands of patients, Dr. Pastore has seen 3 people “outgrew” their allergy
  • No longer testing positive for a true IGE reaction
• Most times allergy will manifest in a different way
• Symptoms will change
  • Less severe, but still have mild symptoms similar to a food intolerance
• Research shows 1 out of 4 people have an immunological reaction to food
  • Much higher for Dr. Pastore - only had 1 case of NOT reacting to a food
  • More than half of Lexie’s clients react to a food
• FARE study showed 300x increase in the past 9 years
  • Will continue to increase exponentially

• “Frankenfoods” of fake meat
  • Past episode “On New Food Technologies” https://drrobertpastore.com/podcasts/034-on-new-food-technologies
  • Soy-based
  • Highly processed & full of chemicals
  • Contain pro-allergen peptide in large quantities
    • Whole food edamame vs. extracted soy isolate protein

What did we learn from this new consumer study? [40:45]

• FARE (Food Allergy Research and Education Organization) in collaboration with
  • Northwestern University Feinberg School of Medicine
  • Ann & Robert H. Lurie Children's Hospital of Chicago
• Assessed food allergies & food allergy labelling
• Need more strict allergy-friendly packaged foods (especially for picky eater children & those with limited financial resources)
• McKinsey & co
• Consumer study showed that...
  • 85 million Americans (roughly 20%)
    • Avoid purchasing food with the top 9 allergens
    • Spend 19 billion annually on foods that clearly avoid these top 9 foods
  • 71% check food labels every time they shop and spend up to 5 minutes examining an ingredient list
    • Labelling regulations not strict, allow loopholes & trickery
  • 68% trust allergy friendly brands
    • Still be cautious & look for “certified” allergy-friendly products
    • May still be at risk for cross-contamination
  • 53% desire clearer easier to understand food allergen labeling
    • Less technical terms
    • Large pronounced wording that it contains allergens
    • Example: won’t have “milk” printed on the label but has milk ingredients
    • “Natural and artificial flavours” can contain common allergens

• Hopefully this study will catch the attention of agribusiness companies to change their labelling

• Bet on the farm, not pharma

Wrap Up [56:00]

• Be an advocate for your own health
• Talk to your family about food allergies
• Share this information with your doctor
• www.drrobertpastore.com
• help@poweronpoweroff.com
• @drrobertpastore

Speak to your doctor regarding:

• A skin prick test
  • Stimulates to see if there is a histamine response

• A total IgE
  • To ensure you have enough IgE to test for
  • If your body is not producing enough IgE, can lead to false negatives
  • Total IgE = how much IgE you produce at any given time, you should be producing some
  • Cutoff is 187, if less than 5 means you may be IgE deficient

• IgE food allergy blood test against specific foods
  • IgE panel should be aggressive as possible, as many foods & environmental allergens as possible
  • Definitely run for the top 9 & any other suspected foods

• If something was flagged, practice an elimination diet for at least two weeks
  • Then, if symptoms are not as severe as anaphylaxis, in the presence of your physician attempt an oral food challenging
    • Eating the suspected allergen to see if it causes a direct response
  • NOT appropriate for everyone, but is definitely helpful in revealing cause and effect