Food sensitivities can be a contributing factor, and sometimes even at the root, of several symptoms and conditions that are commonly seen in practice. The gold standard for identifying food sensitivities, and a stepping stone in the healing of these symptoms on a systemic level, is the elimination diet. The elimination diet, already an integral part of any functional nutrition arsenal, has more clinical indications than previously thought. Clients that present with joint pain, skin issues and digestive complaints are the obvious candidates for food sensitivities- but less common conditions that can clinically benefit from the elimination diet are migraines, asthma, fibromyalgia.
The connection between migraines and food sensitivities has been around since the 1970’s and continues to be validated by new research today. Both the IgG immune response from food sensitivities and the non-immunological response from certain foods can trigger the onset of a migraine.
Individuals with migraines have been shown to have a high IgG reaction to certain foods, and the research shows that migraine sufferers tend to have more than one food sensitivity.
In addition to certain food groups, food additives such as monosodium glutamate, nitrates/nitrites, aspartame and yellow dye number 6 have been linked to migraine onset.
The food categories with highest correlation to migraine headaches are wheat, cheese, cow’s milk, oranges and eggs. Through the use of elimination diets, the research shows a 75-85% improvement in migraines -in both frequency and intensity.
The Takeaway: There is likely a food sensitivity component in the pathogenesis of migraines for a large percent of individuals. Aside from food sensitivities, other dietary factors such as food additives, which are also omitted via a standard elimination diet, can also trigger migraines.
Dive Deeper: PMID: 31456119, PMID:30224869, PMID:32503158
The relationship between true food allergies (IgE mediated) and asthma is clear. What is missing from the conversation is the role of IgG mediated food sensitivities in asthma.
What we are seeing is that food sensitivities such as eggs, peanuts, wheat, shellfish and sesame can contribute to asthmatic symptoms. Elimination diets have been used successfully in both adults and children with asthma. When it comes down to the why, this is because food sensitives upregulate TH2 immunity, which is already favored in asthma. Reducing food sensitivities can help to bring TH1 and TH2 immunity back into balance. We also know that asthma is by nature an inflammatory condition. Reducing the systemic inflammation that is associated with food sensitivities is another proposed mechanism of action through which the elimination diet can be used as a therapeutic tool.
In addition, there is evidence suggesting a strong connection between histamine intolerance and asthma. While not part of a traditional elimination diet, the histamine diet is an extension of the traditional elimination diet and when compounded together can help to manage asthma.
The Takeaway: While food allergies are associated with asthma, looking to food sensitivities and reducing them can provide a therapeutic advantage in asthma management.
Dive Deeper: PMID: 33815958, PMID:33167542, PMID: 15067979
Food sensitivities can cause or increase various symptoms of fibromyalgia such as pain and fatigue. Unlike migraines, the science on the role that food sensitivities play in the pathogenesis and disease processes isn’t well defined in the research. However, the impact of diet as a whole has been evaluated, pointing to food sensitivities not as a root cause, but as a contributing factor to fibromyalgia.
What we know
There is a strong connection between non-celiac gluten sensitivity and the severity and incidence of fibromyalgia flare ups. There is also significant evidence that shows the inflammatory nature of food sensitivities affects the nociceptors, which contributes to pain.
Some evidence suggests that following a low FODMAP diet can improve symptoms, but from a clinical perspective that has not been met by research yet- we are seeing that an elimination diet has the potential to catalyze the healing process. In terms of diet, the elimination diet is likely the best intervention for clinical management of fibromyalgia.
The Takeaway: Determining food sensitivities via the elimination diet is something that to consider in clients who have been diagnosed with fibromyalgia.
Dive Deeper: PMID: 25047419, PMID:32825400
The elimination diet is the gold standard of food sensitivity identification and is useful in the management and treatment of several conditions. The caveat is that it requires a lot of efficient communication from practitioner to client. It also requires a level of support not seen in other protocols. At Fiore, we are big proponents of the elimination diet and have used it to manage many cases. Check out our mini course which teaches you how to properly set up and execute an efficient elimination diet that helps get your clients feel their best.
Author: Lisa Kowalyk, Co-Founder Fiore Health