Food. We need it. We want it to taste delicious. And we can have just about anything today. But many of us have post-prandial disturbances: the gastrointestinal tract often reacts to substances in foods and beverages that it is not equipped biochemically to process smoothly. Hence, a range of discomforts ensue, ranging from belching to diarrhea.
So, do you have a food sensitivity or intolerance? Hold up – they are different states, and not synonymous. Before we discuss how probiotics can help promote optimal digestion in the face of potentially GI-disruptive compounds, let’s first discuss what’s the difference between a food allergy (sensitivity) and intolerance.
If you are concerned about how your digestive system reacts to certain foods and cannot identify why, we encourage you to work with your physician or GI specialist who will administer tests to identify what is “bugging” your digestive system. If you do indeed have an allergy, this can be potentially serious and your physician will give you a dietary protocol and treatment plan.
What’s the Difference Between Food Allergy and Food Intolerance?
Several symptoms of food allergies (sensitivities) and intolerance are the same – notably, discomfort such as bloating, gas, diarrhea, nausea and cramping. However, the distinction is clear because a food allergy induces a reaction of the immune system while an intolerance does not involve your immunity. A sensitivity or allergy to a food or beverage can not only involve digestive issues but affect respiratory tract (cough) and skin (such as a rash or hives), and more serious cases can involve the cardiovascular system.
Conversely, a food intolerance is restricted primarily to the GI system, and these annoyances tend to take longer to emerge than symptoms of a food allergy. Additionally, if you have an intolerance to a food you can still eat a small amount of it without incurring any issues. And if you want to be able to eat that food without the symptoms (because often people have intolerances to foods they enjoy eating), you can take some dietary supplements to help curtail the reaction, such as a lactase enzyme for any milk or dairy product (tres leches cake, anyone?), or alpha-galactosidase (such as Beano®) for that delicious chili with beans. However, for instance, if you have a peanut allergy, you cannot consume any food containing peanuts, and if a food or even a utensil had come into contact with a peanut, this can cause a dangerous allergy.
According to a published scientific review of food intolerance diagnosis, most cases of food intolerance between 15% and 20% -- stem from non-immunological causes, ranging from chronic infections to psychosomatic reactions to enzymopathies. In contrast, the prevalence of authentic food allergy, i.e., immunologically mediated intolerance reactions, is only between 2% and 5%.
What Causes Food Intolerances?
There are several primary causes of food intolerances, and some are rather transitory, such as periods of stress, which causes biochemical cascades that may interfere with digestion and which will amplify any lesser-intensity intolerances you may already have.
However, the lack of sufficient enzymes is a key culprit. For example, intolerance to the sugar, lactose, found in milk. Lactose is a combination of two substances – glucose and galactose – and your body needs to send in lactase (an enzyme) to cleave the glucose from the galactose for digestion and absorption. When lactase is not present to perform this action, the fully formed glucose pulls water from cells in the gut. This then causes increased peristalsis (the rhythmic movement of the intestine that results in excretion). The unabsorbed and intact lactose continues its journey and becomes food for various bacteria in the lower gut. When bacteria eat the lactose, they release gas, causing you to have gas and often cramps.
Similar reactions occur with the lack of other digestive enzymes, such as the absence of low availability of lipase, which digests fats. Undigested fats cause steatorrhea, or oily stool, which contains undigested takes fat-soluble vitamins.
Inability to digest certain proteins lead to food intolerances as well. The best known example is gluten, a protein naturally occurring in wheat and other grains. More recently, attention has been paid to how a cow’s milk beta-casein protein, A1, is often the cause of what many individuals think is lactose intolerance but is the A1 protein intolerance. Undigested proteins can damage the lining of the intestines, causing a condition called leaky gut. Here too, enzymes can be the cause – specifically lack of efficient proteases and peptidases, which break down proteins.
Other intolerances stem from additives in packaged, processed, foods such as sulfites, a class of phytochemicals called amines found in some cheeses, caffeine in chocolates, tea and coffee; and salicylates that occur in many fruits, vegetables, spices, herbs and teas. Additionally, histamine, which we typically think of from spring flowers, are found in mushrooms, pickles and cured foods, can trigger an intolerance.
How do Probiotics Help Ease Food Intolerance?
If you notice you have annoying GI issues after consuming a type of food or beverage – and your physician clears you of any allergies – you can do several things to help your body improve its tolerance toward that substance.
First, cut out any unhealthy habits and foods, and with the guidance of your physician, you may want to try an internal cleanse and detox program.
Second, identify and eliminate or reduce any stressors in your life. The gut-brain axis is often irritated by stress, which results in gastric disturbances and symptoms that may mask as intolerances.
Third, work with your physician or nutritionist to determine if you if you have any enzymopathies and take the appropriate dietary enzymes.
Fourth, add probiotics to your daily supplement regimen. One research team concluded that the potential of specific probiotic strains to lessen food sensitivities lies in their capability of modifying antigens, as well as repairing gut barrier function, and improving the healthy balance of the microbiota, thus restoring local and systemic immune regulation.
Another study found that modulation of commensal of the gut with probiotics has been shown to modulate the immune system and thus have a beneficial effect on reducing incidence and symptomatic intensity of food sensitivities. (Commensal describes the association between bacteria where one bacterium derives benefit from the other.)
Specific probiotic strains may work to reduce certain food sensitivities and intolerances. For example, if you are sensitive to fermented foods (including wine), likely the culprit is a set of chemicals called biogenic amines (as mentioned earlier). One study found that two strains of Lactobacillus plantarum were able to degrade several types of amines (putrescine and tyramine).
If you find out you have an intolerance to histamine (a type of amine) (fermented foods and cured meats such as sausage and salami), certain strains of probiotics are beneficial – L. gasseri, L. salivarius, L. rhamnosus GG, L. plantarum, Bifidobacterium infantis, B. breve, B. bifidum, B. longum, and B. lactis. Conversely, you will want to avoid the following probiotics – L. casei, L. bulgaricus, L. thermophilus, and L. helveticus.
If you are dealing with insufficient digestive enzyme (enzymopathy) such as lactose intolerance, for example, a more recent study illuminated the beneficial relationship between beta-galactosidase activity and the administration of probiotics to reduce lactose intolerance. Lactose intolerance is one of the most prevalent food intolerances, with up to 60% of the human population unable to properly digest lactose because of insufficient lactase; one systematic review of 15 randomized double-blind studies showed that eight probiotic strains showed positive action in this area.
More than ever, we live to eat – and following an optimal nutrient-dense diet no longer requires sacrificing the experience of enjoying food. With the increasing options of healthier-for-you, plant-based foods and beverages, many fortified with nutraceuticals and probiotics, we can all regain balance and well-being. Even so, when you discover you have a food intolerance or sensitivity, you can “eat around” it and taking probiotics will help support improvement in sensitivity resistance, as well as overall healthy GI function.