Immune Complex Food Sensitivity

These occur when antibodies attack allergens but don't manage to kill them. The result is an allergen (called an antigen) with an antibody stuck to it. This creates a whole new animal (an antigen-antibody complex) that the body doesn't recognize. When this happens, the 'new animal' starts circulating around the body, and this circulatory immune complex, or CIC, can eventually lodge in tissue.

CICs create many of the same reactions as classic allergies. When they circulate through or lodge in tissues, such as those of the kidneys, lungs, liver, or joints, they can cause terrible problems by starting immune and inflammatory responses. They can cause joint problems similar to arthritis, and they can cause organs to malfunction. They often interfere with the body's filtering mechanisms, such as the lymphatic system and kidneys. Some researchers believe they contribute to many types of kidney disease, some of which are eventually fatal.

Sometimes, people with serious CIC problems experience widespread conditions — such as migraines, kidney problems, and joint pain — and never realize that all of these problems have a single cause.

Frequently, patients come to me hoping only to lose weight, but when they resolve problems such as excessive CIC production, they also overcome other serious health conditions. One recent patient, for example, not only lost 22 pounds but also recovered from chronic joint pain, migraines, and gallbladder inflammation. This patient was happy to lose her weight, but was overjoyed to solve the other problems. Of course she had to make a serious commitment to her health and change her lifestyle. But she enjoyed the whole process, because she felt so much better every step of the way.

This reinforced my belief in the adage, 'If you just strive for thin, you'll never win. Strive for health, and thin will follow.'

Now you know about the risk factors that make you vulnerable to food reactions, and you know how food reactions work. Good for you! You now have more knowledge about this subject than many doctors do.

Now that you have a good foundation of knowledge, you'll be able to understand why food reactions cause bloating and swelling. Once you understand this, you need never again be a victim of false fat.

Overweight and Food Sensitivity Rule No 1: Delayed Reactions

These are the single most common cause of false fat.

Arguably, delayed food reactions cause as many health problems as some of the most horrific of life's various risk factors, such as smoking or stress. The effects are often subtle and accumulate slowly, but the harm is undeniable. Without a doubt, delayed food reactions cause weight gain. Because 300,000 people die each year from obesity-related problems, anything that exacerbates weight gain is a serious issue.

Therefore, the average person's ignorance about delayed food reactions is a serious public health problem. Don't let yourself be a victim of this lack of knowledge!

Delayed food reactions are very similar to classic allergies. The biggest difference is that when you have sensitivities, you often don't notice symptoms right after you eat. Sometimes it can take as long as three days for symptoms to appear. The reason for the delay is that this type of food reaction is caused by a different antibody than the one that causes classic food allergies, and it takes longer for allergens to come in contact with this antibody. This antibody, IgG (or immunoglobulin G), is found only in the bloodstream, so food molecules need to reach the-bloodstream for problems to occur. As long as food macromolecules stay in the digestive tract, no symptoms may appear. Sometimes food molecules move out of the digestive tract almost immediately, but sometimes they don't.

When reactive food macromolecules do eventually meet up with IgG antibodies, the antibodies wage the same basic type of battle fought by IgE antibodies, which cause classic allergies. The IgG antibodies call the immune system into the fight, and histamines and other chemicals are released, causing swelling and other symptoms.

The IgG antibodies are by far the most common antibodies in the body. They're three times more common than the IgE antibodies that cause classic allergies; that's one reason delayed food reactions are more common than classic allergies.

Because IgG reactions are delayed, people are often unaware of their real cause. If you feel a symptom on Monday morning, it may be hard to link it to something you ate Friday night.

Another reason people are often unaware of their IgG reactions is that these reactions often don't occur in obvious places, such as the skin, as do classic IgE allergies.

Even though an IgG reaction may not be obvious, it can still be very harmful. For example, if you're allergic to bee stings and get an IgE reaction on your skin from a sting, you'll be sure to notice and treat it. However, an internal IgG reaction to a food may ultimately cause you much more generalized, systemic swelling than a bee sting; it's like getting a bee sting to the whole body. But because your reaction is spread over your whole body, you may not be very aware of it. All you'll notice is that you don't feel good and have more bloating and swelling. After you've read this book, though, and learned what to look for, I guarantee that you will notice how drastically food reactions affect your body.

Another antibody that can cause delayed reactions is IgA. IgA fights at the front lines — at the mucous membrane sites and in the digestive tract itself — trying to stop allergens from being absorbed by the body in the first place. To do this, it stimulates secretion of mucus, which blocks absorption.

Studies show, though, that almost half of all Americans don't secrete enough IgA. Non-reactive people secrete 3,000 to 5,000 mg of IgA every day, but some reactive people don't secrete much at all. If you're low on IgA, sooner or later a reactive food molecule will work its way through your intestinal wall and cause a reaction. The more reactive foods you eat, the more likely you'll be to use up your supply of IgA and lose your front-line force against food reactions.

Therefore, if you do 'cheat' and eat an allergenic food, it's smart not to eat too much of the food. One jam doughnut might get blocked by IgA, but three doughnuts may overwhelm your forces and push you past your allergic threshold.

Another factor that depletes IgA is use of certain medications, including antibiotics, antacids, ulcer drugs, cortisone and aspirin. Again, as you can see, it's not just what you eat that can hurt your metabolism and make you fat.

Why you will lose false fat

Donna didn't look fat, at least not in the leggings and long sweater she was wearing as she entered my office. Her legs looked slender and fit, and her sweater hid the rest. But she felt fat.

`I've got a guy's type of weight problem,' she said as she sat down. She was animated and energetic, but obviously frustrated. 'Women are supposed to collect fat in their hips and thighs — aren't they? — but mine sticks right here.' She patted her stomach. When she was sitting, I could see that it bulged, even under the thick sweater. 'I hardly ever overeat,' she said, `but since I've hit 40, I get no forgiveness from my body. It's like my metabolism took early retirement. I take two bites and I can feel the fat cells around my waist start to expand. Literally. I pinch my love handles, and they're thicker before I even get up from the table.' She looked at me expectantly, as if I might not believe her. 'My last doctor,' she said with a sour look, 'told me there's no way that food could make me fat that fast. But I can feel it happening.' Again, she searched my face for reassurance. She had an upbeat personality, but she was almost ready to give up. She ate carefully, exercised hard, and still carried 20 extra pounds.

`It's not your imagination,' I said. 'That feeling of instant weight gain happens to a lot of people. But it's not fat you're gaining. It's fluid retention and bloating, and you're probably getting it from food reactions. A lot of the swelling and bloating from food reactions occurs directly in and around the gut.

That's why you feel it in your midsection right away.'

`If it's not fat,' she said, 'why doesn't it leave as fast as it comes? I look like this almost all the time.'

`Your biochemistry won't allow it to go away, because your body is trying to protect you. When you eat reactive foods, your body sees them as foreign substances, almost as poisons, and it goes all out to protect you. It can take two to three days to stop reacting to some foods.'

Tut it's not like I eat junk. I'm an old-time you-are-what you-eat type. I was eating granola before they even had a name for it.' She smiled, but I could see she felt cheated. For many years, she'd followed all the rules — but the rules had been wrong.

`People can become reactive to healthy foods,' I said, 'even granola, if you eat it all the time. Do you eat a lot of non-fat and artificially sweetened foods?'

`Now that my metabolism has slowed down, I've got to.'

`I hate to say it, but some of those "lite" foods may be doing you more harm than good. If you're reactive to a food, it can be virtually calorie-free and still make you gain weight. Even diet soda can cause bloating and swelling.' She looked surprised. Most people these days are so accustomed to counting calories and fat grams — the quantity of their food — that they forget about the importance of quality.

`I don't think you're eating too many calories,' I said. 'And I don't think your age is the real problem. Your metabolism is slowing down just 5 per cent every decade, and that's not enough to cause what you're experiencing. I think you've just developed some food reactions over a long period of time. When you resolve them, you'll lost your weight.'

Tut I was tested for allergies and they didn't find any.' `Did they explain that not all food reactions are allergies?' I asked.

`No.'

I wasn't surprised. Most doctors don't really understand food reactions. They usually have an all-or-nothing attitude; they think that you either have a classic food allergy, with hives and wheezing, or you have nothing at all.

I gave Donna a brief rundown on how food reactions work and how they cause bloating and swelling. I explained it out of respect for her. Some doctors think it's acceptable to tell patients what to do, without telling them why, but I object to that approach. If patients are willing to change their lives by taking my advice, they deserve to know exactly why these changes will help.

As I gave all the details to Donna, she listened attentively and took notes. Over the next few weeks, she eliminated her false fat foods — one of which was oats, a primary ingredient in most granola — and dropped about 15 pounds.

Now I'll give you the details on how food reactions get started. Then we'll look at how they cause bloating and swelling.

If you're going to make changes in your life, you deserve to know exactly what's going on.

I'm sure some of this information will hit home. Often, when I tell patients about food reactions, they say, 'That's me you're describing.'

Underweight — the other side of the coin

It was Coco Chanel who once said that you can never be too thin or too rich, but she was undoubtedly wrong on at least the first count! The belief that the thinner an individual is, the better, is in fact a dangerous misconception, because research has shown that just as mortality rises along with weight, it also rises with excessive decrease in weight. It is therefore essential to prevent unnecessary weight loss and to be realistic about one's optimal weight for height.

In our society with its ideals of unrealistic thinness, the problem of underweight is often not taken seriously, yet it can cause as much distress as its opposite. The basic cause of underweight is an inadequate energy intake and/or excessive burning up of energy. People who suffer from it are generally very active, tense or nervous get very little rest, smoke, or eat poorly and irregularly. It can of course also affect those whose food intake is low and energy expenditure high due to illness, fever, gastro-intestinal disturbances, cancer or hormonal imbalances.

In recent years, however, there has been an alarming increase in an entirely different cause of excessive thinness, namely self-induced starvation and purging (laxative abuse, vomiting). Otherwise known as anorexia nervosa and bulimia, these serious eating disorders are confined almost exclusively to adolescent girls and young women.

Many researchers maintain that the incidence of eating disorders has increased significantly over the past two decades. Anorexia nervosa used to be a relatively rare condition, but is now said to occur at a rate of one new case per year for every 100-200 middle- and upper-class adolescent and young adult women (between 0,5 and 4% of the population). The incidence of bulimia is estimated to be somewhat higher (5-19%). Anorexia nervosa occurs throughout adolescence and young adulthood with peaks in early adolescence (12-13 year olds) and at about 18 years old. Bulimia sometimes appears as a complication of anorexia nervosa (also called bulimia nervosa) in middle adolescence, or as an isolated phenomenon during adolescence or young adulthood.

Anorexia nervosa

The American Psychiatric Association has defined the following criteria for the diagnosis of anorexia nervosa:

• Refusal to maintain a body weight which is above a minimal normal weight for age and height - for example, weight loss or failure to gain; weight during a period of growth, resulting in a maintained body weight which is 15% below normal.
• Intense fear of gaining weight or becoming fat, even though underweight.
• Disturbances in the way in which one's body weight, size or shape is perceived; for example, the person claims to feel fat even when emaciated or believes that one area of the body is too fat even when obviously underweight.
• In females, absence of at least three consecutive menstural cycles when there is no other underlying cause.

Bulimia nervosa

Criteria for the diagnosis of bulimia have been defined as:

• Recurrent episodes of binge-eating (rapid consumption of a large amount of food in a short period of time).
• A feeling of lack of control over eating behaviour during the eating binges.
• Regular self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, or vigorous exercise, in order to prevent weight gain.
• A minimum average of two bingeing episodes a week over a period of at least three months.
• Persistent over-concern with body shape.

What is true food allergy?

It is important to stress at the outset that contrary to popular belief, true food allergy is not very common. Actual figures for the number of people affected are difficult to estimate, but in general it is thought that no more than between 1 and 4% of the population suffers from a definite food allergy. Interestingly, true food allergies are usually (but not always) seen in people who also have one of the other common allergic conditions, such as hay fever or asthma. Obviously many more than 4% of the population think that they have a food allergy but several careful studies suggest that as many as half of these patients have no allergic symptoms at all. However, they are often so firmly convinced of their allergy that it is difficult for a doctor to persuade them otherwise.

So how do we pinpoint true food allergy? To begin with, we have to look carefully at the mechanisms and symptoms involved.

How do food allergies work?

Studies of food allergy and food intolerance have always been linked and until recently, most attempts to find out how they worked concentrated on the immune system. The root cause of classical or true allergies - including those to food - is the production of Immunoglobulin-E (IgE) antibodies to the offending molecule or allergen (a substance which causes an allergic reaction). IgE is an antibody which normally does the job of protecting the body against parasite infestation, but in allergic people this mechanism has gone awry. When this happens, instead of having a protective role like that of other antibodies, IgE may produce harmful effects in the body. Abnormal amounts of it are produced in response to protein substances which are completely harmless to non-allergic people. IgE binds to cells rich in chemical substances, known as 'mast' cells.

Once an allergen reacts with the IgE molecule, a complex set of biochemical reactions is set in motion and as a result potent chemicals ⁴such as histamine, serotonin and prostaglandins are released into the body. These are what cause the intense itching, swelling and inflammation. A more serious effect occurs when really large amounts of these chemicals are released. They enter the circulation system,causing capillaries to enlarge and become more permeable, which in turn results in a drop in blood pressure. This reaction - known as anaphylaxis - may be fatal. Laboratory tests in people who have true food allergy show high levels of IgE, but this is not the case in food intolerance. In fact, the involvement of IgE is what makes the crucial distinction between the two.

The specific area where IgE is important is in the wall of the digestive tract. When an allergic person eats an offending food it could combine with IgE in the tract and set off local inflammation, which in turn makes the wall of the tract more permeable and allows undigested food molecules to get through. Once absorbed, these molecules can cause a whole range of symptoms.

Several recent studies have shown that patients with food allergy tend to have 'leakier' digestive tracts than do healthy people, although this is not always the case. When food molecules do enter the blood they usually form what are termed 'circulating immune complexes' (CICs) with antibodies. These CICs may cause inflammation and could account for the joint pains and migraine which some patients sufferfrom.

IgE and CICs are not the only immune pathways involved in food allergy. Another possible mechanism is via lymphokines' or `cytokines', which are hormone-like substances that form a communication link between different cells in the immune system. In the case of food allergy, an abnormal immune response to food molecules could lead to the release of lymphokines, followed by unpleasant symptoms such as headache, lethargy, dizziness, joint pains and nausea. Other factors, such as the incomplete digestion of particular food proteins, or certain enzyme deficiencies, may also be relevant in allergic people.

Experts believe that at least two of the defects mentioned above, plus certain environmental triggers, are necessary for the symptoms of food allergy to appear. In other words, the theory is that a combination of several factors could be responsible. If this is so, it could explain why no two victims of food allergy seem to have the same symptoms.