Elimination diets, the "factory of anaphylaxis"?

In an article on Medline, the authors suggest that

widespread and uncontrolled use of elimination diets for atopic dermatitis may have played a role in the increase of allergy and anaphylaxis.

They are talking especially about children with allergy problems. 

The treatment has been avoidance of the foods responsible, once they're identified. 

But the authors think food avoidance may be part of the reason why so many people these days have allergies!  They call elimination diets the "factory of anaphylaxis". 

When someone stops eating a food they're allergic to, they become more sensitive to the food.  There are ways the body tries to combat a food allergy, when someone is eating the food.  Those methods don't work perfectly, but they work somewhat. 

Food allergies are maladaptive, because people need food to survive.  They can be life-threatening.  So people's bodies have evolved to try to correct a food allergy.  But those ways require that the body is exposed to the allergenic food. 

So that raises the question, do the body's attempts to correct a food allergy, tend to suppress allergic reactions in general - inhalant allergies, allergies to other foods?

When food antigens get past the intestinal epithelial barrier, cytokines IL-10 and TGF-beta are generated that downregulate immune reactions.  Having a "leaky gut" - i.e. a leaky intestinal epithelial barrier - actually may enhance the immune downregulation. 

This process can go wrong so that eating an allergenic food actually increases the immune reaction - causing a vicious circle so a new food allergy develops. 

You may have heard of "masked food allergies".  The idea is that people can be profoundly affected, emotionally and physically, by food allergies that "hidden", so that they don't have obvious symptoms after eating the food. 

The way one finds the "masked food allergies" is to eliminate the food and other allergenic foods for a week or so.  Then one tries the foods that have been eliminated one by one, to see if a reaction happens.  During the elimination diet, the body stops doing whatever it was doing to suppress the food reaction - so food reactions are much stronger and more noticeable. 

This tells one about food allergies that have started that the body is trying to combat. 

Even though the body tries to combat these food allergies, they can have severe bad effects.  And when one stops eating the food, it can be extremely helpful.  I experienced that in a huge way after I quit gluten and various other foods. 

But I have been asking myself recently, did completely quitting those foods that made me sick after doing an elimination diet, actually leave my immune system in an up-regulated state? 

I live mostly on an exotic-foods diet.  I'm not allergic to only four foods that I ate at all often before I went gluten-free:  lettuce, radishes, vanilla and mint!  So I did this quitting-foods process to an extreme extent. 

The papers I've cited seem to suggest that it's a bad idea to totally exclude a huge number of foods as I did.

And perhaps, excluding foods at all is a bad idea.  Oral immunotherapy - eating small amounts of foods one is allergic to - has been found to be helpful even for dangerous food allergies that can cause anaphylaxis.

Oral immunotherapy isn't yet a part of allergists' repertoires. 

But I've been trying a kind of oral immunotherapy for myself.  This isn't a good idea for people who have dangerous symptoms, but allergists have never thought my kind of food reactions were dangerous.  The allergist I see in NYC, actually suggested that with oral cromolyn, I might be able to reintroduce the foods I have these allergies to, into my diet. 

Using oral cromolyn, plus the allergy meds Singulair and loratadine, I found I can eat about 10 mg of foods I'm allergic to.  I still have a reaction, but so far, the reaction has faded away after a month or so.

I eat any given food only once every 4 days, because in the past I've found this helped me to avoid developing new food allergies.  In the past, eating even a small amount of a food every day has sometimes created a new allergy to that food.  It activated that vicious circle I mentioned above. 

Patients tend to be more paranoid about food allergies than doctors are.  Avoiding foods, labeling them "bad", doing elaborate precautions to avoid even traces of the food, is similar to a paranoid or obsessive-compulsive disorder.  It engages negative parts of the mind.  I don't say it IS a mental disorder, because there's a real physical reason for it - but it means behaving as if one had a mental disorder.  

So encouraging tolerance of foods seems psychologically healthy as well as hopefully good for my immune system. 

I have been trying this for some of my inhalant allergies, too.  I've been eating tiny amounts of dog allergen.  I asked a friend to rub a piece of towel that I sent him on his dog, and mail it back to me.  I've been eating about 1/8" of thread from this towel, with only a microgram or so of dog allergen (!) once every 4 days.  I've been doing this for a month.  At first, it made me sick for about 2 days, but recently the reaction has gotten less intense, and I'm optimistic that this will help me a lot with my dog allergy!

This may not work for people with less severe inhalant allergies, because the allergen gets digested by stomach acid.  But since I do have reactions, I think it will work for me. 

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Comment by Luara on March 9, 2014 at 7:10am

In the USA, 77% of mothers start out breastfeeding, but only 38% are exclusively breastfeeding at 3 months.  So many mothers are skimping on breastfeeding.  I guess formula is more convenient than using a breast pump.

So this could indeed be part of the cause of the allergy problem. 

 Working mothers could use a breast pump, and save the milk for later.  In one place I worked, there was a lounge area with a door, and a new mother there used the lounge to extract breast milk.  But maybe this isn't possible at many workplaces. 

Comment by Michael Penn on March 7, 2014 at 10:16am

Your "breastfeeding and mixed feeding" is likely a good citing, but to my knowledge most children today are formula fed. Every time we here of a new baby born, and actually visit the family we know who has the baby, we find that baby formula fed. My 2 daughters are in their 40's but were formula babies. Perhaps today the trend is more for going back to breastfeeding if possible. (Not sure.) If so, I would op for the breastfed baby to be the more healthy baby all the way around.

Comment by Luara on March 6, 2014 at 7:32am

There was a time when it was out of fashion, when babies were fed on formula - including the infamous Nestle scam in Africa - but are babies still often fed on formula?

Comment by Luara on March 6, 2014 at 7:31am

According to the article I cited,

Exclusive breastfeeding for 4 months and mixed feeding thereafter will probably promote tolerance to food allergens in newborns.

Exclusive breastfeeding up to the age of at least 4 months seems to have an allergy-preventive effect both in families with or without a predisposition to allergy.  Moreover, to avoid IgE sensitization and food allergy, it seems to be favorable to introduce nutritionally adequate, safe and appropriate complementary foods at around 4 months of age with maintained breastfeeding for at least 2 more months.

Comment by Michael Penn on March 6, 2014 at 6:52am

The breast feeding idea would help to set the child's immune system to handle anything that the mother's system was used to. Just my opinion, but I'm thinking this would work sort of like polio or smallpox vaccinations work. Modern medicine has forgotten such ideas that nature intended and introduced formula instead. Some mothers need to feed using formula. A lot of mothers can breast feed naturally. In America ignorant people seem to think that sucking on a breast will cause it to lose shape, so to the "in mother" breast feeding is "out."

Comment by Luara on March 6, 2014 at 6:34am

include a lack of proper mother and child bonding with the child getting his nourishment from mother's milk, therefore setting his immunities to various allergens.

Is there evidence that breastfeeding helps prevent allergies?  That isn't something I've looked into. 

One of the articles I cited does say that there has been a myth that allergies can be prevented by delaying the introduction of major allergens (including cow's milk) into the child's diet.  In fact it seems that introducing major allergens early can help prevent allergies.  It trains the immune system to cope with allergens. 

Comment by Michael Penn on March 5, 2014 at 3:47pm

I might add that people make their allergies worse by entirely quitting foods they are used to, and this would appear ( to me at least ) to include a lack of proper mother and child bonding with the child getting his nourishment from mother's milk, therefore setting his immunities to various allergens. This process has been altered by modern civilization. Mother's milk today is a man-made formula.

It may be true that not every mother could make milk for her baby enough to where the baby could survive. The answer would be to help the mother in that case. Not to eliminate nursing and  make every child take formula.

Comment by Michael Penn on March 5, 2014 at 3:36pm

I believe that you are very correct, but there has to be a common denominator in processing and preserving food long enough to be processed in the first place. There is a fine line between the two ideas.

Comment by Luara on March 5, 2014 at 1:41pm

I've always thought that a lot of our allergies ... are in how food is processed. It has to do with preserrvatives and additives they allow in our food.

Why do you think this?

Research doesn't support this idea so far as I know. 

The idea I mentioned - that people make their allergies worse if they entirely quit eating foods they're allergic to - is supported by what researchers have learned about how the immune system works. 

Comment by Michael Penn on March 5, 2014 at 11:58am

I've always thought that a lot of our allergies and medical problems are in how food is processed. It has to do with preserrvatives and additives they allow in our food.

In my view consumer products should come from our own areas as much as possible. Doing so would lessen chemicals used in our products. Enter the businessman from many states away who wants to make money dealing in a certain product. Going this route only adds chemicals again to the product so chance of spoilage and alergens will now increase. This entire handling process only makes medical situations increase and puts more people at risk.

Now we take this global and look at what we have. Vegetables and other food from South America and all over the world right here in the USA supermarket. I'm surprised that nobody is figuring this out. They just add more chemicals to prevent spoilage and do business as usual.

It's no wonder we can't cure cancer, or get rid of food allergies, but without this process we probably could not even feed ourselves.

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