• Alison Acerra MS, RDN

Food-Service Approaches to Food Sensitivities

Updated: May 2, 2019

Everywhere we look these days, we can find gluten-free this, dairy-free that. Gluten in particular has replaced fat from the 80’s and carbs from the 90’s as the thing to loathe in the 2010’s. A 2017 report showed that the global gluten-free food market value is projected to rise from 4.26 to 7.38 billion, a nearly 73% increase by 2021. There are plenty who have gotten on the gluten-free bandwagon for reasons that aren’t entirely clear; this classic Jimmy Kimmel episode is a comedic portrayal of the confusion and misinformation that surrounds it.

And yet there are others who are avoiding gluten because including it would put their health at real risk, namely those who carry a diagnosis of celiac disease. But what about all the others who include gluten-containing foods followed by a cascade of undesirable symptoms that simply put, make life suck? According to the group BeyondCeliac.Org, research estimates that 18 million Americans have gluten sensitivity, which is 6 times the amount of Americans who have celiac disease. This condition is now referred to as Non-Celiac Gluten Sensitivity (NCGS) and can manifest as stomach pain, gas, bloating, itching, skin irritation and cognitive changes including mood disturbances and... brain fog.

My Path to Answers

I'm not quite sure when my struggle with brain fog started. At its worst, I was unable to focus, simple tasks were frustratingly not so simple and my exhaustion was at times, paralyzing. For me, the afternoon slump was real. I chalked it up to circadian rhythms and tried my best to shrug it off by walking laps around my office, thinking by getting some more blood circulation to my brain, I would meel better. I didn’t. Active, fit and following a diet balanced with enough protein, quality carbs, healthy oils and plenty of fruits and veggies, I was doing all the “right” things. But it was clear something was most definitely not right.

My research led me to a practitioner specializing in GI health who helped me find the root cause of my digestive issues by way of thorough testing. Stool tests searching for parasites and signs of nutrient malabsorption, extensive blood work and an elimination diet revealed some issues - all caused by some very real food sensitivities. I was about to become #glutenfreeforever.

Food Allergies and Sensitivities On the Rise

It’s easy to confuse a food allergy with a sensitivity. An allergic reaction is the immune system’s response to an offending food of which it perceives as dangerous. Symptoms can be as mild as a skin irritation, or in the case of anaphylactic shock, even deadly. Food sensitivities on the other hand are not an immune system response but a problem digesting the offending food. While not life threatening they can seriously impact quality of life.

My own (abnormal) sensitivity to certain foods is becoming the new normal. Food allergies and intolerances are increasingly prevalent and gluten isn’t the only offender. Between 1997 and 2011, food allergies increased by 18 percent in American children. Similarly, a study by Gupta et al suggests, “tree nut allergy in adults has risen to 1.8 percent from a 2008 estimate of .5 percent, an increase of 260 percent.”

“All Disease Begins in the Gut”

It was Hippocrates who said, “all disease begins in the gut” and more science is now available to support his assertion. Our entire body, and particularly our GI systems are inhabited by trillions of bacteria, referred to as our microbiome. This community of microbes is responsible for the functionality of many metabolic processes and protection from harmful pathogens while offering up immune system support. All this is to say that (whether directly or indirectly) these microscopic organisms impact nearly every single physiological function in the body! More than 1000 species of bacteria (both good and bad!) inhabit healthy adult humans. While there is still much mystery and unknown about the inner workings of these microbes, scientists are beginning to realize the impact they have on autoimmune conditions, metabolic disease (such as obesity and diabetes) and cognitive health. The gut microbiome is now commonly referred to as the “new frontier in medicine.”

While the causes for the dramatic rise in food allergies and sensitivities is not entirely clear, experts are pointing to imbalances in the gut microbiome as playing a key role in their development. Antibiotic use, especially during pregnancy and in early childhood could disrupt the balance of bacteria and the immune system. A diet rich in processed foods and added salt, sugar and fat while limited in whole, plant based foods like fruits and vegetables may lead to a chronic state of inflammation over time resulting in a degradation of the intestinal wall of the GI tract. This diet pattern is also not conducive for healthy bacteria to thrive and populate the gut in healthy numbers.

Food Sensitivities - How Can Food-service Operators Help?

Consumers seeking out food producers, markets and restaurants that cater to their specific food preferences is a trend that is here to stay. The food industry can respond to demand for safe food options (which goes way beyond offering gluten-free granola bars)! These solutions can help relieve anxiety these diners face every time they eat out. Operators will find it good for business through increased revenue generated by satisfying an important consumer need while minimizing risk for lawsuits due to health complications.

1. Put in place a menu management system that can ensure accurate allergen and ingredient labelling by linking ingredients with detailed supplier information.

2. Offer customizable options and give consumers the ability to modify dishes or “build their own.” While this can be more difficult to scale for high volume operations, consumers may be willing to spend the extra time waiting for a meal that suits their needs perfectly.

3. Develop standard operating procedures for managing food allergies at all steps in the food handling process. Ensure staff are 1. well-trained on accurate menu labelling and strategies to minimize cross contact and 2. equipped to handle customer questions.

4. Be sure to offer plenty of fresh, wholesome plant-based options more often than processed ones - these are the foods more likely to serve consumers well in health (and digestion)!

Beyond these approaches, contact us at Strategic Nutrition Design to learn how we can help you approach this complex topic in a way that makes sense for your operations.

Alison Acerra MS, RDN founded Strategic Nutrition Design, recognizing the potential of food to truly transform individuals so they can live empowered lives filled with passion and purpose. She thinks everyone in the business of food has an incredible opportunity to create real and lasting impact on the lives of eaters everywhere. Alison spends her time playing piano, running, cycling, eating and exploring the beautiful San Francisco Bay Area.

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