The Role of Food Sensitivity and Food Intolerance Tests

TANIA TYLES DEMPSEY, M.D.
FOUNDER, AIM
AIM FOR RESULTS
The Role of Food Sensitivities on
Health and Obesity.

Tania Tyles Dempsey, M.D.
 Founder- Armonk Integrative Medicine
 Cornell University 1988-92 B.S. Biological Sciences
 The Johns Hopkins University School of Medicine
1992-96 M.D.
 New York University/ Bellevue Hospital 1996-99
Primary Care/Internal Medicine Residency
 Board Certified in Internal Medicine since 1999
 Vanguard Endocrinology Certification 2011
 Member of The American College of Physicians and
The Institute of Functional Medicine

Reactions to Food
Allergy
Intolerance
Sensitivity/ Hypersensitivity

Food Intolerance or Sensitivity
 Autoimmune Disease
 Celiac- Gluten Intolerance
 Non-IgE mediated food hypersensitivity
 IgG delayed reaction (Type II)
 Type III hypersensitivity
 Contact dermatitis
 Enzyme deficiency
 Lactase deficiency causing Lactose Intolerance
 Inability to digest Fructose
 Reaction to a chemical in the food
 Salicylates
 apples, citrus fruits, strawberries, tomatoes, cherries, and wine
 Chronic activation of the innate immune system

Symptoms of Food Sensitivity
 Gastrointestinal
 Bloating, diarrhea or constipation, irritable bowel syndrome, colitis
 Malabsorption/ Nutrient Deficiencies
 Iron, B12, vitamin D deficiency (osteoporosis)
 Respiratory
 Asthma, chronic cough, sinusitis
 Dermatologic
 eczema, psoriasis, keratosis pilaris (bumps on the sides of arms, legs)
 Neurologic
 Migraine, behavioral problems, ADHD, memory, mood, sleep issues

Symptoms of Food Sensitivity
 Musculoskeletal
 Arthritis, stiff joints, tendonitis
 Endocrine
 Infertility, irregular periods, weight gain or weight loss,
thyroid disease, osteoporosis
 Immune System
 Allergies, ability to fight infections, autoimmune disease

Food Intolerance is Multi-Factorial
 Susceptibility is dependent upon many factors
 Genetics
 The integrity of the natural barrier of the gut wall (“leaky gut”)
 The viability of phase I and phase II detoxification pathways
 The presence or absence of other co-factors
 The amount of the food
 The combination of foods
 STRESS with increased cortisol levels
 Protective secretory IgA antibodies in the gut decrease in
response to stress.
 Undigested food macromolecules invade the bloodstream and
activate the immune system.

Food Sensitivities- Why?
 “Advances" in food technology, including methods of
processing, preserving, and flavoring, with the use of
dyes, pesticides, and fertilizers, has altered food to
the point that these additives, in addition to food’s
natural components, can cause a disruption to the
immune system.
 Genetically modified food also exposes us to new
proteins never before seen in our diet.

Food Sensitivities- Why?
 Further complications arise from the overuse of
antibiotics coupled with an increased consumption
of simple sugars /refined flours (very common in a
food sensitive patient's diet) thus causing an
imbalance in the flora of the intestinal tract and an
overgrowth of yeast (candida).
 Yeast overgrowth affects the mucosal lining of the intestines,
contributing "leaky gut syndrome"
 Non-fully digested food proteins to enter the blood where they
can trigger immune reactions and the release of chemical
mediators of inflammation.

Approach to the patient with suspected
food sensitivities
First, determine which foods are
causing the problem
Elimination diet
IgG testing
ALCAT
Other labs

Elimination Diet
 Elimination diet without lab testing involves
avoiding the most highly allergenic foods and
watching the response.
 Gluten, Dairy, Eggs, Corn, and Soy
 Traditionally, 4 weeks is often thought of as
sufficient to see results, however, food molecules
incorporate into our cells and can remain there for a
long period of time.
 Eliminate these foods for 6 months or more

Testing for IgG Food Sensitivity
 Blood test (Metametrix)
 Looks at levels of IgG to each individual food
 IgG levels may be higher in foods that also have
high IgE associated with it.
 Some people will have high IgG to a food without
obvious symptoms
 Most of the time the IgG is directed to foods that
are eaten very frequently.

IgG or Type II Reactions
 A 25 year ongoing study reveals that 95% of the
population has what is known as a Type II toxic
reaction or IgG response to common everyday foods
that you eat regularly.
 IgG or Type II reactions are delayed reactions to the
offending food.
 They can be difficult to diagnose without specific
blood tests because the reactions can occur hours to
days after the food is eaten.

ALCAT Test- A Different View
 Antigen Leukocyte Cellular Antibody Test
 Does not measure immunity
 Reproducibly measures the final common
pathway of all pathogenic mechanism; whether
immune, non-immune, or toxic.
 It is the only test shown to correlate with
clinical symptoms by double-blind oral
challenges, the gold standard.

Results
Color coated chart reveals 4 different
categories of reactivity:
Red- Severe Intolerance
Orange- Moderate Intolerance
Yellow- Mild Intolerance
Green- No Intolerance

Results
 Separate section for Casein and Whey
sensitivity
 Gluten and Gliadin reported
 Reaction to Candida Albicans (Yeast)

ALCAT for Weight Management
 Baylor study using ALCAT for weight management
 This study showed that 98% of the subjects following the
ALCAT plan either lost scale weight or improved their body
composition.
 Another study using ALCAT
 Dr. J.R. Cabo-Soler, Chief of Biochemistry at the University of
Valencia, reported that iso-caloric food elimination diets,
based on ALCAT test results, promoted enhanced weight loss,
comprised more of adipose tissue, rather than muscle mass, as
determined by DEXA studies in a population of refractory
weight loss subjects.

Food Sensitivity and Effect on Weight
 After eating an offending food, blood level of the
neurotransmitter, serotonin, goes down.
 Ingestion of highly-refined carbohydrates and sugar
cause a rapid release of insulin, increasing blood
levels of tryptophan, a precursor of serotonin.
 In order to compensate for lower brain levels of
serotonin (caused by eating offending foods) food
sensitive people crave foods which will increase
serotonin in the brain.

Inflammation
 “Leaky gut” allows food particles to be exposed to the
gut’s immune system.
 Triggers a system-wide immune response
 Leads to inflammation
 Causes insulin resistance and more fat storage
 Gut flora can also induce insulin resistance apart from the
above immune response.
 Changes in the gut flora can increase the rate of absorption of
fatty acids and carbohydrates, and increase the storage of
calories as fat.
 Obese people have a greater proportion of micro-flora from
Firmicutes, which includes Bacilli and Clostridia.

Case #1
 65 year old female presents with a history of :
 Irritable bowel syndrome
 Migraines
 Prediabetes
 Peripheral neuropathy from chronic L5-S1 nerve impingement
following spinal fusion surgery
 Suspected food intolerances to milk/dairy for years,
anaphylaxis to scallops
 Seasonal allergies and reactive airways/asthma
 Recent onset of alopecia and weight gain
 Osteoporosis
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with
other scientific data and should not expect the same results as those found in case studies alone.

Case #1 Continued
 Treated for years with the following meds:
 metformin
 topiramate for prevention of migraine
 triptans prn for migraine
 montelukast (Singulair®) for asthma and allergies
 Inhaled steroids prn for asthma exacerbations
 proton-pump inhibitor
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these
results with other scientific data and should not expect the same results as those found in case
studies alone.

Case #1 Continued
 She recently went on a Gluten free diet after several
family members were found to have a “sensitivity” to
gluten; but she denied a family history of Celiac.
 Some improvement in symptoms, but short-lived; her
symptoms started to return after a few months.
 She then tried a dairy free diet. For years she had
suspected dairy sensitivity or “lactose intolerance”
but was able to tolerate certain types of dairy
products so continued to consume these.
 Again there was some improvement but after several weeks
some of her symptoms returned.
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with other
scientific data and should not expect the same results as those found in case studies alone.

Case #1 Continued
 She underwent testing that included the
following:
 Thyroid function- including TSH, Free T4, Free T3
and Thyroid Antibodies
 Hemoglobin A1c, Glucose, Insulin, Lipids
 Vitamin/Mineral levels- B12, Folate, 25-OH vitamin
D, Ferritin, and Iron
 She opted to not get food sensitivity testing at this
time due to cost.

Case#1 Continued
 Results are as follows:
 Hemoglobin A1c 5.8% (on Metformin)
 TSH= 2.86, Free T4 =1.0 (normal 0.8-1.6), Free T3
=2.5 (normal 2.3- 3.98)
 Normal thyroid antibodies
 Total Cholesterol 238, HDL >60, LDL 144
 Very low Ferritin level=10, low B12 328
 Normal Vitamin D level on supplementation

Case #1 Continued
 Treatment
 “Paleo-diet”- low carb, high fat/protein
 Armour thyroid
 Activated B vitamins
 Iron not supplemented due to side effects
 Probiotics 100 billion
 S-acetyl glutathione for Peripheral neuropathy
 Alpha lipoic acid

Case #1 Continued
 Follow-up
 Hair stopped falling out
 4 lb weight loss
 TSH levels improved
 Lipids improving- LDL 130
 IBS still present, migraines better but not resolved
 Neuropathy manageable with S-acetyl glutathione

ALCAT
 She finally agreed to ALCAT testing
 Despite some improvement globally, her bowel symptoms
were still severe and she did see some correlation between
symptoms and food intake.
 She was compliant with a low carb, diary-free, gluten-free diet.

ALCAT- Severe Intolerance
 GARLIC
 HADDOCK

 ANCHOVY
 CARDAMOM
 CATFISH
 CUMIN
 KALE
 NECTARINE
 PEACH
 RASPBERRY
 SEA BASS
 SPELT
 SPINACH
 SQUID
 SWISS CHARD
 TAPIOCA
 VENISON
ALCAT- Moderate Intolerance

ALCAT- Mild Intolerance
 ACORN SQUASH*
 APRICOT*
 BAKER'S YEAST*
 BLACK BEANS*
 BLACK CURRANT*
 BLACK PEPPER*
 BOK CHOY*
 CINNAMON*
 FIG*
 FRUCTOSE (HFCS)*
 KIWI*
 LAMB*
 LENTIL BEAN*
 MUSSEL*
 NUTMEG*
 OKRA*
 ORANGE*
 OYSTER*
 PARSNIP*
 PINE NUT*
 PINEAPPLE*
 PISTACHIO*
 PORTOBELLO MUSHROOM*
 ROSEMARY*
 SESAME*
 SHRIMP*
 TUNA*
 VEAL

Additional Reactions
 Mild reaction to Gluten/Gliadin
 Wheat
 Barley
 Rye
 Malt
 Oat
 Mild reaction to Whey
 Cow
 Sheep
 Goat

Treatment
 Elimination of all reactive foods
 4 Day Rotation Diet provided by ALCAT
 Only ate “Green” foods

Follow-Up
 Within 1 week bowel symptoms started to subside
 At 1 month bowel symptoms were resolved.
 After 1 month she added her “Yellow” foods back in a 4-
day rotation.
 She did notice that certain foods on that list caused some mild
symptoms during the reintroduction phase so she continues to avoid
those
 She is still Gluten and Dairy-Free
 10 lb. weight loss in 4 weeks
 Migraines are improved
 1 Migraine recently when she “cheated” on the diet
 Medications are slowly being weaned off.

Case #2
 25 year old female presents with a history of :
 Anaphylaxis to all fish and seafood
 Suspected food intolerances- possibly dairy
 Irritable bowel syndrome
 Eczema
 Seasonal allergies and reactive airways/asthma
 Polycystic Ovarian Syndrome
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these results with
other scientific data and should not expect the same results as those found in case studies alone.

Case #2 Continued
 Initial workup with IgE and IgG testing
confirmed:
 IgE/Type 1 reaction to fish and seafood
 IgE reaction to milk/casein, some nuts/peanuts, and
many other foods
 IgG reactivity to many of the same
Disclaimer: Case studies represent results of a single participant. Consumers should weigh these
results with other scientific data and should not expect the same results as those found in case
studies alone.

Case #2 Continued
 Treated with elimination diet for 3 months.
 She reported some improvement in IBS after
1 month but still considerably symptomatic
 Abdominal pain and cramps at least 3 days a week.
 She started noticing more eczema and
fatigue after about 6 months.
 Eczema did not respond to topical steroids
given to her by her dermatologist.

ALCAT
 She agreed to ALCAT testing which showed
additional food sensitivities.
 Gluten sensitivity confirmed
Oats
 Casein and Whey sensitivity confirmed
 A variety of other foods that she thought was “healthy”
such as kale, millet, beets, broccoli, etc.

 BRAZIL NUT
 FLOUNDER
 KALE
 MACKEREL
 MILLET

 BAKER'S YEAST
 BLUEBERRY
 BOK CHOY
 BUFFALO
 CARAWAY
 CATFISH
 CELERY
 CINNAMON
 CUCUMBER
 DATE
 FENNEL SEED
 GINGER
 GRAPEFRUIT
 JALAPENO PEPPER
 LAMB
 LENTIL BEAN
 LOBSTER
 MUSTARD
 ORANGE
 PEACH
 SAFFRON
 TILAPIA
 TUNA
 VENISONANCHOVY

 BEET*
 BELL PEPPERS*
 BLACK BEANS*
 BROCCOLI*
 CARDAMOM*
 CASHEW*
 CHAMOMILE*
 CHICKEN LIVER*
 CHILI PEPPER*
 DUCK*
 EGG WHITE*
 FAVA BEAN*
 FLAXSEED*
 MACADAMIA*
 MUNG BEAN*
 MUSSEL*
 ONION*
 PEANUT*b
 PEAR*
 PINE NUT*
 PLUM*
 PORK*
 PORTOBELLO MUSHROOM*
 RED/GRN LEAF LETTUCE*
 ROSEMARY*
 SOYBEAN*
 SWEET POTATO*
 SWISS CHARD*
 WHITE POTATO*
 WILD RICE*ACORN SQUASH*

Follow-Up after ALCAT Diet
 Within 2 weeks bowel symptoms completely resolved.
 More energy apparent after a few days.
 5 lb. weight loss after 1 month.
 Eczema initially resistant to treatment and diet
 Review of skin care products revealed multiple ingredients on her
ALCAT list as well as known irritants/toxins:
 Wheat germ
 Soy
 Oats
 Parabens
 Eczema responds dramatically after changing skin care
products.

Case #3
 70 year old female with a past history of
 Multiple Sclerosis (diagnosis in question)
 Migraine
 Hypertension
 Hyperlipidemia
 Hypothyroidism
 Metabolic syndrome X- Insulin resistance
 Osteoarthritis- s/p right knee replacement
 Nephrolithiasis
 Small vessel cerebrovascular disease with mild memory loss
 Depression
 Breast cancer
 Multiple vitamin deficiencies- B12, D

Case #3
 She complained of persistent headaches, fatigue,
insomnia, depression, diffuse joint pain
 Blood work continued to show vitamin D deficiency, elevated
hemoglobin a1c, low HDL, elevated homocysteine.
 Heavy metal testing revealed cadmium toxicity
 Organic acid testing
 Adenosylcobalamin insufficiency
 Tetrahydrofolate deficiency
 Renal ammonia overload
 Deficiency in ATP production
 Bacterial and yeast overgrowth
 Inflammatory cytokine production

Case #3
 Diet was reviewed and contained processed, refined
carbohydrates, sugar and very little protein.
 She also reported a binge eating problem for years.
 Several attempts to change her diet could not be
sustained.
 She agreed to ALCAT testing.

 BOK CHOY
 CLOVE
 DATE
 FIG
 LEEK
 LIMA BEAN
 PAPRIKA

 APRICOT
 BASIL
 BAY LEAF
 BLACKBERRY
 CHERRY
 CLAM
 CODFISH
 CUMIN
 ENDIVE
 HOPS
 MALT
 ORANGE
 PORTOBELLO
MUSHROOM
 PUMPKIN
 RASPBERRY
 RED/GRN LEAF LETTUCE
 SAGE
 SEA BASS
 SOLE
 SWISS CHARD
 THYME
 TROUT

*
 BLACK BEANS*
 BLUEBERRY*
*
 CARROT*
 CELERY*
*
 CRAB*
 DUCK*
 EGG YOLK*
 FENNEL SEED*
 HONEYDEW (MELON)*
 KELP*
 KIDNEY BEAN*
 LAMB*
 MILLET*
 MUSSEL*
 MUSTARD*
 NAVY BEAN*
 OKRA*
*
 PAPAYA*
 PARSLEY*
 PEPPERMINT*
 PORK*
 ROSEMARY*
 SAFFRON*
 SALMON*
 SARDINE*
 SCALLIONS*
 SESAME*
 SQUASH (Yellow)*
 SWORDFISH*
 TAPIOCA*
 TUNA*
 TURMERIC*
 VANILLA*
 WILD RICE*
 ZUCCHINI SQUASH

Follow-up after ALCAT
 Followed rotation diet strictly for 1 month with one
deviation.
 During that time she had only 1 migraine for the
entire month compared to her usual 2-3 per week.
 The migraine occurred right after she “cheated” on the diet.
 She felt less foggy overall and had more energy.
 Her binge eating / food cravings decreased.
 It became clear to her that her original diagnosis of
MS was based on symptoms that may have been due
to food sensitivities, as many of these same
symptoms were slowly improving after 1 month.

Closing Remarks
 Food plays a significant role in our health.
 “We are what we eat.”
 We are being exposed to things in our environment
and in our food supply that we have never been
exposed to in the history of mankind and it is
affecting out bodies.
 More and more people, as they age, are experiencing
food sensitivities.
 INFLAMMATION is known to be at the root of all
chronic health conditions, including obesity and one
major cause of INFLAMMATION is food sensitivity.

What can you do?
 If you or any of your patients have signs or symptoms of
food sensitivity or intolerance consider the ALCAT test.
 Follow the rotation diet as recommended by ALCAT
 Even with negative testing consider gluten intolerance as
a major contributor to obesity and other chronic
diseases.
 Eat Organic Food
 Avoid Genetically-Modified food (corn, soy, wheat, etc.)
 Take care of the “gut”

The Role of Food Sensitivity and Food Intolerance Tests

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