Thursday, February 09, 2012

Food Elimination Q/A Part Two (Effectiveness)

By Christian Wernstedt

I'm doing a lot of work on helping people identify and fix food sensitivities, so I often receive questions related to this. If you have a question, please put it in the comments section, and I will try to answer it in a follow up post. Thanks! /Christian

Q: Do you have any thoughts on the reliability of MRT (“Mediated Release Testing”) vs. other food sensitivity tests?

That's a good question, but it opens up a can of worms!

There are a couple of considerations with regard to “reliability” that we need to discuss, so let's dig in.

I like Mediator Release Testing (MRT) because it saves people a lot of time when trying to pinpoint certain types of food sensitivities that are otherwise quite difficult to detect (for instance, these sensitivities can have delayed symptoms,).

Now, as with all tests, MRT has its inherent limits (for instance, there are many types of food sensitivities that it just cannot discover), and, as with all tests, it can also certainly be abused in many ways when designing therapies based on its results.

The MRT measures a common type of food sensitivities, which are so called “cell-mediated reactions” to food proteins and chemicals.

These reactions (sometimes called “Type IV” sensitivities), which could be thought of as a type of “contact allergy” (think nickel allergy) do not need the involvement of antibodies. This is different from, for example, classic allergies (Type I - e.g., a person dying from exposure to peanuts) or so called IgG delayed sensitivities (Type III), which both involve antibodies that laboratory tests can look for.

So instead of looking for antibodies, MRT measures inflammatory “squirts” of “mediators” that cells produce when exposed to food proteins and chemicals. More squirting equals a higher degree of sensitivity.

Bottom line: What MRT measures is very different from other allergy and food sensitivity tests, and, well, these other tests don’t measure what MRT measures.

To concretize a bit more, MRT cannot discover celiac type gluten sensitivity (or cross reactivity with gluten, e.g, coffee looking like gluten to the body), or issues with lectins. Nor can the MRT discover problems with certain sugars and fibers or “FODMAPS”. (A burp/fart challenge test may be best for these, but I digress!)

However, concerning to the types of sensitivities that MRT does measure (and the other tests don't!), it does so with a high degree of accuracy. (90% according to a clinical study.)

So each type of food sensitivity testing (MRT, IgG, IgE, and many others) or, any other test for that matter, should be considered on its own merits (and limitations) in the context of the person that has the health complaint. (A fantastic idea, isn't it! Forget this under ObamaCare, by the way.)

If your health issues are really tricky, such as if you have autoimmune disease, you could benefit from a whole battery of food sensitivity tests that target different types of sensitivities. The limits mostly being price and the ability of your practitioner to interpret the tests correctly - sometimes more of an art than a science.

Personally, I love the MRT for basically one important and common task, which is that it assists with identifying foods that may cause inflammation of the gut lining (“the intestinal mucosal barrier”) .

This is big, because when the gut lining is perpetually assaulted by foods that cause inflammatory reactions, the stage is set for poor gut flora and intestinal permeability which in turn exacerbates “systemic” (whole body) inflammatory problems (acne, arthritis, migraines, etc), as well as problems with gluten and other types of sensitivities.

Constant inflammatory irritation of the gut lining is also a direct cause of cortisol issues and associated problems such as hormonal imbalances and dangerous visceral fat accumulation. (If you have a cortisol response from eating, you may experience it as a raised pulse rate during or after a meal.)

Now let’s look at two important factors that will determine how effective food elimination based on MRT or other testing technologies might be for you:

The first factor in effectiveness is how much dysfunction related to food sensitivity that you actually have and where exactly. In other words, for instance, the degree of “leaky gut", poor gut flora, or problems with immune function that you have. 

These and other "functional" factors determine the degree to which reactive foods may cause problems for you, but these factors cannot be estimated with confidence through food sensitivity tests alone.

For instance, the MRT uses live blood cells which the laboratory exposes directly to food extracts, and for this reason it cannot tell if food proteins actually tend to leak into the blood stream in the process of your normal digestion. (I'm assuming that you don't juice and then inject your foods.)

In practice this means that a person with a high degree of leaky gut who tests reactive to, say, beef may therefore see powerful improvements in overall symptoms when eliminating beef from the menu, whereas another person with little “leakiness” may experience much more subtle improvements even if beef tests highly reactive. (This said, I actually have yet to encounter anyone who hasn’t reported some noticeable improvement, such as a bit of fat loss, after taking out MRT reactive foods for a couple of months.)

The second factor in effectiveness is the total “therapeutic force" applied to repair damage while eliminating reactive foods.

This issue is most often overlooked by people who think that food-elimination is the end-all-be-all. (It can be, but often it is not.)

All healing, whether it is about healing an annoying paper-cut, or healing an entire digestive tract (or an entire body for that matter), depends on doing enough things right for a long enough time (this is what I call “therapeutic force”) so that a virtuous feedback loop can take hold in the body so that it may heal itself.

To put it differently: One cannot overcome the vicious cycle of a degenerative process without creating at least an equally powerful healing process.

Think of this as the need to use enough force when pushing a boulder up a hill so that it can reach the peak of the hill. Only then may the boulder roll down the slope on the other side.

If you, on the other hand, don’t apply enough (and sufficiently persistent) force to the boulder, you will be like Sisyphus - doomed to roll a boulder up a hill, only to see it roll back down again, and to repeat this for the rest of your life. Not very productive.

So to apply this idea to food sensitivities, it is quite common that people go through Sisyphean torture in the quest for the ultimate elimination diet. For example, people wind up eating extremely restricted diets, such as meat-only diets, or they find themselves stuck in the midst of an ever changing and confusing landscape of food sensitivities and associated symptoms coming and going.

In many cases these types of struggles come from focusing too narrowly on food elimination as the only therapy and therefore from not achieving sufficient “therapeutic force”.

The sticking points may be different from one person to another, but common ones are failure to correct cortisol issues (sleep and stress management are very important); failure to rebalance gut flora (probiotics therapy can accelerate the process); failure to get rid of any pathogens/parasites (very common if intestinal health has been poor for a long time); and the failure to supply enough restorative nutrients (a so called “gut repair protocol” can help tremendously).

Actually, in many cases, after a successful repair process (which can take a year or more) it is often revealed that reactive foods found on food sensitivity tests, particularly if they are “paleo foods” such as meat and veggies, are not actually true root causes of a person’s health problems, but that the foods were merely problematic in the context of dysfunction such as "leaky gut" or a gut flora that was out of balance.

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