ACNE & FOOD SENSITIVITIES
Food sensitivities sound a bit “hippy-dippy,” right? Some people might roll their eyes when you say you are “sensitive” to a food. They may not take it seriously because it is not a true allergy, so you won’t get symptoms right away. However, food sensitivities are most definitely an important factor to investigate when addressing the root cause of your acne!
Food sensitivities are closely related to our last post about leaky gut. If the gut is leaky, it allows the undigested food particles to pass from the digestive tract into the bloodstream, inappropriately activating the immune system upon exposure to a particular food, leading to inflammation and oxidative stress.[1] As we discussed in a previous blog post, inflammation and oxidative stress are key in acne development! If you are struggling with food sensitivities, working on your gut health is key to address your acne.
One of the most important steps in healing the gut involves removing inflammatory foods. Our first instinct is to cut the obvious culprits like processed foods, vegetable/seed oils, refined sugars, etc. However, there is another category of inflammatory foods: foods that trigger food sensitivities.
Differences between allergy, intolerance, and sensitivity
The terms food allergy, intolerance, and sensitivity are sometimes used interchangeably, but it is important to make the distinction. The commonality between these reactions is that each of them produce certain antibodies to a food particle. Let’s discuss the differences:
Food Allergies: True food allergies are rare – they only affect 1-2% of adults.[2] An important factor is that the reaction occurs a few minutes to 2 hours after eating the food. Symptoms can include closing of the throat, fatigue, tearing, hives, itching, runny nose, skin rashes and sometimes even anaphylactic shock.[2]
Food Intolerances: Food intolerances occur when a person lacks the enzymes needed to digest the sugars or carbohydrates in certain foods. The most common intolerances are to gluten, lactose, and fructose.[2]
Food Sensitivities: This blog post will focus on food sensitivities. Food sensitivities are more common – it is estimated that 10-20% of people have food sensitivities! A food sensitivity occurs when antibodies are triggered in response to certain foods. These reactions are considered delayed sensitivity reactions because the symptoms may not appear for several hours, or even several days! This makes it difficult to pinpoint what the trigger could be. Although many foods can cause a food sensitivity, 80% of them are provoked by the following foods: beef, citrus, dairy, egg, corn, pork, and wheat.[2]
The good news is that by avoiding symptom-provoking foods and restoring gut health, most food sensitivities will resolve within 4-6 months. This means that in most cases, your symptoms (like acne!) will begin to clear up after removing the problem food from your diet. After avoiding the food for a few months, you will likely be able to eat it again, symptom-free.
Symptoms of food sensitivities
Food sensitivities can cause a huge variety of symptoms. It may be useful to read over the symptoms below to see if anything resonates with you. Examples of food sensitivity symptoms include, but are not limited to[2]:
Digestive issues (constipation, diarrhea, indigestion, bloating, gas, cramping)
Head issues (headaches, migraines, dizziness)
Mouth and throat symptoms (coughing, sore throat, sores, swelling, pain)
Eye, ear, and nose issues (runny or stuffy nose, post-nasal drip, ringing in the ears, blurred vision, sinus issues, water and itchy eyes, dark circles under the eyes, excessive mucus)
Heart and lung symptoms (irregular heartbeat, asthma, chest pain, shortness of breath)
Skin issues (hives, rashes, psoriasis, eczema, dry skin, excessive sweating, hair loss, and acne)
Muscle and joint problems (general weakness, aches and pains, arthritis, swelling, stiffness)
Energy issues (fatigue, mental dullness, apathy, restlessness, hyperactivity)
Emotional and mind symptoms (mood swings, anxiety, fear, anger, irritability, aggression, food cravings, poor concentration, confusion)
Other symptoms such as weight gain, weight loss, fluid retention, insomnia, genital itch, bed-wetting
How can I find out if I have food sensitivities?
1) Elimination Diet
A common practice is to utilize an elimination diet. The name “elimination diet” indicates that you eliminate certain foods from your diet. The benefits are that it does not cost anything or involve testing – it just requires some education, dedication and possibly experimentation in the kitchen!
2) Testing
Although testing can be beneficial, there is a lot of controversy associated with food sensitivity tests. There are a few main methods, but further research is needed to assess whether a test is reliable. The main methods for testing food sensitivities include:
The Carroll method - The Carroll method does not determine an immune system reaction/allergy, but rather an inability of the digestive system to properly digest and metabolize a food. However, practitioners have criticized this method because it has not been independently verified, and there are no peer-reviewed studies on it.[3]
ALCAT testing – this is also known as cytotoxicity testing. ALCAT stands for "Antigen Leukocyte Cellular Antibody Test". This methodology has also been criticized because it has never shown to be proven, there is a lack of peer-reviewed articles in the literature on it, and the testing is not consistent or reproducible.[3] The ALCAT is similar to MRT testing as it tests mediator release, but it utilizes an older technology that is not as reliable as the MRT.
MRT testing - MRT stands for "Mediator Release Testing". This testing measures changes in the ratio of liquids to solids after exposing the blood sample to certain foods/chemicals; when the cells react, the release mediators (like histamines, cytokines, prostaglandins, etc.) resulting in a change of cellular volume, which is measured by the lab. The strengths of the MRT test include excellent accuracy and reliability (both over 90%).[6] When working with clients, many Holistic Nutrition Professionals will recommend this type of testing.
IgG and IgA (antibody) testing – this test measures the production of certain antibodies to food particles. The methodology is reasonable as it has been published in peer-reviewed literature and independently verified by more than one research group. However, it is not clear if results are consistent and reproducible – it seems to depend a lot on the specific lab and the procedures that the labs use.[3]
It is recommended that you work with a practitioner who can order tests from companies that run legitimate research-based labs (many of the tests available to order online are inaccurate and a waste of your money!). Just remember: any food sensitivity test's results are mainly guidelines and may be inaccurate.
You may be trying to decide whether you should take a food sensitivity test or try an elimination diet. The main drawback of the elimination diet is that it requires you to be compliant with a very restrictive diet and become in-tune with your body to understand what foods are triggering your symptoms. For acne, this can be extremely difficult. Firstly, it may take a long time for your acne to get better after cutting out symptom-provoking foods. Similarly, it may take a while for symptoms to appear after eating a food that you have a sensitivity to! Secondly, the food you are sensitive to may be a random food that is not cut out during an elimination diet – e.g., avocado, or ginger, or cabbage. If your symptom-provoking food is something that is considered part of a healthy anti-inflammatory diet, it may be close to impossible to figure out what it is! And lastly, the stress of worrying about the diet and obsessing about symptoms could just be adding fuel to your acne fire. In the end, a bit of help from laboratory testing through food sensitivity tests could be a better solution to tackle your acne.
Causes of Food Sensitivities
You might be thinking: “Wonderful! All I have to do is run a food sensitivity tests, cut out the foods I’m sensitive to, and my acne will be gone!”. Unfortunately, this may not be the final step. I wish that were the case! The problem is that eliminating the food culprits may not address the true root cause.
What we really need to do is find the underlying cause of what is causing the food sensitivity. It could be dysbiosis, lack of enzymes, medications, poor lifestyle habits, or leaky gut. Unfortunately, cutting out the symptom-provoking foods may not be enough to address the problem that is ultimately leading to your acne. The goal may be to reduce the immune reactivity that is caused by food sensitivities while you address the underlying cause (but you do still need to cut out the foods you are sensitive to!).
Some of the causes of food sensitivities could include:
Dysbiosis (viral infection or bacterial overgrowth (like SIBO), parasites, fungal overgrowth)
Decreased digestive enzymes, such as HCl, pancreatic enzymes, bile insufficiency, lactase, etc.[2],[4]
Sensitivities to certain components in foods, such as histamines, oxalates, salicylates, food additives, preservatives, nitrates, sulfites, or MSG[4]
Therapeutic protocols
Some of the main suggestions to address food sensitivities include:
Cutting out the symptom-provoking foods is key (more on this below)
Address any other sources of inflammation
Glutamine supplementation[2] – this amino acid is important for healing the intestinal tract, which is why it’s also recommended for leaky gut
Quercetin supplementation – quercetin is a bioflavonoid that reduces pain and inflammatory response. It is helpful for allergies, as well as leaky gut[2]
Protein-digesting enzyme supplementation (i.e., protease or proteolytic enzymes) – these enzymes help clear the smaller immune complexes that form when antibodies bind to food particles[2]
Diet for food sensitivities
The key to a food sensitivity diet is avoiding all substances that are causing reactions. An Elimination Diet is the gold standard to determine if food is the main factor causing symptoms like acne. The name “elimination diet” indicates that you eliminate certain foods from your diet for at least 3 weeks.
Here are some tips for best practices during an elimination period:
Track your symptoms to determine if they improve after certain foods have been removed (this is key! We think we will remember how we felt before, but it is so important to write down your foods and symptoms to be able to track symptoms more accurately)
Eliminate the foods that came up in a sensitivity test. If you did not take a sensitivity test, it is suggested that you remove all common allergens (e.g., gluten, dairy, eggs, grains, soy, nuts, seeds, legumes, nightshades). Spend at least 3 weeks on a strict elimination diet.
It is important to eat a variety of healthy foods and not restrict calorie intake. If there is no improvement within 3 weeks, there may not be a food sensitivity OR there is something else complicating the process.
After 3 weeks of the elimination diet, you can begin adding foods back to your diet.
Here are some guidelines to follow when you begin your reintroduction phase[5]:
Before you begin, have your food journal ready. Keep a journal of all the foods you eat, along with any symptoms.
Be sure to add foods one at a time, one every two to three days. Eat the test food at least twice during the day as a full portion. If there is a sensitivity, symptoms will typically arise quickly (within 10 minutes to 12 hours).
Signs to look for include headache, itching, bloating, nausea, dizziness, fatigue, diarrhea, indigestion, sleepiness 30 minutes after a meal, flushing, rapid heartbeat (see the list above under Symptoms for other potential indicators).
If you are unsure if a food caused symptoms, eliminate the food back out of your diet for at least one week and try it again.
The process of an elimination and reintroduction diet will be different for everyone! If you feel overwhelmed, it is recommended that you work with a certified holistic nutrition practitioner who can guide and support you through the process.
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This wraps up the blog series about Acne and Gut Imbalances. As you have learned, the causes of acne can be complicated, and gut health is an important factor to consider. If you feel like you have tried everything but are still struggling with breakouts, your gut health could be the missing piece of the puzzle.
Do you think you might struggle with SIBO, Leaky Gut, or a Food Sensitivity? Book a 15min FREE discovery call to see if a nutrition protocol is the right step for you!
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REFERENCES
[1]Bischoff SC, Barbara G, Buurman W, Ockhuizen T, Schulzke JD, Serino M, Tilg H, Watson A, Wells JM. Intestinal permeability--a new target for disease prevention and therapy. BMC Gastroenterol. 2014 Nov 18;14:189. doi: 10.1186/s12876-014-0189-7. PMID: 25407511; PMCID: PMC4253991. [2] Lipski E. Digestive Wellness : Strengthen the Immune System and Prevent Disease through Healthy Digestion. Mcgraw-Hill; 2020. [3]Kresser C. RHR: Are Food Intolerance Tests Accurate? Chris Kresser. https://chriskresser.com/are-food-intolerance-tests-accurate/. Published July 11, 2019. Accessed November 26, 2020. [4]Considerations in the Causes and Treatment of Acne (webinar lecture). The Great Plains Laboratory, Inc. https://www.greatplainslaboratory.com/webinars/considerations-in-the-causes-and-treatment-of-acne. Released October 31, 2020. Accessed November 9, 2020. [5] Lipski, E. Elimination Diet. Digestive Wellness Book. https://digestivewellnessbook.com/wp-content/uploads/2019/12/ComprehensiveElimimationDiet.pdf. Published 2019. Accessed November 26, 2020.
[6] https://www.nowleap.com/. Accessed November 13, 2021.