food intolerance testing
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Cambridge Nutritional Sciences FOOD INTOLERANCE TESTING Cambridge Nutritional Sciences TOPICS Terminology Mechanisms of food intolerance Symptoms of food intolerance CNS food intolerance tests Test principles Alternative test methods Managing food intolerances Support documentation Cambridge Nutritional Sciences “What is food to one man, may be fierce poison to another” Lucretius circa 75BC Cambridge Nutritional Sciences TERMINOLOGY Cambridge Nutritional Sciences ADVERSE REACTION TO FOOD IMMUNE MEDIATED NON–IMMUNE MEDIATED IgE Type I Allergy IgG Type III Allergy Enzyme Deficiency Pharmacological Effect Chemical Effect Classic ‘Allergic’ Reaction ‘Food Intolerance’ Food Intolerance COMMON TERMINOLOGY Cambridge Nutritional Sciences 1. IMMUNE-MEDIATED REACTIONS FOOD ALLERGY (Type I) FOOD INTOLERANCE (Type III) ? ? Cambridge Nutritional Sciences FOOD ALLERGY Immune system response Production of IgE antibodies Cambridge Nutritional Sciences FOOD ALLERGY ‘Foreign’ food particles (antigens) cause immediate immune reaction Rapid release of histamine Allergic reaction (anaphylaxis) can cause breathing problems and low blood pressure Symptoms include tingling mouth, hives, swelling of the lips, face, tongue and throat Symptoms can be severe or life-threatening Avoid the offending food for life Cambridge Nutritional Sciences FOOD INTOLERANCE (IgG) Immune system response Production of IgG antibodies Cambridge Nutritional Sciences FOOD INTOLERANCE (IgG) “45% of the population suffer from a food intolerance” Non-specific / multiple symptoms Most people are undiagnosed Many clients will be affected Cambridge Nutritional Sciences FOOD INTOLERANCE (IgG) Delayed reaction to ‘foreign’ food (antigen) - hours/days after consumption Body produces IgG antibodies to neutralise antigen Form a complex with antigen: Ag/Ab complex Immune complex Cambridge Nutritional Sciences FOOD INTOLERANCE (IgG) Complexes deposited in tissues around the body Triggers complement cascade Release of inflammatory mediators Cambridge Nutritional Sciences FOOD INTOLERANCE (IgG) Leads to chronic inflammation and gradual appearance of symptoms Symptoms can persist for many days, but are not life-threatening Symptoms can be reversed by elimination of foods Re-introduce small amounts of the offending food Common to be intolerant to several different foods Multiple symptoms are common – difficult to diagnose FI Cambridge Nutritional Sciences 2. NON IMMUNE-MEDIATED REACTIONS ENZYME CHEMICAL & DEFICIENCY PHARMACOLOGICAL ----------------------- FOOD INTOLERANCE --------------------- Cambridge Nutritional Sciences ENZYME DEFICIENCY / INSUFFICIENCY Enzyme deficiencies can cause symptoms because foods cannot be digested LACTOSE INTOLERANCE Caused by a deficiency of lactase (needed to digest lactose) Cannot pass through gut wall, so remains in the gut Causes intolerance Symptoms: bloating, diarrhoea, abdominal pain Cambridge Nutritional Sciences ENZYME DEFICIENCY / INSUFFICIENCY HISTAMINE INTOLERANCE Caused by a deficiency or inhibition of diamine oxidase (DAO) Needed to break down histamine in foods Aggravated by foods high in histamine: red wine, cheese and tuna fish Foods low in histamine can also trigger the release of histamine in the body: citrus foods, bananas, tomatoes, chocolate Symptoms include: migraines, dizziness, bowel/stomach problems, rhinitis, depression, irritation, reddening of the skin Cambridge Nutritional Sciences CHEMICAL / PHARMACOLOGICAL MSG in restaurant / take-away food (headaches, sweating, dizziness) Sulphites in dried fruits and vegetables, wine, beer (asthma) Vasoactive amines such as phenylethylamine in chocolate, citrus fruits (migraines) Natural / artificial additives used to colour, preserve and flavour food (sweating, itching, abdominal pain, nausea/vomiting, diarrhoea) Create biochemical side effects in susceptible individuals Cambridge Nutritional Sciences MECHANISMS OF FOOD INTOLERANCE Cambridge Nutritional Sciences MECHANISMS OF FOOD INTOLERANCE (1) HEALTHY gastrointestinal tract and HEALTHY immune system: Foods digested and broken down to glucose, amino acids and fatty acids Absorbed through the gut lining Partially digested foods will also pass between cells into bloodstream Antibodies produced against these partially digested foods Form antigen / antibody complexes (normal) Efficient immune system will clear these complexes No symptoms despite an immune response occurring Cambridge Nutritional Sciences NORMAL RESPONSE TO FOOD Food Healthy Immune System Healthy Gut Low level of Ab/Ag complexes Complexes removed by macrophages No symptoms Cambridge Nutritional Sciences MECHANISMS OF FOOD INTOLERANCE (2) HEALTHY gastrointestinal tract, but COMPROMISED immune system: Partially digested foods pass through the gut lining Antibodies produced against these partially digested foods Ab/Ag complexes form (normal) Compromised immune system - insufficient macrophages produced Ab/Ag complexes not cleared and circulate in bloodstream Deposited in tissues – causes inflammation Cambridge Nutritional Sciences COMPROMISED IMMUNE SYSTEM Food Compromised Immune System Healthy Gut Low level of Ag/Ab complexes excess complexes deposited in tissues Symptoms Cambridge Nutritional Sciences MECHANISMS OF FOOD INTOLERANCE (3) LEAKY gastrointestinal tract, but HEALTHY immune system: Gut wall becomes more permeable Tight junctions in epithelial layer open up Increased number of partially digested foods enter bloodstream Ag/Ab complexes form – immune system becomes overloaded Complexes cannot be cleared and are deposited in tissues Cambridge Nutritional Sciences LEAKY GUT Food Normal Immune System Leaky Gut High level of Ag/Ab complexes excess complexes deposited in tissues Symptoms Cambridge Nutritional Sciences FACTORS LINKED TO LEAKY GUT Antibiotics Medication/Drugs Candida overgrowth Parasites Intestinal bacterial/viral infection gut with supplements and Glutamine insufficiency Alcohol Poor diet Stress Low stomach acid Low pancreatic enzymes Heal diet Cambridge Nutritional Sciences SYMPTOMS OF FOOD INTOLERANCE Cambridge Nutritional Sciences SYMPTOMS OF FOOD INTOLERANCE Respiratory: Asthma, rhinitis, sinusitis, persistent cough, catarrh Gastrointestinal: IBS, Crohn's disease, abdominal pain, diarrhoea, constipation, bloating, flatulence Skin: Eczema, rashes, spots CNS: Headache, migraine, hyperactivity (ADHD) Cardiovascular: Heart palpitations Musculoskeletal: Joint pain, rheumatoid arthritis, muscle pain, fibromyalgia Psychiatric: Chronic fatigue, insomnia, ME, anxiety, depression Metabolic: Weight gain Cambridge Nutritional Sciences SYMPTOMS OF FOOD INTOLERANCE Many symptoms – difficult to identify the cause (e.g. fatigue) IgG testing can be useful – diagnose / eliminate Cambridge Nutritional Sciences CNS FOOD INTOLERANCE TESTS Cambridge Nutritional Sciences CNS FOOD INTOLERANCE TESTS Food Detective™ FoodPrint ® Food Microplate ELISA Cambridge Nutritional Sciences World’s first rapid test kit for detecting food IgG antibodies Cambridge Nutritional Sciences FEATURES Detects antibodies to 59 common foods Rapid assay format – results in 40 minutes Positive and negative controls included Clear and concise instructions Colour coded reagents Finger-prick blood sample Cambridge Nutritional Sciences BENEFITS Only home-test kit on the market No specialised equipment needed No waiting for laboratory results Act on results immediately Website supported: www.camnutri.com Cambridge Nutritional Sciences CONTENTS Sterile wipe Safety lancet x 2 Plaster x 2 Blood collection tube Sample diluent (A) Antibody detector (B) Developer (C) Wash solution (D) Reaction tray IFU Result card Dietary support guide Cambridge Nutritional Sciences EASY TO FOLLOW INSTRUCTIONS Food Detective instructional video Cambridge Nutritional Sciences TEST PROCEDURE Sterilise finger with wipe Prick finger with lancet Massage finger to obtain blood Fill the capillary tube (50μl) Cambridge Nutritional Sciences TEST PROCEDURE Place in SOLUTION A Pour into tray (Sample Diluent) Leave for 20 minutes Cambridge Nutritional Sciences TEST PROCEDURE SOLUTION D SOLUTION B (Wash Solution) (Antibody Detector) Repeat x 3 Leave for 10 minutes Cambridge Nutritional Sciences TEST PROCEDURE SOLUTION D SOLUTION C (Wash Solution) (Developer) Repeat x 3 Leave for 2 minutes Wash ONCE Cambridge Nutritional Sciences RESULT INTERPRETATION Visually read results If specific-food IgG antibody is present, well is BLUE Determine strength of colour Cambridge Nutritional Sciences RESULT INTERPRETATION White NEGATIVE IgG Pale blue WEAK POSITIVE IgG Mid blue POSITIVE IgG Dark blue STRONG POSITIVE IgG Cambridge Nutritional Sciences RESULT INTERPRETATION Ring / halo INVALID Negative Control must be WHITE Positive Control must be BLUE Cambridge Nutritional Sciences RESULT INTERPRETATION Identify reactive foods from IFU Record on Results Card Cambridge Nutritional Sciences FOODS TESTED GRAINS Oat Wheat Rice Corn Rye Durum Wheat Gluten OTHER Cocoa Bean Tea Yeast DAIRY / EGGS Cow’s milk Whole egg FRUIT Apple Blackcurrant Grapefruit Melon mix Olive Orange and Lemon Strawberry Tomato VEGETABLES Broccoli Cabbage Carrot Celery Cucumber Leek Legume mix Mushroom Peppers Potato Soya Bean FISH / SEAFOOD White fix mix Freshwater mix Tuna Shellfish mix MEAT Beef Chicken Lamb Pork HERBS / SPICES Garlic Ginger NUTS / SEEDS Almond Brazil Nut Cashew Peanut Walnut Cambridge Nutritional Sciences Microarray Food Intolerance Test Cambridge Nutritional Sciences FOODPRINT® LABORATORY TESTS INDICATOR FOOD PANELS SPECIALISED Cambridge Nutritional Sciences TEST FORMAT Food extracts ‘printed’ onto nitrocellulose pads Cambridge Nutritional Sciences FOODPRINT® TESTING PROCESS Finger-prick sample Send to lab FoodPrint microarray Cambridge Nutritional Sciences FOODPRINT® TESTING PROCESS Selected pad = Patient name = 1 22 Hi-res optical scan 20 19 18 17 75 Positive control negative POLENTA borderline negative Negative control negative GARLIC 123 negative SHALLOT negative GINKGO 141 borderline BEAN (broad) negative GINSENG negative BEAN (green) negative TIGER NUT TOMATO 16 15 100 BANANA negative TURNIP 87 14 13 negative PAPAYA BLACKBERRY 165 BLACKCURRANT 204 PEACH PEAR 10 9 4 3 197 CAVIAR 146 MUSSEL negative TROUT 153 MALT 72 ALOE VERA 285 12 CLAM 11 85 OCTOPUS borderline TUNA 131 MILLET negative ANISEED negative RAPESEED 320 OYSTER negative TURBOT borderline OAT negative borderline COCKLE 8 7 borderline BASIL negative RHUBARB negative PERCH 93 WINKLE QUINOA negative BAYLEAF negative ROSEMARY negative PIKE 166 ALMOND 453 RICE borderline CAMOMILE negative SAFFRON negative PLAICE 137 BRAZIL NUT 1314 RYE FLOUR borderline CAPER negative SAGE negative PINEAPPLE CAROB negative PLUM OX 89 CHERRY negative POMEGRANATE negative CUTTLEFISH 184 BEAN (red kidney) LENTIL negative HORSE negative COCONUT borderline RASPBERRY negative DORADO negative RAZOR CLAM negative CASHEW NUT negative y = 52.36xBILLY GOAT negative DATE borderline REDCURRANT negative EEL negative SALMON borderline CHESTNUT negative PORK negative FIG borderline STRAWBERRY negative QUAIL 100 negative RABBIT negative LAMB negative WILD BOAR negative BEETROOT negative LETTUCE 8000 negative BROCCOLI negative MARROW 7000 76 CABBAGE negative MUSHROOM 5000 borderline CARROT negative CAULIFLOWER negative CAYENNE negative 113 319 ONION 6000 4000 3000 PARSLEY 2000 1000 PEA 0 -1000 0 50 negative 100 DUCK 150 negative CELERY negative POTATO negative CHARD negative GOURD (squash) negative TURKEY borderline CHICKPEA borderline RADISH negative PARTRIDGE negative CHICORY 86 CABBAGE (red) negative negative CUCUMBER negative ROCKET negative DILL negative SPINACH negative FENNEL (leaf) negative BRUSSEL SPROUT negative negative Negative control 74 SWEET POTATO 209 Positive control borderline TAPIOCA Concentration 200 POS 0 40 160 POS 0 40 160 POS 0 40 160 154 HAZELNUT GRAPE 70 WATERMELON borderline GRAPEFRUIT 185 AGAR AGAR negative GUAVA 222 ALGA espaguette negative KIWI 86 ALGA spirulina negative LEMON 143 ALGA wakame negative CRANBERRY LIME 90 ANCHOVY negative HOPS 179 AMARANTH 117 borderline 193 negative SESAME SEED 133 CINNAMON CLOVE negative ARTICHOKE SUNFLOWER SEED negative COFFEE negative AUBERGINE COLA NUT 142 324 SOYA BEAN 279 borderline PEANUT 97 COCOA BEAN negative CORIANDER (leaf) negative TARRAGON 191 WHEAT negative CUMIN negative TEA (black) borderline PISTACHIO 297 WHEAT BRAN 210 CURRY (mixed spices) 70 TEA (green) borderline RAISIN 186 ALPHA-LACTALBUMIN 132 GINGER negative THYME 417 BETA-LACTOGLOBULIN borderline HONEY borderline VANILLA BUFFALO MILK borderline LIQUORICE 598 YEAST (baker's) 382 YEAST (brewer's) PINE NUT LYCHEE negative BARNACLE negative HADDOCK 264 BARLEY CHICKEN 226 MANGO negative BASS negative SCALLOP 225 BUCKWHEAT 98 CASEIN negative MARJORAM negative VEAL 100 MELON (Honeydew) negative CARP negative HAKE 93 CANE SUGAR 281 COW'S MILK negative MINT negative BEEF borderline MULBERRY negative HERRING 76 CORN (maize) 95 EGG WHITE 89 VENISON 134 NECTARINE 75 TANGERINE 232 EGG YOLK 114 APPLE 82 OLIVE 73 WALNUT 144 APRICOT negative ORANGE negative ASPARAGUS 481 LOBSTER 97 SHRIMP/PRAWN negative SOLE PEPPERCORNS (B/W) negative negative MACADAMIA NUT 111 negative SARDINE 164 SPELT borderline negative AVOCADO 1 Positive control CRAB BLUEBERRY negative negative 9000 2 187 COD negative OSTRICH LEEK 206 5 71 WATERCRESS negative BEAN (white haricot) negative IgG Standard Curve 6 175 negative RED CHILLI 268 OD 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 21 borderline COUSCOUS negative YUCCA MUSTARD SEED 96 TRANSGLUTAMINASE borderline NETTLE 119 GLIADIN NUTMEG 196 Positive control PEPPERMINT 195 Positive control negative MACKEREL negative SQUID 86 DURUM WHEAT 186 GOAT MILK 77 negative MONKFISH negative SWORDFISH 110 FLAX SEED 100 SHEEP MILK borderline Data conversion borderline PEPPERS (mixed) Test Report Cambridge Nutritional Sciences FOODPRINT® TEST REPORTS Food Groups Order of Reactivity Cambridge Nutritional Sciences FOODPRINT® REPORTS Traffic light system: ELEVATED (≥30 U/ml) BORDERLINE (29-24 U/ml) NORMAL (≤23 U/ml) IgG concentration (U/ml) Cambridge Nutritional Sciences INTERPRETATION OF RESULTS ELEVATED – high level of antibody detected Eliminate food from diet for at least 3 months BORDERLINE – moderate level of antibody detected Reduce or rotate food for at least 3 months NORMAL – low level of antibody detected Food can be eaten freely Cambridge Nutritional Sciences NEW PATIENT REPORT Test Reports + Patient Guidebook Cambridge Nutritional Sciences FOODPRINT® BLOOD COLLECTION VIDEO Cambridge Nutritional Sciences Cambridge Nutritional Sciences PRODUCT RANGE Cambridge Nutritional Sciences FEATURES Kits available for 5, 40, 93 or 109 foods 25µl serum or plasma Assay time <90 minutes 96 well plate assay, strip format Cambridge Nutritional Sciences BENEFITS Ideal for small–moderate sample numbers Ready-to-use reagents Short incubation steps Reliable results CE-marked kits Certified to ISO 9001 & 13458 Cambridge Nutritional Sciences Assay Procedure TEST PROCEDURE 25µl sample into 10ml diluent Dispense samples, standards and controls Incubate 30 minutes Wash Plate x 3 100µl conjugate into each well Incubate 30 minutes Wash Plate x 3 100µl TMB substrate into each well Incubate 10 minutes 100µl Stop solution into each well Read 450nm Cambridge Nutritional Sciences PERFORMANCE CHARACTERISTICS Reproducibility: Intra-assay 5.1-11.9% Sensitivity: 0.4U/ml Interferences: Grossly haemolysed, icteric or lipaemic samples should be avoided Stability: 18 months Cambridge Nutritional Sciences TEST PRINCIPLES Cambridge Nutritional Sciences TEST PRINCIPLES Enzyme-Linked Immunosorbent Assay (ELISA) Standard laboratory method to detect antibodies and antigens FOOD DETECTIVE FOODPRINT MICROPLATE ELISA Reaction Tray Microarray Pad Plate Cambridge Nutritional Sciences Antigens (food) attached to well Cambridge Nutritional Sciences Diluted blood sample: Specific food IgG antibodies Binds to food antigens Cambridge Nutritional Sciences Detector solution / conjugate: Contains enzyme (HRP) linked antihuman IgG Binds to food-specific IgG antibodies Cambridge Nutritional Sciences Developer solution / TMB substrate Enzyme HRP causes oxidation of substrate: Change from colourless to blue Cambridge Nutritional Sciences ALTERNATIVE TEST METHODS Cambridge Nutritional Sciences IgG4 ELISA White Blood Cell Cambridge Nutritional Sciences IgG4 ELISA Detects IgG4 antibodies associated with food allergies Cambridge Nutritional Sciences IgG SUBCLASSES SUBCLASS ABUNDANCE IgG1 66% IgG2 23% IgG3 7% IgG4 4% Cambridge Nutritional Sciences IgG SUBCLASS PROPERTIES NEUTRALISATION Ability of antibodies to neutralise the pathogenic effects of antigens: – block and inhibit biological effects COMPLEMENT ACTIVATION Ability of antibodies to activate complement cascade: – consists of a group of 30 serum proteins – destroy foreign cells by phagocytosis and lysis of cell membranes – creates inflammation Cambridge Nutritional Sciences IgG SUBCLASS PROPERTIES OPSONISATION Ability of antibodies to ‘flag’ foreign cells/antigens for destruction: – cells / antigens are destroyed by phagocytosis (macrophages and neutrophils) – phagocytes need a ‘marker’ to identify what to destroy – markers are antibodies and complement proteins (called opsonins) – installation of opsonins enables phagocytosis BINDING TO PHAGOCYTES Ability of opsonin antibodies to bind to macrophages and neutrophils Cambridge Nutritional Sciences IgG SUBCLASS PROPERTIES PROPERTY IgG1 IgG2 IgG3 IgG4 Neutralisation ++ ++ ++ ++ Activation of complement pathway ++ + +++ Opsonisation +++ + ++ Binding to macrophages ++ + +++ Binding to neutrophils + IgG1 and IgG3 have strong pro-inflammatory properties IgG4 has protective, anti-inflammatory properties + ++ Cambridge Nutritional Sciences IgG4 FUNCTION Acts as a ‘blocking agent’ against the actions of IgE Catches and neutralises the (food) antigen before IgE can bind to it IgG4 acts to prevent acute allergic reactions (Type I allergy) from occurring No complement activation and no opsonising capacities No involvement with Type III (IgG-mediated) food intolerance Impossible to detect ‘delayed-onset’ food intolerance by IgG4 testing! Cambridge Nutritional Sciences PUBLICATIONS AGAINST IgG4 TESTING Testing for IgG4 against foods is not recommended as a diagnostic tool. S. Stapel, R. Asero, B. K. Ballmer-Weber, E. F. Knol, S. Strobel, S. Vieths, J. Kleine-Tebbe. Allergy 2008: 63: 793–796 Conclusion: food-specific IgG4 does not indicate (imminent) food allergy or intolerance, but rather a physiological response of the immune system after exposure to food components. Testing of IgG4 to foods is considered as irrelevant for the laboratory work-up of food allergy or intolerance and should not be performed in case of food-related complaints. Cambridge Nutritional Sciences PUBLICATIONS AGAINST IgG4 TESTING All controlled studies for “food intolerance” are performed with total IgG No controlled clinical trials have been performed with IgG4 Cambridge Nutritional Sciences WHITE BLOOD CELL TEST Tests for cellular responses to foreign substances in-vitro Cambridge Nutritional Sciences WHITE BLOOD CELL TEST (Activated Neutrophil Test and Cytotoxic Test) Principle: the diameter of white blood cells (leukocytes) change after being challenged with foods, moulds, additives, environmental chemicals, dyes and antibiotics. White Blood Cells (separated or EDTA blood) are exposed to antigens: Incubation Primary reactive leukocyte fraction consists of: Activation of immune response in cell Neutrophils Cambridge Nutritional Sciences NEUTROPHIL DEGRANULATION Food antigens bind to antibodies which are attached to surface of a neutrophil. Creates a “cross-linking” which induces a process known as degranulation. Neutrophil Cambridge Nutritional Sciences NEUTROPHIL DEGRANULATION 1. Generates highly toxic reactive oxygen and nitrogen species 2. Release powerful proteolytic enzymes / histamine / chemokines / heparin Damaging to pathogens but also damaging to host tissues Cambridge Nutritional Sciences WHITE BLOOD CELL TEST Healthy cell Mild reaction Strong reaction Cambridge Nutritional Sciences WHITE BLOOD CELL TEST Advantages Errors eliminated due to computerised measurement Disadvantages Neutrophils are unstable - high risk of incorrect test results Morphologically change immediately after blood is drawn Reliable test results only if tested within 6 hours No possibility to send sample by mail Neutrophils are highly sensitive to drug intake and infections - risk of incorrect results Need an automated system to count cells Cambridge Nutritional Sciences MANAGING FOOD INTOLERANCES Cambridge Nutritional Sciences MANAGING FOOD INTOLERANCES 1) Identify foods producing elevated IgG response COMMON PROBLEM FOODS (data collated by CNS) Cambridge Nutritional Sciences MANAGING FOOD INTOLERANCES 2) Remove or reduce reactive foods from diet PLAN THE DIET: Reduce “allergenic load” Compliance important for best results Plan / shop in advance Know your “problem” foods Read ingredients labels Substitute with similar alternatives Concentrate on NORMAL foods Variety – nutrients & intolerance Cambridge Nutritional Sciences MANAGING FOOD INTOLERANCES 2) Remove or reduce reactive foods from diet Foods to avoid, include, recipes, menus, websites Cambridge Nutritional Sciences MANAGING FOOD INTOLERANCES 2) Remove or reduce reactive foods from diet POINTS TO NOTE: Food must be included in diet before testing - no IgG reaction if food is not consumed! Avoid known allergenic foods – negative in IgG test Some clients may feel worse after elimination of reactive foods Immunosuppressants Cambridge Nutritional Sciences MANAGING FOOD INTOLERANCES 2) Remove or reduce reactive foods from diet ADVICE FOR NUMEROUS ELEVATED RESULTS: Leaky Gut? Prioritise - 4 to 6 most reactive foods (reduce allergenic load) Rotate / reduce the remaining foods Work with symptoms and results Cambridge Nutritional Sciences MANAGING FOOD INTOLERANCES 3) Repair Leaky Gut / boost immune system 4) Re-populate gut with beneficial gut flora 5) Strengthen the immune system 6) Re-introduction of foods Avoid elevated foods for 3-6 months Still symptoms – probably not food intolerance Re-introduce foods – gradually Monitor symptoms Avoid for longer if necessary Eat in moderation and vary the diet Cambridge Nutritional Sciences SUMMARY OF ADVICE Eliminate foods with strong reaction (ELEVATED foods) Reduce / rotate foods with moderate reaction (BORDERLINE foods) Eat foods freely from the NORMAL group Replace foods with a similar food from that food group Eat a varied diet Repair leaky gut Support immune system Cambridge Nutritional Sciences SUPPORT DOCUMENTATION Cambridge Nutritional Sciences Scientific Publications Patient Experiences Cambridge Nutritional Sciences SCIENTIFIC PUBLICATIONS ADHD Anti-Aging Autism Fertility Gastrointestinal General Migraine Rheumatoid Arthritis Skin Conditions Weight Loss Cambridge Nutritional Sciences GENERAL (GN1) Toward an understanding of allergy and in-vitro testing Mary James N.D. Great Smokies Diagnostic Laboratory Cambridge Nutritional Sciences GENERAL (GN1) Toward an understanding of allergy and in-vitro testing Mary James N.D. Great Smokies Diagnostic Laboratory Excellent overview of: Immune system Food terminology – hypersensitivity and allergy Immune tolerance and overload Diagnosis Elimination diets Leaky gut Cambridge Nutritional Sciences GENERAL (GN13) Testing for food reactions: the good, the bad, and the ugly Mullin GE, Swift KM, Lipski L, Turnbull LK, Rampertab SD Nutr Clin Pract 2010 Apr; 25(2):192-8 Cambridge Nutritional Sciences GENERAL (GN13) Testing for food reactions: the good, the bad, and the ugly Mullin GE, Swift KM, Lipski L, Turnbull LK, Rampertab SD Nutr Clin Pract 2010 Apr; 25(2):192-8 Literature review Evaluating the validity of tests used to assess food reactions Food hypersensitivity, food allergy, food sensitivity, food intolerance testing and adverse food reactions IgE–mediated food allergy testing was best represented in PubMed IgG–based testing showed promise, with clinically meaningful results Proven useful as a guide for elimination diets Further investigation into the clinical application is required Cambridge Nutritional Sciences GENERAL (W1) Dietary advice based on food specific IgG results Geoffrey Hardman, Gillian Hart. Nutrition and food science Vol 37 No 1 2007 pp 16-23 Cambridge Nutritional Sciences GENERAL (W1) Dietary advice based on food specific IgG results Geoffrey Hardman, Gillian Hart. Nutrition and food science Vol 37 No 1 2007 pp 16-23 Provide evidence that elimination diet based on food-specific IgG testing is an effective, reliable and valid aid in the management of chronic illness Postal survey commissioned by Allergy UK – 5286 participants Questionnaire sent 3 months after IgG food test 76% reported a significant improvement in their condition 68% noticed a benefit within 3 weeks Those with more than 1 condition more likely to report noticeable improvement 92% reported a return of symptoms on reintroduction of offending foods Cambridge Nutritional Sciences GASTROINTESTINAL (GA1) Food elimination based on IgG antibodies in Irritable Bowel Syndrome: a randomised controlled trial W Atkinson, T A Sheldon, N Shaath, PJ Whorwell Gut 2004:53 1459-1464 Cambridge Nutritional Sciences GASTROINTESTINAL (GA1) Food elimination based on IgG antibodies in Irritable Bowel Syndrome: a randomised controlled trial W Atkinson, T A Sheldon, N Shaath, PJ Whorwell Gut 2004:53 1459-1464 To assess the therapeutic potential of dietary elimination based on presence of IgG antibodies to food 150 outpatients with IBS - 3 month study Diet excluding all foods to which they had raised IgG antibodies or a sham diet excluding the same number of foods but not those to which they had antibodies Outcome measures - change in IBS symptom severity and global rating scores True diet resulted in 26% greater reduction in symptom score than sham diet Relaxing the diet led to 24% greater deterioration in symptoms Food elimination based on IgG antibodies effective in reducing IBS symptoms Cambridge Nutritional Sciences GASTROINTESTINAL (GA5) Clinical relevance of IgG antibodies against food antigens in Crohn’s Disease: a double-blind cross-over diet intervention study Bentz, Hausmann, Piberger, Kellermeier, Paul, Held, Falk, Obermeier, Fried, Schölmerich, Rogler Digestion 2010;81:252–264 Cambridge Nutritional Sciences GASTROINTESTINAL (GA5) Clinical relevance of IgG antibodies against food antigens in Crohn’s Disease: a double-blind cross-over diet intervention study Bentz, Hausmann, Piberger, Kellermeier, Paul, Held, Falk, Obermeier, Fried, Schölmerich, Rogler Digestion 2010;81:252–264 Immune responses against food antigens may be a reason for the perpetuation of inflammation associated with Crohn’s Disease (CD) 79 CD patients and 20 healthy controls were tested for food IgG antibodies Based on the IgG antibodies, a nutritional intervention was planned 84% patients had IgG antibodies against processed cheese and yeast Daily stool frequency decreased by 11% Abdominal pain reduced and general well-being improved Cambridge Nutritional Sciences GASTROINTESTINAL (GA6) Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics Drisko, Bischoff, Hall, McCallum. Journal of the American College of Nutrition, Vol. 25, No. 6, 514–522 (2006) Cambridge Nutritional Sciences GASTROINTESTINAL (GA6) Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics Drisko, Bischoff, Hall, McCallum. Journal of the American College of Nutrition, Vol. 25, No. 6, 514–522 (2006) Goal was to investigate the role of food intolerance in IBS patients 20 patients with IBS who had failed standard medical therapies Baseline IgE and IgG food/mould panels and stool analysis were performed Patients underwent food elimination diets based on their results Elevated serum IgG food/mould levels detected in 100% participants Significant improvement after food elimination and rotation diet Identifying food sensitivity in IBS impacts on overall well being and quality of life Cambridge Nutritional Sciences MIGRAINE (M2) Food allergy mediated by IgG antibodies associated with migraine in adults Hernández, Pinto, Montiel. Revista Alergia México 2007;54(5):162-8 Cambridge Nutritional Sciences MIGRAINE (M2) Food allergy mediated by IgG antibodies associated with migraine in adults Hernández, Pinto, Montiel. Revista Alergia México 2007;54(5):162-8 Aim of study was to investigate allergen-specific IgG in patients with migraine 56 patients with migraine, control group without migraine Serum antibodies to specific 108 food allergens were measured Significant differences in number of positives for IgG food allergens between patients with migraine and a controlled group Elimination diets successfully control the migraine without need of medications Serum IgG antibodies to common food should be investigated in patients with migraine Cambridge Nutritional Sciences SCIENTIFIC PUBLICATIONS Abstracts Booklet Excel Library Full Publications Cambridge Nutritional Sciences PATIENT EXPERIENCES Aches & Pains Chronic Fatigue Gastrointestinal Discomfort Migraines & Headaches Skin Conditions Weight Issues Cambridge Nutritional Sciences ACHES & PAINS • Lesley, a retired PA from Ashford, Kent • Aching joints and muscles and flu-like symptoms • Symptoms were worse after she had eaten wheat (especially bread) and dairy together • August 2005, Lesley decided to do a food intolerance test (FoodPrint) • Tested positive for wheat, yeast, cola nut and pineapple • Lesley saw an improvement in her symptoms immediately • Found alternatives to replace the wheat and yeast in particular • Lesley has tried reintroducing some foods but finds that she reacts on each occasion Cambridge Nutritional Sciences CHRONIC FATIGUE • Tansy, a 36-year-old psychotherapist from Horncastle in Lincolnshire • 4 years off work with M.E. - bedridden for up to 10 days a month • Tansy decided to experiment with her diet after a friend advised her to try excluding certain foods • Excluded nuts and eggs – felt slightly better • Excluded wheat and replacing it with rye – felt worse • Eliminating every possible food intolerance by trial and error was time consuming • Decided to try Food Detective test • Reacted to 20 foods, including wheat, rye, dairy, soya, nuts, egg, barley and crab • Ironically, she reacted more to rye than wheat • Tansy took the offending foods out of her diet and within the first week began to feel better Cambridge Nutritional Sciences GASTROINTESTINAL DISCOMFORT • Sandra, 54, from Crawley, West Sussex • Agonising bouts of Irritable Bowel Syndrome (IBS) - laid up in bed for days at time • Over an 18 month period, Sandra underwent numerous medical investigations: - endoscopy, CT scan and multiple blood tests • Eventually one doctor told her she had IBS and would just have to live with it • Sandra went to see a nutritionist who suspected she was suffering from a food intolerance • Performed a Food Detective test • Intolerant to apples, wheat, almonds, rice, brazil nut, cashew nuts, cocoa beans, whole egg and shellfish • Eliminated the foods and began to feel better • Within a few weeks her IBS symptoms disappeared Cambridge Nutritional Sciences MIGRAINES AND HEADACHES • Yvonne, a 58-year-old mum from Poringland in Norfolk • Suffered for 12 years from fortnightly migraines • Yvonne’s GP was helpful in providing medication to manage her migraines • He never got to the root of what was actually causing them • Decided to try Food Detective™ • Reacted to soya bean, wheat, barley, corn, rye, cow’s milk, egg, grapefruit, almond and cashew • Immediately avoided these foods and was felt better within a week Cambridge Nutritional Sciences SKIN CONDITIONS • James, 31, from Cambridge • Suffered from eczema - frustrating and difficult to function normally at work • Prescribed various steroid creams and emollients but nothing addressed the cause of the eczema • Started doing some research on the internet - link between food and eczema • Decided to try a food intolerance test • Reaction to cows’ milk, egg white and also grains and yeast • James eliminated all the foods he was intolerant • Effect on his eczema was astounding - within a couple of days it had completely cleared up • Sleeping through the night and feeling much better for it • Occasionally, James has a meal containing dairy foods or enjoys a couple of beers but the next day his eczema will flare up again Cambridge Nutritional Sciences WEIGHT ISSUES • Tina, 41-year-old from Forest Row, East Sussex • Grossly overweight - BMI was dangerously high – difficulty loosing weight • Visited a local nutritional therapist • Suggested she may be intolerant to some foods - could be inhibiting her weight loss • Given a Food Detective test • Tina tested positive to cow’s milk, citrus fruits and durum wheat • Started using nut milk on cereal and in tea and stopped eating oranges and pasta Cambridge Nutritional Sciences PATIENT EXPERIENCES Booklet Excel Library Cambridge Nutritional Sciences DEMONSTRATION VIDEOS
