Friday, January 18, 2019

Moderation and variety is the mantra for a balanced diet

Food intolerance and food allergy are common terms that are often used interchangeably. But the two are not the same. Symptoms are generally benign in food intolerance and often limited to digestive signs and symptoms. An allergic food reaction, however, may be severe or even life-threatening and may occur even by eating a microscopic amount, touching or inhaling the food

There are IgG food tests to detect insensitivities to various foods. Based on the results, individuals are advised to either omit these foods from their diet or reduce the ingestion of these foods or to consume them on some sort of rotating diet.

While few published studies (Monogr Allergy. 1996;32:221-5; Gut. 2004; 53:1459) have shown the benefits of elimination diets in terms of improvement in symptoms, many reputed international bodies such as the American Academy of Allergy, Asthma & Immunology (AAAAI), European Academy of Allergy and Clinical Immunology (EAACI) and the Canadian Society of Allergy and Clinical Immunology (CSACI) do not recommend IgG tests to detect food allergies or food intolerances / sensitivities.

“The scientific studies that are provided to support the use of this test are often out of date, in non-reputable journals and many have not even used the IgG test in question”, says AAAAI.

The EAACI Task Force Report published in July 2008 in Allergy, the European Journal of Allergy and Clinical Immunology concluded that “foodspecific IgG4 does not indicate (imminent) food allergy or intolerance, but rather a physiological response of the immune system after exposition to food components. Therefore, testing of IgG4 to foods is considered as irrelevant for the laboratory workup of food allergy or intolerance and should not be performed in case of foodrelated complaints.”

The CSACI position statement on the use of food IgG tests says: “the inappropriate use of this test only increases the likelihood of false diagnoses being made, resulting in unnecessary dietary restrictions and decreased quality of life.”

Also, these tests are very expensive and detect only a limited number of food intolerances.

All lifestyle diseases such as hypertension, CAD, obesity, type 2 diabetes, hypothyroidism are now recognized as chronic inflammatory diseases and have been linked to protein in diet.

Proteins are broken down in the body to peptides and then to amino acids. Wheat is broken down into peptides but not amino acids. This is because humans lack the enzymes to completely digest the complex proteins in wheat. Therefore, wheat, which forms a staple part of diet for most Indians, is a chronic inflammatory substance, which has been implicated in the inflammatory process in chronic diseases, as it may cause inflammation even beyond the gut.

Our ancient rituals and traditions have given us a way out of this conundrum. They advocate the principles of “variety” and “moderation” i.e. eat a variety of food, and eat in moderation.

They also recommend including all seven colors (red, orange, yellow, green, blue/purple, white) and six tastes (sweet, sour, salty, bitter, pungent, and astringent) for a balanced diet.

There are several examples of food rotation in our mythology.

Fasting is a tradition for us. But, fasting does not mean ‘not eating’. It means omitting certain foods from the diet on the day of the fast.

Our Vedas advocate that one should observe 80 fasts in a year and these should involve not eating cereals (wheat). Observe one wheat fast a week. Eat only one light meal on the day of the fast they should not contain carbohydrates or wheat cereals. Wheat cereals can be replaced by besan ki roti or Samak rice (fruit), singhare ki roti (fruit), kuttu ki roti (fruit) or sabu dana. Use rock salt in your food instead of usual salt as it helps in better mineral absorption.

For example, wheat and grains are avoided during Monday fasts; non vegetarian food and alcohol are prohibited on Tuesdays; sour foods are completely avoided during Friday fasts.

These traditions were probably a way to desensitize the body to potential food allergens.

But people have mostly stopped observing weekly fasts with change in lifestyle owing to increasing urbanization.  And, possibly since then the incidence of lifestyle diseases has increased.

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA

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