These days, more people are being diagnosed with conditions like Celiac’s than ever before. As awareness for the condition has risen, it’s resulted in more diagnoses and treatment for those who previously were just suffering without knowing why. We never even used to know that people could have gluten intolerances, a finding that has changed many people’s lives, too.
But when everyone around you seems to be following a special diet, it’s easy to wonder if you fall into one of these categories yourself. We all know what it feels like to eat a big meal and have a total belly bomb after. Yet feeling like that every day is no way to live.
If you’re experiencing symptoms of indigestion, nausea, insane gassiness, or just feel downright crummy after most meals, here’s how to figure out if you have a food sensitivity or intolerance.
First, you need to figure out if you have a full-blown food allergy.
A sensitivity might make you uncomfortable or cause indigestion, but an allergy can be life-threatening. Both can cause nausea, stomach pains, excessive gas, and fatigue, but hives, a swollen throat, and itching or tingling of the lips are all signs you’re having an allergic reaction. “Symptoms are usually immediate and can be severe,” Sonya Angelone, R.D., a spokesperson for the Academy of Nutrition and Dietetics. If you think you may have an allergy, stay away from the problem food and visit an allergist to get tested ASAP.
If it’s not an allergy, it could be either a “sensitivity” or an “intolerance,” which seem similar but are two different things.
“Food sensitivity symptoms are usually chronic and affect about 20 to 30 percent of the population,” Angelone says. Sensitivities are also sometimes referred to as delayed food allergies, because they are also mediated by immune responses. “A sensitivity can affect any organ system in the body and can take from 45 minutes to several days for symptoms to become apparent.” Since the physiological mechanisms are complex, and symptoms may be delayed, it’s often difficult to pinpoint a sensitivity, leaving many undiagnosed.
An intolerance, on the other hand, causes similar symptoms but doesn’t involve an immune response. “In this case, when a food is ingested, it is not properly digested and begins to ferment inside the gut,” Angelone explains. “The most common example is lactose intolerance,” which causes symptoms like diarrhea and gas, thanks to the body’s inability to properly digest lactose.
Though the reason a food gives you discomfort is different whether you’re sensitive or intolerant, the solution is the same: Stop eating it.
If you think you have either a sensitivity or intolerance, start tracking everything you eat.
To pinpoint what’s causing your symptoms, start a food diary. Angelone calls it a “food symptom log.” Write down everything you eat, and when symptoms occur. Then, after a week or so, look for correlations that may suggest causation. “It can be up to 72 hours before a reaction occurs, so you can’t just look for an immediate reaction,” Angelone says. This is going to take some detective work on your part, but being aware of what you’re eating and how it affects you is key for pinpointing a sensitivity or intolerance.
Remember to always check the ingredients list on any packaged foods you consume. “Some people might put ‘almond milk’ in their log, and find they have a reaction,” Angelone says. But if you read the label, you might find it’s not almond milk but just one ingredient in it, that’s triggering your reaction. At restaurants, be sure to ask about all the ingredients and find out what your food is cooked in.
Start a basic elimination diet by cutting out all of the foods that you think may be causing problems.
Once you’ve identified the food or foods you think are causing your distress, stop eating them. Pick four or five basic foods that you know for certain aren’t causing your symptoms, and make that your base diet for the next two weeks.
Why two weeks? That’s about how long your body needs to reset itself, Angelone says. “If the intolerance is in GI tract, it will happen right away. But a sensitivity can be immediate or delayed up to 72 hours.” Your body may also take a few days to adjust to a new eating program, Angelone notes. “You might feel more tired, or get headaches” for a few days. It’s also essential that you drink a lot of water and stay hydrated when you’re eliminating foods. “As your body’s getting rid of inflammation, it’s also getting rid of water,” she says.
If your food log didn’t help you narrow things down, you can try just cutting out the most common food allergens: milk, eggs, fish, crustaceans/shellfish, tree nuts, peanuts, wheat, and soy. It’s best if you can narrow the list down, though, because removing all eight of these food groups really limits what you can eat.
You’ll also need to stop drinking alcohol…and probably coffee.
If you want to do it right, you have to cut the booze during this elimination stage. “It effects your gut integrity,” Angelone says, as do cigarettes and other drugs. If these substances are impacting your gut, you won’t get a clear reading on what foods may be causing similar reactions. Ideally, you should give up caffeine, too, Angelone says. “You should never go cold turkey because you’ll suffer from headaches, so it’s best to take several days to wean off it,” she explains.
After two weeks, start to add each food back in, one at a time.
Pick one food (maybe the one you’ve missed the most?) and start eating it again. Wait two or three days, and if your symptoms don’t return, add the next food back in. Keep doing this until you find one that causes symptoms. “If there’s a reaction, take it out,” Angelone says. Once you find a reactive food, “wait three days for the immune system to calm down,” before trying to add another food back in.
Pay particular attention to foods that you eat all the time.
If you’re noticing symptoms often, it’s probably because you have a sensitivity to something that you eat regularly.Angelone says this is very common among the clients she works with. But that doesn’t mean you have to say goodbye to your favorite food forever. “If you get rid of it all and get your immune system to calm down, you can often add some back and be fine,” Angelone says. She suggests waiting about three months to do so, and when you start eating it again, do so less regularly than you before to avoid overloading again.
Sometimes, just switching it up can help. For example, instead of cutting out allwheat, try eating some grains you’re not used to and see what happens. For some people, that can make a big difference. And you may just discover a new favorite.
Be careful when removing entire food groups.
“Trying to improve symptoms in the short term can create long-term deficiency symptoms if you don’t pay attention,” Angelone warns. Cutting out some foods can impact your gut’s microbiome, whereas others can create nutrient deficiencies. For example, you shouldn’t just get rid of dairy and not replace it with other foods that will give you the protein, calcium, and vitamin D you’re now missing. “You need to make sure what you take out you can replace.”
See a dietitian if you’re still having problems.
Some people find solutions quickly. They discover they’re lactose intolerant right away, give up dairy, and feel great again. For many others, a solution requires more intense investigative work, and may not come easily. “The important thing is to not give up if you don’t find anything,” Angelone says. If your at-home elimination diet doesn’t give you solid results, see a professional. A registered dietician can perform a more in-depth analysis to figure out what you’re sensitive or intolerant to, so if your situation is more complicated, bringing in the big guns may ultimately be necessary to finally get some answers.