A Balanced Approach to Food Restriction & Nutrition Therapies

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Hey Spoonful-ers! This is Audrey Inouye, one of the dietitians who helped create the app. I wanted to touch base with you on a difficult topic – food restriction. Over the past year, we’ve seen a growing amount of fear-based nutrition messages aimed at convincing people to unnecessarily cut healthy foods. While Spoonful, by design, helps you make and manage these cuts, we in no way want you to feel overly restricted or anxious about food.

I know how tempting it is to remove ingredients until your symptoms subside, but that can oftentimes be the wrong approach. In this article, I want to shed more light on food intolerances and give you a game plan for navigating your food journey in a safe, evidence-backed way.

Step 1: Follow the Science

Many types of nutrition therapies are known to improve symptoms, but some are not. When considering a dietary change, look for research supporting improvements in your specific symptoms or the condition you have been diagnosed with.  

There is an abundance of research for the low FODMAP protocol for people with IBS and/or certain digestive conditions. Likewise, a gluten-free diet is necessary for people diagnosed with celiac disease, and people with allergies will need to avoid the foods that they are allergic to.  Myself and the Spoonful team have and will always focus on making it easier for people to adhere to these types of nutrition therapies. We even make it possible to accomplish this in the context of a vegan, vegetarian, or pescatarian way of eating.   

Given the enormous amount of nutrition advice online, it is also important to weed out the diets that are not supported by an abundance of research or not applicable to you. The IgG food intolerance test is a classic example. There is no evidence for the use of these tests, but they continue to be used by practitioners. I often work with people who have unnecessarily avoided many foods (like wheat and dairy) for years because of these tests. What about nightshades?  I’m sorry to say that there’s no evidence on nightshades either. If you experience symptoms from eating nightshade vegetables, consider whether your symptoms are the result of a nocebo response, FODMAPs (like in green peppers), or capsaicin (like in hot chili peppers).   

Nutrition research is ongoing and there are many new therapies in the pipeline. The Spoonful team and their dietitians are waiting in the wings to launch new additions to Spoonful once nutrition therapies are ready for mainstream use.  

Be Mindful of Confirmation Bias

Perhaps you have read in a group about someone who experienced symptoms from a specific food, let’s say tomatoes. Maybe you had symptoms on a day that you had tomatoes. You also read that tomatoes are high in histamine. Our brains are always looking for connections, so this seems like an obvious hit. Tomatoes => Symptoms => Histamine Overload => Low Histamine Diet. This type of connection may be correct, but it also might not be. You may end up restricting more than is necessary for you.  Do your best to be objective about your symptoms.  

Step 2: Consider the Pros and Cons

Dietitians take food limits very seriously! We are trained to always consider the possible ups and downs of changing your diet and then we decide the best path forward.  

Pros

  • Your symptoms may improve.
  • You may find the answers you were looking for.
  • Your quality of life may improve.

Cons

  • Your symptoms may not improve.
  • Dietary restrictions can be difficult.
  • You may find it hard to get the nutrition your body needs.
  • Social events are difficult.
  • Your gut microorganisms LOVE diversity, so cutting foods out may have a downside for the gut.
  • You may develop food fears and disordered eating habits.

Food May Not Be the Cause of Your Symptoms

It is important to stay open to the possibility that food may not be the cause, or only cause for your symptoms.  For example, a trial of the low FODMAP protocol is recommended for 2-6 weeks to improve symptoms of IBS.  It is very effective for many people.  However, what happens if your symptoms didn’t improve?  What next?  Rather than cutting anything else out, it is important to work with your health care team to continue looking for answers and be open to the possibility that your symptoms aren’t related to food.  

Step 3: Find Your Individual Threshold

With conditions like celiac disease and food allergies, certain foods need to be completely avoided. However, with food intolerances, it is important to find your own individual threshold.  You can find excellent advice on the FODMAP reintroduction phase here. If you have completely removed a food from your diet but you aren’t certain whether a complete restriction is necessary or not, then you may consider looking for your individual threshold by adding it back in increasing amounts. For example, if you stopped eating all dairy, you may consider trying lactose-free dairy such as cheese or lactose-free yogurt. You may be surprised with the result.   

Get Experienced Support

You don’t have to do this on your own.  Look for a dietitian who has skills in the nutrition therapy that you are considering. Some nutrition therapies are complex and must be adapted to help you find answers. Many dietitians offer virtual counseling, which increases your access to more specialized services. You should look for the right dietitian who will help you be the least restrictive necessary for symptom relief.  

If you are considering trying nutrition therapy or cutting something out of your diet, I hope this article has given you a common sense approach so that you can carefully weigh the pros and cons for yourself. The Spoonful team is always on the lookout for medical nutrition therapies that will fit with the app so stay tuned.

Join the Conversation

  1. Thank you for this article. I have been having stomach issues and will be going through GI testing. Meanwhile, my allergist did tests which showed a wide range of allergies to various foods. I’m not sure if it was the IgG food intolerance test. In any event, hints like eliminating lactose versus all dairy are very helpful. How do I get more information like this?

    1. Hey Elizabeth – thank you for the kind words! We post ~2-3 times a month and are working on getting up a subscribe form so you can get notified when we do. In lieu of that, have you downloaded the Spoonful app?

    2. Hello Elizabeth. This is Audrey, the author of the article. I’m sorry to hear that you are having stomach issues, but it is great that you are going through GI testing. That is really important.

      An allergist is a medical doctor who can diagnose allergies. It is uncommon for a medical doctor such as an allergist to use the IgG food intolerance test in their practice. However, it is very important that you work with your doctors (allergist and family doctor) so that you have a clear understanding of your medical tests and the results. If you aren’t sure, then you should speak with the doctor’s office to confirm the type of testing that you have done.

      In the meantime, the Spoonful app is worth downloading as they will soon be adding the most common allergic foods to the app. I’m sure you will find this to be helpful in light your food allergies.
      Audrey

  2. Thank you, this came on a day when I am at my lowest.

    1. Hi Janet – hang in there! If you ever need further support, we’re here. support(at)spoonfulapp.com

    2. Janet,
      This is Audrey, author of the article. I’m giving you a virtual hug. I hope our article helped improve your day a little. If you are looking for some social support to help with what you are going through, you may enjoy the Spoonful Facebook group – https://www.facebook.com/groups/777006916403808.
      Hugs,
      Audrey

  3. My Holistic Dr recommended the IGg testing, since I’ve had such terrible symptoms. There were many things on there that I would eat regularly, which I have since cut from my diet (1+ yr ago) and have attempted to re-introduce at various times. Each time has resulted in a negative way, which would put me in bed, or on the couch, for several days. So are you saying that these reactions are simply all in my head? “Nacebo” reaction? If I continue to eat them, then, would I simply forget about the reaction and I would eventually feel fine eating this food? I’m really looking forward to that, if it is the case.

    1. Hello Leslie,
      This is Audrey, author of the article. It is impossible for me to say what has contributed to your individual symptoms. However, it is so common for people who have had a history of food related symptoms to develop a fear-based response to food. This is called a nocebo response and I see it all of the time in my practice. It is also possible that some of the foods on your IgG list are actually high in FODMAPs and they have triggered a FODMAP response. Other food reactions are possible as well.
      Rather than live with a lifetime of unnecessary food restrictions, it is worth reaching out to an experienced dietitian in your area to help you bring some of the foods back into your life in a way that is safe and helps you find answers.
      I hope that helps and best of luck on your health journey.

  4. Teri Marshall says:

    So, are you saying the IgGt test is not a good thing to rely on for Celiac Disease? My son was just diagnosed off the elevated level of this test. He had an EGD done, but unfortunately they did not do a duodenal biopsy. What else would cause the level to be so elevated?

    1. The IgG test definitely does not diagnose celiac disease. It is important to continue working with your doctor to be properly screened for celiac while your son is on a gluten containing diet.

      The controversial thing about the IgG food intolerance test is that it is not clear what a high or low reading means. According to the American Academy of Allergy, Asthma & Immunology, IgG is a normal antibody that is found in many tissues throughout our body. The presence of high IgG is likely a normal response of the immune system to the variety of foods that we eat. In fact, higher levels of IgG4 to foods may simply be associated with a high tolerance to those foods. This article may help with your understanding of the IgG test – https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/igg-food-test.
      I hope that helps you find some more clarity on your journey.
      Audrey

    2. Teri,
      Teri,
      If you are referring to the tTG-IgG test for celiac, it is used in the screening process for celiac disease. The tTg-IgG test is different from the IgG food intolerance test that I referred to in the article. I recommend reaching out to your medical team if you have questions about your son’s diagnosis.

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