Paleo Deconstructed Part 2: You Probably Don’t Have a Food Allergy

I used to think food allergies were a joke. How can stuff that comes out of the ground—stuff nature provides for us—make us sick or cause any sort of unpleasant or even painful reaction? I was naïve back then—back when I first entered the confusing labyrinth of human nutrition—believing that food “allergies” were all in people’s heads.

Turns out I was wrong—but I’m also partially right. Think of it like this:

Your body exists between two environments: the one inside, and the one outside. If you constantly expose the outside part of your body to poisons, you’ll get sick, and you’ll likely die. Expose your insides to toxic substances, and although it may take longer, the same thing will happen.

This is where Paleo enters the arena. Paleo continues to raise awareness that food—the quality more than the quantity—holds the key to health, longevity and even performance, to a certain degree. If you disagree with this premise, you’re an idiot—my words there, not Paleo’s.

Aside from its stupid name, I’ve come to dislike Paleo because certain prominent Paleo advocates scare the crap out of everyone by twisting statistics to prove that everyone must necessarily be allergic to every food that’s not Paleo-certified. One disclaimer: I’m not talking about everyone in the Paleo community here. Witness my man-crush on Robb Wolf as evidence.

Over the past decade or so, science has shed some light on a vast array of mechanisms that cause allergic reactions to food. The body produces antibodies that leave traces we can test to detect potential allergies. You’ll see immunoglobulin A and E (IgA and IgE, respectively), with IgE being the predominant marker used to detect an allergy. Doctors can also look at any abnormalities by performing a biopsy of the two sections of the digestive tract that connect the stomach to the small intestines. These things, along with dietary experimentation, can tell us whether certain foods actually do trigger allergies in a given individual.

Prior to this, we relied on guesswork and people’s preconceived notions by giving them a questionnaire with simple queries regarding whether they thought they had allergies to certain foods (“Do you have an allergy to milk? Yes or no?”). Today’s direct testing methods tell us far more than a random guess.

Do you think you have a food allergy? There’s a good chance you believe you do. If not, then the whole Paleo movement would be a bloated donkey carcass surrounded by flies, with vultures circling overhead. Here, then, is a list of common foods that people believe they’re allergic to:

I hope she doesn't have an undiagnosed milk allergy, because that will definitely leave a rash.

I hope she doesn’t have an undiagnosed milk allergy, because that will definitely leave a rash.

17% of people believe they’re allergic to milk and dairy.
10% of people believe they’re allergic to shellfish.
9% of people believe they’re allergic to tree nuts.
7% of people believe they’re allergic to chicken eggs.
2% of people believe they’re allergic to peanuts. The same is true for fish.
35% of people think they’re allergic to something.
(References: 1-3)

I omitted gluten from this list, because gluten deserves its own section, which I’ll address another time. If you look at these statistics closely, you’ll understand why the Paleo community is hell bent on convincing everyone that they’re allergic to everything. This gives rise to some seriously radical dietary suggestions—radical in the eyes of the US government, to be sure—to eat, in most cases, pretty much nothing but meat.

To be perfectly honest, eating nothing but meat isn’t such a bad way to go. The Inuit people of the Arctic Circle ate essentially nothing but meat and fat—with almost no vegetation—and stayed incredibly healthy[4-7]. It wasn’t until we introduced them to Western-style food that they started developing all the diseases common to the rest of the world. Recent bone-collagen studies performed on the fossils of Paleolithic humans have also confirmed that for a great part of our existence, we almost NEVER ate any vegetation whatsoever[8-16].

If we made it a million years without vegetables, would it be absurd to claim that we could probably make it another million by continuing to not eat them?

This may go a bit too far, because it’s limiting. Sure, if 40 percent of people actually suffer from the allergies they believe they do, this isn’t a bad idea. This leads us to a very big problem, however. There’s a vast difference between what we think we’re allergic to, and what we’re allergic to in reality. The following list is the actual rate of food allergies among people using a double-blind, placebo food challenge, and IgE detection procedure (the gold standard for detecting food allergies[17, 20, 22, 26-30]):

Milk: 2%
Shellfish: 1.4%
Treenuts: ~3%
Eggs: ~1%
Peanuts: ~2%
Fish: 0.5%
Odds of having an allergy to any food: 5%
(Results of a meta-analysis, reference 3)

This is obvious evidence that there’s an extremely wide gap between perception and reality with regard to food allergies, and this has been confirmed, time and time again, across the globe[2, 18-22]. The numbers don’t lie: You’re ten times more likely to believe that you or your child has a food allergy than you are to actually suffer from a real one[3, 23].

It’s All In Your Head

These numbers tell me I was right to assume that most people’s supposed food allergies don’t exist. We’ve been scared into believing that we must be allergic to something. Believing myths is part of being human—especially in terms of myths we can relate to an experience. Did you eat a bad clam once? Sniff a rotten egg and became nauseous? Then you’re obviously allergic to all shellfish and all eggs. Have you had an upset stomach after a glass of milk and a peanut butter and jelly sandwich? Yep, you must be allergic to both peanuts and milk. Hell, maybe you’re allergic to fruit, too.

This, unfortunately, is how we think. As humans, we search for confirmation bias, which means we look for reasons to believe what we think should be true. That’s why science is so important. It eliminates these fantasies. If you think you’re allergic to a certain type of food, go to a food allergy specialist and find out for sure.

So, does it really hurt us to just avoid these foods, even if we have no medical or scientific basis for believing we’re allergic? Well, no. Not really. Problems arise upon accidental—or occasional—ingestion if you really think you’re allergic. If you really, truly believe you have an allergy, this can cause a full-blown, stress-related reaction—even if it’s not an allergic reaction to the food itself[24-25].

How can you maintain a healthy diet and lifestyle if you’re constantly stressed out about what you’re eating?


How Did We Get Here?

It’s not hard to find studies telling us how allergic we are to food. Some of the most referenced studies used as proof of the food allergy epidemic base their findings on food questionnaires[31-48]. Claiming that food allergies exist to such a high degree based on anecdotal evidence—i.e., what people assume they’re allergic to—is not science. This only tells us that food scares people. It doesn’t tell us what they’re actually allergic to.

A good example of this can be found in the meta-analysis in reference 3. Researchers found 954 food allergy studies in various populations. Ironically, the number of papers that actually used testing to determine the true rate of allergy is much smaller: just 51.

What’s the truth here? The reality of the situation is that the current Paleo-induced fear of food is the real epidemic. There’s not even one reliable study to support the claim that the incidence of allergic reaction to food is increasing. The only thing that’s increasing here is our level of irrational, unfounded fear.

Is It Worth Getting Tested?

Absolutely. If you believe you’re allergic to something—or that your child is—it’s worth finding out for certain. Consistent low-grade IgE production (the immune response to a true food allergy) can cause problems over time, like exercise-induced asthma, skin rashes, and, in children, chronic asthma[49].

The verdict? Although food allergies are real, and can have lasting negative effects, we need, first, to ascertain how much of this is real, and how much is rooted in fear. If you’re worried, find out for sure.


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