March 2, 2008

Food Sensitivities in Children – An Introduction

I used to think that “food sensitivities” were merely a convenient excuse for neurotic parents to explain less than desirable behavior in their children… until I became a teacher. As a Montessori teacher of 3-6 year olds, I became vaguely aware of behavior changing for the worse after lunch: attention spans diminished, and cooperation and motivation were lacking compared to the morning. I didn’t make a direct correlation between food and behavior as there were other assumed reasons for the afternoon change: they just came in from being outside, they were tired, they had held it together all day and needed to let it all hang out after lunch. Then along came Carl and there was no longer a question in my mind of the correlation between food and behavior.

Carl was a lovely 4 year old boy who had been in my class for a year. He was helpful, pleasant, smart, a hard worker and a contributor to the community. He was the “cooperative” child earmarked to work with the student teachers. One day his mother told me that he was exhibiting undesirable behavior at home, that they suspected he was allergic to wheat, and he could no longer have the crackers we served for snack. That seemed a little over the top to me as I had never noticed any questionable behavior in Carl, but I agreed to help him remember not to eat the school crackers and to instead eat his crackers from home. One day after snack we were having circle time when a lot of giggling broke out. I looked around and noticed Carl’s body sitting calmly, but his face was continually contorting into grotesque visages beyond the scope of your average four year old - there was practically smoke coming out of his ears. I asked him to stop, which would normally settle the issue, but instead he continued making the faces. It was at that point that I realized that he couldn’t stop; he looked straight ahead and continued to contort his face, without laughing or looking around at the other children.

After the circle my assistant and I did some investigating and learned that Carl had, in fact, eaten some wheat crackers for snack. His facial contortions seemed to be involuntary and related to the discomfort that he felt in his body as a result of eating a food to which he was sensitive. Watching Carl’s behavior was as if a switch had gone off, a veritable Jekyll and Hyde reaction; the next day he was his usual calm and cooperative self.

While this is an extreme example, it is a crystal clear picture of food sensitivity. Different children will display food sensitivities in different ways. Below are a list of signs that may indicate that your child is sensitive to a food he or she is eating:

Spaciness
Headaches
Stomach aches
Runny nose
Sneezing
Loose stools
Chronic colds, flus, sore throats
Chronic ear infections
Constipation
Restlessness
Hyperactivity
Dark circles under the eyes
Skin rashes
Asthma
Allergies
Tiredness
Stomach Aches
Irritability
Lethargy
Tiredness
Low Mood

The foods that seem to be the biggest culprits are the ones containing the largest proteins: gluten-containing grains (barley, wheat, spelt, rye), dairy products, soy products and eggs. A further list of potential culprits unrelated to large proteins include chocolate, nuts, fruit (citrus in particular), potato, corn, coffee, tomatoes, refined white sugar, and food/chemical additives such as aspartame/Nutra-Sweet, artificial colors and flavors and MSG. In my practice I have observed gluten to be the biggest culprit, and have seen most other food sensitivities melt away when gluten is avoided. This is why I call gluten “the mother of all food sensitivities.” Keep in mind that every person with food sensitivities will react differently depending on their body’s weaknesses. In my own three children I have seen reactions to wheat and gluten consist of dark circles, bowel inconsistencies, stomach aches, headaches, asthma, bloating, chronic colds, erratic behavior and even hives. I have seen sensitivity to almonds and bananas in the form of skin rashes, and to dairy in the form of frequent colds, loose stools and chronic congestion. A classic reaction to dairy products is eczema.

Why do children react to certain foods?
Occasionally our bodies will become sensitized to a food that has been a mainstay in our diets. It may simply create irritation or stimulate an immune response. “Inflammation” is the process of histamines and other chemicals being released by tissues to commence an immunological attack on a foreign body. Think about your nose when you have a cold, your throat when you have the flu or your stomach when you eat a tainted food. Each example is the body’s way to clear out the offending organism by increasing blood flow to the area which brings increased immune factors, which increases mucous and creates swelling. Occasionally, certain foods are mistakenly recognized as a threat and are given the same treatment as a foreign organism. Another possibility is that a food may simply irritate the gastrointestinal system, which in turn can create obvious symtpoms of gas and bloating, or seemingly unrelated symptoms such as skin rashes and eczema. The only way to turn off these unnecessary reactions is by avoiding the food in question.

Once the body has the chance to rest and heal from its overreaction to a food, the food can be reintroduced in small quantities with a close eye on any resulting symptoms. This is the “gold standard” in terms of measuring a body’s reaction to a certain food – avoidance and reintroduction. If during the time of reintroduction the food continues to create adverse symptoms, it must be avoided for another length of time (usually 2-4 weeks) and then reintroduced as before. In the meantime one has learned to substitute other foods and is less reliant on the food in question.

Children are a particularly elegant “litmus test” in terms of food sensitivities as their bodies are so untainted in comparison to an adult’s. Their reactions are much more obvious as they have not yet learned to ignore their body’s signals, or to compensate for discomfort, and parents with a watchful eye are apt to notice subtle changes, especially after a food has been avoided for a couple weeks. People often assume that a food sensitivity must elicit gastrointenstinal symptoms. I state emphatically that GI symptoms are only one example of many possible reactions that a child might experience from an offending food. Some children experience physical symptoms like a rash or headache, others emotional/behavioral sequelae like Carl and for some growth inconsistencies. Each child's response is going to be different depending on his or her weak spot. Think about yourself, are you one to get frequent colds, headaches, back pain? Children have their weaknesses too; even at a tender age they are revealing their basic consitutions.

There is so much more to say on this subject. I will devote subsequent postings to practical tips on how to remove certain foods from one’s diet, including substitutions, shopping lists, and recipes, and more detail on certain food sensitivities, genetics and familial tendencies. I encourage parents to listen more closely when your child complains of discomfort, put on you investigator hat and assume that there is merit to your children’s comments, especially if you notice that there is a pattern or regularity to their complaints. Consider that a food may be causing your child discomfort and notice if there are complaints after certain foods are eaten, keeping the most watchful eye out for the four proteins mentioned above (gluten, dairy, soy and eggs). You may even consider starting a "food and symptom journal" which may help you to keep track of foods and their side effects. In many ways our children are wiser than we are, we owe it to them to listen.

A licensed Naturopathic Physician (ND or NMD)can help you identify food sensitivites by doing testing or guiding you through elimination and reintroduction. There are a number of great websites devoted to support for folks with food sensitivities.