Eliminating Guesswork for Food Sensitivity

Food sensitivities, also known as food intolerances, are extremely common, affecting roughly 1 out of every 5 people.1 Despite this prevalence, diagnosis and treatment of food sensitivity is a significant challenge.

The current standard of care employs a broad elimination diet that then systemically re-introduces foods in a guess-and-check manner. This can be a lengthy and frustrating process for patients, and the success of this approach has not been sufficiently validated. Here, we’ll review the preliminary report of a clinical trial employing a new silicon-based peptide microarray to accurately diagnose and treat food sensitivities with improved precision.

Food Sensitivity: Difficult to Diagnose

Food sensitivities are notoriously difficult to diagnose. Unlike food allergies that cause a more rapid and acute anaphylactic response, the symptoms of food sensitivities appear much more gradually.

Symptoms slowly manifest several hours or even days later, meaning that several meals may have been consumed before symptoms begin to occur. This can make it challenging for both patients and healthcare providers to identify the dietary component causing issues. Further complicating the picture are the variety of symptoms, both gastrointestinal (GI) and extra-GI, that are associated with food sensitivity, including abdominal pain, bloating, joint pain, dermatitis, and more. When left untreated, more serious complications can arise from the chronic inflammation caused by regular intake of the offending food.

Unfortunately, the current approach to diagnosis relies heavily on the process of elimination.2 Appropriately identifying food sensitivity often occurs only after excluding other diseases with overlapping clinical manifestations.

The clinical gold standard for confirmation and treatment of food sensitivity relies on broad elimination diet. Foods are slowly reintroduced one at a time to determine which ingredient (or ingredients) are causing problems. Patients struggle to adhere to this strict elimination diet, and the process can be incredibly time-consuming, highlighting the need for a better approach.

A New Data-Driven Intervention

A recent clinical trial explored a novel approach to identifying and addressing food sensitivities based on their immunological roots.3 While food allergies are driven by Immunoglobulin E (IgE), food sensitivity is mediated by Immunoglobulin A (IgA) and Immunoglobulin G (IgG) antibody responses.4,5

This molecular understanding of food sensitivity forms the basis of a new silicone-based peptide microarray assay able to accurately detect and identify IgA and IgG antibodies against 262 food antigens. Importantly, this microarray screens antibody epitopes at both the protein and peptide level, capturing a more complete picture of a patient’s food sensitivities. This blood-based assay, designed by Vibrant Wellness, was used in this study to identify food sensitivities for 52 participants experiencing GI symptoms and guided the creation of individualized elimination diets for the cohort.

Participants followed their personalized elimination diets for 4 weeks, and the severity of their symptoms was ranked on both the Food Sensitivity- Symptom Severity Scale (FS-SSS) and Global Improvement Scale (FS-GIS). An overwhelming majority of patients reported statistically significant improvements in their symptoms after a month on their tailored diets.

Self-reported symptoms improved with the median FS-SSS score dropping from 19.5 down to 6 by the end of the trial. Physician observations matched the self-assessment, with 84.17% of participants demonstrating improved health scores on the FS-GIS.

These improvements corresponded with improved antibody titers for food sensitivity as well. Using the silicone-based microarray assay, the research team measured a reduction in IgG levels in 96% of patients following the trial, as well as reduced IgA titers in 84% of study participants.

Providing Hope to Patients

Patients need a faster, more efficient approach to food sensitivity symptom relief that current practices can’t provide. By harnessing our understanding of the immunological drivers of this condition, serological assays can be designed that definitively diagnose food sensitivities and allow healthcare teams to curate diets that will reduce IgA and IgG responses. Medicine shouldn’t rely on guesswork, and this study shows that a more data-driven path to addressing food sensitivities is possible.

References

1. Tuck CJ, Biesiekierski JR, Schmid-Grendelmeier P, Pohl D. Food Intolerances. Nutrients. 2019 Jul 22;11(7):1684. doi: 10.3390/nu11071684. PMID: 31336652; PMCID: PMC6682924.

2. Vora A, Vance D, Alnouri G, Sataloff RT. Food Sensitivity and Laryngopharyngeal Reflux: Preliminary Observations. J Voice. 2021 May;35(3):497.e5-497.e7. doi: 10.1016/j.jvoice.2019.09.005. Epub 2019 Nov 1. PMID: 31685326.

3. Hari Krishnan Krishnamurthy, Michelle Pereira, Vasanth Jayaraman et al. Personalized Food Elimination Diet: A Clinical Trial based on Food sensitivity assessment, 19 June 2024, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-4596789/v1]

4. Velikova, Tsvetelina & Kukov, Alexander & Georgieva, Viktoriya & Peruhova, Milena & Yurukova, Nonka & Michova, Antoaneta & Marinova, Tsanka & Mizgova, Gergana & Terzieva, Velislava & Zhelezova, Galina & Altankova, Iskra & Ivanova, Ludmila. (2018). METHODS FOR DETECTION OF FOOD INTOLERANCE. 1. 106-119.