Cooked Scallion

Cooked scallions, also known as green onions, are a popular addition to many dishes due to their nutritional value and unique flavor profile. 

While they are generally considered beneficial, it is important for clinicians to be aware that cooked scallions, like other Allium species such as garlic and onions, may trigger allergic reactions in some individuals, especially in those with unexplained food sensitivities or gastrointestinal and respiratory symptoms.

What are Cooked Scallions?

Cooked scallions (allium fistulosum), also known as green onions or spring onions, are a nutritious addition to many dishes. 

Cooked scallions are young onions harvested before the bulb fully develops; cooking them enhances their flavor while altering their texture. While heat-sensitive nutrients may be slightly reduced during cooking, many of their beneficial compounds remain intact.

Key nutrients in cooked scallions include Vitamin K, which plays a vital role in blood clotting and bone health, and Vitamin C, an antioxidant that supports immune function and collagen production. 

Scallions are also a good source of folate (Vitamin B9), essential for cell growth and DNA synthesis, and potassium, an electrolyte that helps regulate blood pressure and muscle function. Additionally, scallions provide fiber, which promotes healthy digestion.

One of the standout components of scallions is their organosulfur compounds, like allicin precursors, which may offer potential health benefits. These compounds are common in other allium vegetables such as garlic and onions; cooking can modify their potency, though some effects remain.

Cooked Scallions: Not a Direct Biomarker

It’s important to note that while cooked scallions provide these nutrients, they are not directly measured in blood tests. Instead, the focus is on their nutritional benefits, which can contribute to a balanced diet and support overall health.

However, in some people, scallions may cause an allergic reaction, which can be measured.

Food Allergies and Sensitivities to Cooked Scallions

Food allergies to scallions, including other Allium species like garlic and onions, should not be overlooked in patients with unexplained food-related symptoms. 

A study of over 8,000 allergy patients found that approximately 2.92% had hypersensitivity reactions to garlic or onion, with symptoms including chronic diarrhea, dyspepsia, asthma, urticaria, and contact dermatitis. 

The primary allergenic components were identified as lipid transfer proteins (LTPs) specific to garlic and onion, with no significant cross-reactivity to other common allergens like peach or wheat. 

Interestingly, raw or undercooked scallions can trigger severe reactions, including anaphylaxis in some individuals, while well-cooked scallions might be better tolerated. 

Clinicians should consider scallions in food allergy diagnostic workups, particularly in patients with ambiguous food sensitivities or those presenting with gastrointestinal or respiratory symptoms.

Food Allergies vs. Food Sensitivities

Food allergies and food sensitivities are different immune responses to food. Whether a person has a food allergy or food sensitivity, the proteins in a particular food are often (but not always) responsible for triggering the immune system to react. 

Food allergies, typically IgE-mediated, cause immediate, sometimes severe reactions like anaphylaxis within minutes to hours of eating the food, often triggered by common allergens like nuts, seafood, or dairy. 

On the other hand, food sensitivities are more common and involve delayed non-IgE-mediated immune reactions such as gastrointestinal discomfort or skin issues, and usually occur hours or days after consuming the food. They may involve an IgG-mediated immune response, and other immune-mediated chemicals may also be present.

While food allergies can cause life-threatening reactions like anaphylaxis and are often identified early, food sensitivities are not life-threatening and can be managed with dietary changes. 

Both are triggered when the immune system mistakenly identifies food proteins as harmful, but food allergies involve an immediate IgE response, while food sensitivities are due to a delayed immune reaction.

What is Food Sensitivity Testing?

Food sensitivity testing such as this panel identifies various immune reactions, helping clinicians pinpoint which foods may trigger symptoms. 

This testing can be helpful when it’s important to differentiate food sensitivities from food allergies, as they require different management strategies. Unlike traditional allergy testing, which focuses on immediate responses, food sensitivity testing can reveal delayed, less obvious reactions.

What is Tested for in Food Sensitivity Testing?

Different companies offer different panels, which may assess various biomarkers. Increasingly, a combination of the following biomarkers is seen: 

Antibodies

IgG, IgA, IgM, and IgE antibodies are the primary markers tested for food sensitivities. IgG is a commonly tested antibody in food sensitivity panels, as it reflects a delayed, chronic immune response. 

IgA and IgM are also assessed regarding mucosal immunity and initial immune responses, respectively. 

IgE is typically tested in food allergy testing, but it can sometimes be part of food sensitivity panels if a clinician suspects allergic reactions in addition to sensitivities.

Other Immune-Mediated Biomarkers

Complement Markers may also be tested in some panels, offering insights into inflammation and immune system activation.

Commonly Tested Foods

Food sensitivity panels often test for common foods like dairy, gluten, soy, eggs, nuts, and shellfish. These foods are frequently implicated in immune reactions due to their protein structures, which can provoke an immune response in sensitive individuals. 

However, many companies are now offering testing for additional foods to help clinicians craft more personalized food plans for patients. The specific foods tested will depend on the patient’s history, symptoms, and dietary considerations.

What Results Mean

Test results typically include a range of reactivity, from low to high. Low reactivity indicates minimal immune involvement and may not be clinically significant. 

High reactivity suggests that the food is likely a trigger for symptoms. It’s essential to interpret these results in the context of the patient’s clinical presentation. 

Positive results are not definitive diagnoses but guide further clinical action, such as elimination diets or further testing.

Clinical Indications for Food Sensitivity Testing

Food sensitivity testing is most useful when patients present with chronic, unexplained symptoms that don’t fit into conventional diagnostic categories. Conditions like irritable bowel syndrome (IBS), autoimmune disorders, and other inflammatory conditions may be associated with food sensitivities. 

Testing may be especially useful when symptom patterns or patient history suggest a dietary trigger but when traditional allergy testing has been negative.

Food sensitivities are often tied to gut health and inflammation. Leaky gut syndrome, where the intestinal lining becomes permeable, is frequently linked with food sensitivities. Identifying specific triggers can help reduce systemic inflammation and improve gut function.

Challenges and Limitations

While food sensitivity testing can be highly informative, there are limitations. 

False positives and false negatives can occur, as these tests may detect immune reactions that are not clinically significant. Additionally, sensitivity testing is not a one-size-fits-all solution—other factors, such as gut microbiota and leaky gut, should also be considered when interpreting results. 

Finally, food sensitivity testing remains a somewhat controversial area, with some mainstream practitioners questioning its validity.

As with any assessment or treatment, the potential benefits should be weighed against the risks for every patient. 

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