Nutrition
|
May 24, 2024

Personalized Nutrition Strategies for Combating Gluten, Dairy, and Egg Sensitivities: A Guide for Healthcare Practitioners

Medically Reviewed by
Updated On
December 13, 2024

Food sensitivities and intolerances occur in up to 65% of the US population, with the most common causes being gluten, dairy, and eggs. In contrast to food allergies, many patients will have food sensitivities undiagnosed for years based on nonspecific symptoms and the lack of definitive diagnostic testing.Β 

Dietary changes, which can involve eliminating entire food groups, are crucial to treating food sensitivities. Personalized nutrition strategies are vital to improve symptoms and ensure adequate nutrition for optimal treatment.

[signup]

What Are Food Sensitivities?

Food sensitivities and intolerances occur when patients react adversely to certain foods or ingredients. These differ from food allergies, which involve an exaggerated immune response to the food and cause more severe symptoms, like hives, swelling, or anaphylaxis.Β 

Sensitivities and intolerances result from a direct response within the gastrointestinal tract. Possible symptoms include:

  • Abdominal pain
  • Bloating
  • Diarrhea
  • Constipation
  • Flatulence
  • Headache
  • Skin rash
  • Mood changes
  • Fatigue

Causes of food intolerances and sensitivities can include individual health factors, enzyme deficiencies, and inflammation.

How to Diagnose Food Sensitivities

Diagnosing food sensitivities can be difficult, requiring a thorough clinical history and an elimination diet.

Initial Evaluation

The first step is to obtain a detailed history, including the signs and symptoms the patient is experiencing. A food diary can be a helpful tool in identifying possible connections between a particular food and symptom occurrence.

Diagnostic TestsΒ 

The gold standard for diagnosing food sensitivities is an elimination diet. Eliminating the food of concern for at least 4 weeks and noting symptom improvement suggests a food intolerance.

Beyond dietary testing, food-specific IgG testing is often used, but its specificity and applicability are widely debated. Other nonspecific, less-validated biomarkers can be used to check for gut inflammation and enzyme deficiencies, yet their reliability is also unknown.

Personalized Nutrition Strategies

Formulating personalized nutrition strategies is critical for the long-term management of food sensitivities.

It includes text highlighting various elements such as magnesium, elimination and reintroduction of foods, and alternative supplementation.

Elimination and ReintroductionΒ 

The first step is eliminating the offending agent for at least 4 weeks. If symptoms resolve with the elimination, consider slowly adding the food back to assess tolerance in small amounts. However, if symptoms recur after reintroducing the food, eliminating it from the diet is the best treatment.

Alternative Nutrient Sources

Patients can focus on alternative food sources to ensure adequate nutrition when food sensitivity requires eliminating gluten, dairy, or eggs.Β 

Gluten-free, nutrient-dense options include quinoa, rice, and gluten-free oats, providing complex carbohydrates, fiber, vitamins, and minerals.Β 

Dairy alternatives like almond, soy, or coconut milk products are substitutes for calcium and vitamin D.

With the elimination of eggs, consider alternative protein sources like lean meats, tofu, or legumes. Also, be sure to include a variety of fruits and veggies to ensure micronutrient adequacy.

SupplementationΒ 

Supplementation is warranted if patients cannot obtain all the necessary nutrients from their diet. When excluding dairy, the most common deficiencies are calcium and vitamin D, which are vital for bone health.Β 

With gluten avoidance, patients may have vitamin B12, folate, magnesium, or iron deficiency.Β 

If patients cannot eat eggs, most nutrients, like fats, cholesterol, and fat-soluble vitamins, can be obtained from other animal products.Β 

Creating Balanced Meal Plans

While adhering to long-term dietary modifications that eliminate offending agents, it is essential to maintain a balanced, varied, and nutrient-dense diet. Incorporating different foods and flavors that are well-tolerated can make meals more enjoyable and improve long-term adherence.

Many free resources are available for recipe and meal ideas to avoid certain food groups. Consulting with a nutrition professional can also help jumpstart significant dietary changes.

Patient Education and Support

Adhering to an appropriate diet for food sensitivities and intolerances involves reading food labels and recognizing hidden ingredients. Be sure to look for "dairy-free" or "gluten-free" on the label, as cross-contamination is common.Β 

Dining out can be challenging due to uncertainty about the ingredients used in various dishes. Be sure to notify restaurant staff about your dietary restrictions.

Implementing dietary restrictions can be difficult, as it may involve eliminating favorite foods or isolation in social gatherings that center around food. Ensuring patients have the appropriate knowledge and adequate social support helps facilitate long-term adherence.

Monitoring and Long-Term Management

Follow-up visits with patients should include monitoring symptoms, nutrient intake, and ongoing reevaluation of overall health status.Β 

By noting any changes in symptoms, energy levels, and overall well-being, patients can be empowered to manage their health. Incorporating patient feedback is crucial to effectively managing food sensitivities and restrictive diets.

Serial lab testing is necessary to monitor the development of nutrient deficiencies and ensure prompt correction. Consider monitoring the following labs, plus others as indicated:

Ongoing, regular communication between patients and healthcare professionals helps promote optimal health outcomes.

[signup]

Key Takeaways

  • Common food sensitivities are prevalent in clinical practice, often causing significant impacts on patients' quality of life.
  • Using an elimination diet is the gold standard of diagnosing based on symptom resolution, and avoiding that food group is the necessary long-term treatment.Β 
  • However, following a restrictive diet puts patients at risk of nutrient deficiencies and other psychosocial stressors.Β 
  • Adopting a personalized nutrition approach with regular follow-up is vital to effectively managing food sensitivities.Β 

Food sensitivities and intolerances may affect up to 65% of the US population, with common triggers including gluten, dairy, and eggs. Unlike food allergies, many individuals may have food sensitivities that remain undiagnosed for years due to nonspecific symptoms and the absence of definitive diagnostic testing.Β 

Dietary changes, which can involve avoiding certain food groups, are important for managing food sensitivities. Personalized nutrition strategies can be helpful in supporting symptom management and ensuring adequate nutrition.

[signup]

What Are Food Sensitivities?

Food sensitivities and intolerances occur when individuals experience adverse reactions to certain foods or ingredients. These differ from food allergies, which involve an exaggerated immune response to the food and can cause more severe symptoms, like hives, swelling, or anaphylaxis.Β 

Sensitivities and intolerances may result from a direct response within the gastrointestinal tract. Possible symptoms include:

  • Abdominal discomfort
  • Bloating
  • Diarrhea
  • Constipation
  • Gas
  • Headache
  • Skin rash
  • Mood changes
  • Fatigue

Factors contributing to food intolerances and sensitivities can include individual health factors, enzyme deficiencies, and inflammation.

How to Identify Food Sensitivities

Identifying food sensitivities can be challenging, often requiring a thorough clinical history and an elimination diet.

Initial Evaluation

The first step is to gather a detailed history, including the signs and symptoms the individual is experiencing. A food diary can be a useful tool in identifying possible connections between a particular food and symptom occurrence.

Diagnostic ApproachesΒ 

A common approach for identifying food sensitivities is an elimination diet. Avoiding the food of concern for a period and noting symptom changes may suggest a food intolerance.

Beyond dietary testing, food-specific IgG testing is sometimes used, but its specificity and applicability are widely debated. Other nonspecific, less-validated biomarkers can be used to check for gut inflammation and enzyme deficiencies, yet their reliability is also uncertain.

Personalized Nutrition Strategies

Developing personalized nutrition strategies is important for the long-term management of food sensitivities.

It includes text highlighting various elements such as magnesium, elimination and reintroduction of foods, and alternative supplementation.

Elimination and ReintroductionΒ 

The first step is avoiding the offending agent for a period. If symptoms improve with the elimination, consider slowly adding the food back to assess tolerance in small amounts. However, if symptoms return after reintroducing the food, continuing to avoid it may be beneficial.

Alternative Nutrient Sources

Individuals can focus on alternative food sources to ensure adequate nutrition when food sensitivity requires avoiding gluten, dairy, or eggs.Β 

Gluten-free, nutrient-dense options include quinoa, rice, and gluten-free oats, which provide complex carbohydrates, fiber, vitamins, and minerals.Β 

Dairy alternatives like almond, soy, or coconut milk products can be substitutes for calcium and vitamin D.

With the avoidance of eggs, consider alternative protein sources like lean meats, tofu, or legumes. Also, be sure to include a variety of fruits and veggies to support micronutrient adequacy.

SupplementationΒ 

Supplementation may be considered if individuals cannot obtain all the necessary nutrients from their diet. When avoiding dairy, common nutrients to focus on include calcium and vitamin D, which are important for bone health.Β 

With gluten avoidance, individuals may need to focus on vitamin B12, folate, magnesium, or iron intake.Β 

If individuals cannot eat eggs, most nutrients, like fats, cholesterol, and fat-soluble vitamins, can be obtained from other animal products.Β 

Creating Balanced Meal Plans

While following long-term dietary modifications that avoid certain foods, it is essential to maintain a balanced, varied, and nutrient-dense diet. Incorporating different foods and flavors that are well-tolerated can make meals more enjoyable and support long-term adherence.

Many free resources are available for recipe and meal ideas to avoid certain food groups. Consulting with a nutrition professional can also help guide significant dietary changes.

Patient Education and Support

Adhering to an appropriate diet for food sensitivities and intolerances involves reading food labels and recognizing hidden ingredients. Look for "dairy-free" or "gluten-free" on the label, as cross-contamination can occur.Β 

Dining out can be challenging due to uncertainty about the ingredients used in various dishes. It's helpful to notify restaurant staff about dietary restrictions.

Implementing dietary restrictions can be difficult, as it may involve avoiding favorite foods or feeling isolated in social gatherings that center around food. Ensuring individuals have the appropriate knowledge and adequate social support can help facilitate long-term adherence.

Monitoring and Long-Term Management

Follow-up visits with individuals should include monitoring symptoms, nutrient intake, and ongoing reevaluation of overall health status.Β 

By noting any changes in symptoms, energy levels, and overall well-being, individuals can be empowered to manage their health. Incorporating feedback is crucial to effectively managing food sensitivities and restrictive diets.

Regular lab testing may be necessary to monitor the development of nutrient deficiencies and ensure prompt correction. Consider monitoring the following labs, plus others as indicated:

Ongoing, regular communication between individuals and healthcare professionals can help promote optimal health outcomes.

[signup]

Key Takeaways

  • Common food sensitivities are prevalent in clinical practice, often impacting individuals' quality of life.
  • Using an elimination diet is a common method for identifying sensitivities based on symptom changes, and avoiding that food group may be necessary for long-term management.Β 
  • However, following a restrictive diet can put individuals at risk of nutrient deficiencies and other psychosocial stressors.Β 
  • Adopting a personalized nutrition approach with regular follow-up is important for effectively managing food sensitivities.Β 
The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

Learn more

No items found.

Lab Tests in This Article

No lab tests!
  1. BascuΓ±Γ‘n KA, Vespa MC, Araya M. Celiac disease: understanding the gluten-free diet. Eur J Nutr. 2017;56(2):449-459. https://pubmed.ncbi.nlm.nih.gov/27334430/
  2. Christie, J. (2023, November 22). The Top 10 Conditions Related to a Food Sensitivity That May Surprise You. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-food-sensitivities-testing-and-treatment
  3. Cloyd, J (2023, March 21). 5 Lab Tests You Need to Know About If You Want to Test for Gluten Sensitivity. Rupa Health. https://www.rupahealth.com/post/5-lab-tests-you-need-to-know-about-if-you-want-to-test-for-gluten-sensitivity
  4. Cloyd, J. (2023, June 5). A Functional Medicine Celiac Disease Protocol: Diagnosis, Nutrition, and Supplements. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-celiac-disease-protocol-diagnosis-nutrition-and-supplements
  5. Cloyd, J. (2023, June 15). A Functional Medicine Lactose Intolerance Protocol: Specialty Testing, Elimination Diet, and Supplement Suggestions. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-lactose-intolerance-protocol-specialty-testing-elimination-diet-and-supplement-suggestions
  6. Cloyd, J. (2023, December 1). How to Interpret CBC Results: A Comprehensive Guide. Rupa Health. https://www.rupahealth.com/post/how-to-interpret-cbc-results-a-comprehensive-guide
  7. Cloyd, K. (2024, January 17). Understanding Nutritional Deficiencies: When to Utilize Micronutrient Testing. Rupa Health. https://www.rupahealth.com/post/understanding-nutritional-deficiencies-when-to-utilize-micronutrient-testing
  8. DeCesaris, L. (2022, August 30). How to Do an Elimination Diet. Rupa Health. https://www.rupahealth.com/post/how-to-do-an-elimination-diet
  9. DeCesaris, L. (2024, January 9). Maximizing Patient Engagement: Innovative Strategies for Functional Medicine Practices. Rupa Health. https://www.rupahealth.com/post/maximizing-patient-engagement-innovative-strategies-for-functional-medicine-practices
  10. Diorio, B. (2023, April 7.) Could Your Patients Benefit from the Phytonutrient Spectrum Food Plan? Rupa Health. https://www.rupahealth.com/post/could-your-patients-benefits-from-the-phytonutrient-spectrum-food-plan
  11. Facioni MS, Raspini B, Pivari F, Dogliotti E, Cena H. Nutritional management of lactose intolerance: the importance of diet and food labeling. J Transl Med. 2020;18(1):260. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318541/#:~:text=The%20major%20risk%20associated%20with,deficiency%20and%20compromising%20bone%20health.
  12. Greenan, S. (2021, November 17). The 8 Most Common Signs of a Food Sensitivity. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-food-sensitivities-testing-and-treatment
  13. Greenan, S. (2021, August 10). Top 4 Food Sensitivity Tests for Functional Medicine Providers. Rupa Health. https://www.rupahealth.com/post/top-5-food-sensitivity-test-for-functional-medicine-providers
  14. Li A, Zheng J, Han X, et al. Advances in Low-Lactose/Lactose-Free Dairy Products and Their Production. Foods. 2023;12(13):2553. https://pubmed.ncbi.nlm.nih.gov/37444291/
  15. Matthews, R. (2022, September 21). You Could Be Gluten Sensitive and Not Know It. These Are the Signs. Rupa Health. https://www.rupahealth.com/post/non-celiac-gluten-sensitivity
  16. Preston, J. (2024, February 7). Iron 101: RDA, Iron-Rich Foods, and Supplementation. Rupa Health. https://www.rupahealth.com/post/iron-101-rda-iron-rich-foods-and-supplementation
  17. Preston, J. (2024, February 15). Magnesium 101: RDA, Magnesium-Rich Foods, and Supplementation. Rupa Health. https://www.rupahealth.com/post/magnesium-101-rda-magnesium-rich-foods-and-supplementation
  18. Rupa Health. (n.d.-a). Folate. Rupa Health. Retrieved May 17, 2024, from https://www.rupahealth.com/biomarkers/folate
  19. Rupa Health. (n.d.-b). Iron. Rupa Health. Retrieved May 17, 2024, from https://www.rupahealth.com/biomarkers/iron
  20. Rupa Health. (n.d.-c). Magnesium. Rupa Health. Retrieved May 17, 2024, from https://www.rupahealth.com/biomarkers/magnesium
  21. Rupa Health. (n.d.-d). Vitamin D. Rupa Health. Retrieved May 17, 2024, from https://www.rupahealth.com/biomarkers/vitamin-d
  22. Rupa Health. (n.d.-e). Zinc. Rupa Health. Retrieved May 17, 2024, from https://www.rupahealth.com/biomarkers/zinc
  23. Smith E, Foxx-Orenstein A, Marks LA, Agrwal N. Food Sensitivity Testing and Elimination Diets in the Management of Irritable Bowel Syndrome. J Am Osteopath Assoc. 2020;120(1):19–23. https://pubmed.ncbi.nlm.nih.gov/31904770/
  24. Sweetnich, J. (2023, April 26). Unlocking the Benefits of Vitamin B12: The Importance of Maintaining Optimal Levels. Rupa Health. https://www.rupahealth.com/post/vitamin-b12-101
  1. Sweetnich, J. (2023, May 8). Understanding the Importance of Folate Testing and Proper Supplementation for Optimal Health. Rupa Health. https://www.rupahealth.com/post/understanding-the-importance-of-folate-testing-and-proper-supplementation-for-optimal-health
  2. Sweetnich, J. (2023, May 4). Vitamin D 101: Testing, RDAs, and Supplementing. Rupa Health. https://www.rupahealth.com/post/vitamin-d-101-testing-rdas-and-supplementing
  3. Tuck CJ, Biesiekierski JR, Schmid-Grendelmeier P, Pohl D. Food Intolerances. Nutrients. 2019;11(7):1684. https://pubmed.ncbi.nlm.nih.gov/31336652/
  4. Vici G, Belli L, Biondi M, Polzonetti V. Gluten free diet and nutrient deficiencies: A review. Clin Nutr. 2016;35(6):1236–1241. https://pubmed.ncbi.nlm.nih.gov/27211234/#:~:text=Micronutrients%20are%20also%20found%20to,%2C%20zinc%2C%20magnesium%20and%20calcium.
  5. Viswanathan, T. (2019, September 3). The Complete Guide to Good Sensitivity and Intolerance Testing. Rupa Health. https://www.rupahealth.com/post/the-complete-guide-to-food-sensitivity-and-intolerance-testing
  6. Vitamin B12. Reference Guide. Rupa Health. https://www.rupahealth.com/biomarkers/vitamin-b12
  7. Yoshimura, H. (2023, March 30). The Importance of Running Comprehensive Metabolic Panel on Your Patients. Rupa Health. https://www.rupahealth.com/post/the-importance-of-running-comprehensive-metabolic-panel-cmp-on-your-patients
  8. Yoshimura, H. (2023, July 17). Using Functional Medicine as Personalized Medicine. Rupa Health. https://www.rupahealth.com/post/using-functional-medicine-as-personalized-medicine
  9. Zurzolo GA, Mathai ML, Koplin JJ, Allen KJ. Hidden allergens in foods and implications for labeling and clinical care of food allergic patients. Curr Allergy Asthma Rep. 2012;12(4):292–296. https://pubmed.ncbi.nlm.nih.gov/22555906/
Order from 30+ labs in 20 seconds (DUTCH, Mosaic, Genova & More!)
We make ordering quick and painless β€” and best of all, it's free for practitioners.

Latest Articles

View more on Nutrition
Subscribe to the magazine for expert-written articles straight to your inbox
Join the thousands of savvy readers who get root cause medicine articles written by doctors in their inbox every week!
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Subscribe to the Magazine for free to keep reading!
Subscribe for free to keep reading, If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Trusted Source
Rupa Health
Medical Education Platform
Visit Source
Visit Source
American Cancer Society
Foundation for Cancer Research
Visit Source
Visit Source
National Library of Medicine
Government Authority
Visit Source
Visit Source
Journal of The American College of Radiology
Peer Reviewed Journal
Visit Source
Visit Source
National Cancer Institute
Government Authority
Visit Source
Visit Source
World Health Organization (WHO)
Government Authority
Visit Source
Visit Source
The Journal of Pediatrics
Peer Reviewed Journal
Visit Source
Visit Source
CDC
Government Authority
Visit Source
Visit Source
Office of Dietary Supplements
Government Authority
Visit Source
Visit Source
National Heart Lung and Blood Institute
Government Authority
Visit Source
Visit Source
National Institutes of Health
Government Authority
Visit Source
Visit Source
Clinical Infectious Diseases
Peer Reviewed Journal
Visit Source
Visit Source
Brain
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Rheumatology
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the National Cancer Institute (JNCI)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Cardiovascular Magnetic Resonance
Peer Reviewed Journal
Visit Source
Visit Source
Hepatology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Clinical Nutrition
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Bone and Joint Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Kidney International
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Allergy and Clinical Immunology
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Chest
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Neurology, Neurosurgery & Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Blood
Peer Reviewed Journal
Visit Source
Visit Source
Gastroenterology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Respiratory and Critical Care Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Diabetes Care
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of the American College of Cardiology (JACC)
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Clinical Oncology (JCO)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Clinical Investigation (JCI)
Peer Reviewed Journal
Visit Source
Visit Source
Circulation
Peer Reviewed Journal
Visit Source
Visit Source
JAMA Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
PLOS Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Nature Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The BMJ (British Medical Journal)
Peer Reviewed Journal
Visit Source
Visit Source
The Lancet
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the American Medical Association (JAMA)
Peer Reviewed Journal
Visit Source
Visit Source
Pubmed
Comprehensive biomedical database
Visit Source
Visit Source
Harvard
Educational/Medical Institution
Visit Source
Visit Source
Cleveland Clinic
Educational/Medical Institution
Visit Source
Visit Source
Mayo Clinic
Educational/Medical Institution
Visit Source
Visit Source
The New England Journal of Medicine (NEJM)
Peer Reviewed Journal
Visit Source
Visit Source
Johns Hopkins
Educational/Medical Institution
Visit Source
Visit Source

Hey practitioners! πŸ‘‹ Join Dr. Chris Magryta and Dr. Erik Lundquist for a comprehensive 6-week course on evaluating functional medicine labs from two perspectives: adult and pediatric. In this course, you’ll explore the convergence of lab results across different diseases and age groups, understanding how human lab values vary on a continuum influenced by age, genetics, and time. Register Here! Register Here.

Hey practitioners! πŸ‘‹ Join Dr. Terry Wahls for a 3-week bootcamp on integrating functional medicine into conventional practice, focusing on complex cases like Multiple Sclerosis. Learn to analyze labs through a functional lens, perform nutrition-focused physical exams, and develop personalized care strategies. Register Here.