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Cambridge Nutritional Sciences FOOD INTOLERANCE TESTING.

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1 Cambridge Nutritional Sciences FOOD INTOLERANCE TESTING

2 Cambridge Nutritional Sciences TOPICS  Terminology  Mechanisms of food intolerance  Symptoms of food intolerance  CNS food intolerance tests  Test principles  Alternative test methods  Managing food intolerances  Support documentation

3 Cambridge Nutritional Sciences “What is food to one man, may be fierce poison to another” Lucretius circa 75BC

4 Cambridge Nutritional Sciences TERMINOLOGY

5 Cambridge Nutritional Sciences ADVERSE REACTION TO FOOD IgE Type I Allergy IgG Type III Allergy Enzyme Deficiency Pharmacological Effect Chemical Effect IMMUNE MEDIATEDNON–IMMUNE MEDIATED Classic ‘Allergic’ Reaction ‘Food Intolerance’Food Intolerance COMMON TERMINOLOGY

6 Cambridge Nutritional Sciences 1. IMMUNE-MEDIATED REACTIONS FOOD ALLERGY (Type I) ? FOOD INTOLERANCE (Type III) ?

7 Cambridge Nutritional Sciences FOOD ALLERGY Immune system response Production of IgE antibodies

8 Cambridge Nutritional Sciences  ‘Foreign’ food particles (antigens) cause immediate immune reaction  Rapid release of histamine  Allergic reaction (anaphylaxis) can cause breathing problems and low blood pressure  Symptoms include tingling mouth, hives, swelling of the lips, face, tongue and throat  Symptoms can be severe or life-threatening  Avoid the offending food for life FOOD ALLERGY

9 Cambridge Nutritional Sciences FOOD INTOLERANCE (IgG) Immune system response Production of IgG antibodies

10 Cambridge Nutritional Sciences “45% of the population suffer from a food intolerance”  Non-specific / multiple symptoms  Most people are undiagnosed  Many clients will be affected FOOD INTOLERANCE (IgG)

11 Cambridge Nutritional Sciences  Delayed reaction to ‘foreign’ food (antigen) - hours/days after consumption  Body produces IgG antibodies to neutralise antigen  Form a complex with antigen: Ag/Ab complex Immune complex FOOD INTOLERANCE (IgG)

12 Cambridge Nutritional Sciences  Complexes deposited in tissues around the body  Triggers complement cascade  Release of inflammatory mediators FOOD INTOLERANCE (IgG)

13 Cambridge Nutritional Sciences  Leads to chronic inflammation and gradual appearance of symptoms  Symptoms can persist for many days, but are not life-threatening  Symptoms can be reversed by elimination of foods  Re-introduce small amounts of the offending food  Common to be intolerant to several different foods  Multiple symptoms are common – difficult to diagnose FI FOOD INTOLERANCE (IgG)

14 Cambridge Nutritional Sciences CHEMICAL & PHARMACOLOGICAL 2. NON IMMUNE-MEDIATED REACTIONS ENZYME DEFICIENCY FOOD INTOLERANCE

15 Cambridge Nutritional Sciences Enzyme deficiencies can cause symptoms because foods cannot be digested LACTOSE INTOLERANCE  Caused by a deficiency of lactase (needed to digest lactose)  Cannot pass through gut wall, so remains in the gut  Causes intolerance  Symptoms: bloating, diarrhoea, abdominal pain ENZYME DEFICIENCY / INSUFFICIENCY

16 Cambridge Nutritional Sciences HISTAMINE INTOLERANCE  Caused by a deficiency or inhibition of diamine oxidase (DAO)  Needed to break down histamine in foods  Aggravated by foods high in histamine: red wine, cheese and tuna fish  Foods low in histamine can also trigger the release of histamine in the body: citrus foods, bananas, tomatoes, chocolate  Symptoms include: migraines, dizziness, bowel/stomach problems, rhinitis, depression, irritation, reddening of the skin ENZYME DEFICIENCY / INSUFFICIENCY

17 Cambridge Nutritional Sciences  MSG in restaurant / take-away food (headaches, sweating, dizziness)  Sulphites in dried fruits and vegetables, wine, beer (asthma)  Vasoactive amines such as phenylethylamine in chocolate, citrus fruits (migraines)  Natural / artificial additives used to colour, preserve and flavour food (sweating, itching, abdominal pain, nausea/vomiting, diarrhoea)  Create biochemical side effects in susceptible individuals CHEMICAL / PHARMACOLOGICAL

18 Cambridge Nutritional Sciences MECHANISMS OF FOOD INTOLERANCE

19 Cambridge Nutritional Sciences HEALTHY gastrointestinal tract and HEALTHY immune system:  Foods digested and broken down to glucose, amino acids and fatty acids  Absorbed through the gut lining  Partially digested foods will also pass between cells into bloodstream  Antibodies produced against these partially digested foods  Form antigen / antibody complexes (normal)  Efficient immune system will clear these complexes MECHANISMS OF FOOD INTOLERANCE (1) No symptoms despite an immune response occurring

20 Cambridge Nutritional Sciences NORMAL RESPONSE TO FOOD Food Healthy Gut No symptoms Low level of Ab/Ag complexes Complexes removed by macrophages Healthy Immune System

21 Cambridge Nutritional Sciences HEALTHY gastrointestinal tract, but COMPROMISED immune system:  Partially digested foods pass through the gut lining  Antibodies produced against these partially digested foods  Ab/Ag complexes form (normal)  Compromised immune system - insufficient macrophages produced  Ab/Ag complexes not cleared and circulate in bloodstream  Deposited in tissues – causes inflammation MECHANISMS OF FOOD INTOLERANCE (2)

22 Cambridge Nutritional Sciences Food Healthy Gut Symptoms Low level of Ag/Ab complexes excess complexes deposited in tissues COMPROMISED IMMUNE SYSTEM Compromised Immune System

23 Cambridge Nutritional Sciences LEAKY gastrointestinal tract, but HEALTHY immune system:  Gut wall becomes more permeable  Tight junctions in epithelial layer open up  Increased number of partially digested foods enter bloodstream  Ag/Ab complexes form – immune system becomes overloaded  Complexes cannot be cleared and are deposited in tissues MECHANISMS OF FOOD INTOLERANCE (3)

24 Cambridge Nutritional Sciences Food Leaky Gut Symptoms High level of Ag/Ab complexes excess complexes deposited in tissues LEAKY GUT Normal Immune System

25 Cambridge Nutritional Sciences  Antibiotics  Medication/Drugs  Candida overgrowth  Parasites  Intestinal bacterial/viral infection  Glutamine insufficiency  Alcohol  Poor diet  Stress  Low stomach acid  Low pancreatic enzymes FACTORS LINKED TO LEAKY GUT Heal gut with supplements and diet

26 Cambridge Nutritional Sciences SYMPTOMS OF FOOD INTOLERANCE

27 Cambridge Nutritional Sciences SYMPTOMS OF FOOD INTOLERANCE Respiratory: Asthma, rhinitis, sinusitis, persistent cough, catarrh Gastrointestinal: IBS, Crohn's disease, abdominal pain, diarrhoea, constipation, bloating, flatulence Skin: Eczema, rashes, spots CNS: Headache, migraine, hyperactivity (ADHD) Cardiovascular: Heart palpitations Musculoskeletal: Joint pain, rheumatoid arthritis, muscle pain, fibromyalgia Psychiatric: Chronic fatigue, insomnia, ME, anxiety, depression Metabolic: Weight gain

28 Cambridge Nutritional Sciences  Many symptoms – difficult to identify the cause (e.g. fatigue)  IgG testing can be useful – diagnose / eliminate SYMPTOMS OF FOOD INTOLERANCE

29 Cambridge Nutritional Sciences CNS FOOD INTOLERANCE TESTS

30 Cambridge Nutritional Sciences CNS FOOD INTOLERANCE TESTS  Food Detective ™  FoodPrint ®  Food Microplate ELISA

31 Cambridge Nutritional Sciences World’s first rapid test kit for detecting food IgG antibodies

32 Cambridge Nutritional Sciences Detects antibodies to 59 common foods Rapid assay format – results in 40 minutes Positive and negative controls included Clear and concise instructions Colour coded reagents Finger-prick blood sample FEATURES

33 Cambridge Nutritional Sciences Only home-test kit on the market No specialised equipment needed No waiting for laboratory results Act on results immediately Website supported: BENEFITS

34 Cambridge Nutritional Sciences CONTENTS Sterile wipe Safety lancet x 2 Plaster x 2 Blood collection tube Sample diluent (A) Antibody detector (B) Developer (C) Wash solution (D) Reaction tray IFU Result card Dietary support guide

35 Cambridge Nutritional Sciences EASY TO FOLLOW INSTRUCTIONS Food Detective instructional video

36 Cambridge Nutritional Sciences TEST PROCEDURE Sterilise finger with wipe Prick finger with lancet Massage finger to obtain blood Fill the capillary tube (50μl)

37 Cambridge Nutritional Sciences Place in SOLUTION A (Sample Diluent) Pour into tray Leave for 20 minutes TEST PROCEDURE

38 Cambridge Nutritional Sciences SOLUTION D (Wash Solution) Repeat x 3 SOLUTION B (Antibody Detector) Leave for 10 minutes TEST PROCEDURE

39 Cambridge Nutritional Sciences SOLUTION D (Wash Solution) Repeat x 3 SOLUTION C (Developer) Leave for 2 minutes Wash ONCE TEST PROCEDURE

40 Cambridge Nutritional Sciences RESULT INTERPRETATION  Visually read results  If specific-food IgG antibody is present, well is BLUE  Determine strength of colour

41 Cambridge Nutritional Sciences NEGATIVE WEAK POSITIVE POSITIVE STRONG POSITIVE White Pale blue Mid blue Dark blue  IgG IgG RESULT INTERPRETATION

42 Cambridge Nutritional Sciences Ring / halo INVALID Negative Control WHITE must be WHITE Positive Control BLUE must be BLUE RESULT INTERPRETATION

43 Cambridge Nutritional Sciences Identify reactive foods from IFU RESULT INTERPRETATION Record on Results Card

44 Cambridge Nutritional Sciences FOODS TESTED DAIRY / EGGS Cow’s milk Whole egg FISH / SEAFOOD White fix mix Freshwater mix Tuna Shellfish mix FRUIT Apple Blackcurrant Grapefruit Melon mix Olive Orange and Lemon Strawberry Tomato GRAINS Oat Wheat Rice Corn Rye Durum Wheat Gluten HERBS / SPICES Garlic Ginger MEAT Beef Chicken Lamb Pork NUTS / SEEDS Almond Brazil Nut Cashew Peanut Walnut VEGETABLES Broccoli Cabbage Carrot Celery Cucumber Leek Legume mix Mushroom Peppers Potato Soya Bean OTHER Cocoa Bean Tea Yeast

45 Cambridge Nutritional Sciences Microarray Food Intolerance Test

46 Cambridge Nutritional Sciences FOODPRINT ® LABORATORY TESTS INDICATOR FOOD PANELS SPECIALISED

47 Cambridge Nutritional Sciences  Food extracts ‘printed’ onto nitrocellulose pads TEST FORMAT

48 Cambridge Nutritional Sciences Finger-prick sample Send to lab FoodPrint microarray FOODPRINT ® TESTING PROCESS

49 Cambridge Nutritional Sciences Hi-res optical scan Data conversion Test Report FOODPRINT ® TESTING PROCESS

50 Cambridge Nutritional Sciences FOODPRINT ® TEST REPORTS Food GroupsOrder of Reactivity

51 Cambridge Nutritional Sciences FOODPRINT ® REPORTS IgG concentration (U/ml) Traffic light system: ELEVATED ( ≥ 30 U/ml) BORDERLINE (29-24 U/ml) NORMAL (≤23 U/ml)

52 Cambridge Nutritional Sciences INTERPRETATION OF RESULTS ELEVATED – high level of antibody detected  Eliminate food from diet for at least 3 months BORDERLINE – moderate level of antibody detected  Reduce or rotate food for at least 3 months NORMAL – low level of antibody detected  Food can be eaten freely

53 Cambridge Nutritional Sciences NEW PATIENT REPORT  Test Reports + Patient Guidebook

54 Cambridge Nutritional Sciences FOODPRINT ® BLOOD COLLECTION VIDEO

55 Cambridge Nutritional Sciences

56 PRODUCT RANGE

57 Cambridge Nutritional Sciences FEATURES  Kits available for 5, 40, 93 or 109 foods  25µl serum or plasma  Assay time <90 minutes  96 well plate assay, strip format

58 Cambridge Nutritional Sciences BENEFITS  Ideal for small–moderate sample numbers  Ready-to-use reagents  Short incubation steps  Reliable results  CE-marked kits  Certified to ISO 9001 & 13458

59 Cambridge Nutritional Sciences Assay Procedure TEST PROCEDURE Incubate 30 minutes Incubate 30 minutes Wash Plate x 3 100µl conjugate into each well Incubate 10 minutes Wash Plate x 3 100µl TMB substrate into each well 100µl Stop solution into each well Read 450nm Dispense samples, standards and controls 25µl sample into 10ml diluent

60 Cambridge Nutritional Sciences PERFORMANCE CHARACTERISTICS  Reproducibility:Intra-assay %  Sensitivity:0.4U/ml  Interferences:Grossly haemolysed, icteric or lipaemic samples should be avoided  Stability:18 months

61 Cambridge Nutritional Sciences TEST PRINCIPLES

62 Cambridge Nutritional Sciences TEST PRINCIPLES Enzyme-Linked Immunosorbent Assay (ELISA)  Standard laboratory method to detect antibodies and antigens MICROPLATE ELISA Plate FOODPRINT Microarray Pad FOOD DETECTIVE Reaction Tray

63 Cambridge Nutritional Sciences Antigens (food) attached to well

64 Cambridge Nutritional Sciences Diluted blood sample: Specific food IgG antibodies Binds to food antigens

65 Cambridge Nutritional Sciences Detector solution / conjugate: Contains enzyme (HRP) linked anti- human IgG Binds to food-specific IgG antibodies

66 Cambridge Nutritional Sciences Developer solution / TMB substrate Enzyme HRP causes oxidation of substrate: Change from colourless to blue

67 Cambridge Nutritional Sciences ALTERNATIVE TEST METHODS

68 Cambridge Nutritional Sciences IgG4 ELISA White Blood Cell

69 Cambridge Nutritional Sciences IgG4 ELISA Detects IgG4 antibodies associated with food allergies

70 Cambridge Nutritional Sciences IgG SUBCLASSES SUBCLASSABUNDANCE IgG166% IgG223% IgG37% IgG44%

71 Cambridge Nutritional Sciences IgG SUBCLASS PROPERTIES NEUTRALISATION Ability of antibodies to neutralise the pathogenic effects of antigens: – block and inhibit biological effects COMPLEMENT ACTIVATION Ability of antibodies to activate complement cascade: –consists of a group of 30 serum proteins –destroy foreign cells by phagocytosis and lysis of cell membranes –creates inflammation

72 Cambridge Nutritional Sciences OPSONISATION Ability of antibodies to ‘flag’ foreign cells/antigens for destruction: –cells / antigens are destroyed by phagocytosis (macrophages and neutrophils) –phagocytes need a ‘marker’ to identify what to destroy –markers are antibodies and complement proteins (called opsonins) –installation of opsonins enables phagocytosis BINDING TO PHAGOCYTES Ability of opsonin antibodies to bind to macrophages and neutrophils IgG SUBCLASS PROPERTIES

73 Cambridge Nutritional Sciences PROPERTYIgG1IgG2IgG3IgG4 Neutralisation++ Activation of complement pathway Opsonisation Binding to macrophages Binding to neutrophils++  IgG1 and IgG3 have strong pro-inflammatory properties  IgG4 has protective, anti-inflammatory properties IgG SUBCLASS PROPERTIES

74 Cambridge Nutritional Sciences IgG4 FUNCTION  Acts as a ‘blocking agent’ against the actions of IgE  Catches and neutralises the (food) antigen before IgE can bind to it  IgG4 acts to prevent acute allergic reactions (Type I allergy) from occurring  No involvement with Type III (IgG-mediated) food intolerance  Impossible to detect ‘delayed-onset’ food intolerance by IgG4 testing!  No complement activation and no opsonising capacities

75 Cambridge Nutritional Sciences Testing for IgG4 against foods is not recommended as a diagnostic tool. S. Stapel, R. Asero, B. K. Ballmer-Weber, E. F. Knol, S. Strobel, S. Vieths, J. Kleine-Tebbe. Allergy 2008: 63: 793–796 PUBLICATIONS AGAINST IgG4 TESTING  Conclusion: food-specific IgG4 does not indicate (imminent) food allergy or intolerance, but rather a physiological response of the immune system after exposure to food components.  Testing of IgG4 to foods is considered as irrelevant for the laboratory work-up of food allergy or intolerance and should not be performed in case of food-related complaints.

76 Cambridge Nutritional Sciences  All controlled studies for “food intolerance” are performed with total IgG  No controlled clinical trials have been performed with IgG4 PUBLICATIONS AGAINST IgG4 TESTING

77 Cambridge Nutritional Sciences WHITE BLOOD CELL TEST Tests for cellular responses to foreign substances in-vitro

78 Cambridge Nutritional Sciences (Activated Neutrophil Test and Cytotoxic Test) WHITE BLOOD CELL TEST Incubation Activation of immune response in cell White Blood Cells (separated or EDTA blood) are exposed to antigens: Principle:the diameter of white blood cells (leukocytes) change after being challenged with foods, moulds, additives, environmental chemicals, dyes and antibiotics. Primary reactive leukocyte fraction consists of: Neutrophils

79 Cambridge Nutritional Sciences NEUTROPHIL DEGRANULATION Food antigens bind to antibodies which are attached to surface of a neutrophil. Creates a “cross-linking” which induces a process known as degranulation. Neutrophil

80 Cambridge Nutritional Sciences  Damaging to pathogens but also damaging to host tissues 1.Generates highly toxic reactive oxygen and nitrogen species 2.Release powerful proteolytic enzymes / histamine / chemokines / heparin NEUTROPHIL DEGRANULATION

81 Cambridge Nutritional Sciences WHITE BLOOD CELL TEST Healthy cell Mild reaction Strong reaction

82 Cambridge Nutritional Sciences Advantages Disadvantages Errors eliminated due to computerised measurement Neutrophils are unstable - high risk of incorrect test results  Morphologically change immediately after blood is drawn  Reliable test results only if tested within 6 hours  No possibility to send sample by mail Neutrophils are highly sensitive to drug intake and infections - risk of incorrect results Need an automated system to count cells WHITE BLOOD CELL TEST

83 Cambridge Nutritional Sciences MANAGING FOOD INTOLERANCES

84 Cambridge Nutritional Sciences 1) Identify foods producing elevated IgG response COMMON PROBLEM FOODS (data collated by CNS) MANAGING FOOD INTOLERANCES

85 Cambridge Nutritional Sciences 2) Remove or reduce reactive foods from diet PLAN THE DIET:  Reduce “allergenic load”  Compliance important for best results  Plan / shop in advance  Know your “problem” foods  Read ingredients labels  Substitute with similar alternatives  Concentrate on NORMAL foods  Variety – nutrients & intolerance MANAGING FOOD INTOLERANCES

86 Cambridge Nutritional Sciences 2) Remove or reduce reactive foods from diet  Foods to avoid, include, recipes, menus, websites MANAGING FOOD INTOLERANCES

87 Cambridge Nutritional Sciences 2) Remove or reduce reactive foods from diet POINTS TO NOTE:  Food must be included in diet before testing - no IgG reaction if food is not consumed!  Avoid known allergenic foods – negative in IgG test  Some clients may feel worse after elimination of reactive foods  Immunosuppressants MANAGING FOOD INTOLERANCES

88 Cambridge Nutritional Sciences 2) Remove or reduce reactive foods from diet ADVICE FOR NUMEROUS ELEVATED RESULTS:  Leaky Gut?  Prioritise - 4 to 6 most reactive foods (reduce allergenic load)  Rotate / reduce the remaining foods  Work with symptoms and results MANAGING FOOD INTOLERANCES

89 Cambridge Nutritional Sciences 3) Repair Leaky Gut / boost immune system 4) Re-populate gut with beneficial gut flora 5) Strengthen the immune system 6) Re-introduction of foods  Avoid elevated foods for 3-6 months  Still symptoms – probably not food intolerance  Re-introduce foods – gradually  Monitor symptoms  Avoid for longer if necessary  Eat in moderation and vary the diet MANAGING FOOD INTOLERANCES

90 Cambridge Nutritional Sciences  Eliminate foods with strong reaction ( ELEVATED foods)  Reduce / rotate foods with moderate reaction ( BORDERLINE foods)  Eat foods freely from the NORMAL group  Replace foods with a similar food from that food group  Eat a varied diet  Repair leaky gut  Support immune system SUMMARY OF ADVICE

91 Cambridge Nutritional Sciences SUPPORT DOCUMENTATION

92 Cambridge Nutritional Sciences Scientific PublicationsPatient Experiences

93 Cambridge Nutritional Sciences ADHD Anti-Aging Autism Fertility Gastrointestinal SCIENTIFIC PUBLICATIONS Rheumatoid Arthritis Migraine General Skin Conditions Weight Loss

94 Cambridge Nutritional Sciences GENERAL (GN1) Toward an understanding of allergy and in-vitro testing Mary James N.D. Great Smokies Diagnostic Laboratory

95 Cambridge Nutritional Sciences GENERAL (GN1) Toward an understanding of allergy and in-vitro testing Mary James N.D. Great Smokies Diagnostic Laboratory Excellent overview of:  Immune system  Food terminology – hypersensitivity and allergy  Immune tolerance and overload  Diagnosis  Elimination diets  Leaky gut

96 Cambridge Nutritional Sciences GENERAL (GN13) Testing for food reactions: the good, the bad, and the ugly Mullin GE, Swift KM, Lipski L, Turnbull LK, Rampertab SD Nutr Clin Pract 2010 Apr; 25(2):192-8

97 Cambridge Nutritional Sciences GENERAL (GN13) Testing for food reactions: the good, the bad, and the ugly Mullin GE, Swift KM, Lipski L, Turnbull LK, Rampertab SD Nutr Clin Pract 2010 Apr; 25(2):192-8 Literature review  Evaluating the validity of tests used to assess food reactions  Food hypersensitivity, food allergy, food sensitivity, food intolerance testing and adverse food reactions  IgE–mediated food allergy testing was best represented in PubMed  IgG–based testing showed promise, with clinically meaningful results  Proven useful as a guide for elimination diets  Further investigation into the clinical application is required

98 Cambridge Nutritional Sciences GENERAL (W1) Dietary advice based on food specific IgG results Geoffrey Hardman, Gillian Hart. Nutrition and food science Vol 37 No pp 16-23

99 Cambridge Nutritional Sciences GENERAL (W1) Dietary advice based on food specific IgG results Geoffrey Hardman, Gillian Hart. Nutrition and food science Vol 37 No pp  Provide evidence that elimination diet based on food-specific IgG testing is an effective, reliable and valid aid in the management of chronic illness  Postal survey commissioned by Allergy UK – 5286 participants  Questionnaire sent 3 months after IgG food test  76% reported a significant improvement in their condition  68% noticed a benefit within 3 weeks  Those with more than 1 condition more likely to report noticeable improvement  92% reported a return of symptoms on reintroduction of offending foods

100 Cambridge Nutritional Sciences GASTROINTESTINAL (GA1) Food elimination based on IgG antibodies in Irritable Bowel Syndrome: a randomised controlled trial W Atkinson, T A Sheldon, N Shaath, PJ Whorwell Gut 2004:

101 Cambridge Nutritional Sciences GASTROINTESTINAL (GA1) Food elimination based on IgG antibodies in Irritable Bowel Syndrome: a randomised controlled trial W Atkinson, T A Sheldon, N Shaath, PJ Whorwell Gut 2004:  To assess the therapeutic potential of dietary elimination based on presence of IgG antibodies to food  150 outpatients with IBS - 3 month study  Diet excluding all foods to which they had raised IgG antibodies or a sham diet excluding the same number of foods but not those to which they had antibodies  Outcome measures - change in IBS symptom severity and global rating scores  True diet resulted in 26% greater reduction in symptom score than sham diet  Relaxing the diet led to 24% greater deterioration in symptoms  Food elimination based on IgG antibodies effective in reducing IBS symptoms

102 Cambridge Nutritional Sciences GASTROINTESTINAL (GA5) Clinical relevance of IgG antibodies against food antigens in Crohn’s Disease: a double-blind cross-over diet intervention study Bentz, Hausmann, Piberger, Kellermeier, Paul, Held, Falk, Obermeier, Fried, Schölmerich, Rogler Digestion 2010;81:252–264

103 Cambridge Nutritional Sciences GASTROINTESTINAL (GA5) Clinical relevance of IgG antibodies against food antigens in Crohn’s Disease: a double-blind cross-over diet intervention study Bentz, Hausmann, Piberger, Kellermeier, Paul, Held, Falk, Obermeier, Fried, Schölmerich, Rogler Digestion 2010;81:252–264  Immune responses against food antigens may be a reason for the perpetuation of inflammation associated with Crohn’s Disease (CD)  79 CD patients and 20 healthy controls were tested for food IgG antibodies  Based on the IgG antibodies, a nutritional intervention was planned  84% patients had IgG antibodies against processed cheese and yeast  Daily stool frequency decreased by 11%  Abdominal pain reduced and general well-being improved

104 Cambridge Nutritional Sciences GASTROINTESTINAL (GA6) Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics Drisko, Bischoff, Hall, McCallum. Journal of the American College of Nutrition, Vol. 25, No. 6, 514–522 (2006)

105 Cambridge Nutritional Sciences GASTROINTESTINAL (GA6) Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics Drisko, Bischoff, Hall, McCallum. Journal of the American College of Nutrition, Vol. 25, No. 6, 514–522 (2006)  Goal was to investigate the role of food intolerance in IBS patients  20 patients with IBS who had failed standard medical therapies  Baseline IgE and IgG food/mould panels and stool analysis were performed  Patients underwent food elimination diets based on their results  Elevated serum IgG food/mould levels detected in 100% participants  Significant improvement after food elimination and rotation diet  Identifying food sensitivity in IBS impacts on overall well being and quality of life

106 Cambridge Nutritional Sciences MIGRAINE (M2) Food allergy mediated by IgG antibodies associated with migraine in adults Hernández, Pinto, Montiel. Revista Alergia México 2007;54(5):162-8

107 Cambridge Nutritional Sciences MIGRAINE (M2) Food allergy mediated by IgG antibodies associated with migraine in adults Hernández, Pinto, Montiel. Revista Alergia México 2007;54(5):162-8  Aim of study was to investigate allergen-specific IgG in patients with migraine  56 patients with migraine, control group without migraine  Serum antibodies to specific 108 food allergens were measured  Significant differences in number of positives for IgG food allergens between patients with migraine and a controlled group  Elimination diets successfully control the migraine without need of medications  Serum IgG antibodies to common food should be investigated in patients with migraine

108 Cambridge Nutritional Sciences Excel Library SCIENTIFIC PUBLICATIONS Abstracts Booklet Full Publications

109 Cambridge Nutritional Sciences Gastrointestinal Discomfort PATIENT EXPERIENCES Migraines & Headaches Skin Conditions Weight Issues Chronic FatigueAches & Pains

110 Cambridge Nutritional Sciences ACHES & PAINS Lesley, a retired PA from Ashford, Kent Aching joints and muscles and flu-like symptoms Symptoms were worse after she had eaten wheat (especially bread) and dairy together August 2005, Lesley decided to do a food intolerance test (FoodPrint) Tested positive for wheat, yeast, cola nut and pineapple Lesley saw an improvement in her symptoms immediately Found alternatives to replace the wheat and yeast in particular Lesley has tried reintroducing some foods but finds that she reacts on each occasion

111 Cambridge Nutritional Sciences CHRONIC FATIGUE Tansy, a 36-year-old psychotherapist from Horncastle in Lincolnshire 4 years off work with M.E. - bedridden for up to 10 days a month Tansy decided to experiment with her diet after a friend advised her to try excluding certain foods Excluded nuts and eggs – felt slightly better Excluded wheat and replacing it with rye – felt worse Eliminating every possible food intolerance by trial and error was time consuming Decided to try Food Detective test Reacted to 20 foods, including wheat, rye, dairy, soya, nuts, egg, barley and crab Ironically, she reacted more to rye than wheat Tansy took the offending foods out of her diet and within the first week began to feel better

112 Cambridge Nutritional Sciences GASTROINTESTINAL DISCOMFORT Sandra, 54, from Crawley, West Sussex Agonising bouts of Irritable Bowel Syndrome (IBS) - laid up in bed for days at time Over an 18 month period, Sandra underwent numerous medical investigations: - endoscopy, CT scan and multiple blood tests Eventually one doctor told her she had IBS and would just have to live with it Sandra went to see a nutritionist who suspected she was suffering from a food intolerance Performed a Food Detective test Intolerant to apples, wheat, almonds, rice, brazil nut, cashew nuts, cocoa beans, whole egg and shellfish Eliminated the foods and began to feel better Within a few weeks her IBS symptoms disappeared

113 Cambridge Nutritional Sciences MIGRAINES AND HEADACHES Yvonne, a 58-year-old mum from Poringland in Norfolk Suffered for 12 years from fortnightly migraines Yvonne’s GP was helpful in providing medication to manage her migraines He never got to the root of what was actually causing them Decided to try Food Detective™ Reacted to soya bean, wheat, barley, corn, rye, cow’s milk, egg, grapefruit, almond and cashew Immediately avoided these foods and was felt better within a week

114 Cambridge Nutritional Sciences SKIN CONDITIONS James, 31, from Cambridge Suffered from eczema - frustrating and difficult to function normally at work Prescribed various steroid creams and emollients but nothing addressed the cause of the eczema Started doing some research on the internet - link between food and eczema Decided to try a food intolerance test Reaction to cows’ milk, egg white and also grains and yeast James eliminated all the foods he was intolerant Effect on his eczema was astounding - within a couple of days it had completely cleared up Sleeping through the night and feeling much better for it Occasionally, James has a meal containing dairy foods or enjoys a couple of beers but the next day his eczema will flare up again

115 Cambridge Nutritional Sciences WEIGHT ISSUES Tina, 41-year-old from Forest Row, East Sussex Grossly overweight - BMI was dangerously high – difficulty loosing weight Visited a local nutritional therapist Suggested she may be intolerant to some foods - could be inhibiting her weight loss Given a Food Detective test Tina tested positive to cow’s milk, citrus fruits and durum wheat Started using nut milk on cereal and in tea and stopped eating oranges and pasta

116 Cambridge Nutritional Sciences Excel Library PATIENT EXPERIENCES Booklet

117 Cambridge Nutritional Sciences DEMONSTRATION VIDEOS


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