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Food Intolerances.

Caroline J Tuck1,2, Jessica R Biesiekierski2, Peter Schmid-Grendelmeier3

  • 1Gastrointestinal Diseases Research Unit, Queen's University, Kingston, ON K7L 2V7, Canada.

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Summary
This summary is machine-generated.

Understanding food intolerances is complex due to varied symptoms and mechanisms. Research highlights FODMAP sensitivity but needs more studies for conditions like non-coeliac gluten sensitivity and food additives.

Keywords:
dietary therapyfood hypersensitivityfood intolerancefunctional gastrointestinal disorders

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Area of Science:

  • Gastroenterology
  • Clinical Nutrition
  • Immunology

Background:

  • Food intolerances affect up to 20% of the population.
  • Diagnosis and management are complicated by varied presentations and non-immunological mechanisms.
  • A scientific update on common food intolerances is needed.

Purpose of the Study:

  • To provide a scientific update on common food intolerances.
  • To review mechanisms, diagnosis, and management of gastrointestinal and extra-intestinal symptoms.
  • To highlight research gaps and future directions.

Main Methods:

  • Literature review of common food intolerances.
  • Analysis of evidence for mechanisms, diagnosis, and management.
  • Focus on FODMAP sensitivity, non-coeliac gluten/wheat sensitivity, food additives, bioactive food chemicals, and enzyme deficiencies.

Main Results:

  • FODMAP sensitivity has strong mechanistic evidence (osmotic activity, fermentation, visceral hypersensitivity).
  • Limited reproducible studies exist for non-coeliac gluten/wheat sensitivity, food additives, and bioactive food chemicals.
  • Enzyme deficiencies (e.g., histamine intolerance, sucrase-isomaltase deficiency) are proposed mechanisms.
  • Lack of reliable diagnostic biomarkers necessitates a trial-and-error approach for dietary management.

Conclusions:

  • FODMAP sensitivity is well-supported, but other intolerances require more rigorous research.
  • Identifying reliable biomarkers is crucial for targeted dietary therapies.
  • Future studies should focus on biomarker discovery for personalized food intolerance management.