There is growing evidence that food sensitivities are a common cause of anxiety disorders. It is, however, not commonly appreciated by the public. David Perlmutter, M.D. comments on this in his popular new book “Grain Brain”:
“The idea that brains are sensitive to what we eat has been quietly circulating in our most prestigious medical literature recently. This information begs to be known by the public, which is increasingly duped by the food industry that sells foods commonly thought to be nutritious.”
While his book focuses on gluten from grains, the concepts are the same for any food that an individual reacts to.
The real question most people with anxiety have is how can what I eat cause my brain to not work right? The answer comes from examining a few well established concepts about the human body. An immune reaction against food begins in the digestive tract, but the reaction occurs throughout the body including the brain. This is why when we have a cold which is a viral infection in the sinuses and chest, we ache all over. The chemical inflammatory attack our immune system mounts against it is systemic.
Another part of the immune activation is that it alerts the brain by causing a stress response. The stress response is really a fear response which causes a high amount of alertness in the brain by raising the levels of the hormone cortisol. This alertness is designed to be a short term process. Unfortunately with a food sensitivity the immune reaction becomes chronic, and the brain begins to become over stimulated.
The best trait about the brain is that it learns. If you stimulate it with hearing and seeing French over time, neurons or brain cells form connections with other neurons called synapses. A complex connection of many neurons become functionally connected, in essence becoming the “wired program” that is the memory of French.
The worst trait of the brain, however, is also that it learns. An ongoing immune problem that secondarily causes cortisol elevation and ongoing alerting of the brain will begin to cause a learning pattern the same as studying French does. Sustained cortisol activation of the brain eventually trains the brain to react with too much alertness to everyday, non-stressful events. This perception is one of anxiety.
Anxiety patterning in the brain may relate to how the brain processes information. Visual, sound and other inputs are first processed in the back of the brain. They must be processed to the front of the brain through several areas that help with processing to form what we think we actually see and hear. Some of that information is processed through the right side of the brain and some through the left.
Generally the left side of the brain processes more analytically, while the right side processes more emotionally. With normal brain processing most information gets processed both through the left and right sides of the brain resulting in a balance of analytical (what do I think) and emotional processing (how do I feel). The alert state of the brain caused by frequent and sustained cortisol activity causes a shift to more right- sided processing. Once the brain learns this, normal things begin to activate the brain more emotionally which generates anxiety.
It is good to have a little anxiety when you see someone approaching with a handgun. The alertness is needed for the “fight or flight response”. However, we should not get that same reaction simply answering the phone at work.
With time the brain will try to shut down some of the excessive anxiety pattern causing to process “too flat” at times. This is the clinical expression of depressive traits. In the classic sense disorders of mood typically transition through stages:
Supporting this continuum of anxiety and depression is the common management of anxiety or depression with the same medications.
The current understanding is:
Dr. Perlmutter is correct in his comment that the brain is sensitive to what we eat. Fortunately by finding the trigger of this abnormal brain activation the pattern of anxiety/depression can often be reversed. To quote the slogan from one of our American organizations, the mind is a terrible thing to waste.
Rather than the last resort as is common, anxiety should call for the screening for food sensitivity. Anxiety feeds on itself, and time is the worst thing one can give it. While it can be softened by a drug, it cannot be cured that way.
Food sensitivities are becoming very common due to several changes in our food supply and environment. Patients diagnosed with a food sensitivity typically have suffered through a long course looking for the cause of their symptoms with extensive testing, treatment and little relief. These symptoms may range from abdominal bloating/pain, reflux, indigestion, diarrhea/constipation, skin problems, fatigue, sleep difficulty, “brain fog”, anxiety and others.
While food allergies are more easily understood, food sensitivities are less appreciated primarily because they are slow onset, delayed reactions. While the symptoms of a food allergy occur immediately, the onset of the symptoms from a food sensitivity may be delayed from a few hours to a couple of days from the food exposure. The consumption of many other foods during this interval makes the linking of the symptoms to a particular food very difficult.
Food sensitivities are caused by different immune mechanisms compared to food allergies, so the typical food allergy tests such as skin testing or blood tests miss the diagnosis. Food allergy testing looks for antibodies that are made against the food. Food sensitivities involve inflammatory cytokine reactions rather than antibody reactions. They are thought to be the most common food reaction, perhaps 4-6 times more common than antibody induced food allergies.
So How Does a Food Sensitivity Happen?
The immune system protects us by reacting to harmful organisms and chemicals and creating cells that remember them so if they see them again, they can initiate and attack against them. These immune cells that have been “trained” to recognize a potentially harmful organism do so by reading the surface of the organism and recognizing the chemical sequence. The immune reaction causes inflammation. This is why we feel so sick when we get the flu. It is also why symptoms of achiness and fatigue occur after vaccination.
When the immune cells learn to react to “virus X”, they can misread a surface area of a food molecule as the surface of that virus creating a reaction to it. The result is a chronic inflammatory immune reaction to the particular food.
Why are Food Sensitivities Becoming so Common?
Food sensitivities are becoming very common. There are several reasons this seems to be happening including:
Some of the main food components such as corn, soy, sugar beet, canola and others are dominantly genetically modified. It is estimated that 80-90% of these foods are genetically modified. Humans developed “immune tolerance” to food proteins through thousands of generations of previous exposure to the same foods. In less than one human generation, a major portion of the diet has been genetically altered looking foreign to the human immune system.
The immune system has an immense job looking at everything foreign that we are exposed to and reacting to those exposures to protect us. It is estimated that the average adult is exposed to over 80,000 chemicals of which less than 15% have been adequately tested for long-term health risks. Perhaps 25-50% or 20,000-40,000 of the chemicals that 40-60 year old adults are exposed to through food, water, air and consumer products did not exist when they were born.
The immune system is highly compromised by chronic disease, poor diet and stress. Many people have significant immune weakness resulting from some combination of these factors. This results in a weaker immune system trying to deal with an increased work load our environment generates.
Diagnosing Food Sensitivities
Reactive testing is the most active method to look for type 1 food sensitivities. Methods used for this include white blood cell reactive testing and physical reactivity testing. The most efficient form of reactive testing is meridian response testing. Meridian response testing involves testing electrical conductivity in immune meridian points during food exposures. This testing isolates the likely offending food components which then are eliminated.
Meridian reactive testing is about 80% accurate. It easily leads to the absolute diagnostic method which is a period of strict avoidance for 3-4 months to measure symptom response. In addition to avoidance, the patient will typically take a desensitization homeopathic remedy to help down-regulate the immune reactivity. When the immune system has been activated over a long period of time, simply eliminating the triggering food may not be enough. A chronic immune reaction often needs to be taught to turn off which is the function of the homeopathic allergy remedies.
Those with unresolved digestive symptoms, skin problems, fatigue, “brain fog”, anxiety and other symptoms are likely to find their solution through food sensitivity testing and treatment. Perhaps the greatest challenge currently is raising awareness of the problem of food sensitivities as the earlier they are discovered and treated, the better their outcome.
Neurofeedback is guided brain training. Guided is the key word. Many commercials are appearing for brain training systems to offset or undo many of the progressive brain problems that occur over time such as memory loss, anxiety, depression and others. Most systems simply are exercises to try to re-teach the brain into a more normal pattern of function whether for memory difficulty, anxiety or for other common problems. However, no two people have the same pattern of brain imbalance, and therefore no two will respond as well to a single training program.
Neurofeedback training sessions are EEG guided meaning that brain wave patterns are monitored during the training sessions to reward the brain only if it is adapting in the desired pattern. The training is very specific to the exact imbalance of each brain.
How Does Brain Dysfunction Happen?
The body shows its wear with life. Diet, stress, injuries and other occurrences all lead to changes in the body progressively over time. That seems pretty obvious. The brain is no different, changing with every challenge life throws at it.
Just as the changes are seen in the body with life’s stresses over time, changes are also seen in the brain. The only difference is that the changes in the brain show up primarily as changes in function; a little anxiety, forgetfulness, depression, learning difficulty, attention deficit and more.
The common “stressors” that negatively affect brain function over time include:
Chronic psychosocial stress seems to be greater for all of us than it was 20-30 years ago, and it is a way of life for many people. Mental stress activates the stress response system. This system activates the adrenal glands to produce cortisol which alerts the brain and alters our ability to lower blood sugar. The brain runs primarily on glucose so during high alert states induced by stress, we are hormonally driven to maintain higher blood sugar. Chronic stress and the cortisol reaction can eventually cause ongoing elevations of blood sugar.
Mental stress also activates the sympathetic nervous system or the “alarm system”. This increases pulse rate, blood pressure and inhibits digestion. Over time those changes adapt to chronic stress and become ongoing.
When chronic mental stress alerts the brain over too long an interval, the brain “learns” that pattern. In the short-term it is a state of heightened alertness. However, over the long-term, chronic activation of this pattern causes anxiety.
The brain is the most metabolically active tissue in the body. It is also the only tissue that must run almost exclusively on glucose. Reoccurring episodes of low blood sugar or high blood sugar begin to alter brain function. Typical imbalances that occur from chronic chemical stress to the brain include anxiety, ADD, ADHD, “brain fog” and depression.
The brain is also very sensitive to food additives called “excitotoxins”. The most notorious of these is MSG, but they include many other additives such as dyes, flavor enhancers and others. There is a very good book on this subject that was written by a medical neurologist, The Excitotoxins: The Taste that Kills, by Russell Blaylock, MD. (http://www.youtube.com/watch?v=tTSvlGniHok)
Cortisol is a multitasking hormone. In addition to raising brain alertness to deal with stress, it is also anti-inflammatory. Perhaps the greatest ongoing cause is an allergy or sensitivity, particularly food sensitivities. When the adrenal glands are chronically activated to fight inflammation, the abnormally high levels of cortisol change brain activation to an ongoing pattern of anxiety.
Eventually The Brain Learns the Stress Pattern
A key trait of the brain is that it is neuroplastic. This simply means that you can teach it new information or function with repetition. This is both the best and the worst trait of the brain. If it is taught tennis, it will learn tennis. If it is taught stress, it will learn stress.
Over time all of the above factors generating a stress response pattern in the brain actually teach the brain to operate in an imbalanced stress pattern. When this happens normal everyday events that are not stressful are perceived as stressful by the brain altering its function. This induces anxiety, attention deficit, and other changes that over time produce depression. Some degree of memory loss is a universal feature in all of those states.
The Good News: The Brain Can Be Retrained Back to Normal Function
The good news is that if the brain has been trained into a bad pattern inducing memory loss, anxiety, attention deficit, and other problems, the best trait of the brain can be used to correct it. EEG guided neurofeedback training can be used to re-train the brain back into a normal pattern.
Neurofeedback uses two simultaneous methods to retrain the brain back to more normal function. The first is “entrainment” which uses different colored light-emitting diodes to teach different areas of the brain more balanced brain wave patterns. Glasses with 4 diodes in each side emit different frequencies and colors of flashing lights. Each frequency and color pattern stimulates a different part of the brain cortex teaching it a more balanced pattern.
Entrainment has been compared to an observation made with two pendulum clocks in the 17th century. If the pendulums are out of sync and the two clocks are left close to each other for a period of time, their vibrational pattern eventually causes them to oscillate in synchronization.
The second training method is neurofeedback itself. This involves watching a movie while monitoring EEG electrodes are measuring brain wave activity over a specific brain lobe. The EEG feedback is integrated with the movie sight and sound. When the brain waves wander off the desired training pattern, the sight and sound of the movie dims causing the brain to “gain” or seek the right balance to return a clear picture and sound. Over subsequent sessions the brain gradually learns the correct brain wave activation pattern until it becomes an imbedded, learned response.
Neurofeedback is done simultaneously with entrainment for a compound training effect. The light diodes for entrainment are in the corners of the training glasses with the central area being open to allow the viewing of the movie.
Brain dysfunction and decline are becoming epidemic in society. One in five Americans uses a medication for a psychiatric or behavioral disorder such as anxiety or depression with 1 in 4 women doing so. This is an increase of 30% in one decade. Currently 6.5 million children use medications for ADD and ADHD, a startling 41% increase in one decade.
The problem is really not one of bad brain chemistry that can be compensated with a drug; it is a problem of function, and function can be changed. For those who want to get their brain back, neurofeedback is the best choice.
Could I Have One?
People generally have a better understanding of a food allergy than they do of a food sensitivity. Food allergies typically cause pronounced symptoms soon after eating certain foods. This allows the individual to associate the symptoms directly with the food consumption.
Food sensitivities in contrast are delayed food responses typically delayed from several hours to a day or more. This makes associating them with food very difficult as we have typically eaten several times before the symptoms begin.
Two additional factors often cloud the diagnosis of a food sensitivity. The first is that the symptoms often are not in the digestive tract. This is the result of the mechanism through which the symptoms occur. The intestinal immune cells misread the surface of a food component as something dangerous and initiate an immune attack against it. While this often causes local digestive symptoms such as abdominal pain, bloating, diarrhea/constipation or reflux symptoms the dominant symptoms may be in some other area of the body such as the skin, brain, joints and others.
However, although the immune system is activated locally, it creates a systemic response. This is why when someone has the flu, the exposure may be activated through the respiratory tract yet they ache all over. The hallmark rule of the immune system is that it is activated locally but often the body’s response is systemic. The common non-digestive symptoms include:
The second factor that makes the diagnosis of food sensitivities difficult is that they cannot be diagnosed with standard medical allergy testing. This testing involves measuring an antibody that is made against the food called “IgE” or looking for a reaction IgE causes by injecting different foods under the skin. Food sensitivities are caused by other immune mechanism different from IgE antibodies.
This lack of appreciation with standard medicine was highlighted in a recent study comparing gluten sensitivity with gluten allergy. Patients who were eventually diagnosed with a food sensitivity completed questionnaires about the disorders. The eventual process that led to diagnosis was initiated by their physician only 10% of the time. A striking 80% had to initiate the diagnostic testing on their own from an outside source or with a less than highly co-operative medical provider.
The result of all of these properties is that food sensitivities often go undiagnosed for decades causing considerable suffering and expense looking for answers about “strange, unexplained symptoms”.
Fortunately more suitable methods for diagnosing food sensitivities have been developed allowing the problem to be isolated. These include acupuncture meridian response testing , white blood cell reactive testing and testing of other antibodies (IgG, IgM, IgA). Each method has its pros and cons, and a skilled practitioner will generally correlated it with a thorough history, focused clinical suspicion and other factors. This typically leads to an accurate plan to resolve the patient’s symptoms and halt the disease process.
Perhaps the most significant change in human dietary patterns over the past several generations besides the addition of large amounts of sugars, has been the large shift towards increased grain consumption. Recent research is showing that this shift is causing difficulty in the brain’s ability to produce neurotransmitters such as serotonin. Serotonin is the neurotransmitter that is thought to be involved in depression, anxiety and some eating disorders. The commonly used drugs to treat depression are selective serotonin reuptake inhibitors. Their job is to keep what serotonin there is in the brain active longer. The link below shows a short animation about the activity of serotonin in the brain.
Grains, like most natural foods contain a mix of content supplying some carbohydrate, some fat and some protein. The protein content, however, is different than that from other sources such as meat and dairy in the amount of the different amino acids present. When we digest protein, it is ultimately broken down into the various amino acids which the body uses for different tasks. One of these amino acids, tryptophan is used by the brain to make serotonin.
The use of tryptophan in the body is highly dependent on the mix of other amino acids that are available at the same time. The different amino acids compete with each other for transportation around the body and into different areas such as the brain. Tryptophan is one of the least competitive amino acids, so when many of the other more competitive amino acids are present, tryptophan is poorly utilized.
Here is where grain comes in. Grain proteins contain a different mix of amino acids, a mix that favors the utilization of the other amino acids rather than the tryptophan that is available. A recent study compared the blood tryptophan levels following the ingestion of 3 different protein meals. They also looked at the ratio of the blood tryptophan to the other more competitive amino acids. This measure has been shown to accurately predict how well tryptophan can be transported into the brain.
A dairy protein called alpha-lactalbumin resulted in a 300% increase in blood tryptophan and a 50% increase in the tryptophan ratio. This predicts that the large increase in blood tryptophan will result in higher transport into the brain for serotonin production. The other two proteins were wheat gluten and zein which is the main protein in corn. Both resulted in decreases in blood tryptophan and decreased blood tryptophan ratios. Not only did these two common grain proteins result in lower absorption of what tryptophan was available in them, they resulted in much higher levels of other amino acids that limit the ability to transport tryptophan into the brain.
The conclusion of the study was that different protein sources are likely to exert different influences on brain chemistry and behavior. It appears that the common grains in the western diet impede tryptophan blood levels and transport into the brain for serotonin production. This may be a significant factor in disorders related to low serotonin availability such as depression.
In addition to the tryptophan transport mechanism above, a high grain diet affects brain serotonin through other mechanisms. A high grain diet is generally pro-inflammatory by virtue of its high omega-6 fatty acid content and by the tendency for grain peptides such as gluten to induce allergic sensitivities. Inflammation causes the use of brain tryptophan to produce quinolinic acid which heightens pain signaling and diverts tryptophan away from the serotonin production pathway.
An excellent book on the subject called Grain Brain is scheduled for release shortly.
The author is a board certified neurologist who specializes in the treatment of brain dysfunction.
The striking rise in depression rates highly suggests that changes occurring in our lifestyle may be driving them. Perhaps at the top of the list is diet. We spend billions annually on drugs that try to make serotonin function longer in the brain but spend very little time examining why the brain may not be making enough to begin with.
Our diet contains many times the amount of grain than did that of humans 10,000 years ago, yet our genetic makeup is more than 99% identical. Grain consumption has increased 300-400% in just the past century with the US daily intake averaging 8 servings/day. This shift to a grain dominant diet has not been without adverse impact. Depression is just thought to be one of many related problems.
This is a thought provoking question that is being asked in light of the epidemic of allergies in the United States. Perhaps one of the best ways to address it is to compare allergy rates in children born outside the U.S. to that of those born and residing in the U.S.
Research presented at the American Academy of Allergy, Asthma and Immunology suggests that the answer is a strong “yes”. The data from the 2007-2008 National Survey of Child Health compared the rates of several forms of allergic disease in children between 0-17 years of age who were born and resided in the United States to that of children born in other countries but who had more recently moved here. The data is very convincing. All forms of allergic disease were much lower in those who were born elsewhere but recently relocated to the United States.
A second piece of data was even more convincing of the relationship. Those children who were born outside the United States and moved here developed allergy rates 3 to 6 times higher after 10 years of U.S. residence. This takes the issue of genetic background out of the equation and clearly makes the issue the U.S. environment.
This data strongly supported previous studies which found higher rates of allergic disease in highly developed nations. This higher rate has been attributed to the “hygiene hypothesis” which suggests that the excessive use of antibiotics and other similar practices during childhood in highly developed nations is a predominant factor. Children receiving repeated antibiotic exposure during the first year of life have been shown to have a doubling of allergy rates. The hypothesis suggests that tolerance in the immune system must be trained in children with a reasonable amount of challenge by microorganisms.
Other factors explaining this epidemic have evolved. It seems that allergies are rare in parts of the world where minor parasite infections are high. Children previously infected by helminth parasites were found to have very low allergy rates. It seems that the parasitic infection “teaches” the immune system self tolerance. The lesson is not that children should be allowed to get these minor parasite infections but more what these infections do. They lead to the development of an immune cell called CD4+ Treg cells which are important in learning immune self tolerance. Allergies are simply a self immune attack.
It seems that the friendly bacteria that live in the human digestive tract also lead to the development of an immune cell called CD4+ Treg cells. Unfortunately, these bacteria are reduced by therapeutic antibiotic exposure, so hence the allergy connection to antibiotic use.
Most of these bacteria are transferred from the mother to the infant during birth and during breast feeding. If the mother’s “population” had been altered by antibiotic use or antibiotic pass-through from standard meat/dairy/eggs, the child’s “population” is then affected. Early probiotic use has been shown to decrease the risk of allergic disease by age 2 by 60%
Another piece of the puzzle is our food environment. The immune system must react to everything foreign and decide to activate or tolerate. Many of the foreign substances in food in the U.S. are not allowed in many other developed nations, and packaged, manufactured food does not exist in under-developed nations. Dyes are a perfect example. A recent uproar over a different version of macaroni and cheese with artificial dye being sold in the U.S. than the version sold in Europe where these dyes are banned is telling.
Allergies are in many ways just an angry immune system that decides to attack “self”. As we understand what makes the immune system excessively angry, preventing and correcting the problem seems realistic.