Rhinitis (or ‘runny nose’ in normal language) is a common problem in children. In natural medicine, it is often seen a potential manifestation of ‘food intolerance’. Food intolerance has the ability to cause a myriad of other unwanted conditions or symptoms too, including asthma. So, it’s not uncommon for naturally-oriented practitioners who see children with conditions to seek to identify problem foods and reduce or remove such fare and offer appropriate replacements.
The identification and management of food sensitivities does have some scientific support too: One study showed that 90% of children with asthma or allergic rhinitis (runny nose due to allergy) improved on a food elimination programme [1]. This study suffers from the absence of a ‘control’ group (a group of children who were not treated with an elimination diet for comparison), though a 90 per cent success rate does strongly suggest a real effect was taking place here.
In practice, my experience is that managing potential food sensitivities is usually highly useful in helping children who are prone to runny, snotty or generally blocked noses.
I was therefore interested this week, while perusing the British Medical Journal, to come across a report of a study which, apparently, shows that rhinitis is generally not due to food ‘allergy’, and that treatment for rhinitis due to food allergy is therefore rarely indicated [2]. The fact that this conclusion is in such stark contrast to the clinical experience of many practitioners means it deserves some comment, I think.
In conventional medicine, the term ‘food allergy’ is generally used to describe food-based immune reactions that involve a particular type of antibody known as ‘immunoglobulin E’ or ‘IgE’. IgE levels in the blood can be tested for. Another way of identifying foods that present problems through this particular mechanism is to apply extracts of foods to skin which has fist been breeched through some abrasion (the so-called ‘scratch test’).
The problem is that conventional testing take a very narrow view of food sensitivity. The reality is that the body may react to foods in ways that extend beyond the production of IgE. For instance, it is possible for the body to manifest unwanted reactions to food through the production of another form of immunoglobulin known as ‘IgG’.
The researchers responsible for study [1] above followed it up with another larger study [3]. Of 322 children with asthma or rhinitis, 91 per cent improved on food elimination. Again, no control group, but these results nonetheless look quite compelling and are difficult to ignore. Re-challenging the children with foods revealed that milk was the worst offender ” a phenomenon that is certainly mirrored in my own clinical experience.
Interestingly, the authors of this study that skin tests for food allergens rarely correlated with the results obtained when children were re-challenged with actual foods. The suggestion here, of course, is that conventional testing may be inadequate for identifying some types of food sensitivity. Which should, in my opinion, cause us to be wary of the pronouncements of doctors and scientists who rely on such tests.
References:
1. Ogle KA, et al. Children with allergic rhinitis and/or bronchial asthma treated with elimination diet. Ann Allergy 1977;39:8-11
2. Malik V, et al. Rhinitis due to food allergies: fact or fiction? Journal of Laryngology & Otology 2007;121:526-9
3. Ogle KA, et al. Children with allergic rhinitis and/or bronchial asthma treated with elimination diet: a five-year follow-up.
Ann Allergy. 1980 May;44(5):273.
