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Food intolerance

Food intolerance occurs when someone experiences difficulty in the digestion of certain foods, therefore expressing unpleasant physical reaction to them. Contrary to some allergies, food intolerances alone are not considered life-threatening. They are extremely common though, with up to 20% of the world’s population having one or more of them. Τhey lead to a variety of symptoms, which normally start within a few hours of consuming the food you are intolerant to. Still, some symptoms take up to 48 hours to show and can last for hours or days, making it hard to find the offending food just by observation. Food intolerance symptoms vary, but they mostly include the digestive system, skin and respiratory system.

Symptoms

The most common symptoms involve:

Diarrhea

Bloating

Rashes

Headaches

Nausea

Fatigue

Abdominal pain

Runny nose

Reflux

Flushing of the skin

 

Diagnosis

 The most common way of food intolerance diagnosis is by elimination diet. Elimination diets are designed to narrow down offending foods. In detail, foods that are mostly linked with intolerances are cut out for a period of time, until symptoms subside. Foods are then reintroduced one at a time, while inspecting for symptoms. This type of diet helps people identify which food or foods are causing symptoms.

 

Most common food intolerances

 

Dairy Lactose is a sugar found in milk and dairy products.It is broken down in the body by an enzyme called lactase, which is necessary in order for lactose to be properly digested and absorbed. Lactose intolerance is caused by a shortage of lactase enzymes, which causes an inability to digest lactose and results in digestive symptoms, such as bloating, abdominal pain, diarrhea, gas and nausea. It can be diagnosed with a lactose-tolerance test, lactose breath test or a stool PH test. People with lactose intolerance should avoid dairy products (milk, ice cream).

 

Gluten is the general name given to proteins found in wheat, barley, rye and triticale. Several conditions relate to gluten, including celiac disease, non-celiac gluten sensitivity and wheat allergy. Celiac disease involves an immune response, which is why it is classified as an autoimmune disease.When people with celiac disease are exposed to gluten, the immune system attacks the small intestine and can cause serious harm to the digestive system. Symptoms of non-celiac gluten sensitivity are similar to those of celiac disease and involve bloating, abdominal pain, diarrhea or constipation, headaches, fatigue, joint pain, skin rash, anemia and anxiety. Both celiac disease and non-celiac gluten sensitivity are managed with a gluten-free diet.

 

Caffeine is a bitter chemical that is found in a wide variety of beverages, including coffee, soda, tea and energy drinks. It’s a stimulant, meaning it reduces fatigue and increases alertness when consumed. It does so by blocking receptors for adenosine, a neurotransmitter that regulates the sleep-wake cycle and causes drowsiness/dehydration. Some people are more sensitive to caffeine and experience reactions even after consuming a small amount. This hypersensitivity to caffeine has been linked to genetics, as well as a decreased ability to metabolize and excrete caffeine. Some symptoms include rapid heartbeat, anxiety, jitters, insomnia, nervousness and restlessness. People with a sensitivity to caffeine should minimize their intake by avoiding foods and beverages that contain caffeine, including coffee, soda, energy drinks, tea and chocolate.

 

Salicylates are natural chemicals that are produced by plants as a defense against environmental stressors like insects and disease. They have anti-inflammatory properties for the plants and can be found in a variety of foods, including fruits, vegetables, teas, coffee, spices, nuts and honey. Salicylates are also used as a food preservative and may be found in medications. Symptoms of salicylate intolerance include stuffy nose, sinus infection, asthma, diarrhea, colitis and hives. Those with salicylate intolerance should avoid spices, coffee, raisins and oranges, as well as cosmetics and medications that contain salicylates.

 

Amines are produced by bacteria during food storage and fermentation and found in a wide variety of foods. Though there are many types of amines, histamine is most frequently associated with food-related intolerances. It is a chemical in the body that plays a role in the immune, digestive and nervous systems. It helps protect the body from infection by creating an immediate inflammatory response to allergens. This triggers sneezing, itching and watery eyes in order to potentially excrete harmful invaders.The most common reason for histamine intolerance is impaired function of the enzymes responsible for breaking down histamine — diamine oxidase and N-methyltransferase. Symptoms of histamine intolerance include flushing of the skin, headaches, hives, itching, anxiety, stomach cramps and low blood pressure. People with an intolerance to histamine should avoid foods like cured meats, citrus fruits, avocados, aged cheeses, vinegar and smoked fish.

 

FODMAPs is an abbreviation that stands for fermentable oligo-, di-, monosaccharides and polyols. They are a group of short-chain carbohydrates found naturally in many foods that can cause digestive distress. FODMAPs are poorly absorbed in the small intestine and travel to the large intestine, where they are used as fuel for the gut bacteria there. The bacteria break down or “ferment” the FODMAPs, which produces gas and causes bloating and discomfort. These carbohydrates also have osmotic properties, meaning they draw water into the digestive system, causing diarrhea and discomfort. Symptoms of a FODMAP intolerance involve bloating, diarrhea, gas, abdominal pain, and constipation. FODMAP intolerances are very common in people with irritable bowel syndrome (IBS). In fact, up to 86% of people diagnosed with IBS experience a reduction in digestive symptoms when following a low-FODMAP diet. There are many foods high in FODMAPs, including apples, soft cheeses, honey, milk, artichokes, bread, beans, lentils and beer.

 

Sulfites are chemicals that are primarily used as preservatives in foods, drinks and some medications. They can also be found naturally in some foods like grapes and aged cheeses. Sulfites are added to foods like dried fruit to delay browning and wine to prevent spoilage caused by bacteria. Sulfite sensitivity is most common in people with asthma, though people without asthma can be intolerant to sulfites as well. Common symptoms of sulfite sensitivity include hives, skin swelling, stuffy nose, hypotension, flushing, diarrhea, wheezing and coughing. Sulfites can even cause airway constriction in asthmatic patients with sulfite sensitivity, and, in severe cases, it can lead to life-threatening reactions.

 

Fructose, which is a type of FODMAP, is a simple sugar found in fruits and vegetables, as well as sweeteners like honey, agave and high-fructose corn syrup. In people with fructose intolerance, fructose isn’t efficiently absorbed into the blood. Instead, the malabsorbed fructose travels to the large intestine, where it is fermented by gut bacteria, causing digestive distress. Symptoms of fructose malabsorption include reflux, gas, diarrhea, nausea, abdominal pain, bloating and vomiting. People with an intolerance to fructose are often also sensitive to other FODMAPs and can benefit from following a low-FODMAP diet.


Celiac Disease

 

Coeliac disease is a condition where your immune system attacks your own tissues when you eat gluten. This damages your gut (small intestine) so you are unable to take in nutrients. Coeliac disease is caused by a reaction to gluten, a group of various proteins found in wheat and in other grains such as barley and rye and can cause a range of symptoms, including diarrhoea, abdominal pain and bloating, loss of appetite, and among children failure to grow normally.

Non-classic symptoms are more common, especially in people older than two years. There may be mild or absent gastrointestinal symptoms, a wide number of symptoms involving any part of the body, or no obvious symptoms. Coeliac disease was first described in childhood; however, it may develop at any age. It is associated with other, such as Type 1 diabetes mellitus and Hashimoto's thyroiditis, among others.

It usually occurs in people who are genetically predisposed. Upon exposure to gluten, an abnormal immune response may lead to the production of several different autoantibodies that can affect a number of different organs. In the small bowel, this causes an inflammatory reaction and may produce shortening of the villi lining of the small intestine (villous atrophy).This affects the absorption of nutrients (iron, vitamin K, copper and zinc, folic acid, calcium, vitamin D, vitamin B12 and selenium) , frequently leading to anaemia.

The only known effective treatment is a strict lifelong gluten-free diet, which leads to recovery of the intestinal lining (mucous membrane), improves symptoms, and reduces the risk of developing complications in most people. If untreated, it may result in cancers such as intestinal lymphoma, and a slightly increased risk of early death. Rates vary between different regions of the world, from as few as 1 in 300 to as many as 1 in 40, with an average of between 1 in 100 and 1 in 170 people.It is estimated that 80% of cases remain undiagnosed, usually because of minimal or absent gastrointestinal complaints and lack of knowledge of symptoms and diagnostic criteria. Coeliac disease is slightly more common in women than in men.



MOLECULAR BIOLOGY

Genes influence every aspect of human physiology, development, and adaptation. They are pieces of DNA (deoxyribonucleic acid) inside our cells that tell the cell how to make the proteins the body needs to function. DNA is the genetic “blueprint” in each cell. Genes affect inherited traits passed on from a parent to a child, such as hair and eye color or height. They can also affect whether a person is likely to develop certain diseases. Genetic testing looks for specific inherited changes (variants) in a person’s genes. Genetic variants can have harmful, beneficial, neutral (no effect), or unknown or uncertain effects on the risk of developing diseases. Harmful variants in some genes are known to be associated with an increased risk of developing cancer.

Cancer

Cancer is not usually inherited, but some types – mainly breast, ovarian, colorectal and prostate cancer – can be strongly influenced by genes and can run in families. Genetic testing may help: • Predict your risk of a particular disease • Find if you have genes that may pass increased cancer risk to your children • Provide information to guide your health care in order to prevent it. No genetic test can say if you will develop cancer for sure. But it can tell you if you have a higher risk than most people. We also offer cardiovascular and metabolic genetic testing along with the tests for hereditary cancer, tumor profiling and liquid biopsy test, for therapy selection. Furthermore, we offer Whole Exome Sequencing (WES) analysis, providing accurate results with unrivalled sensitivity and specificity.


Obesity

Overweight and obesity are characterized as abnormal or excessive fat increases that tend to lead to a variety of health impairments.Body mass index (BMI) is a simple index of weight-for-height used for the classification of overweight and obesity in adults. It is defined as a person's weight in kilograms divided by the square of his height in meters (kg/m2 ). Facts about obesity According to WHO  Worldwide obesity has nearly tripled since 1975.  39% of adults aged 18 years and over were overweight in 2016, and 13% were obese.  Most of the world's population live in countries where overweight and obesity kills more people than underweight.  Over 340 million children and adolescents aged 5-19 were overweight or obese in 2016.  39 million children under the age of 5 were overweight or obese in 2020. Obesity is a multifactorial disease resulting from the interaction between genetic factors and lifestyle. As it is poreventable, identification of rare genetic variations with strong effects on obesity has been useful in diagnosing and designing personalized therapy for early-onset or syndromic obesity. Health consequences Obesity can be a significant risk factor concerning diseases such as:  cardiovascular diseases (mainly heart disease and stroke),  diabetes,  musculoskeletal disorders (especially osteoarthritis – a highly disabling degenerative disease of the joints) and  some cancers (including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney, and colon). Obesity reduction Supportive environments and communities are essential tools for the reduction of obesity. At the individual level, people can:  limit energy intake from total fats and sugars,  increase fruit and vegetables intake, as well as legumes, whole grains and nuts; and  enroll in regular physical activity (60 minutes a day for children and 150 minutes spread through the week for adults).

Thrombophilia

Thrombophilia is a condition that increases your risk of blood clots. It's usually treated with anticoagulant medicines. Your blood forms clots to help stop bleeding. If you have thrombophilia, it means your blood can form clots too easily. Blood clots can be very serious and need to be treated quickly.Thrombophilia increases your risk of: • deep vein thrombosis (DVT), a blood clot in a vein, usually the leg , • pulmonary embolism (PE), a blocked blood vessel in your lungs Thrombophilia does not have any symptoms. You only tend to find out you have thrombophilia when you develop a blood clot


Dr. Gkirtzimanaki Katerina,Genetisist-Molecular BiologistPostdoctoral researcher, IMBB FORTH,Head of Molecular Biology and Genetics Dpt., Asklipios Diagnosis, Herakleion, Greecephone:6983270280