Is perceived intolerance to milk and wheat associated with the corresponding IgG and IgA food antibodies? A cross sectional study in subjects with morbid obesity and gastrointestinal symptoms

Abstract

BackgroundSerum IgG and IgA food antibodies have been used for dietary advice to subjects with gastrointestinal symptoms and perceived food intolerance, but the role of these antibodies in mediating intolerance is controversial. The present study investigated associations between perceived gastrointestinal intolerance to milk-or wheat and the corresponding s-IgG and s-IgA food antibodies in subjects with morbid obesity.MethodsSubjects with morbid obesity (BMI ≥ 40 kg/m2 or ≥35 kg/m2 with obesity-related complications) were included. Irritable Bowel Syndrome (IBS) was diagnosed based on the Rome III criteria. Severity of specific gastrointestinal symptoms were measured with the Gastrointestinal Symptom Rating Scale (GSRS)-IBS. S-IgG against cow’s milk, cheese, wheat and gluten, and s-IgA against casein and gliadin were measured.ResultsNinety-seven subjects (80 females) with mean age 45 (SD 8.4) years were included, 70 had gastrointestinal complaints, 25 had IBS, and 22 and 20 reported milk- and wheat- intolerance respectively. There were no significant differences in serum concentrations or proportions of subjects above defined cut-off values for the antibodies between subjects with and without gastrointestinal complaints. In the group with gastrointestinal complaints, no significant differences were found between subjects with and without perceived food intolerance. Except for a significant correlation between IgG against cheese and GSRS-diarrhea (Rho: -0.25, P = 0.04), no significant correlations were found between the antibodies and type or degree of gastrointestinal symptoms, including IBS.ConclusionsThe study showed no associations between perceived milk or wheat intolerance and the corresponding s-IgG and s-IgA food antibodies in subjects with morbid obesity.

Association between Food-Specific Immunoglobulin G4 Antibodies in Adults with Self-Reported Signs and Symptoms Attributed to Adverse Reactions to Foodstuffs

“…Gluten and IgG reactions might be associated with systemic inflammation [34] and contribute to the pathophysiology of IBS [38]. Furthermore, the literature suggests that overweight and obese subjects tend to have a higher frequency of GI comorbidity [39]. Barley, and its components, also appear to play an important role in obesity [40,41].…”

Specific Immunoglobulin E and G to Common Food Antigens and Increased Serum Zonulin in IBS Patients: A Single-Center Bulgarian Study

“…Several epidemiological and uncontrolled studies have confirmed IgG hyperresponsiveness to dietary antigens in patients with IBS [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. In addition, the role of specific IgG4 subclasses in food antigens was confirmed in childhood [ 27 ], adults with IBS [ 28 , 30 , 31 ] and those with migraine combined with IBS [ 34 ].…”

“…Some studies even found an association between food hypersensitivity and inflammation in the gut, obesity or functional disorders [ 33 ]. However, most studies demonstrated controversial and unconvincing results regarding eliminating diets in IBS and other conditions [ 29 , 32 , 34 ].…”

“…Kvehaugen and co-workers failed to find a link between patients’ suspected milk and wheat intolerance and the corresponding antibodies (IgG and IgA) [ 32 ]. Therefore, the authors of this study recommend not using the results of IgG antibody testing for dietary recommendations in patients with morbid obesity and gastrointestinal complaints [ 32 ]. We also did not establish associations between the anamnestic data and the results obtained for specific IgG antibodies to the same foods.…”

Study on Aberrant Eating Behaviors, Food Intolerance, and Stereotyped Behaviors in Autism Spectrum Disorder

“…It's difficult to say the serum specific IgG antibodies are the cause or results of GI symptoms. On the one hand, increased gut permeability could potentially result in elevated levels of the food antibodies, while there was an inverse association between tight-junctional gut permeability and perceived food intolerance ( 37 ), suggesting other underlying mechanism for the concentrations of antibodies. On the other hand, GI symptoms are only a clinical manifestation, which could be caused by digestive disease, intestinal flora disturbance, or even organic disease.…”