Food Allergy vs. Food Intolerance

By Michele Reid, PhD – Certified Integrative Nutrition Coach

There are two different kinds of food sensitivities – food allergy and food intolerance. Often times they are confused because they are both reactions to foods that we eat and some of the symptoms can be very similar. However, it’s worth taking a moment to distinguish their differences.

Food Allergy

It is an immune systemresponse – the body thinks that the food you ingested (most likely a protein in the food) is a harmful substance and it creates antibodies to defend against it. Symptoms depend on where the antibodies and histamine are released, and they can include rash or hives, nausea, stomach pain, diarrhea, itchy skin, shortness of breath, chest pain, swelling of the airway and even anaphylaxis.

Our intestines are designed to be impermeable to large protein molecules that our body may mistake as “invaders” and launch an “attack” – resulting in allergic reactions. Our diet, lifestyle and medications often times compromise the permeability of our digestive tract, creating what is known as the “leaky gut” syndrome. When the intestine becomes permeable to larger protein molecules, these molecules can get into our bloodstream and trigger an immune response.

Food allergies can be triggered by even a very small amount of food, and occurs every time the food is consumed. If you suffer from food allergy, you are most likely advised to avoid the trigger food altogether. However, if you work with a qualified professional, you may be able to resolve the root cause of the allergic reaction (e.g. leaky gut), allow time for the antibodies to clear up (usually 2 – 4 weeks), and then you may be able to ingest a small amount of the food every 3 to 4 days without triggering allergic reactions.

Peanuts, tree nuts (such as walnuts, pecans and almonds), shellfish, milk, eggs, soy products, and wheat are the most common triggers for food allergies. People who are allergic to aspirin can also be allergic to foods that contain salicylates – such as many fruits, vegetables, nuts, coffee, juices, beer, and wine.

Food Intolerance

It is a digestive systemresponse – the digestive system is unable to properly digest some substance in the food, or the food irritates the digestive tract. Most symptoms of food intolerance are confined to the GI tract, including nausea, stomach pain, gas, cramps, bloating, vomiting, heartburn, and diarrhea, with the exception of headache and irritability or nervousness. In most cases, food intolerance is caused by the lack of certain enzymes and the body becomes unable to digest certain substances in the food.

Food intolerance, in most cases, is dose related. For example, some people who are lactose intolerant can use milk in their coffee, eat a moderate amount of yogurt (in which some of the lactose is pre-digested by the probiotics) or hard aged cheese (which has a lower amount of lactose).

The most common food intolerance is lactose intolerance, in which the person is unable to digest dairy products due to the inability to produce the enzyme lactase. However, food intolerance can also be caused by chemicals such as food colorings and additives such as monosodium glutamate (MSG) or sulfites.

Reference:

http://www.webmd.com/allergies/foods-allergy-intolerance

Diagnosing Food Sensitivities

There are a few ways to find out if certain systemic or digestive issues are triggered by food sensitivities – from trial and error to working with a healthcare professional:

1. Food Diary– keeping a food diary over the course of a week can be the most straightforward and low-cost way to find out what foods you may be sensitive to. Any time you notice an allergic reaction, you refer back to what you have eaten and try to identify the common factors. Since reaction may be triggered not by the main ingredients of the dish, you need to be as detailed and specific as possible. If a packaged food triggers a reaction, you may need to go back and read the label to make sure you have addressed all the ingredients. Also make sure you record all meals, snacks and beverages for accurate interpretation of the results.

In your food diary, record the date and time of your meal as well as any symptoms and the time that the symptoms occur.

2. Elimination Diet and Food Challenge Test– an elimination diet involves removing foods from your diet that you suspect is causing allergy reactions – common ones are diary, eggs, nuts, wheat and soy. This elimination phase usually lasts 2 – 4 weeks so that all the antibodies that cause the allergic reaction are cleared and you have a clean slate for the food challenge test. Most people who do have a food allergy would feel better at the end of this phase.

It is recommended that you work with a qualified professional to ensure that your diet still contains the nutrition and calories your body needs without accidentally including the potentially allergenic foods that you set out to test. During this phase, it’s best to prepare your own meals to avoid contamination. If you have to dine out, make sure you ask your server about the ingredients used in the dishes. If you eat any packaged foods, read the ingredient lists carefully to make sure that you are not ingesting foods that are being eliminated – you may be surprised how certain food or ingredient is lurking in everything that we buy!

After the elimination diet phase, you will enter the food challenge phase during which you will be adding the suspected foods back into your diet, one at a time, and noting any reactions you have using a food diary. You can then discuss the results with the health professional that you are working with and work with a health coach/nutrition consultant etc. to design a diet that addresses your specific needs.

3. Skin Test or Blood Test– these tests are carried out at a doctor’s office to determine various causes of allergies. A “positive” result means that the person has a specific allergic antibody to the substance tested. However, a positive allergy test does not necessary mean that the person will display allergic reaction to the substance in question. Therefore, an allergist is required to not only perform the test but also to interpret the results based on the patient’s symptoms. Of course, knowing what causes allergic reactions can save lives at times, but there are also people who got “false positive” results, which lead them to eliminate many foods from their diet and making their lives miserable.

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