What’s the difference between a food intolerance and food allergy?
Physical reactions to certain foods could be caused by a food intolerance rather than a food allergy. A food intolerance can cause some of the same signs and symptoms as a food allergy, so people often confuse the two.
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A true food allergy causes an immune system reaction that affects numerous organs in the body. It can cause a range of symptoms. In some cases, an allergic reaction to a food can be severe or life-threatening.
Common Food Allergens
• Peanuts, tree nuts, milk, eggs, wheat, soy, fish and shellfish
In contrast, food intolerance symptoms are generally less serious and often limited to digestive problems. If you have a food intolerance, you may be able to eat small amounts of the offending food without trouble.
Common Food Intolerances
• Lactose: This is a sugar in cow’s milk that requires the enzyme lactase to be broken down into simple sugars for absorption in the gastrointestinal tract.
• Sucrose or maltose: Both are sugars requiring enzymes for digestion into simple sugars for absorption.
• Histamine and tyramine: These are substances created in the fermentation process in aged cheeses, processed meats, beer, wine, vinegars, and soy sauce. They naturally occur in some foods as well.
• Tartrazine: This is an artificial food color used in food.
• Benzoates, butylhydroxyanisol (BHA), butylhydroxytoluene (BHT), sulfites: These are preservatives added to foods.
• Monosodium glutamate (MSG): This is a naturally occurring or added flavor enhancer in foods.
• Other food dyes: These are color additives used in food.
Causes of food intolerance include:
Absence of an enzyme needed to fully digest a food. Lactose intolerance is a common example.
Irritable bowel syndrome. This chronic condition can cause cramping, constipation and diarrhea.
Food poisoning. Toxins such as bacteria in spoiled food can cause severe digestive symptoms.
Sensitivity to food additives. For example, sulfites used to preserve dried fruit, canned goods and wine can trigger asthma attacks in sensitive people.
Recurring stress or psychological factors. Sometimes the mere thought of a food may make you sick. The reason is not fully understood.
Celiac disease. Celiac disease has some features of a true food allergy because it involves the immune system. However, symptoms are mostly gastrointestinal, and people with celiac disease are not at risk of anaphylaxis. This chronic digestive condition is triggered by eating gluten, a protein found in wheat and other grains.
Weeding Out the Culprits
While most food intolerances are found through trial and error, there are methodologies to help identify and isolate these intolerances.
Although testing is best, not all medical offices or labs are equipped to handle some of the testing required to diagnose some intolerances. In the case of lactose intolerance, for example, it’s much easier to avoid drinking lactose than to undergo breath testing.
Following identification of food intolerances, avoidance of the offending foods is the short-term recommendation, but in the long term, it’s important to investigate the underlying cause of the intolerance since, in many cases, food intolerances are reversible. See whether the intolerance has a cause and address it.
Elimination diets are also an important part of the process. Food intolerances are found through trial and error, but an elimination diet is the optimal way to help identify food intolerances.
Strategies for Elimination
To start the elimination diet process:
• Start a food diary. Keep a detailed food record, including meal and snack times, for about two to three weeks. At this point, no food is off limits. If symptoms occur with a particular food, record the reaction in detail.
• Become a super sleuth. After the two weeks, study the food record closely and identify trends in the records with foods eaten and symptoms experienced.
• Avoid the alleged offender. Avoid the offending food for four to six weeks with the goal of being symptom free during this time. The last step of the elimination diet is the challenge. Introduce one of the suspect foods back into the diet and see whether there’s a reaction. If you experience the reaction, you know there’s intolerance to that particular food and should avoid it.