Food Allergies vs. Food Intolerances

When it comes to food allergies and food intolerances, we as coaches often find that there is either a lack of education surrounding the terms, and/or a psychological component which leads an individual to assume that they have one or the other when they may not. To clear the air considering that both of these are very real and serious, I would like to discuss the differences between food allergies and food intolerances, common signs and symptoms of each, suggested methods for managing symptoms, and whether or not you should spend your precious resources of time and money to get an allergy test done.

What does it mean to have a food allergy?

In simple terms, a food allergy is an immune response occurs when an individual consumes an offensive food that triggers the release of histamine and serotonin, ultimately resulting in an allergic reaction ranging anywhere from mild to severe. In most cases, symptoms of the allergic reaction will appear relatively immediately. Acute responses will occur anywhere from 1 minute to 2 hours (most common), while delayed responses will occur anywhere from 2-48 hours. The top 8 allergens which are required to be labeled on all food products per the Food Allergen and Labeling and Consumer Protection Act of 2004 are: peanuts, tree nuts, soybeans, wheat, milk, eggs, fish, and crustacean shellfish. These 8 allergens make up roughly 90% of all food allergies.

What are the signs and symptoms suggestive of a food allergy?

Typical signs and symptoms include nausea, vomiting and/or diarrhea, abdominal bloating/pain, cramping, hives, throat tightening, and asthma.

How should I manage a food allergy?

Avoid any and all foods that cause an allergic reaction.

What does it mean to have a food intolerance?

Contrary to food allergies, food intolerances do not involve the immune system (non-immunological) and there is no immediate reaction. Food intolerances can occur for a variety of reasons such as the body is unable to digest or absorb a specific food or even just a specific compound of a food. Common examples are food intolerances are lactose and gluten. Now, food intolerances are tricky because there is a large psychological component that can come into play here. You can absolutely think yourself into having a food intolerance.

 If you believe that you will have an adverse reaction to a specific food, you probably will.

That does not mean you are actually intolerant, but rather that maybe you have some food fear (ex. afraid to consume carbohydrates so you convince yourself that you have a gluten intolerance, or you are afraid of dairy and tell yourself you can’t have it or else your GI tract will be wrecked). Deeming yourself as intolerant does not mean that you are, you may just need to work on entering meals in a parasympathetic (rest and digest) state, and all will be well. Now, if you are going into meals cool, calm and collected with zero though about a food impacting you negatively (just as one example), it is possible that there may be an intolerance present.

 What are the signs and symptoms suggestive of a food intolerance?

Some of the signs and symptoms of food intolerances overlap with food allergies, but again, intolerances present much more gradually then food allergies. Common signs and symptoms include abdominal pain, diarrhea, and gas.

How should I manage a food intolerance?

It may be necessary to avoid the food(s) that cause a reaction. For example, those with lactose intolerance should avoid products such as milk, whey and butter. It should be noted, however, that certain fermented foods may be tolerated such as yogurt. If your dairy intake is lacking due to lactose intolerance, you may consult with your physician about incorporating supplements to make up for some of the vitamins and minerals that will be missing from your diet.

Because food intolerances are not as “dangerous” as food allergies, it can be worth experimenting to see if the intolerance reaction can be managed by simply reducing the frequency with which you eat a specific food. For example, if you feel whack every time you drink milk but you consume cheese and whey protein powder as well throughout the day, it could just be the fact that you are consuming lactose containing products 3 times each day and not because you have an issue with milk. Journaling and reflecting are incredibly important in order to have records of the foods you are eating and how you feel before/during/after so as to analyze any trends that may be occurring.

Should I get a food allergy test?

The skin prick test, which has been the most common to come up with clients, can identify a food allergen but cannot diagnosis what type of food allergy it is (IgE, Mixed IgE, non-IgE). What seems to happen to those who get allergy tests done via skin prick is that the results come back with an excessive amount of foods that they are “allergic to” and “can’t eat”, when in reality it may just be that the cumulative effect of the frequency with which they eat the food is what is showing up on the test. All to say that it’s possible that if someone is having wheat bread for lunch and wheat pasta for dinner, or eggs for breakfast every day of the week, there may be a cumulative effect making them more sensitive to that food and if they just dial back the frequency that it is consumed, they would be more than fine. The gold standard for allergy tests it what is called the Double-Blind Placebo Controlled Food Challenge which masks food in gelatin capsules. Additionally, the hydrogen breath test can be utilized to help detect if there is any malabsorption of carbohydrates. I personally do not have clients get skin prick tests because I find that simply working through some elimination style methods such as low FODMAP accompanied by journaling can find the culprit(s), if any.

In conclusion, food allergies and food intolerances are real and should be managed appropriately. It is imperative that people have the proper knowledge of these terms before they begin eliminating foods completely from their diet. If you believe that you have a food allergy or intolerance, it is crucial to work with a professional in order to figure out the best way for you to proceed with your nutrition to make sure that no offending foods are being consumed and/or to figure out how to incorporate specific foods in a way that will eliminate any sort of intolerance reaction.

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