With the holidays approaching and lots of family gatherings revolving around food and eating together, it seems a good time to discuss the differences between food allergies and food intolerance, as they are not the same thing.
When one member of your family tells you that their child is “allergic to nuts” and another tells you that their child cannot “drink milk”, they may not be talking about the same phenomena at all. There is a big difference and it important to understand why.
Food allergies are immune mediated adverse reactions to foods. While any food protein can trigger an allergic response, only a few foods account for most allergic reactions. Eggs, milk, peanuts, soy, fish, shellfish, tree nuts and wheat are the most common causes of true immune mediated food allergies.
The most common symptoms of an acute allergic (anaphylactic) reaction to a food include such things as: itching around the mouth and lips, swelling of the throat, difficulty breathing, cough, shortness of breath, wheezing, nausea, abdominal pain, vomiting, diarrhea, flushing, and or hives. A person may present with only a few of these symptoms after being exposed to a food, or may have multiple symptoms that occur. The most common symptom of an allergic reaction is with the acute onset of hives (urticaria) and itching, which may then be followed by other symptoms of respiratory or gastrointestinal tract.
An allergic reaction to food is a medical emergency and may cause serious of even life threatening reactions and requires immediate treatment. If this is a new onset food allergy and a person is thought to be symptomatic call 911 as a serious reaction can happen quite quickly. If there is a known food allergy and someone is inadvertently exposed to the food, they should carry injectable epinephrine and use it immediately along with an antihistamine….then call their doctor or go to the emergency room for follow up. Remember, anaphylaxis is life threatening!
Food intolerance is a different story. It is NOT an immune mediated event and while you may feel miserable after ingesting certain food, such as milk, it is not life threatening. In most cases of food intolerance a person learns that they may ingest small amounts of the offending food without any problems (maybe a small scoop of ice cream), but cannot tolerate drinking an entire glass of milk without experiencing GI complaints, often with abdominal cramping and diarrhea. Lactose seems to be one of the most common offending agents, while others seem to be sensitive to gluten or even food additives like sulfites and dyes. The best treatment for this is to stay away from foods that cause you to have symptoms, or to only ingest small amounts.
So, if you have a relative with true food allergies make sure to check with them before planning a meal and avoid cross contamination of foods during preparation. For those with intolerances….they may just choose to skip the offending food and double up on others!