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Food Intolerance Vs. Allergy Vs. Sensitivity: What's The Difference?

Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Oct 22, 2019
Last Modified Date: Oct 22, 2019
Published Date: Oct 18, 2019

Have you ever experienced diarrhea, migraines or ended up with an upset stomach after ingesting a certain food? Do you worry that you may have some allergies to some food? While both allergies and intolerances to food and food ingredients may show somehow similar symptoms, they are two different reactions to food that trigger two different mechanisms in the body. It's important to know the difference so you do not hold back on the food you like for no good reason.

Food is an essential element in our life. Our body needs it to function properly and grow. When we eat, the macronutrients and micronutrients, contained in every food, enter the body as a source of information and materials. When the wrong types of nutrients enter our system, messages get disrupted and sabotaged; as a result, both the metabolic processes and our body suffer.

Food and drinks provide our body with nutrients; and, depending on what you decide to eat, a certain combination of nutrients enter the body. While some are of animal origin, others can originate from; but, all contain essential elements like carbohydrates, proteins, fat, vitamins and minerals.

For most healthy individuals, moderation and variety is the key to a healthy dietary lifestyle. But, for others, specific food choices, despite being highly nutritious, can trigger some abnormal functions and lead to unwanted reactions that may be as extreme as life-threatening.

1. Food Intolerance: an intolerance is the inability of your body to breakdown certain foods due to the lack of enzyme being created in the body.

One example of food intolerance is lactose intolerance. The body of an individual experiencing lactose intolerance does not have the enzyme lactase to help aid the body in digestion of dairy products, therefore leading to an upset stomach, constipation or diarrhea after consuming dairy products.

2. Food Sensitivity: a sensitivity is a delayed immune reaction (IgG) to a specific food or foods that may cause unpleasant symptoms such as fatigue, difficulty concentrating, joint pains, headaches or migraines days after consuming the food. This type of reaction is not an allergic reaction.

3.Food Allergy: an allergy is an immediate immune reaction (IgE) created by your body in response to the allergen being in contact with your body either by consumption, skin contact or airway.

An allergic reaction occurs immediately when the antigen (food, pollen, dust, etc.) comes in contact with your body. These reactions happen almost instantly or within a few minutes of being in contact with the allergen, unlike a sensitivity which can happen days after consumption.

If an individual is allergic to a specific antigen they are typically advised to refrain from consuming or contacting that item as it may result in a life threatening immune response known as anaphylactic shock.

If you have a known allergy, it may not show up on a food sensitivity test and vice versa. The tests are different for either an allergy or sensitivity as different antibodies are being tested.

Food Intolerance

What is Food intolerance?

Food intolerance is when your body experiences abnormal unpleasant physiological reactions to certain kinds of food when digested. This is commonly caused by the inability of the body to completely breakdown the food into smaller particles that can be digested easily. Commonly, this is the result of a lack of enzymes that are small proteins responsible for breaking down food in our digestive system. People who are food intolerant will end up having non broken-down food that remains unabsorbed and free to be used by the bacteria living in our digestive system. One of the most common forms of food intolerances is lactose intolerance that is affecting more than half of the population worldwide.

You need to keep in mind that food intolerance is completely different from food allergies. These two should not be mixed. While food intolerance causes disturbances and signs and symptoms; food allergies is an immunological response of our body to the specific protein in the food. Also, food intolerance is not life threatening.

What are the types of food intolerance?

Despite the fact that food intolerance is not dangerous, it could be problematic for many. It is estimated that around twenty percent of people are intolerant to something. While there are many intolerances, these are the most common types:

  • Lactose intolerance: lactose is a sugar found in milk and dairy products. This sugar is normally broken down into simple sugars with the help of an enzyme called lactase. People who are lactose intolerant lack this enzyme which means that they cannot properly digest anything dairy. This type of intolerance is very common and can lead to symptoms such as abdominal pain, bloating, diarrhea, gas, and nausea. If you are experiencing any of these symptoms, you need to get tested. certain dairy product such as age cheeses and fermented food can be easier to digest by those who are lactose intolerant as they have less of the sugar in them.
  • Gluten intolerance: gluten is a protein found in wheat, barley, rye and triticale. While this intolerance is common, it can be linked to certain health conditions such as celiac disease that consist the involvement of the immune system. and that specific case, these people ‘s immune system attacks the small intestines leading to harmful effects in the digestive system. those who are gluten intolerant (without having a celiac disease) they experience some symptoms such as bloating, abdominal pain, diarrhea or constipation, headaches, fatigue, joint pain, skin rashes, depression, or even anemia. Following a diet that is free of gluten is the best solution for those intolerant to gluten. Food that may contain this protein include bread, pasta, cereals, beer, baked goods, crackers and some sauces.
  • Salicylate intolerance: salicylates are chemicals that are produced by plants and have anti-inflammatory properties, protecting the plant from environmental stressors such as diseases and insects. These natural components are found in many food options such as fruits, vegetables, teas, coffee, spices, nuts and even honey. Other than their protective properties, they are used as food preservatives in many industries. They are also found in medications. While most people have no problem consuming certain amounts of salicylates, excessive amounts can be harmful to our health. Being intolerant to salicylate means that you may experience symptoms such as having a stuffy nose cover sinus infection, nasal and sinus polyps, asthma, diarrhea, colitis, and even hives.
  • Amines intolerance: amines result from food storage and fermentation of a wide variety of food and are caused by bacteria. There are many types but the most common one is histamine with is linked the food intolerances. This chemical please a major role in our immune system, digestive system, as well as nervous system. People that are intolerant the histamine cannot metabolize and excrete properly this amine. Symptoms accompanying this intolerance include having flushing of the skin, headaches, hives, itching, anxiety, stomach cramps, diarrhea, and even low blood pressure. If you are intolerant to histamine you may need to stay away from fermented foods, cured meats, dried fruits, citrus fruits, avocados, aged cheese, smoked fish, vinegar, and fermented alcoholic beverages like wine beer.
  • Fructose intolerance: fructose is a simple sugar found in fruit and vegetables. Is also a component of honey, agave, and high fructose corn syrup. Individuals who are fructose intolerant, cannot digest this sugar feeding to malabsorbed fructose reaching the large intestines and getting fermented by the bacteria leading to digestive distress. Fructose intolerance is accompanied by symptoms such as reflux, gas, diarrhea, nausea, abdominal pain, formatting, as well as bloating. Some of the food that needs to be avoided would be soda, honey, apples, watermelon, cherries come up pears, as well as some vegetables such as sugar snap peas.
  • Aspartame: it is an artificial sweetener that is used in sugar-free food choices. Intolerance to this sweetener is accompanied by signs like depression and irritability.
  • Eggs: such an intolerance is accompanied by signs like diarrhea and abdominal pain.
  • MSG (monosodium glutamate): this is an additive that is used to enhance the flavor of certain food. Intolerance to this additive include signs like hives, chest pain and headaches.

How is a food intolerance diagnosed and treated?

Best way to detect food intolerance is to get tested. While some resort to elimination diets that involve removing the food from the diet and then reintroducing it step by step; this process can be time consuming any misleading. Once diagnosed with food intolerance, understand that this is not at this is that would be treated. This is rather a lack of digestive enzymes. So, the management of this condition is as simple as cutting the food out of the diet. There are some supplements that do provide the just of enzymes making life easier. For example, lactase supplements for those who are lactose intolerant.

Getting diagnosed with food intolerance should be simple and prompt. There are excellent tools that can help you identify your intolerances, such as the ALCAT test.

Food Sensitivity

What is food sensitivity?

Food sensitivity is neither food allergy nor food intolerance. When a person has food allergies, extreme life-threatening reactions could occur that are IgE-mediated immune responses. This is for example the case when you eat peanuts and strawberries and you’re allergic to them. The reaction usually occurs within minutes eating the food and can be mild to severe causing an impairment of breathing and a drastic drop in blood pressure.

Food sensitivity, on the other hand, is more difficult to understand. It is usually triggered by the specific food that causes a reaction of the immune system that is mediated by the IgG. Symptoms normally take as long as seventy-two hours to start developing, which makes it very difficult to pinpoint the exact food that caused this sensitivity reaction.

What are the common signs of food sensitivity?

There are many signs and symptoms accompanying food sensitivity. These include fatigue, brain fog and difficulty concentrating, joint pains, headaches or migraines, eczema, rashes and skin irritations, stomach aches, acid reflux, bloating, constipation or diarrhea, losing weight for no obvious reason, gaining weight for an obvious reason, and finally some behavioral problems in children.

How to diagnose food sensitivity?

While some resorted elimination diet, this method for pinpointing your food sensitivity is not error free and can be time consuming. Unlike food allergies, for food sensitivities the immune system takes as much as seventy-two hours to start showing some symptoms. During this long time, you would have probably eaten a lot of different types of food. When you try to understand what you are sensitive for using this type of diet, you need to eliminate most food that may cause sensitivity and re-introduce them one at a time waiting for a few days between each of the food.

With the advances in medicine and science, tests exist to identify your food sensitivities with no possible errors. It is a great way to do a comprehensive analysis of the numerous food around that could possibly cause sensitivity.

How do you address food sensitivity?

You did your test now you have the results. What do they mean and what can you do? Included with all Food Sensitivity testing is a consultation to help you understand the results as well as the additional information that is provided to you such as a rotation diet. The rotation diet is provided as a guide to help you determine when and how often you can or should eat foods that may be causing reactions in your body. The rotation diet helps you eliminate the high sensitivity foods immediately from your diet, remove moderate sensitivity foods and mild sensitivity foods from your daily intake. Mild food sensitivity does not mean you need to completely cut them out of your diet, but it is advised you do not consume them everyday. The rotation diet allows you to integrate any food item that shows up as a sensitivity slowly back into your diet after a certain amount of time.

Food Allergy

What is a food allergy?

Food allergy is when your body’s immune system reacts to a certain kind of food after eating it. It doesn’t matter the amount that you are eating as the tiniest piece of this allergy causing food could trigger signs and symptoms. The mechanism behind these allergies is somehow simple. When you are allergic to a certain kind of food, this normally means that your immune system identifies it or an ingredient found in it, as a harmful host. This will trigger a reaction from the immune system where its cells end up releasing an antibody known as Immunoglobulin E to neutralize the effect of the causative agent: the allergen. As a result, every time your body eats this substance or food, the IgE antibodies detect it and send a message to the immune system leading to the release many chemicals into the bloodstream, such as histamines. According to a study published by the journal of allergy and clinical immunology, two percent of adults in the united states have food allergies; but, a different epidemiological studies are lacking.

What are common foods that trigger allergies?

Children and adults may experience food allergies differently. Children, for example, may face an allergic reaction caused by proteins in peanuts, tree nuts, eggs, cow’s milk, what or soy. Adults’ major allergic reactions are, on the other hand, caused by shellfish like shrimps, lobsters and crab, peanuts, tree nuts or fish. Some are also allergic to pollen, which is referred to as oral allergy syndrome. Those who have the pollen allergy may also have reactions to wards some fresh fruits and vegetables, as well as nuts and spices.

According to Mayo Clinic, certain environmental allergies can also have an effect on food allergies. For example, those who are allergic to ragweed pollen, may also have a reaction when eating bananas, cucumbers, melons, and zucchini. Those who are allergic to birch pollen, may have some reactions to almonds, apples, apricots, carrots, celery, cherries, hazelnuts, peaches, peanuts, pears, plums, raw potatoes, as well as some herbs and spices. Allergies to grasses could trigger reactions to cucumbers, melons, oranges, peanuts, white potatoes and even zucchini.

What are the signs and symptoms of food allergies?

Food allergies can be life threatening. How each individual reacts to an allergic reaction caused by a particular of food can be different. Some may feel uncomfortable and show signs like tingling or itching in the mouth; swelling of the lips, face, tongue or throat; wheezing and nasal congestion; trouble breathing; having abdominal pain, diarrhea, nausea or even vomiting; and even feeling lightheaded. Others experience more accentuated and severe reactions like anaphylaxis. This is a dangerous effect of ingesting a food you are allergic to. It is accompanied by symptoms like having a rapid pulse, witnessing constriction and tightening of the airways, having a rapid pulse, as well as feeling dizzy and lightheaded to the point of fainting. Emergency care in this case is critical to prevent coma or even death.

According to a study published in the journal of allergy, asthma and clinical immunology, food allergy is the main cause of anaphylaxis in emergency departments. Every year, two hundred people die of anaphylaxis caused by food allergies in the United States. The study explains that while some food allergies (to milk, eggs, soy, and even wheat) can be outgrown in the first ten years of life; other allergies last for a life long (peanuts, tree nuts, fish and shellfish).

How is a food allergy diagnosed and treated?

The best way to prevent allergic attacks is to abstain completely from ingesting a substance or food you are allergic to. You have to know what are the ingredients of the food and drinks you are having. If you are positive of a certain allergy, make sure you inform the people around you. You have to explain to your servers in restaurants about your allergies. Also, try to keep a prescribed emergency epinephrine pen with you at all time in case of a severe allergic reaction.

Food allergy cannot be treated but should be managed properly and with extreme care. While the exact risk factors are not very well understood; but, factors like age, family history, asthma and other allergies can be the culprits.

With food allergies, the best efficient and safe way to diagnose yourself is getting tested, numerous blood tests exist to help you understand your body and identify any possible food allergies.

Children and Allergies

Being born with an allergy can be challenging for both parents and children. Having to worry about changing allergies, finding alternatives and making sure the child is not being exposed to the allergen can be hectic. The truth is that around a quarter of children who have allergies outgrow them by the age of 5 years and 4 months. Also, those who are allergic to milk, eggs and soy were more likely to outgrow their allergies than those who are allergic to shellfish, tree nut and peanuts. A study published in the Annals of Allergy, Asthma and Immunology explained that the earlier the signs of allergies show in children, the more likely they are to overcome them.

Surprising enough, the Wexner Medical Center at the Ohio State University explains that 80% of those who have allergies to egg, milk and wheat, tend to outgrow them by the age of 16. It adds that while doctors used to ask parents not to expose their children to common allergens at a young age, studies have shown that an early exposure might prevent this allergy. A study split kids who are at high risk of developing peanut allergies into two groups. The first group were introduced to peanuts at an early age while the other group was asked to avoid it. Results showed that those who were given peanuts were less likely to develop peanut allergies later on.

One of the recommendations of the American Academy of Allergy, Asthma and Immunology recommends parents to start introducing eggs, dairy, peanuts, tree nuts, fish and shellfish to their babies anywhere between the age of 4 and 6 months. A pediatrician may be able to direct you into what is the best way to achieve it.