Food Allergy vs. Food Intolerance
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.
It is an immune system response – 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.
It is a digestive system response – 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.
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:
- 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.
- 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. – your area of expertise] to design a diet that addresses your specific needs.
- 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.
Leaky Gut and Food Allergies
Our intestines are designed to be impermeable to large protein molecules that our body may mistake as “invaders” and launch an “attack” by producing antibodies, which lead to allergic reactions. Modern diet, lifestyle and medications often times compromise the permeability of our digestive tract, creating what is known as the “leaky gut” syndrome. When the gut becomes permeable to larger protein molecules, they can get into our bloodstream and trigger an immune response, resulting in symptoms of food allergies.
Here are some strategies to help protect and heal the digestive tract:
Maintain Healthy Gut Flora:
- Increase intake of probiotics, eat foods such as yogurt, kefir, natto, kimchi and sauerkraut.
- Eat fermentable fibers (starches like sweet potato, yam, yucca, etc.)
- Avoid antibiotics, birth control and NSAIDs
- Use herbs such as slippery elm and marshmallow roots, which helps coat and heal the intestinal lining and reduce inflammation
- Increase intake of omega-3 fatty acids – supplement at therapeutic dosage, cold water fish, walnuts, and flaxseed to help support the immune system and reduce inflammation (EPA in particular helps reduce inflammation)
- Avoid refined carbohydrates, including refined sugar – which irritates the intestinal lining
- Avoid alcohol, which is an irritant
- Avoid caffeine, which irritates the gut and dehydrates the body
Positive Lifestyle Changes:
- Reduce stress
- Practice mindful eating
- Chew well
Lactose Intolerance and Dairy Alternatives
Dairy is one of the most common substances that people develop allergy or intolerance toward. If you are suffer from lactose intolerance, which means your body is unable to produce the enzyme lactase to digest the lactose, you can supplement with lactase enzyme whenever you eat dairy products.
There are also many ways we can avoid dairy and substitute dairy products in meal preparation without having to lead a completely “miserable” life in the culinary department.
For some people who are allergic to commercial cow’s milk and cow’s milk products, goat’s or sheep’s milk may be better tolerated and can be used instead in moderation. Raw milk is also a great alternative – the enzymes present in raw dairy products are not destroyed by the process of pasteurization, helping pre-digest the protein molecules and lactase, which are the causes of allergic reaction or symptoms of lactose intolerance, respectively.
“Milks” made from nuts, seeds and grains can be substituted for cow’s milk for drinking and cooking – provided that you are not allergic to those foods (nuts and soy in particular). More common ones that you can find in stores include soymilk, almond milk, hazelnut milk, coconut milk, hemp milk, rice milk and oat milk. Their consistency and taste vary – from type to type and from brand to brand, so you may need to experiment to see what suits your taste or makes the best substitute for your recipes.
If you buy commercial nut, seed or grain milk, make sure you read the label to avoid added sugar as much as possible. Also, additives are often added to these products to make their consistency and taste closer to cow’s milk. If you want to avoid additives altogether, the best bet is to make your own.
For a more creamy texture in cooking, mashed tofu can be used. However, soy products such as soymilk and tofu should be used in moderation by most and sparingly by those who suffer from hypothyroidism. Soy has a high allergenic potential as well, so if you have other food allergies or a family history of food allergies, you may want to be careful and pay special attention to see if you have any reaction. If you are allergic to other legumes, such as beans, peas and peanut, you are more likely to be allergic to soy as well.
Another word of caution about soy: Soy contains phytoestrogens that may have an impact on our hormonal system, and anti-nutrients that may affect the absorption of vitamins and minerals. The problem with most commercially available soy products today lies in the fact that a majority of them are highly processed, without having gone through the traditional process that can remove their anti-nutrients. Soy protein isolates, found in many processed and packaged foods, are highly concentrated. These processed soy products are very new to our diet, so their effects on our body are essentially unknown. Also note that a lot of the soy in our food chain today is genetically modified, and again, this is so new to us as a species that we just can’t be sure if there is any negative health impact for our body.
Many health coaches first become aware of the food they eat because of the symptoms of food allergy or intolerance that they or their loved ones suffer from. Tell your story here and relate to your audience on a personal level if this is something you have overcome yourself, or help others in your life conquer.
Gluten is a protein composite found in grains such as wheat, barley and rye. This protein can causes reactions in people who have celiac disease or gluten sensitivity.
Gluten intolerance can manifest itself as a wide range of symptoms. Here are some most common ones, although by no means exhaustive: abdominal pain and cramping, arthritis, attention deficit disorder (ADD), bloating, constipation, irritability, stunted growth (due to poor absorption of nutrients), fatigue, headaches, nausea, osteoporosis, teeth and gum problems, unexplained weight gain or weight loss.
Celiac disease – a digestive condition triggered by the consumption of gluten – can cause damage of the villi in the intestinal lining, resulting in a gradual decrease in the ability to absorb any nutrients from ingested food, leading to stunted growth and malnutrition. The damage that are done to the intestinal lining also leads to a higher likelihood of leaky gut syndrome, which can create other types of food sensitivities and systemic health issues.
In the case of gluten sensitivity, the protein composite escapes the confines of the digestive tract and makes its way into the bloodstream. When the protein composite reaches the brain, it can cause damages leading to mood issues, attention deficit and sometimes learning disabilities.
Usually an elimination diet is the most common and definitive way to confirm gluten intolerance. However, some doctors recommend blood testing and allergen testing to be done first so that biomarkers indicating celiac disease can be confirmed.
If you are indeed tested positive for gluten sensitivities, care needs to be taken to avoid gluten in your diet. Grains such as wheat, barley, bulgar, kamut, spelt and rye are of course the obvious foods to avoid (oat and oatmeal themselves do not contain gluten, but can be contaminated due to processing and manufacturing process), however, there are also hidden sources of gluten in our food supply that we may not be aware of. These can include: cheese spreads, flavored yogurt and other frozen dairy products, hot chocolate mixes, chocolates, candy/energy bars, soup mixes and canned soups, processed meat (hot dogs, sausages), gravies and other sauces mixes, ketchup, mustards, marinades, nut butter, soy sauce, drink mixes and other packaged beverages, hydrolyzed vegetable protein (found in may prepared or processed foods), children’s modeling dough (Play-Doh), some nutritional supplements, some medications, and some cosmetics such as lipstick and lip balms.
Since gluten can be found in so many hidden sources, it’s best to stick with whole foods as much as possible. If you have to buy processed and packaged foods, read the labels carefully and pick ones that have as few additives as possible.