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Food Allergy Awareness Week 2020: What is Food Intolerance, Allergy And Sensitivity?

| Reviewed By Alex Maliekal

Food Allergy Awareness Week (FAAW) is a national week to raise awareness of food allergies and to support those who are affected by this condition. The week also aims to educate the public about different food allergies and how they can be life-threatening. The FAAW is an initiative by Food Allergy Research and Education.

Every year, FAAW starts on the second Sunday of May and continues for a week. This year (2020), the week falls on 10-16 May. However, the events related to this day takes place the entire month.

In this article, we will discuss about food allergy, food intolerance and food sensitivity. Also, some discussion on elimination diet and how it is carried out. Take a look to know more about them.

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What Is Food Intolerance?

Food intolerance (FI) is a condition when your body lacks a certain enzyme to digest a particular food. It is basically a trigger response by the digestive system. For example, lactose intolerance. When there's insufficient production of lactase in the small intestine, the body is unable to break down lactose, a sugar found in the milk, causing symptoms such as bloating and diarrhoea.

The condition is more prevalent in children and older adults. If lactose intolerance starts from childhood, it may continue to a lifetime. In older adults, the condition starts due to their age-related factors. The formation of lactase becomes less as they age and they are unable to digest milk products. [1]

FI often runs in families. Symptoms include bloating, runny nose, migraines, stomach pain, cough, skin rashes and diarrhoea. The symptoms vary from person to person. It may begin after a few hours or can be delayed up to 48 hours. Also, the symptoms may last for hours or weeks. Though FI is not life-threatening, it can be very uncomfortable for the person.

Not only lactose intolerance, but there are other causes of food intolerance. They are

  • Chemical causes: Tolerance due to the presence of certain chemicals in food such as caffeine found in tea, coffee and chocolates.
  • Food containing toxins: Some naturally occurring toxins present in foods such as beans or shellfish. [2]
  • Foods containing histamines: Such as legumes, vinegar, yoghurt, aged cheese or fermented, canned or pickled foods.
  • Food containing salicylates: Fruits (avocado, grapefruit and cherries), vegetables (capsicum, cucumber and radish) and dry fruits (pistachio and brazil nuts)

What Is Food Allergy?

Food allergy (FA) is different from food intolerance. It is a defect of the body's immune response towards certain food. FA is often life-threatening as even a small amount of allergic food can trigger severe symptoms in people, such as anaphylaxis.

When a person ingests some allergy-causing food, the immune system mistakenly thinks them as harmful or foreign substances. As a result, they immediately trigger an immune response to neutralise the food (allergen) and in the process, causes severe symptoms.

The prevalence of food allergy is more in children under the age of three. In some children, the condition gets severe while some children outgrow the allergy as they age. FA is regarded life-threatening as the symptoms start within a few minutes.

Symptoms of FA include itching in the mouth, hives, eczema, swelling of the lips, mouth and tongue, problem in breathing, vomiting, fainting and diarrhoea. If the severe allergic reaction triggers, it may cause anaphylaxis resulting in the drop in blood pressure, rapid pulse and tightening of the windpipe. [3]

Causes of food allergy mainly include:

  • Proteins in food: Such as peanuts, fish, eggs, soy and shellfish
  • Pollen-based foods: Such as peach, pear, plum, herbs, apple and almond
  • Exercise-induced food allergy: When a person starts to exercise after consuming certain foods.

What is Food Sensitivity?

It is severe than food intolerance but less severe compared to food allergy. Food sensitivity (FS) is also due to a defective immune response against certain foods. However, the symptoms are not as severe as food allergy and take time to develop, unlike the prior that develops within minutes.

There's still controversy regarding food sensitivity and how it develops. Symptoms are not life-threatening but disruptive such as joint pain, brain fog, headache and digestive problems. FS goes away with time due to the changing of the intestinal microbiome. At some point in life, people may be able to eat certain triggering foods without any symptoms. [4]


What Is Elimination Diet?

An elimination diet is a diet plan in which all those foods which are believed to cause severe food reactions are eliminated. In short, it is a kind of dietary experiment for identifying food allergies, sensitivities and intolerances through diet.

It is carried out by removing certain types of foods from the diet for a particular period and then reintroducing them to know whether they are causing mild symptoms or severe problems. [5]

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How is it carried out?

An elimination diet is carried out in four steps; Planning, Avoiding, Challenging and Creating.

  • Planning: In this step, in consultation with a medical expert or dietician, foods are listed down which may be the cause of problems. The medical expert suggests the person keep a diary and record foods which they have eaten and symptoms caused after consuming them. The record helps identify foods causing problems.
  • Avoiding: Here, a diet plan is made for two weeks eliminating foods which are causing trouble. This step needs a lot of discipline to follow. Even if you eat outside, consider checking the ingredients in foods to avoid symptoms.
  • Challenging: This process starts once your symptoms have improved after eliminating certain foods. A new diet plan is made with a combination of certain eliminated foods to check whether the symptoms are still persist or disappeared. Eat the eliminated food in the morning and look for symptoms. If there's none, have a larger portion both in the afternoon and at night. Check for symptoms for two days. If there are no symptoms, it is good to be added back in the diet plan. Add a new food group every three days. [6]
  • Creating: Here, a final diet plan is made with the help of a practitioner, considering the type of food hypersensitivity (intolerance, sensitivity or allergy), symptoms and nutrition needed by the body.
Alex MaliekalGeneral Medicine
Alex Maliekal