Food intolerance and food allergy are often perceived as the same condition, which they aren’t. However, there is a great deal of confusion and controversy over these two conditions!
Food allergy is a reaction of the body’s immune system to a specific food resulting in the release of histamine, which can cause itchy skin rashes, vomiting, diarrhoea or even asthma. Severe food allergy can be of rapid onset and even be life threatening. Antihistamines will control allergies but will not affect food intolerance.
Intolerance is also an adverse reaction to a specific food or ingredient, but histamine is not released so classical allergy symptoms aren’t present. The commonest symptoms of food intolerance are diarrhoea, abdominal cramps and bloating. Some cases result from unknown irritants, toxins or food additives. Foods such as onions, peppers and fried food can cause intolerance.
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One major cause of intolerance is absence of a vital enzyme needed to fully digest specific foods. The most common item to which people are intolerant is the sugar found in milk called lactose. About 70% of the world’s population suffer from some degree of lactose intolerance. Symptoms include abdominal cramps, bloating and excess wind. Dairy products such as hard cheeses, yoghurt and sour cream have low lactose levels and are better tolerated.
Other foods causing intolerance are wheat, barley and rye products which all contain gluten. This condition is called Coeliac Disease and is one cause of babies failing to grow normally, especially between 6 and 18 months. Many gluten free foods are available on NHS prescription.
Foods that commonly cause allergies and intolerance include eggs, milk, fish, shellfish, nuts, wheat, cheese, yeast, chocolate and strawberries. Food colourants and dyes, such as the orange colourant tartrazine (E102) can also be culprits, so read food labels carefully. Labels showing the presence of sulphites (sulfites) or salicylates may indicate foods more likely to cause intolerance or allergy in susceptable individuals.
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Unlike food allergies, there is no single cause of food intolerance. The symptoms experienced after eating a particular food are probably caused by a number of different mechanisms, most of which are poorly understood.
Many foods can cause a food intolerance. But the most common in the UK are:
milk
lactose
gluten
wheat
food additives
naturally occurring compounds in foods
Lactose intolerance, which affects around 5% of people in the UK, is caused by a shortage of the enzyme lactase, which is needed to break down the sugar lactose found in cow milk. This prevents the sugar from being absorbed from the gut.
Because lactose is present in milk, people often assume they have lactose intolerance when they may be intolerant to some of the proteins present in milk instead. This is also different from a milk allergy.
Gluten intolerance, or coeliac disease, is thought to affect as many as one in three hundred people in the UK. Coeliac disease is an autoimmune disease triggered by eating gluten, a protein present in cereals such as rye, wheat and barley. In some people with coeliac disease, symptoms are also triggered by eating oats, which also contains a protein similar to gluten.
People may mistake an intolerance to wheat with an intolerance to gluten as they are often found in the same foods, which is why it is important to have it checked out by your GP or a registered dietician.
Some people are sensitive to naturally occurring compounds found in foods. These include caffeine in coffee and amines in some cheeses, which can cause headaches.
Only a small number of people are affected by food additives. Those most commonly linked to food intolerance include an artificial colourant called tartrazine (E102) and sulphites, metabisulphites and benzoates, which are used as preservatives.
Certain foods can also trigger or exacerbate pre-existing health conditions such as asthma, irritable bowel syndrome, Crohn’s disease and migraines.
It is important to consult with your GP before excluding foods from your diet. This is particularly important when dealing with children, or if you already have a health condition.