Are you allergic, or just intolerant? And if your body is intolerant of a food, do you have to avoid it entirely? Here’s an expert’s real-world guide to living with food sensitivities.
My wife recently was going to make pumpkin muffins for a party. I was pretty excited, because they’re delicious. Then we looked at our guest list: Two friends were sensitive to gluten. Another one couldn’t eat eggs. Still others avoided nuts and dairy. By the time we’d made to the bottom of the list, and considered everyone’s food issues, we’d pretty much ruled out anything other than meat and vegetables.
In the past few years, it seems like food allergies and intolerances have become more prevalent. But despite increased awareness there’s still a lot of confusion over the difference between those allergies and intolerances, and how to address them. Here’s a quick primer on each of those food issues, along with simple strategies for keeping them in check.
One of the best ways to illustrate the difference between allergies and intolerances is to examine dairy. Some people cannot handle dairy due to allergies, intolerance, or both. For those who are allergic, it’s the proteins in dairy – either whey or casein – that cause a reaction. But for intolerance sufferers, the villain is lactose, the sugar compound in dairy that’s made up of glucose and galactose.
Lactose intolerance is one of the most common food intolerances, impacting 10 to 15 percent of Americans. If you are lactose intolerant, your body simply does not know what to do with the compound. Normally, the lactase enzyme gets into your digestive track, breaking down lactose and allowing glucose and galactose to be absorbed by your intestinal cells. If your body does not produce sufficient lactase, the excess lactose will pass though digestive track undigested. This leaves you bloated and uncomfortable –the telltale signs of lactose intolerance.
There are different levels of lactose intolerance. Some people can tolerate small amounts of lactose while others cannot handle any whatsoever. It depends on how much lactase your body can produce.
Two strategies for dealing with intolerances:
1. GIVE YOUR BODY WHAT IT NEEDS – Supplemental lactase, available at drugstores, usually is effective at providing enough lactase to the body for it to break down lactose. Other products, like the Lactaid line of dairy products, come with lactase already added.
Taking a lactase supplement with a dairy-containing meal is a simple solution to lactose intolerance. By supplementing with the enzyme, you’re giving your body what it’s missing.
2. AVOID OR LIMIT EXPOSURE – If your lactose intolerance is severe, another option is to limit or remove lactose-containing dairy. (Not all dairy products contain lactose. Many hard cheeses, like cheddar, contain no carbohydrates and thus are lactose free.)
It is important to find out what dairy products you can eat and how much (i.e. milk vs. Greek yogurt, ½ cup vs. 1 cup, etc). While most lactose intolerant people still produce some of the lactase enzyme, enabling them to digest some lactose, if you completely remove lactose from your diet, you’ll avoid the cause of your intestinal problems.
Dealing with Allergies
With intolerances, the issue is with processing and metabolism. With allergies, the reaction that occurs is an immune system response. These responses are typically due to a protein –in the case of a dairy allergy, the response is to either whey or casein protein. According the FDA, eight foods account for up to 90 percent of food allergies: milk, eggs, peanuts, tree nuts (i.e. almonds, cashews, walnuts), fish, shellfish, soy, and wheat.
Because they involve the immune system, responses to food allergies can vary with respect to the area of the body where symptoms appear and the severity of the response. Dairy allergies can manifest in the form of eczema, asthma, or even a rare, life-threatening anaphylactic reaction.
Unlike intolerances, you can’t take a pill to alleviate the symptoms and stop an immune response. The best-case scenario with a food allergy is to outgrow it, although “outgrowing” a food allergy may just be a change in the manifestation of symptoms.
There is only one surefire treatment for food allergies: Avoidance. The severity of your allergy dictates the level to which you need to avoid the food. Severe, life-threatening reactions are rare, but they can happen. With certain nut allergies, the mere act of touching a hand that had previously touched a nut can lead to anaphylaxis.
Cross-Contamination: The Real Danger
Avoiding foods that produce allergic reactions becomes tricky because of cross-contamination. That’s what happens when the food you are eating does not contain any allergens but has been tainted with an allergen during the process of cooking, storage, or preparation. Cross-contamination is a huge danger to people with severe food allergies because they unknowingly are exposed to a dangerous allergen.
Cross-contamination can occur via cutting boards, cooking surfaces or silverware, among other places, and isn’t as severe of an issue with dairy protein allergies as it is with allergies to shellfish, nuts, and gluten. So a person with a shellfish allergy would know not to order shrimp at a restaurant, but they couldn’t know that the steak they ordered instead was grilled in the same spot as an order of shrimp was minutes earlier.
While restaurants seem to be more aware of cross-contamination today than in the past, there are no guarantees that someone with a food allergy will be in the clear when they eat out. The best precaution you can take is to be proactive about your food, communicate the severity of the situation to restaurant staff, and insist that they take the appropriate steps to protect you.