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What’s the difference between a food intolerance    and a food allergy?

Answers from James T C Li, M.D., Ph.D.

A true food allergy causes an immune system reaction that  affects  nume- rous organs in the body. It can cause a range of symptoms. In  some  cases, an  allergic  food  reaction  can  be  severe  or  life-threatening. In contrast,  food intolerance symptoms are generally less serious and often limited  to digestive problems.

If you have a food intolerance, you may be able to eat small amounts of the offending food without trouble. You may also be able to prevent a reaction. For example, if  you  have  lactose  intolerance,  you  may  be  able  to  drink lactose-free milk or take lactase enzyme pills (Lactaid) to aid digestion.

Causes of food intolerance include:

  • Absence of an  enzyme  needed  to  fully  digest  a  food. Lactose intole-  rance is a common example.

  • Irritable bowel syndrome. This chronic condition can cause cramping, constipation, and diarrhea.

  • Celiac disease. Celiac disease has some features of a true  food  allergy because  it  involves  the  immune  system.  However,   symptoms   are mostly gastrointestinal, and people with celiac disease are not at  risk of anaphylaxis. This chronic digestive condition is triggered by eating gluten, a protein found in wheat, including  khorasanand, rye, barley, oats, and other grains.

If you have a food allergy,  you may be at risk of a life-threatening allergic reaction (anaphylaxis) – even if past reactions have been mild. Learn  how to recognize a severe allergic reaction and know what to do if  one  occurs. You  may  need  to  carry  an  emergency  epinephrine  shot   (Adrenaclick,  Auvi-Q, EpiPen)  for  emergency  self-treatment.

From Antonella Cianferoni, MD, PhD and Antonella Muraro, MD, PhD

Although a wide range of foods has been reported as the  cause of  anaphy- laxis, the most commonly implicated foods worldwide  are  Nuts;  namely almonds, hazelnuts, walnuts, cashews, pecan nuts,  Brazil nuts,  pistachio nuts,  macadamia  (or Queensland);  Peanuts;  Soybeans;  Milk  (including lactose);  Egg,  Sesame seeds,  Fish, and  shellfish,  in both adults and chil- dren.

Other less common are Crustaceans  (for example prawns, crabs, lobster,  crayfish); Celery (including celeriac); Coconut; Mustard; Sulphur dioxide  /sulphites, where added and at a level above 10mg/kg  or  10mg/L  in the finished product. This can be used as a preservative in dried fruit; Lupin, which includes lupin seeds and flour and can be found in types of  bread, pastries, and pasta; and Molluscs like,  mussels,  whelks,  oysters,  snails, and squid.

However, the individual food allergy  varies  by  culture  and  population. For  example,  peanut  allergy  is  one  of  the  most   common   causes   of anaphylaxis in the United States, United Kingdom, and  Australia, but is rare in Italy and Spain  (where  consumption  of  peanut  is  significantly lower than in the United States) or China  (where peanut consumption is similar to that in the United States).