Food Allergy/Chemical Sensitivities and Adverse Food Reactions
Food allergies, food sensitivities, and food intolerance are often used interchangeably and inappropriately. In fact, there is active debate in scientific and medical circles as to how to define and use these three terms. The general consensus is that food allergy can be defined as any adverse reaction to food that involves our immune system. This further breaks down into two kinds of reactions, food allergy, and food sensitivity. Food intolerance does not involve the immune system.
Perhaps the best-known example of food allergy is also it’s least common – and most dangerous. Anaphylactic shock is a severe hyper-reaction of the immune system caused by a massive release of histamine and other chemical mediators from certain types of white blood cells called mast cells and basophils.
Not everyone with food allergies experiences anaphylaxis though. The immunological triggering mechanism that causes the mast cells (and basophils) to release their chemicals is called IgE and is a very well understood phenomenon. This underlying mechanism is considerably different from the triggering mechanisms found in food sensitivities.
The most common foods implicated in food allergy are peanuts, other nuts, shellfish, or foods containing sulfites. People with anaphylaxis can die within minutes if they ingest even one molecule of their allergic food. Food allergy affects about 1-2% of the population and accounts for only a small percentage of all adverse food reactions. Most immediate reactions are not life threatening but do produce uncomfortable symptoms.
People suffering from food allergy can usually identify what foods they are allergic to without the help of a doctor or testing. This is because the reaction occurs every time and shortly after they eat their allergic food.
Food sensitivity (also known as delayed food allergy) is quite another story. Delayed reactions manifest in many different ways as they can affect any organ system in the body and can take from 45 minutes to several days for symptoms to become apparent. The delayed onset of symptoms and complex physiological mechanisms involved in food sensitivities make them an especially difficult puzzle to try and solve either on your own or with most laboratory serum tests.
In fact, food sensitivities often go undiagnosed or misdiagnosed. The treatments prescribed usually provide only temporary relief that mask the symptoms instead of addressing the root cause of the problem.
The differences between the two kinds of immune-mediated adverse food reactions are summarized in the table below:
Food intolerance can produce some digestive symptoms that are similar to food sensitivity but it doesn’t involve the immune system. Instead, when the food in question is consumed, it is not properly digested and begins to ferment inside the gut. The best example of food intolerance is lactose intolerance. This condition is characterized by bloating, loose stools or diarrhea, and gas.
Lactose intolerance is caused by an inability of the body to produce enough of the enzyme lactase, which breaks down lactose, the primary sugar found in milk. Avoiding milk products or supplementing the diet with lactase enzyme is the best way for a person with lactose intolerance to overcome the problem.