Food Allergies and Intolerances

Lindsay and I talk a lot about food allergies, celiac disease, and intolerances on our sites.  We thought this would be a good time to discuss what exactly these things are, and what they mean.  Sometimes people tend to think of a food allergy as anything that creates an upset stomach, indigestion, or other issue, but this is not the case.  Food allergies can be a much more serious problem than food intolerances are.  

Food Allergies

Food allergies are the body’s allergic response to eating a trigger food.  The 8 most common food allergies are (fish, shellfish, tree nuts, peanuts, soy, wheat, eggs, and dairy).  Food allergies are present in about 5% of children according to WebMD, but some put estimates as high as 20% of people today.  Regardless, that number continues to grow.  When someone who is allergic to one of these foods accidentally eats it, the immune system responds as if it is being attacked, and produces an IgE antibody against the food.  The IgE antibody reacts with mast cells which are all over the body, and the cells respond by producing histamine, and other chemicals.  The result of this can be different depending on where the chemicals are released, but it can involve hives, nausea, vomiting, diarrhea, trouble breathing, itching in the mouth, trouble swallowing, and a drop in blood pressure.  When more than one of the body’s systems is affected by the allergen, or low blood pressure occurs, the reaction is considered anaphylaxis, and at this point a dose of epinephrine can be given to the patient to stop the potentially life-threatening reaction.  While epinephrine is very effective in dealing with food allergies, it is important to note that it is not foolproof.  In some cases even after epinephrine is administered, people die from their reactions.  This is why it is so important for people with food allergies to avoid the foods they are allergic to, and for people around them to be respectful of their needs.

The number of people with food allergies is rising, and no one is exactly sure why, although the main theory points to changes in hygiene.  The hygiene hypothesis surmises that we live in cleaner environments these days and are exposed to fewer germs.  In general, first born children are more likely to develop food allergies, as well as those living in an urban environment.  Use of antibiotics is also thought to be part of the equation.  A recent op-ed in the New York Times also hypothesized that moving away from farming and not being around cows, specifically, may be playing a part in the development of food allergies. Genetics also plays a role in who develops food allergies  and children whose parents have hay fever or other allergies are more likely to have food allergies.  The best summary of this information I have seen is provided by UCLA Health and can be found here:

 Food Intolerance

Food intolerances are other non-allergic reactions to food. There are different types of food intolerances and they are caused by different things.  Lactose intolerance is a common food intolerance which is widespread and well-known.  It is caused specifically by the inability to digest lactose, a sugar found in milk.  It is commonplace for adults to stop making lactase (the enzyme used to digest lactose), and thus lose the ability to digest milk.  While this affliction causes discomfort and can cause stomach pain, bloating, and diarrhea, it is not as severe as a milk allergy as seen above.  Other types of food intolerances exist and have different causes.  Both gluten sensitivity and celiac disease fall in this category as they are not IgE meditated allergic reactions to the food proteins that one eats.  For more information on gluten intolerance and celiac disease, see our gluten 101 post:  Other somewhat common intolerances include sucrose intolerance and fructose malabsorption.

Reading Labels for Food Allergens

If a food allergy is present complete avoidance of the food allergen is required.  If you have ever looked at food labels, you may understand how tough this can be with some of the major allergens.  Cooking at home, with whole foods is one of the best ways to avoid food allergens.  Food labeling laws now require any of the top 8 allergens to be listed — in plain English — on food labels, they cannot be hidden, and they may either be listed as part of the ingredient list or directly after the ingredient list as part of a “Contains: …”  statement.  It is important to note that food labeling laws currently do not apply to cross-contamination.  For instance, popcorn containing no allergens may be run on a line that had previously processed trail mix containing nuts.  Companies are NOT required to let you know this!  Many companies do list a statement such as: “produced in a facility that contains tree nuts”, but they are not required to do so.  I have personally had issues with nuts that have been processed in a facility with wheat but have not been labeled that way.  They still contained enough wheat to make me sick (due to my celiac disease), so it is important for highly sensitive people to be even more careful (I now buy my nuts from which are certified gluten free).

Cooking without Food Allergens

Luckily today there are many great sources of recipes out there for cooking without food allergens.  Most of the recipes posted on Lindsay’s blog are allergy friendly or can be easily modified.  Another one of my favorite sources (especially for baking) are Cybele Pascal’s website and cookbooks: The Allergen-Free Baker’s Handbook  and Allergy-Free and Easy Cooking  

Eating out with Food Allergies and Intolerances

In my opinion eating out is the hardest part of living with food allergies and intolerances.  It can be done, but you are always taking a risk when you go out to eat and have to trust the people working at restaurants to take your food allergy seriously.  Luckily, more restaurants are seeing the need to be friendly to people with food allergies and intolerances and it is becoming easier.  There are even some restaurants around the country now that have completely gluten free kitchens.  It takes research in your area in order to find local places that are willing to accommodate you.  Some national chains that are known for their allergy free or gluten free menus include:  PF Changs, Outback Steakhouse, Chipotle, Bone Fish Grill, Chic-Fil-A, Red Robin, and Longhorn Steakhouse.  Another good source of listings for local gluten-free chains is: Find Me Gluten Free where people can rate how well restaurants accommodated their gluten free needs.  

Now, go check out what Lindsay has to say on the subject!





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