Food Allergies, Sensitivities and Intolerances

Seems there aren’t enough words to describe all the ways a certain food may not work for a person. And it can be confusing to figure out which of the “conditions” applies to you and what to do about it. So let’s start with some basic definitions (which I’m not sure are universally accepted, but I find it clearer to distinguish based on root cause)…

  • Food allergy: Foods that cause an IgE reaction are considered food allergies. IgE antibodies are the ones that cause anaphylaxis and other Emergency type reactions. A prominent example of a food allergy is nut allergies.
Note that IgE is just one of the five types of antibodies. There are also IgA, IgD, IgG and IgM antibodies (think of them like the different branches of the military… they have a common goal of protecting your body, but they go about it in different ways). Personally, I’d prefer to put all antibody reactions in this category as I feel like it would be clearer that these reactions are “learned” reactions by the adaptive immune system, but non-IgE antibody reactions go in the next category.
  • Food sensitivity: When your immune system reacts to a food in any number of ways that are non-IgE, it’s considered a sensitivity. It can be a result of IgA or IgG antibodies or a reaction of the innate immune system (ie, the one you are born with). Think of all the immune system components like different parts of the protection forces (including the military, coast guard, police and fire departments) and they all use different kinds of bullets. With food sensitivity, one or more of those soldiers/officers fires their weapons when you eat a food to which you are sensitive and any number of symptoms occur. An example here is gluten, which is often handled by IgA and/or IgG antibodies. (Check out this blog post for more information about food sensitivities.)

Immune System

  • Food intolerance: If you are lacking the physiology (ex: enzymes, receptor cells) to properly digest and absorb a food/nutrient, you are considered intolerant to it. The most commonly recognized example is lactose intolerance… the person is lacking enough of the lactase enzyme to digest (ie, break down) lactose into glucose and galactose. I think I am a little bit fat intolerant as I feel really ill after eating a lot of fatty foods… I might not produce enough lipase (the pancreatic enzyme that breaks up fat) or bile (the liver fluid that helps with fat digestion and absorption).

Even though there are different names, the goal is to figure out which foods don’t work for you (for whatever reason) and avoid them as much as possible or fix the cause of the problem (if that’s possible). In other words, personalize your nutrition.

There are tests that can be done for at least some foods in all of the above categories (ex: food challenge for food allergy, ALCAT or Cyrex for food sensitivities, and hydrogen breath test for lactose intolerance). However, there are not tests for all foods in all categories. Heck, there aren’t even tests for all foods in one category! And many of the tests that are available are not 100% accurate.

If you believe you have food sensitivities or intolerances that you haven’t been able to identify, I can help you via one-on-one nutrition coaching.  Or, if you are ready to do an elimination program and want guidance, join my group Elimination Diet.

(NOTE: If you have a food allergy, clearly there is no need for a test or an elimination diet because the food can kill you! But you already knew that.)

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