Dealing with food allergies and intolerances might seem daunting, but it doesn't have to complicate your life. Just like choosing between an omelet or a smoothie can depend on your mood, figuring out whether you're dealing with an allergy or an intolerance can greatly influence your daily well-being. Common culprits like peanuts, milk, wheat, and shellfish often trigger allergies, while dairy, wheat, soy, and eggs might just upset your stomach due to intolerance. Understanding these differences is key—not only for your health but also for enjoying your meals without worry.

Navigating your dietary needs can be as simple as swapping out ingredients that bother you for those that don't. Whether you're tweaking a favorite recipe or trying out a new snack, knowing what foods to avoid and what alternatives you have can make all the difference. Let's dive into how to manage these food sensitivities with ease, keep your meals exciting, and still cater to your nutritional needs. You'll learn how to adapt your food choices so you can dine out or cook at home without stress, making your diet work for you in the most delicious way possible.

Defining allergies and intolerances

A food allergy is an abnormal response of the immune system. When you eat something you are allergic to, your body sends out antibodies that react with the substance you are allergic to, which causes symptoms like itching, hives, rashes, and GI upset.

Food intolerance is caused by the body's inability to digest a particular food or a chemical in that food.

Test tube with blood sample for food intolerance test


Symptoms overview

A true food allergy elicits an immune system response, and some of the symptoms can be life-threatening. Symptoms of a food allergy can include itchy skin or a rash, hives, and wheezing, as well as gastrointestinal symptoms like nausea or diarrhea. In some cases, the response of the immune system can be fast and intense, leading to anaphylactic shock.

A food intolerance, on the other hand, has milder symptoms and only affects the gastrointestinal system.

Asian woman with stomach ache and pain holding a glass of milk. Dairy intolerant, Lactose intolerance, allergy, health care concept


Impact on health

An allergic reaction can be life-threatening. Signs of a severe allergic reaction include trouble breathing, flushing of the skin, feeling faint, itching on the palms and soles, rapid heart rate, low blood pressure, and loss of consciousness. An anaphylactic reaction is a medical emergency.

Severe allergic reactions are treated with epinephrine, and many people who know they have severe food allergies carry epinephrine with them in case of an emergency. While food intolerance may cause abdominal discomfort, the symptoms are not nearly as severe as those of food allergies.

EPI pen Erin Deleon / Shutterstock.com


Major allergens

The nine most common food allergens are milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, soybeans, and sesame.

Symptoms are generally the same no matter what the allergen is: hives, flushed skin, swelling in the face or mouth, wheezing, swelling of the throat, abdominal cramping, diarrhea, and vomiting.

infographic explaining the different types of food allergens


Avoiding triggers

A food allergy can be triggered when a person eats, touches, or inhales a protein in food  that they have antibodies against. Some people can react when they touch or breathe in foods they are allergic to; even eating the smallest amount can lead to a significant reaction.

Exposure can also occur in other ways, for example, through cross-contamination or food processing. The allergen may not be listed as an ingredient, but if the food was in the same facility or prepared in the same kitchen as the allergen, there is a chance that someone can still have an allergic reaction.

Close up image of arm suffering severe urticaria or hives or kaligata with ilustration of allergy trigger foods. Eggs, milk, beans, strawberry, and chesse.


Preventive strategies

Avoiding allergens is critical to avoid an anaphylactic reaction. To avoid exposure, read the ingredient labels at least twice to ensure you do not accidentally eat something you are allergic to. Some packages will have a warning label clearly stating what allergens the product contains or if the product is processed in facilities with an allergen.

If you're going out to eat, speak to the restaurant beforehand to ensure they can accommodate your needs. Stick with simple dishes with limited ingredients, and avoid desserts as they often contain allergens.

Food allergy cross contamination warning placard notice sitting on stable at a restaurant


Signs of intolerance

Signs of a food intolerance usually appear a few hours after eating the food or ingredient that is causing it. The most common symptoms include bloating, passing gas, abdominal pain, or diarrhea, but some people may also experience rashes, fatigue, headache, or joint pain. Symptoms can last hours to days.

Young woman having painful stomach ache. Chronic gastritis. Stomach or menstrual cramps. Abdomen bloating concept.


Diagnostic tests

There are several ways to check for food intolerance. A doctor may recommend an elimination diet, where you stop eating certain foods and then add them back into your diet one at a time until your symptoms return to pinpoint what is causing the intolerance. Doctors can also use blood tests to determine food sensitivities or a breath test to check for lactose or fructose intolerance.

Young woman undergoing procedure of allergen skin tests in clinic


Interpreting results

Research on the effectiveness of blood testing for food intolerances is somewhat limited, but some studies show that it can be beneficial for people with irritable bowel syndrome.

Multiple studies found that an elimination diet based on food antibodies found through blood testing was more effective for controlling mixed IBS than a low FODMAP diet, which eliminated foods with certain types of sugars.

Analysis and testing for allergies photo concept. Doctor points with pen in his hand on result of patient allergy test in foreground, standing in medical gown with stethoscope in blurred background


New allergens

Sesame was added to the list of common allegens that must be identified on food labels. Research shows that sesame allergies have grown rapidly. Researchers have yet to identify the precise reason, but it may be because of the increased use of soy around the work.

Macro Close up of Organic White Sesame seeds(Sesamum indicum) or white Til with shell on a white ceramic soup spoon. Top view, over gradient background of itself.


Adult-onset allergies

Adults may develop allergies due to pollen food allergy syndrome, which occurs when someone has a sensitivity to a specific type of pollen and then eats a fruit or vegetable that has a similar protein structure to the allergen.

For example, someone allergic to ragweed pollen may develop an allergy to melons, bananas, zucchini, or cucumbers, while someone allergic to grass pollen may develop an allergy to tomatoes, oranges, or celery. New onset food allergies in adulthood may also be caused by infections, changes in the environment, and hormonal shifts.

Doctor doing skin allergy test at light table, top view


Management and awareness

To manage emerging allergies, figure out what you are allergic to. A doctor can perform allergy testing, or you can try to determine what you may be allergic to by keeping track of your exposures and your symptoms. Steroid nasal sprays and antihistamines can help control seasonal allergies, or you can talk to your doctor about allergy shots to desensitize your body to an allergen.

Medical equipment and drugs for bronchial asthma treatment. Nebulizer, medical inhaler, spacer, nebula, anti-inflammatory drugs to manage asthma. Bronchi asthma cure, emergency allergy asthma concept


Understanding histamine intolerance

Histamine intolerance is a sensitivity to dietary histamine. The body cannot break down histamine, so it accumulates, leading to many possible symptoms, including bloating, diarrhea, headache, nasal congestion, itching, rashes, or hives.

Some foods that contain histamine or cause your body to release histamine include alcohol, cheeses, pork, chocolate, nuts, egg whites, and processed meats. Histamine intolerance can be mistaken for a food allergy, but your doctor can do tests to determine the cause of your symptoms.

Blood sample for Histamine blood test, to diagnosis of anaphylaxis, mastocytosis, or mast cell activation.


Causes of intolerance

Histamine intolerance is believed to be caused by a deficiency of an enzyme called diamine oxidase (DAO) in the GI tract. This deficiency can affect the body's ability to degrade histamine in foods. Many things can lead to a DAO deficiency, including genetics, liver and kidney diseases, age, medications, and conditions that affect the gut.

Character with food allergy. Grocery intolerance, products causing flatulence and heartburn. Hypersensitivity to components of the food. Flat vector illustration


Dietary adjustments

The most common strategy for managing histamine intolerance is a low histamine diet. Generally, this diet involves avoiding foods high in histamine, like cured meats, fermented foods, processed seafood, shellfish, alcohol, chocolate, nuts, and soy. For people with a confined histamine intolerance, it can be beneficial to work with a nutritionist to learn more about what to eat and what to avoid.

Histidine rich food with structural chemical formula of essential amino acid histidine. Natural food sources of histidine include high protein foods like eggs, dairy products, meat, nuts, seeds.


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