Question: How do I know if I have a food allergy or sensitivity, or just don’t digest food as well?

Answer: You can categorize adverse reactions to food into three groups: food sensitivity, a food intolerance or a food allergy.

Starting with the most important group, the food allergy, The National Institute of Allergy and Infectious Diseases defines a food allergy as an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food.

This means that every time you ingest a food substance that your immune system perceives as harmful, you will exhibit an “allergic response” either immediately or within hours. Allergies do not come and go; you will always react to the allergen.

Basically when you are exposed to a substance that produces an allergic reaction, the allergy antibody causes the cell it has attached to, to release (mostly) histamines. These reactions can range in severity from hives, diarrhea, shortness of breath and even death.

It is important to get a diagnosis from a physician trained in allergies who can accurately determine which allergens you need to avoid. People with food allergies rate a significantly lower quality of life, with negative effects on their psychosocial wellbeing, and run the risk of nutrient deficiencies, so establishing that you do actually have an allergy is just as important.

An allergist/immunologist will perform specific tests, skin reactions, blood tests or an oral food challenge. There are certain tests that are not recommended to diagnose food allergies and include the IgG test or IgG4, which can be purchased online, are not FDA approved and would not be used by a medically trained allergist. These tests can show multiple supposed allergies (90-100 foods) when in fact the IgG test actually reflects a “memory” antibody, meaning that you have been exposed to that food at some time in your life! So it would not be unusual for a person to show “reactions” to a multitude of foods.

The American, Canadian and European Academies of Allergy, Asthma and Immunology all recommend against using IgG testing to diagnose food allergies or food intolerance/sensitivities.

Of interest, there are at least 170 foods identified that elicit an allergic reaction, but eight foods are responsible for 90% of all food allergies. These include eggs, milk, peanuts, tree nuts, wheat, fish, crustacean shellfish and soy.

A food intolerance is your gastrointestinal (GI) tract having difficulty digesting a food and may result in excessive gas production and diarrhea. The most common intolerance world-wide is to lactose, a carbohydrate found in milk. Some people have a life-long lactose intolerance, and others develop it as they age, or undergo medical treatments.

People with lactose intolerance can often eat lower lactose containing foods like cheese and yogurt with no side effects. Food intolerance is not deemed life threatening and may cause more unpleasantness to those around you.

A food sensitivity is thought to be caused by a non-life threatening immune reaction to a food substances. Symptoms can include joint pain, fatigue, rashes and brain fog. More people seem to be reporting sensitivity to gluten, which should not be confused with Celiac Disease. Although it’s not a true allergy, Celiac Disease can result in numerous GI issues and malnutrition.

Most importantly, if you believe you have a food allergy, seek immediate medical guidance and be prepared to carry an epinephrine pen with you at all times. Food intolerance and sensitivity, while not life threatening, can result in self-directed diet changes and decreased intake of specific nutrients. This should also be taken seriously, especially in growing children, pregnant women or people with underlying health conditions.

Bottom line: if you suspect any of the above reactions to foods, discuss further with your health care provider and then a registered dietitian to help you formulate a diet plan. From a nutritional standpoint, restricting food/nutrient intake unnecessarily can result in deficiencies and should be approached with caution.

Ally F. Gottfried MFN, RD, CSO, LD is a registered dietitian and Board Certified Specialist in Oncology at the Community Cancer Center. She has over 20 years of experience in hospitals, pediatric health and community settings. www.cccroseburg.org

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