Dairy-free. Gluten-free. Vegan. For some, these are diets. For others, a healthy lifestyle choice. But for a growing number of people, it’s a matter of life or death.
That’s right, 1 in 13 North Americans are avoiding these (or other) foods out of necessity. For them, it is not a choice, but a life-saving measure. Yes, we’re talking about food allergies.
But what’s the difference between a food allergy and a sensitivity? There’s still a lot of confusion surrounding these terms. So let us break things down for you.
First, it’s important to understand the difference between a food allergy and a food sensitivity.
The former is triggered by the immune system, while the latter is caused by the digestive system.
Why does that matter? Well to start, the immune response can be fatal, while digestive issues are just that… issues. Think gas and bloating, diarrhea, constipation, cramping, nausea. So a person who is lactose intolerant has a food sensitivity.
→Common causes of sensitivities are: additives, alcohol, coffee, corn, egg, gluten, lactose/dairy, soy, yeast.
While an allergic reaction can result in digestive symptoms like those listed above, there are other warning signs to look out for, whether they appear on the skin (hives, rash, itching, and swelling) or affect the respiratory tract (swollen lips or tongue, wheezing, hoarse voice, difficulty breathing).
→Top allergens in North America are: egg, dairy/milk, mustard, peanuts, seafood/fish, sesame, soy, sulphites, wheat
Diagnosing a food sensitivity or intolerance can be tricky, and more often that not, an elimination diet is the way to go. Suspect foods are removed from the diet and are re-introduced, one by one, over the course of several days. Keeping a food diary is a great way to keep track of symptoms and determine which foods are causing digestive upset.
Food allergies are typically diagnosed after a reaction has occurred. The individual will be referred to an allergist, and a skin-prick test will be conducted. During this test, a drop of an individual allergen (usually in serum form) is placed on a patient’s skin. The allergist will then use a needle to prick the spot, making sure the allergen gets under the skin. If a hive with a diameter of 3 mm or more appears, the outcome will be a positive diagnosis.
Because skin-prick tests are only 50% accurate, many allergists will only test for a food allergy if an individual has previously experienced a reaction to a food. While false negatives are rare, there is a 50-60% chance of obtaining a false positive.
Blood tests are no more accurate than skin-prick tests (and are significantly more expensive), so this type of testing is typically administered to gather more information after a diagnosis. For example, an allergist may conduct a blood test to see if a patient appears to be outgrowing an allergy, and may recommend a medically supervised oral challenge.
When it comes to food allergies, a positive diagnosis consists of these two parts: a reaction to a specific food coupled with a sizeable hive during a skin-prick test.
Prevention and treatment
Avoidance of the food or allergen is the best way to prevent any sort of reaction. When it comes to sensitivities, however, there are over-the-counter medications that can be taken to ease digestive symptoms if the wrong food was ingested.
For those with food allergies, ingestion is never an option. Even trace elements of an allergen can result in an anaphylactic reaction—which means food-allergic individuals must be on the lookout for “may contain” warnings and be vigilant about the possibility of cross contamination.
In the event of an anaphylactic reaction, time is of the essence. It is advised to administer the EpiPen even before calling 9-1-1. For this reason, individuals with food allergies are urged to carry one or more EpiPens with them at all times.
Epinephrine, while a life-saving medication, is far from a cure. But there are a number of clinical trials that provide hope to those living with food allergies. From the “peanut patch” to oral immunotherapy (OIT), researchers are certainly working on ways to ease the burden of a life with food allergies. The goal, however, is not to cure the allergy, but instead to reduce the sensitivity to an allergen and minimize the possibility of anaphylaxis.
By now it should be clear that a food sensitivity and a food allergy are two very different things—and the terms should not be used interchangeably. Treating a food allergy the same as lactose intolerance, for example, could put someone’s life at risk.
If you are concerned you may have developed an allergy, request an allergist referral as soon as you can, and refrain from eating your suspected allergen until you’ve undergone testing.