Do you have a food intolerance?

How to tell if you have a food allergy or intolerance.

Health Agenda magazine
July 2017

Step into almost any café in Australia and the menu has notes to tell us which dishes are nut-free, gluten-free, dairy-free... and the list goes on. As a society, have we become more sensitive to a wide range of foods or more particular about what we eat? The truth is, it’s probably a combination of both.

Just 9 common foods – peanuts, tree nuts, cow’s milk, eggs, wheat, soy, sesame, fish and shellfish – are responsible for 90% of allergic reactions in Australia, but there are more than 170 foods that are potential allergens that people can be intolerant to.

“We’ve certainly got an increasing number of young children being diagnosed with multiple food allergies,” says Maria Said, CEO of Allergy and Anaphylaxis Australia. “We don’t know why there’s been an increase. There are lots of theories but we don’t have a clear-cut answer.”

Dietitian Caitlin Rabel agrees it’s an increasing problem and believes “people are starting to get more in tune with their bodies, and noticing symptoms they may have previously ignored”.

Spotting an allergy

They’re often spoken of interchangeably, but allergies and intolerances are different. Said describes allergies as “an immune response to, usually, a food protein” (a component of food).

Symptoms of allergies range from mild to severe and can include:

  • itchy or running eyes and nose
  • hives
  • rashes
  • diarrhoea and vomiting
  • swelling of the face, lips and eyes
  • anaphylaxis, a severe, life threatening allergic reaction, which can begin with the above symptoms and quickly worsen to include trouble breathing, rapid heartbeat, fainting and cardiac arrest.

Symptoms generally come on fairly quickly; within 2 hours of eating. Allergies are immune reactions and can usually be diagnosed by blood or skin prick tests, which can be requested by a GP or allergist. Specialists may also conduct food challenge tests, where patients eat the food suspected of being problematic under medical supervision.

For advice on managing a food allergy, visit the Australian Society of Clinical Immunology and Allergy website.

Detecting intolerance

Rabel describes intolerance as “a chemical reaction that can cause similar symptoms to food allergy,” but a food intolerance doesn’t involve the immune system or lead to anaphylaxis.

Symptoms of food intolerances can include:

  • gastrointestinal symptoms, such as bloating, diarrhoea, constipation, excessive flatulence, nausea/vomiting and abdominal pain
  • whole-body symptoms, such as migraines, fatigue, joint aches, skin rashes and hay fever.

They tend to happen a considerable time (up to 72 hours) after the food has been consumed. Intolerances can’t be diagnosed by blood tests and are usually confirmed by elimination diets with the help of a health professional like a dietitian.

While the vast majority of allergies are due to the 9 foods mentioned earlier, when discussing intolerances with clients Rabel also looks at lactose, FODMAPs (a group of poorly absorbed sugars found in foods ranging from wheat and onion to milk and apples that contribute to irritable bowel syndrome) and certain food chemicals, both natural and added. “You can have a food intolerance to almost anything.”

Assisting diagnosis

If you think you might have a food allergy or intolerance:

  • Take note of your medical history. This should include rashes, asthma, hay fever, vomiting and diarrhoea and any other symptoms.
  • Your doctor will refer you to an allergist, who can use blood and skin tests to help determine what you’re allergic to.
  • If you have no specific allergens, your doctor will ask you to keep a food diary which, along with your medical history, can identify possible problem foods. Avoid eliminating foods unless under medical advice (such as the advice of a dietitian), as this may deplete your body of essential nutrients. Trendy eating plans, such as ‘clean eating’, or cutting out any one food category unnecessarily, may inadvertently harm your health. 

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