The big ques­tion: are food in­tol­er­ances re­ally a thing?

Noth­ing ir­ri­tates a coeliac quite like say­ing you’re “a bit al­ler­gic”. Di­eti­tian Laura Tilt gets the facts

Women's Health Australia - - DECEMBER -

We asked a di­eti­tian for her take on the al­lergy-ver­sus-in­tol­er­ance de­bate

AAt­tend a din­ner party and I guar­an­tee that at least one per­son will be un­able to eat at least one thing on the ta­ble. One in three Aussies avoid gluten, dairy or meat, ac­cord­ing to CSIRO fig­ures. Meat­free di­ets aside, does this mean that food sen­si­tiv­i­ties are on the rise, or are we just much more symp­tom-aware?

First, in­tol­er­ances and al­ler­gies are very dif­fer­ent things. An al­ler­gic re­ac­tion hap­pens when your im­mune sys­tem mis­tak­enly re­acts to a food pro­tein, trig­ger­ing symp­toms such as a rash, wheez­ing, swelling or itch­ing. Not fun. Food al­ler­gies af­fect about 1 to 2 per cent of adults and range from mild to lifethreat­en­ing. We all know about coeliac dis­ease – an al­lergy to gluten – while al­ler­gies to peanuts, fish and shell­fish are also su­per com­mon and tend to be di­ag­nosed by skin­prick and blood tests.

But it gets murkier when it comes to food in­tol­er­ances. They don’t in­volve the im­mune sys­tem and they aren’t usu­ally life-threat­en­ing, but be­cause ‘in­tol­er­ance’ is an um­brella term for a whole host of symp­toms, from bloat­ing to loose bowel move­ments and headaches, it’s dif­fi­cult to de­fine. And as many of these symp­toms over­lap with IBS and ap­pear sev­eral hours af­ter eat­ing, it can be hard to iden­tify the source.

So what causes an in­tol­er­ance? Good ques­tion! While we don’t know ex­actly, it’s thought it can be trig­gered by a lack of the en­zymes needed to break down food, as well as a re­ac­tion to cer­tain ad­di­tives and chem­i­cals. Sul­phites (preser­va­tives found in dried fruits and wine), for in­stance, have been linked with eczema, itch­ing and wheez­ing. Other food chem­i­cals and ad­di­tives (such as his­tamine and MSG) can also trig­ger gut symp­toms, hives and headaches. So, if pinot or pad thai brings you out in a rash, an in­tol­er­ance could be to blame (could, be­cause di­ag­nos­ing an in­tol­er­ance isn’t easy). Lac­tose and fruc­tose aside, there aren’t any tests that give ac­cu­rate re­sults. As for gluten, while ‘non-coeliac gluten sen­si­tiv­ity’ has been de­scribed in sci­en­tific pa­pers, it’s not yet widely ac­cepted and there’s no way to test for it. Of­ten it’s not gluten but short­chain sug­ars, FODMAPS, that are ac­tu­ally to blame.

Ex­pe­ri­enc­ing tricky symp­toms? See your GP to rule out ob­vi­ous causes (such as IBS), then think about seek­ing pro ad­vice from a di­eti­tian so that, if you do cut out any food groups, you don’t miss any key nu­tri­ents. WH

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