Is it a food allergy or intolerance?
What’s the difference and how to manage each.
Lasagna. Peanut butter and jelly. Omelets. Crab dip. Mixed nuts. Cinnamon rolls.
For many of us, such foods sound delicious. But for 33 million Americans, they may be scary.
About 11% of adults and 8% of children under 18 in the U.S. have food allergies. Additionally, others have something called food intolerances.
So what’s the difference?
Food allergies
If you have an allergy to a specific food, you usually know it right away.
After you’ve taken a bite, you might notice something’s doesn’t feel right. It’s your immune system’s way of protecting your body from what it sees as a danger.
Among the many signs or symptoms of an allergic reaction, the most alarming may be:
- Rash, hives, itchiness and/or swelling
- Trouble breathing
- Dizziness
- Nausea or vomiting
Half of adults with food allergies have severe symptoms. And about 45% of people with allergies react to more than one type of food.
Among the most common foods that cause reactions (mild to severe) are:
- Shellfish such as clams, shrimp or oysters
- Milk and/or dairy products from cows
- Peanuts
- Tree nuts such as walnuts, almonds or cashews
- Fish
- Soy
- Wheat
- Eggs
- Sesame seeds and sesame oil
If you have any doubts about what foods cause your allergic reaction, your doctor can use skin tests and blood tests to help you identify them. You might also ask close relatives. Some kinds of allergies can run in the family.
Once you know what foods trigger your allergies do what you can to avoid them.
It means you’ll get good at reading labels and asking questions about ingredients in foods served at parties or restaurants.
Family and friends can also help you find foods that are safe.
“It’s your health or maybe even your life that’s at stake. Don’t be shy about letting people know,” says Cecelia Jacobson, RD, a dietitian at PeaceHealth in Springfield, Oregon.
If you experience severe symptoms, your provider might recommend you carry an epi-pen in case you eat something you’re allergic to by accident.
You might also consider wearing a medical alert bracelet or necklace. And let your clinician know to record the allergy in your medical record.
Food intolerances
Food intolerances are less severe than food allergies. But they can still make you feel bad.
Symptoms of an intolerance may include:
- Bloating
- Gas
- Diarrhea
- Cramps
These often happen within a few hours of eating the trigger food.
It usually means your body is having a tough time breaking the food down in your stomach or intestine. This might be because you don’t have enough enzymes to digest that type of food. Or it could have to do with how healthy your gut is.
Intolerances aren’t related to the whole trigger food, but rather to certain components within it. One common example is lactose intolerance — when it’s difficult to digest a sugar found in cow’s milk. But you might tolerate it fine when it’s in something that’s cooked.
“Everyone is different. You really have to listen to your body to understand what’s going to work for you,” says Jacobson.
To diagnose a food intolerance, your healthcare provider may suggest keeping a food diary when you eat foods that seem to cause your symptoms.
Stop eating foods that seem to cause problems. Then, one by one, try adding them to your diet again.
Write down how you feel after eating a certain food. Then compare how you feel when you eat that food to how you feel when you don’t.
Knowing your trigger foods means you can try to avoid them altogether.
You also may use digestive aids like antacids or anti-gas medications to manage your symptoms.
Another option is to switch to a different form of the food, such as lactose-free dairy products. You can also consider using alternative ingredients in recipes.
You don’t have to figure this out on your own. Your healthcare provider can suggest specialists like allergists, gastroenterologists or registered dietitians to support you.
These experts can help diagnose and treat your digestive concerns — and give you strategies to make meals less scary and more enjoyable.
