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What Is The Difference Between A Food Allergy, Intolerance, & Sensitivity?

Does your throat itch when you eat almonds? Do you have issues in the bathroom when you eat a specific food? Are you sick of…

Does your throat itch when you eat almonds? Do you have issues in the bathroom when you eat a specific food? Are you sick of being bloated after certain meals, but still can’t pinpoint the food causing it? Any of these symptoms could be a food allergy, intolerance, or sensitivity, but how do you tell the difference? While some adverse food reactions may seem similar, they are very different, and can all be serious or even deadly. Many are not familiar with the difference, however, I’m here to show you the difference and help you see why it’s important to know which type of reaction you are dealing with.

Table Of Contents:

  1. Defining These Adverse Food Reactions
    1. Allergy
    2. Intolerance
    3. Sensitivity
  2. Misconceptions & Facts
  3. Treatment, Management, and Prevention

Defining These Adverse Food Reactions:

“Adverse reactions to food (ARF) encompass food allergies and food intolerances, both of which can result in distressing symptoms and adversely affect health.” 1 Though a food Allergy, Intolerance, and Sensitivity could all cause similar distressing symptoms, the effects they have on the body (both short-term and long-term) are quite different.

what is the difference between a food allergy, intolerance, and sensitivity title image
symptoms of a food allergy include: hives, itching, eczema, swelling of the mouth or other areas, itching in the mouth, shortness of breath, abdominal pain, diarrhea, nausea, vomiting, fainting, dizziness, lightheadedness, etc.

Food Allergy

A Food Allergy involves a response from the immune system (usually IgE mediated responses), due to the allergy of a protein within the food.

Symptoms will occur within minutes, or up to 2 hours, after eating the food (even small amounts), thus leading to an immune response or reaction. When an individual has a food allergy, the body sees the substance as harmful and reacts in a way to protect itself. This reaction often results in dangerous inflammation, digestive issues, skin rashes, or other immune responses, but everyone’s experiences will vary. Food allergy responses can also be triggered from not only consumption but even direct contact or airborne. 1-2

Example of a Food Allergy: Dairy Allergy: An “intolerance” to dairy, due to being allergic to a milk protein such as whey.

Symptoms of a food allergy include the following: hives, itching, eczema, swelling of the mouth or other areas, itching in the mouth, tingling in the mouth, shortness of breath, abdominal pain, diarrhea, nausea, vomiting, fainting, dizziness, lightheadedness, wheezing, etc.

Symptoms of a food intolerance include: bloating, cramps, diarrhea, vomiting, diarrhea, heartburn, nausea, irritability, etc.

Food Intolerance

A food intolerance consists of a reaction that does not involve the immune system and is not caused by a protein within the food.

Instead one will experience an inability to digest, absorb, or metabolize a certain food, due to the lack of certain agents, such as digestive enzymes. This often results in digestive complications, but other reactions can occur. Oftentimes, individuals with an intolerance can eat a small amount of the specific food without experiencing symptoms, but this is not the case for everyone. Even so, symptoms and reactions can occur from 30 minutes to 24 hours after consumption. 1

Example of a Food Intolerance: Lactose (dairy) Intolerance- An intolerance to dairy (specifically lactose) due to the lack of producing lactase, an enzyme needed to digest lactose.

Symptoms of food intolerance include, but are not limited to bloating, cramps, diarrhea, vomiting, diarrhea, heartburn, nausea, irritability, etc.

Food Sensitivity

“The umbrella generic term food sensitivity is used when it is unclear whether the reaction is immunologically related or due to a biochemical or physiologic defect.” 1

A reaction or symptom may occur soon after consumption but could take 72 hours (3 days) to appear. A reaction can also be similar to symptoms as a food allergy or intolerance. Because of this, “diagnosing” a food sensitivity, is extremely complicated and difficult. Oftentimes, these are difficult to link to food because the symptoms could occur such a long time after eating the food. Normally, with a food sensitivity or intolerance, the individual must consume the food in order to have a reaction, whereas an allergic reaction could occur by simply touching the food or something that had cross-contact with the allergen. Some research has found that environmental factors could trigger a food sensitivity, such as stress, life-changing events, toxicity, gut complications such as IBS, SIBO, etc., food poisoning, antibiotic intake, or more. Thus, a sensitivity could be temporary or permanent. 1,3

  • Ex. Dairy-Sensitivity: This one gets more complicated. An individual eats dairy one day, then have a migraine or intense inflammation 2 days later.
  • Ex. Dairy-Sensitivity: An Individual could grow up consuming dairy regularly, but during their first year of college, they didn’t get as much sleep, experienced high amounts of stress, and ended up coming down with regular infections, which required antibiotics. The consistent intake of antibiotics, the chronic stress, and lack of sleep could have lead to an imbalance of gut microbiome, and put the body in a fight or flight (often a weekend state), thus the inability to properly digest many foods. (more about gut health in this blog HERE.)
  • Symptoms of food intolerance include, but are not limited to bloating, cramps, diarrhea, vomiting, nausea, etc.

Misconceptions & Facts

Take a guess! Which of these are facts & which are myths?

Scroll through the statements below and guess if each is a myth or fact, then scroll further to see the answers and learn more!

  • myth of fact: the u.s. has 8 common food allergies
  • myth or fact: you are born with a food allergy
  • myth or fact: sensitivities and intolerances are not as serious as food allergies
  • myth or fact: the most common food allergy is peanuts
  • myth or fact: allergies sensitivites and intolerances are detectable with a simple blood or saliva test
  • myth or fact: if you keep your infant away from a food heshe is less likely to develop an allergy
  • myth or fact: food allergies become more severe overtime

Check Your Answers Below!

  • the statement "allergies-sensitivites-and-intolerances-are-detectable-with-a-simple-blood-or-saliva-test" is a myth
  • the statement "food-allergies-become-more-severe-overtime" is a myth
  • the statement "if-you-keep-your-infant-away-from-a-food-heshe-is-less-likely-to-develop-an-allergy" is a myth
  • the statement "sensitivities-and-intolerances-are-not-as-serious-as-food-allergies" is a myth
  • the statement "the-most-common-food-allergy-is-peanuts" is a myth
  • the statement "the-u.s.-has-8-common-food-allergies" is a myth
All statements were myths! Learn More Below!

Myth: The most common food allergy is peanuts

False. The most common food allergy may change depending on where you live. In the U.S., it is dairy, but in France, latex-related foods seemed to be the most common, especially bananas and avocados. Cow’s milk and eggs seem to be the most common across the globe, but many countries experience different levels of the occurrences. Nonetheless, milk is the most common allergen worldwide. Peanuts are just more commonly discussed due to them having high rates of anaphylaxis and death. 4-6

Myth: Food allergies become more severe over time

False, even though some may experience this. There is no such thing as a mild, moderate, or severe allergy, however, there can be mild, moderate, and severe reactions. While some individuals claim that their reactions become more severe over time, there is no scientific evidence to back up these testimonies. 2,7

Myth: You are born with a food allergy

False. Contrary to popular belief, allergies are developed after birth, not in the womb. While some infants may develop food allergies, this is uncommon in the first year of life. 3,7

Myth: If you keep your infant away from a specific food, he/she is less likely to develop an allergy

False. Although this used to be common practice, this method has actually been proven to cause the opposite results. Studies have found that infants who were exposed to common allergens within the first year of life through airborne, direct contact, or even breast milk, were less likely to develop an allergy. 7,8

Myth: Sensitivities and intolerances are not as serious as food allergies

False…kind of. While an allergy may produce a severe reaction right away, sensitivities and intolerances can still be very serious and could lead to other chronic and dangerous medical issues down the road. 1

Myth: The U.S. now has 8 top common food allergies

False. There are now 9 top allergies: milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, soybeans, and as of 2020 sesame.

Myth: Allergies, sensitivities, and intolerances are easy to diagnose & detect

False. All of the following methods of testing are actually very complex.

1. The “golden measure” for testing and measuring food allergies, intolerances, and sensitives, is Oral Food Challenges (OFC). This is performed under the supervision of a health care professional. The patient consumes a small amount of the food over a period of time while documenting any symptoms. You should not seek to perform an OFC without supervision! (You can learn more about this in part 2 of this blog.)

2. Self-reporting is another method used when individuals experience symptoms/reactions.

3. The 3rd most common way to measure is IgE testing. However, this is not usually done for sensitives or intolerances, but for allergies only. 2,3,7

What about those sensitivity tests you can buy online?
Though these may seem promising, they are not regulated and can provide results that may not be 100% accurate or dependable. Furthermore, you can learn more about these tests in part 2 of this blog.

Treatment, Management, and Prevention.

treatment of allergies, intolerances, and sensitivities title image

In conclusion, the cause of adverse food reactions is not fully understood. Research is just beginning to uncover some of the underlying reasons, such as illness, genetic, infancy nutrition, pregnancy nutrition, and more. Some treatment and management of any adverse food reaction may be easy but is oftentimes a stressful, tedious, and daunting task. Thus, management and treatment can differ for every individual. Research is constantly being conducted on the best methods for this, as well as methods to prevent adverse food reactions.
In Part 2 of this blog, we discuss what research currently says about prevention, treatment, and management.

Didn’t find what you were looking for? Ask your specific nutrition question(s) here!

Disclaimer

***As always consult your physician or healthcare team before beginning any exercise or diet program. This information is not intended to diagnose or treat any medical condition or to replace your healthcare professional’s advice and instruction. Consult with your healthcare professional to see what is right for you.***

Sources

  1. Mahan LK, Raymond JL. Krause’s Food & the Nutrition Care Process.; 2017.
  2. Woods RK, Abramson M, Bailey M, Walters EH. International prevalences of reported food allergies and intolerances. Comparisons arising from the European Community Respiratory Health Survey (ECRHS) 1991–1994. European Journal of Clinical Nutrition. 2001;55(4):298-304. doi:10.1038/sj.ejcn.1601159
  3. Prescott SL, Pawankar R, Allen KJ, et al. A global survey of changing patterns of food allergy burden in children. World Allergy Organization Journal. 2013;6:21. doi:10.1186/1939-4551-6-21
  4. Irani C, Maalouly G. Prevalence of Self-Reported Food Allergy in Lebanon: A Middle-Eastern Taste. International Scholarly Research Notices. 2015;2015:1-5. doi:10.1155/2015/639796
  5. Kanny G, Moneret-Vautrin D-A, Flabbee J, Beaudouin E, Morisset M, Thevenin F. Population study of food allergy in France☆. Journal of Allergy and Clinical Immunology. 2001;108(1):133-140. doi:10.1067/mai.2001.116427
  6. Nwaru BI, Hickstein L, Panesar SS, Roberts G, Muraro A, Sheikh A. Prevalence of common food allergies in Europe: a systematic review and meta-analysis. Allergy. 2014;69(8):992-1007. doi:10.1111/all.12423
  7. Pratap K, Taki AC, Johnston EB, Lopata AL, Kamath SD. A Comprehensive Review on Natural Bioactive Compounds and Probiotics as Potential Therapeutics in Food Allergy Treatment. Frontiers in Immunology. 2020;11. doi:10.3389/fimmu.2020.00996