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Food Sensitivity vs Food Allergy

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Food allergy

A food allergy is an abnormal immune response triggered when someone eats specific foods. In this scenario, the immune system identifies certain proteins in the food as harmful, sparking a rapid immune reaction. This reaction leads to the release of chemicals, like histamine, causing allergic symptoms.

Symptoms

Some common symptoms of a food allergy include:

  • Skin Reactions: Itchy skin, hives (red, raised, itchy bumps on the skin), eczema (chronic itchy rash), swelling, and redness.
  • Gastrointestinal Symptoms: Nausea, vomiting, abdominal pain, cramps, diarrhea, and sometimes even bloody stools.
  • Respiratory Issues: Runny or congested nose, sneezing, coughing, wheezing, shortness of breath, chest tightness, and difficulty breathing.
  • Cardiovascular Symptoms: Rapid heartbeat, drop in blood pressure, lightheadedness, dizziness, and fainting.
  • Oral Symptoms: Itchy or tingling sensation in the mouth, lips, or throat, swelling of the lips, tongue, or throat, and throat tightening.
  • Systemic Symptoms: Anaphylaxis is a severe, life-threatening allergic reaction that can affect multiple body systems simultaneously. It can lead to a combination of symptoms, including difficulty breathing, a sudden drop in blood pressure, loss of consciousness, confusion, and a sense of impending doom.

It’s important to note that food allergies can range in severity. Some individuals may experience mild symptoms, while others may have severe or even life-threatening reactions.

Common allergens

AllergenExamplesIncidence
Cow’s MilkMilk, cheese, yogurt, butter, ice cream, cream-based soupsEstimated 0.5-3% of infants and young children
EggsEggs (scrambled, boiled, in baked goods), mayonnaise, certain breads, pastries, dessertsEstimated 1-2% of children
FishSalmon, tuna, trout, cod, halibut, sardines, anchoviesApproximately 0.2-0.5% of the general population
PeanutsPeanut butter, roasted peanuts, peanut oil, certain candies, baked goods, snacksEstimated 1-2% of the general population
ShellfishCrab, lobster, shrimp, prawns, crayfish, mussels, clams, oystersApproximately 1-2% of the general population
SoySoybeans, tofu, soy milk, soy sauce, soy-based products, some processed foodsEstimated 0.4% of children
Tree NutsAlmonds, walnuts, pecans, cashews, hazelnuts, pistachiosApproximately 1-2% of the general population
WheatBread, pasta, cereals, pastries, cookies, cakes, sauces, soups with wheat flourEstimated 0.4-0.5% of children and adults
List of common food allergens

Some less common food allergies include:

  • Linseed
  • Sesame seed
  • Peach
  • Banana
  • Avocado
  • Kiwi fruit
  • Passion fruit
  • Celery
  • Garlic
  • Mustard seeds
  • Aniseed
  • Chamomile

Testing

There are several different methods used to test for food allergies:

  • Skin Prick Test: This is a commonly used diagnostic test for IgE-mediated food allergies. A small amount of the suspected allergen is placed on the skin, usually on the forearm or back. The skin is then pricked or scratched with a sterile device to allow the allergen to enter the skin. If a person is allergic to that particular food, they may develop a localized allergic reaction at the test site, such as redness, swelling, or itching.
  • Radioallergosorbent Blood Test (RAST): This measures the levels of IgE antibodies specific to certain food allergens in the blood. It can provide an indication of the presence and severity of the allergy.
  • ImmunoCAP Blood Test: This is a more advanced and accurate version of the RAST test. It measures the levels of specific IgE antibodies to specific food allergens.
  • Elimination Diet: An elimination diet involves removing suspected food allergens from the diet for a certain period, typically several weeks. Then, the eliminated foods are gradually reintroduced one at a time while closely monitoring for any allergic reactions. This method helps identify specific foods that may be causing the allergic symptoms.
  • Oral Food Challenge: This is considered the gold standard for diagnosing food allergies. It involves consuming gradually increasing amounts of the suspected allergenic food under medical supervision. If an allergic reaction occurs, it confirms the presence of an allergy.

Food sensitivity

Food sensitivity, also known as food intolerance, refers to an adverse reaction to certain foods that does not involve the immune system. Unlike food allergies, food sensitivities do not trigger an immune response mediated by IgE antibodies. Instead, they are often caused by an inability to properly digest or process specific food components.

Symptoms

Symptoms of food sensitivity can vary widely among individuals and may occur hours or even days after consuming the problematic food. Some common symptoms of food sensitivity include:

  • Digestive Issues: Abdominal pain, bloating, gas, cramping, diarrhea, constipation, and nausea.
  • Headaches and Migraines: Recurrent headaches, migraines, or tension headaches.
  • Skin Problems: Eczema, rashes, hives, itching, or other skin irritations.
  • Fatigue: General tiredness, lack of energy, or feeling sluggish.
  • Joint Pain: Achy or swollen joints, stiffness, and inflammation.
  • Respiratory Symptoms: Congestion, runny nose, post-nasal drip, or wheezing.
  • Mood Changes: Irritability, anxiety, depression, or changes in behavior.
  • Cognitive Issues: Difficulty concentrating, brain fog, or memory problems.

It’s important to note that food sensitivities can be challenging to diagnose because the symptoms are often nonspecific and can overlap with other conditions. Identifying food sensitivities typically involves a process of elimination, where suspected foods are temporarily removed from the diet and then gradually reintroduced to observe any symptom changes.

Common sensitivities

ConditionExamplesIncidence
Caffeine SensitivityCoffee, tea, chocolate, energy drinks, some medications.Prevalence not well-documented, affecting individuals more susceptible to the stimulating effects of caffeine.
Fructose IntoleranceFruits (e.g., apples, pears), honey, high-fructose corn syrup, some processed foods.Relatively rare, estimated to affect less than 5% of the population.
Gluten SensitivityWheat, barley, rye, and related products.Estimated to affect a small percentage of the population, potentially around 0.5-6%.
Histamine IntoleranceAged cheese, fermented foods, smoked meats, certain fish, alcoholic beverages.Incidence is unclear and varies among individuals; considered relatively uncommon.
Lactose IntoleranceMilk, ice cream, cheese, butter, yogurt.Affects around 65-70% of the world’s population, with varying rates among different ethnic groups.
Sulfite SensitivityWine, dried fruits, processed foods, certain condiments.Relatively rare, primarily affects individuals with specific sulfite-metabolizing enzyme deficiencies.
List of common food sensitivities

Some other food sensitivities include:

  • Salicylates
  • Aspartame
  • Eggs
  • MSG
  • Food colouring’s
  • Yeast
  • Sugar alcohols

Testing

Testing for food sensitivities can be more challenging compared to food allergies because there is no universally accepted diagnostic test for identifying food sensitivities. However, here are a few methods that can help identify potential food sensitivities:

  • Elimination Diet: The most common approach is an elimination diet. This involves removing specific foods or food groups from your diet for a certain period, typically two to four weeks. After this elimination period, the foods are gradually reintroduced one at a time while carefully monitoring for any symptoms or reactions. This method helps identify which specific foods may be causing the sensitivity.
  • Food Diary: Keeping a detailed food diary can help track your diet and symptoms. By noting the foods you eat and any symptoms you experience, you may be able to identify patterns or correlations between specific foods and symptoms. This method requires consistent and accurate record-keeping.
  • IgG Blood Tests: Some laboratories offer IgG antibody blood tests, claiming to identify food sensitivities. These tests measure IgG antibody levels against various foods. However, the scientific validity and clinical usefulness of these tests are debated, as the presence of IgG antibodies to certain foods does not necessarily indicate a sensitivity or intolerance.

Summary: Sensitivity vs Allergy

Food sensitivities and food allergies are both immune system reactions to specific foods, but they differ in terms of the underlying mechanisms and the severity of the response. Here are the key differences between food sensitivities and food allergies:

AspectFood SensitivitiesFood Allergies
Immune ResponseInvolves immune system activation but not immediateTriggers rapid and potentially severe allergic reaction
Timing of the ReactionDelayed, occurring over hours to daysImmediate, within minutes to a couple of hours
Severity of SymptomsMilder symptoms (e.g., digestive issues, headaches)Wide range, including anaphylaxis in severe cases
Mechanism of the ReactionNon-IgE immune responsesIgE-mediated immune response triggers histamine release
Diagnostic TestingElimination diets, blood tests (IgG food sensitivity)Skin prick tests, blood tests (e.g., measuring IgE)
TreatmentIdentify and eliminate problematic foodsStrict avoidance of allergenic food; may require epinephrine auto-injectors for severe cases
Comparison: Food Sensitivities vs Food Allergies

How can I figure out which one I have?

Distinguishing between a food sensitivity and a food allergy can be challenging, but here are some useful and practical tips to help you differentiate between the two:

  1. Keep a Food Diary: Maintain a detailed record of the foods you consume and any symptoms you experience afterward. Note the specific ingredients and any patterns or correlations you observe. This can help identify potential triggers and patterns associated with either food sensitivities or allergies.
  2. Timing of Symptoms: Pay attention to the timing of your symptoms after consuming certain foods. Food allergy symptoms typically occur within minutes to a few hours after ingestion, while food sensitivity symptoms can have a delayed onset and may appear hours or even days later.
  3. Severity of Symptoms: Food allergies often produce more immediate and potentially severe symptoms, including anaphylaxis, which is a life-threatening reaction. Food sensitivities generally cause milder and more chronic symptoms, such as digestive issues, headaches, or skin irritations.
  4. Allergy Testing: If you suspect a food allergy, consider getting tested by an allergist. They can perform skin prick tests or blood tests to detect specific IgE antibodies associated with allergies. Keep in mind that these tests are not available for food sensitivities, as there is no standardized diagnostic test for sensitivities.
  5. Elimination Diet: Consider implementing an elimination diet under the guidance of a registered dietitian or healthcare professional. This involves temporarily eliminating common allergenic or trigger foods from your diet and gradually reintroducing them to observe any symptom changes. This method can help identify food sensitivities.

See also

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  • Heavy metals: an overview
    The most common heavy metals that negatively impact human health are lead, mercury, cadmium, arsenic, and chromium.
  • IgG Food Sensitivity Testing
    IgG food sensitivity testing lacks good scientific evidence to support its accuracy and clinical utility, often leading to false positives.
  • Low FODMAP Diet: an overview
    The low FODMAP diet aims to reduce certain types of carbs that can cause bloating and gas. It can sometimes help reduce symptoms of IBS.
  • How To Eat Mindfully
    Mindful eating involves paying attention to the food you are eating, your body’s hunger cues, and your thoughts and emotions related to food.

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