Symptoms seen in minutes to days causing chronic inflammation over time
Examples include sensitivities to food additives, even foods generally considered safe and healthy like beans, fruits, veggies, etc
Responsible for many chronic diseases
The body lacks the enzyme helpful in digestion of the food
Immediate to delayed symptoms up to 48 hrs
Examples include lactose in which lactase enzyme is missing or is deficient
Even one molecule of the allergic food can cause adverse reaction
Usually anaphylactic and immediate, few seconds to minutes, needs urgent attention and could be life-threatening
Examples include peanut and nut allergies, etc
Although they are often confused with sensitivities and intolerances, allergies are fairly easy to differentiate.
Allergies are specific IgE-mediated immune responses to substances. An allergic reaction produces IgE antibodies, which attack the offending substance (like pet dander, pollen, bee venom, or peanuts). This triggers a release of histamine, causing immediate, severe, and often life-threatening reactions. The symptoms are usually experienced in the airways or on the skin in the form of anaphylaxis or hives.
In the event of exposure to an allergen, treatment must include a swift injection of epinephrine (widely known as an EpiPen) or as a second wave of defense, administration of an antihistamine.
About 35% of Americans have reported a food allergy, but it is likely that a portion of these cases are in fact non-immune-mediated food intolerances. While research is limited and most food allergy data relies of self-reported information, actual prevalence may be up to 10%, especially in Western countries.
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Source: https://www.autoimmuneinstitute.org/articles/living-well/food-sensitivity-intolerance-or-allergy/
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The ESNM Gut Microbiota for Health section defines an intolerance as an abnormal, non-immune mediated, functional response to a food. This could result from an enzyme deficiency, malabsorption, or other issues.
Individuals with food intolerance are unable to properly process certain foods in the digestive tract—think lactose in cow’s milk or histamine in fermented foods. Intolerances trigger symptoms such as abdominal pain, bloating, gas, nausea, and diarrhea.
In the case of milk, intolerant individuals do not produce any or enough lactase to fully break down the lactose (milk sugars) and enable absorption by the body. The dosage tends to have an effect on the severity of the reaction, which also varies depending on the individual.
Lactose intolerance is common after infancy, and affects roughly 65% of the world’s population. It is extremely prevalent in African Americans, Hispanics, and Asians (3).
People with histamine intolerance may lack the enzyme called diamine oxidase (a.k.a. DAO), that is primarily responsible for breaking down ingested histamine and preventing build-up and absorption by the bloodstream.
As histamine intolerance is less studied and often misdiagnosed, the true prevalence is unknown, however it is estimated that it affects roughly 1% of the population (4).
Common food intolerances:
Lactose (dairy products)
Histamine (fermented foods, alcohol, shellfish, smoked meats, legumes, chocolate, certain fruits and vegetables)
FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyls, including fructose, lactose, mannitol, sorbitol, GOS, and fructan)
Caffeine (coffee, chocolate)
Lactose and histamine intolerances are functional and primarily involve the digestive system.
Other adverse food reactions—like sensitivities—may involve the immune system, but in a different way than allergies.
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Source: https://www.autoimmuneinstitute.org/articles/living-well/food-sensitivity-intolerance-or-allergy/
The ESNM Gut Microbiota for Health section offers some clarity, reporting that sensitivities result from an inappropriate activation of the immune system upon exposure to a particular food. This is an IgG-mediated immune response, as opposed to the IgE-mediated response involved in allergic reactions (9) or an autoimmune response as in celiac disease. Some sensitivities, like wheat or gluten, may be associated with autoimmune markers, however the mechanisms remain largely unknown.
Food sensitivities can cause a wide range of painful or uncomfortable reactions that may be felt immediately, or even days later. Potential symptoms include abdominal pain, anxiety, bloating, brain fog, diarrhea, fatigue, headaches, heartburn, joint pain, nausea, and rashes, which closely mirror many autoimmune disease symptoms.
Most food sensitivities are self-reported and many are discovered through elimination diets, as testing is full of controversy. Most experts agree that IgG testing is inaccurate and not a viable method for identifying trigger foods, as high antibody levels may actually indicate tolerance to a particular food rather than intolerance.
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A contributing factor in food sensitivities seems to be increased intestinal permeability, otherwise known as leaky gut. This condition is often seen in people with autoimmune disease, including celiac. When the intestinal lining becomes too permeable, unwelcome molecules can cross the gut barrier and enter the bloodstream. The immune system sees these molecules—even partially digested food proteins or gut microbes—as foreign bodies and therefore prepares to attack them.
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This imbalanced immune response may also involve the gut microbiome. Researchers suspect that “a disruption in an individual’s gut microbiota may lead to a change in how the immune system recognizes and reacts to certain foods” (1).
Eating trigger foods can result in inflammation and further disruptions in the gut microbiota.
Thus, it is no surprise that many people with autoimmune disease—who so often exhibit intestinal impermeability, chronic inflammation, and compromised gut health—may experience food sensitivities.
Common food sensitivities:*
Gluten (wheat, barely, rye) a.k.a. Non-Celiac Gluten Sensitivity (NCGS) or Non-Celiac Wheat Sensitivity (NCWS)
Casein (dairy products)
Eggs
Corn
Soy
Yeast
Citrus
Nightshades (tomatoes, eggplants, peppers, goji berries)
Legumes (peanuts, lentils, chickpeas, beans)
Nuts (walnuts, cashews, hazelnuts, almonds)
Food additives (sulfites, artificial colors, preservatives)
Source: https://www.autoimmuneinstitute.org/articles/living-well/food-sensitivity-intolerance-or-allergy/
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