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What Is The Difference Between A Food Allergy And An Intolerance?

A food allergy is a serious immune reaction to certain foods that can be life-threatening. On the other hand, food intolerance involves the digestive system and is uncomfortable but generally not dangerous. People with food allergies need to completely avoid the foods that trigger their reactions, while those with food intolerances may be able to eat small amounts without severe issues.

Key Differences Between Food Allergy and Food Intolerance

  • Immune Response: A food allergy happens when the body’s immune system mistakenly sees a harmless food (like peanuts) as a danger. This can cause the body to release chemicals that lead to a range of symptoms, from mild to very severe. In contrast, food intolerance, such as lactose intolerance, mainly involves the digestive system. This means the body struggles to break down certain foods due to a lack of specific enzymes, causing discomfort without involving the immune system.
  • Symptoms and Severity: Symptoms of a food allergy often appear quickly after eating the allergen and can be life-threatening, such as trouble breathing, swelling in the throat, a drastic drop in blood pressure, and even loss of consciousness. In comparison, food intolerances usually result in delayed reactions, primarily affecting the stomach and intestines, and can cause bloating, gas, cramps, diarrhoea, and nausea. While these symptoms can be unpleasant, they are rarely severe.
  • Trigger Amount: Even a tiny amount of allergy-causing food can lead to a serious reaction in someone with a food allergy. For instance, even a trace of peanuts can trigger a reaction in someone allergic to them. However, with food intolerances, how much of the food is consumed matters. A person with lactose intolerance might be fine eating a little dairy, but could have issues if they eat a lot.
  • Diagnosis and Management: To diagnose food allergies, doctors often use skin tests, in which a small amount of the potential allergen is applied to the skin, or blood tests to detect specific responses. Food intolerances are usually identified through elimination diets, in which a person removes suspected foods from their diet and then slowly reintroduces them while monitoring for symptoms. The main way to manage both conditions is to avoid the foods that cause problems.

Common Examples

  • Food Allergies: Common allergens include milk, eggs, peanuts, tree nuts (such as almonds and walnuts), seafood (such as fish and shellfish), wheat, soy, and sesame seeds. These foods can cause different reactions in people with allergies.
  • Food Intolerances: An example is lactose intolerance, which occurs when the body can’t digest lactose (the sugar in milk) because it doesn't have enough of the enzyme needed to break it down. Other food intolerances may be related to gluten (found in wheat, barley, and rye) or to reactions to certain food additives, such as sulphites or MSG (monosodium glutamate).
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