Does this sandwich have gluten in the bread? Is this ice cream soy-based? Can I switch out the peanut dressing for that salad? Are these eggs from free-range chickens? These days, it seems like more and more people are particular about what goes in their food. However, there's a big difference between those who are choosing to modify their meals based on tastes or fad diets and those people who are restricted in their food choices because of intolerances or allergies.
In fact, according to research published in Deutsches Arzteblatt, a German medical magazine, "More than 20 percent of the population in industrialized countries suffer from food intolerance or food allergy." That's 1 of every 5 people who experience food-related physical reactions. And based on those physical reactions, it can be difficult to determine if the response is from an allergy or an intolerance.
So, what's the difference? Though allergies and intolerances can share many symptoms, they have different causes. According to Dr. James Li, a board-certified asthma and allergy specialist and chair of the division of allergic diseases in the department of internal medicine at Mayo Clinic, "A true food allergy causes an immune system reaction that affects numerous organs in the body." The reaction is triggered when the body thinks the food, usually a protein within the product, is harmful. The automatic response is to then release chemicals such as histamine and immunoglobulin E.
About 5 percent of adults and 8 percent of children have food allergies, and the numbers are rising, according to research from the Jaffe Food Allergy Institute. Eight foods cause most allergic reactions: milk, eggs, tree nuts, peanuts, shellfish, wheat, soy and fish. Symptoms of food allergies can range from minor inconveniences such as hives or rashes, nausea, stomach pain, cramping and diarrhea to severe reactions such as swelling, shortness of breath or anaphylactic shock.
Unlike allergies, "food intolerance symptoms are generally less serious and often limited to digestive problems," says Li. While people with allergies should avoid that offender altogether, people with intolerances can usually handle small amounts of the troublesome food.
The most common food intolerances by a mile are dairy and gluten. If you have an issue with dairy, lactose intolerance might be to blame. Your body does not create enough of the intestinal enzyme lactase to properly break down the sugar lactose in cheese, milk, yogurt and other dairy products. People who have issues with gluten have trouble digesting the protein found in foods made from wheat, barley, triticale or rye. This intolerance is often confused with Celiac disease, an autoimmune disorder where the presence of wheat encourages the body to attack the small intestine, harming the digestive system. The symptoms -- bloating, nausea, headaches, abdominal pain, fatigue -- can be very similar, and the treatment -- a gluten-free diet -- is the same as well.
Other common intolerances are caffeine, salicylates, amines, sulfites, fructose, eggs and FODMAPs -- short for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. Despite the big name, FODMAPs are tiny carbohydrates that aren't always properly digested in the gut and can cause uncomfortable side effects for people with irritable bowel syndrome, a chronic condition that can cause cramping, diarrhea and constipation, according to Li.
If you think you might have an allergy or an intolerance, keeping a record of your diet, including eating times and symptom occurrences, can be the best way to pinpoint what is causing the irritation or more severe reaction. Keep this record for a number of weeks in order to find connections between symptoms and food choices.
So before you judge someone when you hear them wondering about ingredients or adjusting an order, remember to check your gut reaction and think kind thoughts.