04.02.2021 Nutrition

Food allergy or intolerance?

Oliver LeJus examines the confusing use of the term ‘food allergy’ and its impact on people’s lives

I have long been fascinated by the subject of food allergies, which have become almost an epidemic in the last decade. I suspect it is because I have always been a picky eater. While my older sister has the uncanny ability to eat almost anything, I have been very difficult when it comes to food since I was a baby, and, believe me, it is very hard to change.

This has left me wondering why some of us have so many problems with food, and also what really constitutes an allergy.

We all have an emotional connection to our food. This explains why losing weight can be so difficult. The foods associated with fond memories from our childhood stay with us forever. The reverse is also true, so maybe the reason I hate beetroot so much is because it was always served at the canteen of my primary school where I had a miserable time.

In the United States alone, nearly 26 million people (almost 11% of the population) have a food allergy, which is very similar to the situation in the United Kingdom.

Yet according to a recent survey published in The Guardian , “The number of adults who think they have a food allergy is almost double the figure who actually have one…

This distinction was the subject of research conducted in the US with more than 40,000 adults between October 2015 and September 2016. After the participants had been questioned about their reactions to their food allergies, the team assessed whether the reported symptoms were the results of allergies or food intolerance. For example, ingested foods causing throat tightening or vomiting were caused by allergies, but symptoms of bloating, stomach pain or diarrhoea were rejected since they could be the results of lactose or food intolerance.

This is an important distinction since a true food allergy is caused by an immune system reaction that affects numerous organs in the body resulting in very severe, or even life-threatening, consequences.

In contrast, food intolerance episodes are generally due to digestive problems and the symptoms are a lot more benign.

While 10.8% of participants were deemed to have at least one convincing food allergy, almost twice as many, 19%, reported they had such a problem.

The most common “real” allergies were caused by shellfish, followed by milk and peanuts.

Dr Stephen Till, a specialist in the treatment of allergy at King’s College in London, commented:

“I often see patients who think that they have a severe allergy who either aren’t allergic or who have mild allergy. They may have been unnecessarily prescribed adrenaline auto-injectors and be on a restricted diet avoiding even trace exposure to the suspected culprit,” he said, noting that this could cause significant anxiety and difficulties.

“Unfortunately, there is a shortage of physicians who are trained in adult allergy and so this amplifies these kinds of problems.”

To make the picture even more confusing, while it has long been understood that food allergies begin in childhood, we have now discovered that in over 40% of the American cases, their reaction to foods didn’t manifest until they became adults. As a result, there are many people with an allergy but who do not have a prescription for their potentially life-threatening condition, and many others who might be avoiding foods unnecessarily.

Dr Ruchi Gupta, a professor of paediatrics who was involved with the American research, commented that it was very concerning that in the case of adult allergies, sufferers were still not able to diagnose what had changed in their environment, or in their own bodies, to cause this new food allergy.

Of course, there many people who are suffering from real food allergies, and this can have a dramatic effect on their lives and even survival. We all have heard the shattering stories of kids who have died from ingesting minute amounts of peanut in a restaurant or a food canteen.

Unfortunately, this general confusion about allergies has resulted in the rise of multiple bogus allergy tests.

According to the British organisation Sense about Science, such tests are misdiagnosing thousands of people, thus leading them into wrongly thinking that they have allergy.The outcome is that many children are being put on inadequate diets resulting in malnutrition for no reason.

Consequently, they have produced, in collaboration with a team of specialists, a very useful guide called “Making Sense of Allergies”, which can be freely downloaded from their website (https://senseaboutscience.org).

According to the guide, most internet tests have no scientific basis.They include hair follicle testing and the Vega test, which combines, I am ashamed to say, acupuncture and muscle testing, as well as a home testing kit called The York Test. This looks for specific IgG antibodies in the blood, although scientific evidence has shown that elevated levels of these antibodies have no connection with allergies.

The good news is that medical specialists around the world have been busy researching methods to cure allergies for many years. The first treatment for peanut allergies is likely to be approved next year, and this will be the topic of my next column for NOVA.

Olivier Lejus

Olivier Lejus BHSc.MHSc. is a registered acupuncturist and Chinese herbalist practising in Sydney. A former casual university lecturer and tutor in Oriental medicine with over 15 years experience in clinical practice, Olivier specialises in Japanese- style acupuncture for the treatment of male and female infertility, migraine, pain, and insomnia.www.olejusacupuncture.com