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Food allergies and food sensitivities are often inappropriately used interchangeably. There are different types of negative food reactions and I’d like to help you understand the difference between these. My hope is that this knowledge may benefit your health and may even ease some frustration.
Up to 35% of Americans report adverse reactions to certain foods, only 3.5% of them are actually due to true allergies. It is estimated that 50 to 90% of adverse food reactions are actually due to sensitivities or intolerances.
There are three types of negative food reactions: allergies, intolerances and sensitivities. They are differentiated by the type of exposure, the body’s reaction to the substance, the timeline of the onset of symptoms and the variety of symptoms associated with the type of reactivity.
Food Allergies are the immune system’s emergency response to a substance that is perceived as a ‘foreign invader’ (antigen) that the body has become hypersensitive to.
Exposure: through ingestion, inhalation or skin contact.
Reaction: The body creates IgE antibodies, then triggers the release of pro-inflammatory mediators, such as histamine.
Timeline: The reaction is typically immediate, within 10 minutes after exposure. Late-phase reactions can occur 2-4 hours after exposure.
Symptoms: swelling, hives, and difficulty breathing.
Food sensitivities also involve the immune system, but not an immediate or life-threatening response.
Exposure: through ingestion – food or chemicals.
Reaction: The immune system creates antibodies (not IgE). The circulating white blood cells react to the food or chemical and release pro-inflammatory chemicals known as “mediators” into the bloodstream. These inflammatory mediators circulate all over the body and can trigger symptoms in any tissue or organ system.
Timeline: These reactions often occur within 72 hours of exposure. The reaction is also dependent on the amount ingested (dose-dependent).
Symptoms: Someone who is suffering from a food sensitivity can have multiple symptoms, not just one or two localized symptoms. Some examples of food sensitivity symptoms:
You may consider food sensitivity if you have health conditions commonly linked to food sensitivities and chronic inflammation, which can exacerbate symptoms of the following conditions:
The most common food sensitivities are listed below. However food sensitivities can be from many different food or food additives.
Food Intolerance does not involve the immune system, and can have mild to very uncomfortable symptoms.
Exposure: through ingestion – food
Reaction: a lack of certain digestive enzymes for digestion of the particular substance. The reaction will be dependent on the amount consumed.
Timeline: 10 minutes to 24 hours.
Symptoms: abdominal pain, gas, bloating, diarrhea, nausea, vomiting, heartburn. Digestive enzymes can be helpful in decreasing or eliminating symptoms.
Example: Lactose intolerance is the lack of the digestive enzyme lactase, which breaks down lactose. Lactose intolerance can result in gas, bloating, abdominal pains and diarrhea.
The most common food intolerances are listed below. However food sensitivities can expand far beyond this list.
How do you find out if you have food allergies, food sensitivities or food intolerances?
A food allergy test is typically done by a medical practitioner. These tests include oral challenge, skin prick testing, and/or IgE blood testing. These tests DO NOT test for food sensitivities, they only test for IgE and not other immune mediators.
There are several tests for food sensitivities. The best tests are:
Mediator Release Testing (MRT) which uses technology that monitors to see how much the white blood cells shrink in size after exposure to these antigens. The more the cells shrink, the more pro-inflammatory mediators they have released which means the stronger the food sensitivity. Mediators are what cause food sensitivity symptoms, so they are arguably the most important thing to measure.
Immunoglobulin Testing typically assess IgG and IgA mediator release. These tests are the most accessible therefore the most popular and well-known type of test for food sensitivities. Unfortunately this test is limited to only 1 to 3 mediators, IgG, IgA and sometimes IgM. For this reason you may miss other food sensitivities and also may have a lot of false positives because eating a lot of any food – even if you are not reactive to it, may increase IgG antibody levels.
What to do with the results?
It is important to note that food sensitivity tests are only sources of information, but how you use that information is what really matters. Food sensitivity testing results should NOT be interpreted as a list of foods to eliminate forever.
Results should be used to guide an elimination plan, gut restoration and food reintroduction program.
It is best to work with a dietitian that specializes in food sensitivities and gut healing protocols to guide a comprehensive plan to improve your digestive health and immune responses to food.
Food allergies can be life-threatening and cause immediate, severe reactions. Food sensitivities have delayed, non-life-threatening responses with various symptoms. Food intolerances, while not allergies, lead to discomfort, especially during digestion.
Recognizing these differences is crucial for wellness. At Premier Fitness Camp, we offer testing (additional fee required) to help you understand or uncover any food-related challenges you may have. This helps you make informed diet choices, personalized for your health and fitness goals. Understanding these reactions improves overall well-being and holistic health management, making life healthier, happier, and more fulfilling.
Katie Di Lauro, RDN
Director of Nutrition