The rise of food intolerances – fact or fiction?
From dairy to gluten, wheat and caffeine, intolerance to common foods seems to be all around us.
And increasingly so. Only 20 years ago, the concept of food intolerance was almost unheard of. Nowadays it’s part of every social setting, as hosts, caterers and chefs clamber to accommodate an ever-growing list of diners’ requirements. Are people becoming increasingly intolerant to certain foods, is it simply a health craze or is there something else going on?
Part of the confusion seems to stem from a muddling of the difference between food intolerance and food allergy. There’s a very clear and critical distinction between the two conditions – one which can mean the difference between life and death.
What is a food intolerance?
Food intolerance is when the body has difficulty digesting certain foods, causing a reaction in the digestive system such as bloating, nausea, stomach pain, vomiting or diarrhoea. These reactions tend to set in slowly – in some cases up to one or two days after consuming a problematic food.
Unfortunately, food intolerances are not easy to diagnose. As it can take some time to develop a reaction, it can be difficult to determine which food was problematic. There’s also no testing available that can confirm whether someone has a food intolerance.
Further complicating the issue is there can be a range of other factors that could be causing digestive problems, rather than an intolerance. If someone has been ill, stressed or run-down, this will often trigger a stomach or bowel problem. Cancer patients, for example, can develop problems with certain foods. Then there’s coeliac disease, an autoimmune condition that can cause sufferers serious harm if they eat foods containing gluten.
What is a food allergy?
A food allergy on the other hand, is a response by the immune system to a certain food. Sometimes even contact on the skin can cause a reaction. When a person comes into contact with that food, the body considers it a threat and triggers their immune system to send out antibodies, causing an allergic reaction. Unlike with a food intolerance, allergic reactions usually happen quickly – within minutes of coming into contact with the food.
Symptoms can range from swelling, to hives, vomiting, abdominal pain and in the most severe cases, anaphylaxis. “That’s very different to what people experience with a food intolerance, which affects the digestive system,” says Allergy NZ spokesperson, Penny Jorgensen.
Food allergies start in early childhood (unlike food intolerances, which tend to show up later in life), and it’s “pretty clear” what food has caused the reaction, says Jorgensen. Globally, there are the ‘top eight’ foods which most commonly cause the allergic reactions: milk, eggs, peanuts/tree nuts, fish, shellfish, soy, wheat and sesame. However, people can develop an allergic reaction to almost any food. Coriander and cardamom are two recent examples Jorgensen has seen. Interestingly, there’s also regional variation around what foods people are typically allergic to, based on what people eat regularly. In France mustard allergy is common, and in Switzerland, celery.
Around one in 10 children have a food allergy by the age of 12 months, according to Allergy New Zealand. Some will outgrow their allergies, while up to 8% of school age children and up to 4% of adults will continue to have it. The rate is higher among Asian and Pacific communities, according to research.
Food allergies are on the rise – “not just New Zealand but globally,” says Jorgensen. Better awareness is likely to be a contributor. However, it’s difficult to get the whole picture due to a “frustrating” lack of local research, says Jorgensen.
Hurt, shame and pain
There’s no doubt having a reaction to certain foods is a significant burden for sufferers. One that can be stressful, time-consuming and costly. For some, their condition can be so hard to manage they don’t want to leave the house.
Diane Stride is a registered dietitian in Hawke’s Bay and regularly works with clients who have a food intolerance. It’s a personal issue for Stride, who suffered from her own battle with irritable bowel syndrome and autoimmune disease. Through research and education her conditions have vastly improved, prompting her to want to help others struggling with their own health.
When clients first come to see her, they often haven’t told their doctor about their symptoms because of embarrassment. “When someone tells me what they’re experiencing, I know what that feels like. I understand how that can impact your life”, she says.
In many cases, clients are convinced they have an intolerance to a food – frequently gluten – but the reality turns out to be quite different. Stride has worked with more than 1000 clients experiencing stomach issues and gluten is seldom the issue, she says.
How to tell if you have a food intolerance
Diagnosing a food intolerance is done by food elimination but it’s important to not jump in and start randomly eliminating foods, says Stride. This can generate the wrong results, make people miserable because they’re missing their favourite foods and even trigger eating disorders through a fear of food. Done correctly with professional support, a food elimination diet should only take three weeks. “My goal is to limit their diet as little as possible,” says Stride.
One recent client had become fearful around food due to bowel symptoms after eating. As a result she’d started restricting several foods because she didn’t know which ones were problematic. “She’d lost her confidence for shopping and cooking, and she was tired from all of the stress it was placing on her life.” Under Stride’s supervision the client eliminated some foods using a tailor- made menu and discovered she had an intolerance to lactose and onion. Now symptom free and back to normal life, the client feels confident to cook again, go to social events and enjoy all of the things she used to do.
Another client whose life has been turned around, is a woman in her 80s. Usually active and social, she had become a virtual hermit as a result of her stomach issues that were causing her to have diarrhoea up to 11 times a day. With Stride’s help, this is now down to once a day and she’s got her life back.
Why are food intolerances rising?
While some people who experience stomach issues, choose to eliminate the foods they believe are problematic, for others, the switch to gluten, wheat or dairy free foods, or plant-based milk is an attempt to lose weight and be healthier. Yet there’s no evidence to suggest these kinds of diets are better for us. In fact, plant-based milk is lower in protein than cow’s milk.
Food allergies and food intolerances do seem to be on the rise but we don’t know why. The increase in rates could simply be because of a growing awareness, say the experts. “Overall it’s (growing intolerance) a fairly recent epidemic. It’s only in the last 20-30 years it’s become an issue,” says Jorgensen.
Leaping on the food intolerance bandwagon by self-diagnosis can make it harder for people with genuine food-related illness. If you do suspect you have a food intolerance, the first step is to visit your GP and work with them or another professional to carry out a food elimination diet. Once you have a proper diagnosis, you’ll be able to continue a normal life and hopefully those around you will be more tolerant of your intolerance.