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Do you have a swollen tongue?

You may have a FOOD INTOLERANCE

Food intolerance occurs when specific adverse effects occur after eating a particular food or food ingredient. Genuine food intolerance is different from psychologically based food aversion, where a person strongly dislikes a food and believes that a food produces a particular reaction.

What foods are involved?

The most common food intolerances, in order of frequency are milk, eggs, nuts, fish/shellfish, wheat/flour, chocolate, artificial colours, pork/bacon, chicken, tomato, soft fruit, cheese and yeast.

With food intolerance, food chemicals such as 50 additives and some natural food chemicals are involved, see brochure. These can be in many different foods. For example, asthmatics are most likely to be affected by sulphite preservatives (220-228) in a wide range of foods and drugs including fruit flavoured cordials and drinks, wine, bread, sausages and dried fruit and some medications.

Whilst not all food intolerances are related to meat and dairy products, it can be seen from the above list that vegetarians, and particularly vegans, will suffer less from food intolerance because they already eliminate some of the most common causes of intolerance.

Symptoms

The most common symptoms of allergy include asthma, gastro-intestinal symptoms (nausea, vomiting, and diarhhoea), eczema, urticaria (hives), rhinorrhea (heavy discharge from the nose), and swelling of the blood vessels and tongue.  Other more long-term symptoms include can depression, anxiety, fatigue, migraine, sleeplessness and hyperactivity in children

Food intolerance is a pharmacological reaction (like the side effects of a drug) to the chemicals in foods. Food allergy is an immunological reaction to food proteins.

Family history

Intolerance: migraine, irritable bowel symptoms, behaviour problems

Allergy: hayfever, eczema or asthma

Who is affected? 

Allergies are most likely to affect babies and young children because of their underdeveloped immune system.

Intolerances. 

Children are vulnerable because dose for weight they consume a higher dose of food chemicals than adults. Women of child-bearing age are vulnerable because of hormonal influence. Senior citizens are vulnerable because ageing livers and kidneys are slower to excrete chemicals from the body. Exposure to toxic chemicals, pharmaceutical drugs or illness such as gastrointestinal infection can trigger food intolerance.

How common?

Food allergies (not airborne allergies such as pollens) are considered to be relatively rare - affecting up to 8% of babies under 12 months, 3% of children under five, and less than 1% of adults.

Food intolerance is much more common, affecting babies (through breastmilk), children and adults. Some experts suggest 10% are affected, although, in theory, everyone will react if the dose is high enough, so you would expect more people to be affected as levels of additives rise.

Timing

Allergic reactions are quick. They usually occur within 30 minutes and are often easy to identify.

Food intolerance reactions can be delayed up to 48 hours or more. Identification of reactions can be difficult. When problem foods are consumed frequently, symptoms can appear to be a chronic condition rather than a food reaction.

Dose

Allergic reactions can be to the tiniest amount of an allergen.

Intolerance reactions to food chemicals are dose-related. Some people are more sensitive than others. In theory, everyone will react to food additives if they consume enough and one study on monosodium glutamate confirmed this, although a few of the subjects reacted to very high doses which were unlikely to be consumed in one sitting.

Symptoms

Allergic reactions can be itching, swelling, rash, spreading hives, vomiting, diarrhea, breathing difficulties and in the most severe of the allergic disorders, anaphylaxis can lead to collapse and death. By definition, anaphylaxis is an allergic reaction which involves two of the body's systems (eg respiratory and gastrointestinal or skin). Anaphylactic deaths as a result of insect bites or penicillin are usually very quick - within minutes - and due to cardiac arrest, anaphylactic deaths due to food allergies are usually due to suffocation (breathing difficulties).

Food intolerance reactions can be the same as above, as well as:

skin (rashes, swelling)
airways (asthma, stuffy or runny nose, frequent colds and infections)
gastrointestinal tract (irritable bowel symptoms, colic, bloating, diarrhea, vomiting, frequent mouth ulcers, reflux, bedwetting, 'sneaky poos', 'sticky poos')
central nervous system (migraines, headaches, anxiety, depression, lethargy, impairment of memory and concentration, panic attacks, irritability, restlessness, inattention, sleep disturbance, restless legs, moodswings, PMT).

Symptoms of food intolerance can come and go and change throughout life.

Diagnosis

Food allergies: involve an IgE response and can be identified by skin prick tests or RAST blood tests and confirmed with avoidance and challenge.

Food intolerance: there are no foolproof laboratory tests. The only way to identify provoking foods is through a comprehensive elimination diet and careful challenges.

Treatment

Food allergies: scrupulous avoidance and retest once a year in the case of babies and children who may grow out of it. Life-threatening peanut allergies in particular are increasing. This is thought to be due to exposure through the use of peanuts in many Western-style processed foods. In allergic families, complete avoidance of peanuts, peanut-containing products (and also cows milk) is recommended for pregnant women for the last six weeks of pregnancy and throughout breastfeeding. Some schools have banned peanut butter.

Food intolerances: an elimination diet with challenges to pinpoint the culprits, gradual reintroduction of certain chemicals to ascertain tolerance, and subsequent avoidance to that limit.  For an occasional antidote to a reaction, try a pinch of soda bicarb in half a glass of water, or half to one Caltrate plain white 600 mg calcium supplement tablet.

Find out more about food intolerance

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