Mom, what is the difference between food allergies and intolerances?

Teachable moments happen most often when we take the time to let others talk and then listen. Personally I learn and teach best when on the move and outside! Before school closures, I had planned to teach nutrition classes to Noah’s fourth-grade classmate in some fun and active ways! Like everyone, I am now adapting to school at home where kids are now in front of screens like office workers for several hours a day trying to learn.

There is snow on the ground here and it has been snowing off and on for two weeks. As we adapt, we have been reveling in moments outside for reprieve, connection, and conversation. Outside is healing. Outside brings calm to our family.

As Noah and I stomped across the field of crusty snow behind our house to see what the school-sponsored grab-and-go lunch was offering that day, he began talking about a classmate who says he is allergic to wheat.

Our school district is offering breakfast and lunches to all kids eighteen and under, elderly, and those with disabilities during our local “shelter-in-place . It isn’t always the quality of food I chose for our family but, it provides moments, a reason to go somewhere within our confines, and extends time between trips to the grocery store and therefore, also exposures.

Noah starts, “Jessie (name changed for privacy) is allergic to wheat so he can’t have the school lunches.”

“Really? I thought there were no food allergies in your class this year.”

“He never eats bread at school.”

I say, “Is he allergic or does he have an intolerance?”

“Well,” Noah continues, ” He isn’t gluten-free but, he calls it an allergy. What is the difference?”

And there it is, my moment to shine and teach something I know!!

What is the difference, Mama, between a food allergy and food intolerance? Well, son, let me tell you…….

They can be similar in that they both make you feel unwell and have an upset stomach but, they are very different.

• Food intolerances are centered around inflammation of the intestines, part of the digestive system. This can be very uncomfortable but are not immediately life-threatening.
• Food allergies are an immediate immune response to a food and can be life-threatening even with the smallest amount.

A food intolerance is also sometimes referred to as a sensitivity. It is a digestive sensitivity to certain foods due to inability to break down components of that food. Milk, for example, contains a naturally occurring sugar known as lactose. Some people lack enough of the enzyme lactase to digest lactose and will get severe stomach cramping and diarrhea after drinking milk. This is not a milk allergy.

Celiac disease and non-celiac gluten sensitivity are also food intolerances to gluten, a protein found in wheat, barley, and rye. It is thought that there is a larger amount of gluten in commercially made bread found on store shelves because it goes through a shorter fermentation process than traditional baking processes. The food triggers inflammation of intestine the inhibits digestion and absorption of the food. Again, this is not a food allergy.

When Noah asked me if rye bread had gluten, I was curious. “Does Jessie (classmate) rye bread?” He didn’t know. If he would have said yes this could have been a clue as to whether Bob, in fact, has an allergy to wheat or a sensitivity to gluten. Wheat allergies exist but, are not super common. Rye bread often contains (but not always) wheat flour. So if it is a wheat allergy or gluten intolerance the classmate may avoid rye bread but, if it is he is eating rye bread absent of wheat flour, he may have a try food allergy. We may never know in this case but, as a dietitian, I am curious enough to try and solve this mystery by asking his parents.

My experience with food allergies includes both professional and personal. My older son, Eric has a severe peanut allergy. Food allergies are can cause nausea, vomiting, and stomach upset but, the also involve an immune response that leads to hives, itchiness, swelling of the skin, and anaphylaxis. which is difficulty breathing, light-headedness, and possible loss of consciousness. Even the smallest amount of allergic food can lead to anaphylaxis and be life-threatening. This is a key difference from an intolerance.

Because the classroom teacher has never informed us of any of the students having a food allergy, I suspect that Jessie is avoiding gluten, like many of his classmates, and has misinterpreted it has a wheat allergy. It is very common for kids to be on gluten-free these days. Noah can tell me exactly who in his class is gluten-free and he is only ten years old. Wheat allergies are less common but, more common in kids that outgrow them as adults.

There you have it. If you are isolating at home and pondering dietary questions. Consider signing up for my email list to receive more nutrition nuggets from our home base to yours.

Hey! Stuck at home and wondering what to eat to stay healthy? Creating a eating routine by planning what foods to eat when will help you stay on ahead of mindless snacking. It will also be helpful in making quick, efficient and low-touch trips to get groceries.

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