Gluten free. Grain free. Diary free. Keto. Whole 30. Paleo. There are so many labels related to diet and nutrition these days it can make your head swim! There seems to be more and more people with “dietary restrictions”. But what does it all mean? Is one way of eating better for you than the others? What about food allergies versus food intolerances?
Many diet trends stem from food allergies and intolerances, so let’s start with the basics.
Food Allergies
According to the American Academy of Allergy Asthma and Immunology, food allergies involve the immune system. With a food allergy, even a small microscopic amount of the food has the potential to lead to a serious life threatening reaction.
Many people who think they are allergic to a food actually just have an intolerance to it. Although the symptoms for both are similar, the differences are very important. For instance, if you are truly allergic to a food, your immune system overreacts to a particular protein found in that food. Sometimes these reactions can be life threatening.
Food allergy can occur in adults and children, although they are usually diagnosed in young children. Many children can outgrow the allergy. The most common food allergens are cow’s milk, eggs, fish, peanuts, shellfish, soy, tree nuts, and wheat. Symptoms usually occur within minutes of being exposed to the trigger, although they can also appear a few hours later. These may include:
- hives, itchy, red skin
- vomiting, stomach cramps, diarrhea
- stuffy, itchy nose, sneezing
- itchy, watery eyes
Life threatening reactions, or anaphylactic reactions, may include:
- Throat tightness, or feeling of lump in throat
- wheezing, chest tightness, or trouble breathing
- tingling in the hands, feet, lips, or scalp
**It’s important to note that if you or anyone you know experiences symptoms associated with anaphylaxis you should call 911 immediately.
Food Intolerance
A food intolerance, or sensitivity, is a problem with the digestive system and occurs when the body has difficulty digesting a particular food. Although symptoms may include the digestive, skin, and respiratory systems. They usually include:
- nausea, vomiting, diarrhea, or abdominal pain
- rashes or flushing of the skin
- headaches
- fatigue
- reflux
- runny nose
Although the symptoms can be pretty miserable, they are rarely life threatening.
Common food intolerances include gluten, dairy (or lactose), caffeine, and eggs. Other, lesser known, intolerances may include:
- Salicylates: natural chemicals produced by plants, but also used as a preservative
- Amines: most commonly, histamine.
- FODMAPs: Fermented oligo-, di-, mono- saccharides, and polyols; short chain carbohydrates found naturally in many foods; these intolerances are common among people with IBS (Irritable Bowel Syndrome)
- Sulfites: chemicals primarily used as preservatives; found naturally in grapes and aged cheeses
- MSG: monosodium glutamate; a flavor-enhancing additive in foods
- Sugar alcohols: used as zero calorie alternatives to sugar
- Food colorings
Diagnosing food allergies
There is a very serious difference between allergy and intolerance, so if you think you have a food allergy it’s best to see an allergist. Diagnosing food allergies can be complicated. Start by keeping a food diary, noting what foods you eat along with when and what kinds of symptoms you might get. The allergist will probably order a blood test (such as ImmunoCAP) and/or skin prick tests, both of which will indicate if food-specific IgE antibodies are present. Neither test is completely conclusive, however, since positive results do not always mean you’ll have a reaction when the food is eaten.
An oral food challenge (OFC) is the gold standard for food allergy diagnosis, according to the American College of Allergy, Asthma, and Immunology. These are rarely performed, however, because they are costly, time consuming, and potentially dangerous. You are fed the suspected food in measured doses, gradually increasing the dose until there is a reaction.
An OFC is performed in a medical facility by an allergist, with emergency medications and equipment available.
The Food Allergy Research and Education, or FARE, website is a great resource for information and support related to food allergies.
Healthy Eating and Fad diets
Popular fad diets seem to change from year to year. But they all have promises of quick weight loss and/or certain health claims with little to no scientific evidence to support them. Ketogenic, Whole 30, Paleo, Atkins, juice cleanses, and even intermittent fasting are all fad diets. I know people, myself included, who have tried these various diets with great success! But the fact remains that most of these are impossible to stick to long term.
Most fad diets focus on eliminating entire food groups, such as carbohydrates, dairy, grains, or legumes. And although you could loose weight in the short term by doing this, in the long term you could damage organs and muscles because they are deprived of certain nutrients. And high protein diets could lead to dehydration and eventually kidney stones or gallstones.
Many dietitians will suggest, however, that trying a popular diet for a few days or weeks can help to reset your eating habits. So even if these fads are not sustainable long term, they might still be beneficial in some ways. They may help you understand and bring awareness to what you’re eating.
So ultimately, a healthy lifestyle involves a well balanced diet as well as physical activity. The Dietary Guidelines for Americans 2015-2020 suggest a healthy eating plan to include:
- fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products
- lean meats, poultry, fish, beans, eggs, and nuts
- low in saturated fats, trans fats, cholesterol, salt (sodium), and sugars
- staying within your daily calorie needs
What are your thoughts on food and diet trends? Do you have a success or horror story with a “fad diet”? Do you, or someone you know, have a food allergy? Let me know your thoughts!
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Some helpful resources:
