Sometimes words are interchangeable. We can offer the compliment as, “You look beautiful!” or “You look pretty,” without having to split hairs about the difference between the two. You know that a food review using the phrase, “This dish is scrumptious!” is a lot like your teen yelling, “That was bussin’!”
Sometimes, however, there are nuances to the words we choose and they are not interchangeable. Saying something is minuscule isn’t quite the same as saying something is small. They’re similar to a point. Both reference sizes, particularly size on one end of the scale. Small tends to be a general term, while minuscule references an extreme sort of small.
The difference in terms we use can matter. This is why it’s important to understand the difference between food allergies, food intolerance, and food sensitivity. All of them may be reasons we avoid certain ingredients, but they are not the same. In fact, the differences between them are significant.
Food Intolerance
If your digestive system struggles to break down certain foods or enzymes, you’ve got a food intolerance. As an example, lactose intolerance is the body’s inability to break down lactose, the sugar found in dairy products. The body lacks or has low levels of the intestinal enzyme lactase. If you’ve been diagnosed with a fructose intolerance, your body has a hard time absorbing the sugar (fructose) found in fruits and vegetables.
If you have a food intolerance and consume an offending food, you’ll likely experience gastrointestinal symptoms: gas, diarrhea, bloating, and/or stomach pain. You may be able to tolerate small exposures to the foods you’re intolerant to. For some, a single slice of cheese on a burger may mean slight bloating, whereas an ice cream sundae yields more severe symptoms. The tipping point is different for each person.
While avoidance of specific foods is a reasonable course of action, those with intolerances do have some other options. As an example, individuals with lactose intolerance may take an over-the-counter medication that provides the lactase enzyme before a meal to help improve tolerance. You may even find foods that are lactose-free or have reduced levels of lactose present to mitigate symptoms.
Food Allergies
Conversely, food allergies involve the immune system. Your immune system’s job is to identify and destroy bacteria and viruses that can make you ill. When you have allergies, your immune system misidentifies something harmless as a germ and attacks it. The reaction you may experience is your immune response. Your body is trying to get rid of the allergen. Symptoms associated with a reaction can range from rashes, itching, runny nose, to profuse vomiting, shortness of breath, or precipitous drop in blood pressure (among others). Allergic individuals may experience anaphylaxis, which is a severe reaction that involves more than one part of the body. Any allergic reaction can quickly become life threatening and should be taken seriously.
There is no safe amount of exposure for a person with a food allergy. There is no “it’s just a bite.” Food allergies require complete avoidance. Reactions are not predictable. The person who has only ever experienced mild responses to their allergens could be one exposure away from a life threatening response … or not. There is no way to predict. Vigilance and avoidance are the first line of defense for those with food allergies. Being prepared with an emergency action plan and carrying self-administered epinephrine is crucial (i.e. devices like EpiPen, Auvi-Q, or Neffy).
Food Sensitivity
If you’ve searched for answers about your symptoms online, you may have come across a variety of at-home tests and treatments to help you identify food sensitivities. It’s important to note that these tests often measure immunoglobulin G antibodies (IgG) levels in the blood. The test companies (and those that offer you solutions based on them) suggest that elevated levels of IgG in the blood stream indicate a food sensitivity. However, elevated IgG is a normal response to previous exposure to a food, and according to the American Academy of Allergy and Immunology, higher levels of IgG4 to foods may actually be associated with tolerance to that food.
“Food sensitivity” is not a medically recognized term. Symptoms you experienced after eating particular foods can be indicative of other conditions. It’s important not to self-diagnose, especially if your symptoms are particularly bothersome. See a medical professional to help you identify whether your symptoms are indicative of a treatable condition, intolerance, or allergy.
Why It Matters
As we noted above, someone with food allergies – even someone that has only ever experienced mild reactions to exposure – are always at risk for a potentially deadly reaction with their exposure. When they sit down at a restaurant and tell the wait staff they are allergic to dairy and need the assurance that their broccoli isn’t going to be coated in butter, it needs to be taken seriously.
The allergic person in your group can’t “just pick the walnuts” out of their salad and safely consume the dish. Everything on that plate has been exposed to the proteins that trigger a reaction and could still present a real (severe) risk to a person with an allergy. When we misuse the term “allergy” and then behave in a way that is not supportive of that diagnosis, we can contribute to general misunderstanding and doubt the next time someone insists on legitimate accommodations.
If you’ve ever heard someone say “Well, my sister’s friend is allergic to eggs and she just pushes the bit of egg in the salad off her plate. What’s the big deal?” you know what we mean. If you’ve ever heard, “Oh yeah, my cousin is allergic to dairy. She just takes that lactase pill and she’s fine. Have you tried that?” you understand the importance of using proper terms.
