Food intolerances and allergies: 10 rules to manage them
What are food intolerances, and what are food allergies instead? They are the same thing? No, because they involve different biological mechanisms, immune or non-immune (for example, enzymatic deficiencies), but both cases are adverse reactions to food.
In the case of food intolerances , the reaction to certain foods occurs first of all in longer times than an allergy, i.e. it can last for hours or days and is susceptible to the threshold level of exposure to certain foods or agents, while instead the allergy causes a precise immune reaction (with the production of some antibodies) and with immediate effects .
Oral allergic syndrome, for example, is a typical condition of many allergies, of mild or medium severity : it manifests itself with itching of the oral cavity, swelling of the mouth and tongue, with immediate effect from the ingestion of a certain food (from a few minutes to a few hours), and is generally caused by a cross-action or cross-reaction between certain foods (dried fruit, fruit, vegetables, shellfish) and some pollen or other contaminants (birch, cucurbt, etc.).
Food allergy therefore always causes a response of the immune system, of the mediated Ig-E type (ie a specific type of antibodies come into play).
Intolerances, on the other hand, are not immune-mediated, but can be caused by enzymatic deficiencies (lactose intolerance, favism), pharmacological (histamine intolerance), or pseudo-reactions (for example by some additives).
In this case a lot depends on how much a particular food is consumed : small doses do not cause problems and often in small doses you can even resolve an intolerance (or use probiotics), high or continuous doses on the other hand.
At the intermediate level we find some syndromes, such as celiac disease (referred to as auto-immunity) or nickel syndrome: in this case we always have a response from the immune system , but it is not like allergies, i.e. it is not Ig – And mediated.
For example, in the case of gluten, we can have:
– celiac disease (immune-mediated but not Ig-E mediated, it is a disease)
– allergy to wheat (allergy, therefore Ig-E mediated)
– sensitivity to non-celiac gluten (susceptible to the level- threshold, probably caused by antibody reactions).
The symptoms can vary between food intolerances and food allergies : in allergies, in addition to the oral allergic syndrome, we can also have serious reactions, from urticaria to anaphylactic shock.
In intolerances and diseases involving the immune system we can have non-immediate reactions, such as abdominal swelling, colic, migraines, digestive problems that can be very serious, such as the destruction of the intestinal villi, leaky gut , etc.
What to do if we have an intolerance or an allergy?
Here are ten rules according to ADI, the Italian Association of Dietetics and Clinical Nutrition .
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