In our two previous posts, we discussed what exactly is meant by a food allergy as well as a food intolerance. Today, we’re going to discuss food sensitivities.
Now with the word sensitivity, things are starting to look up. It’s not being misused as much as the other words; however, it has even less scientific meaning than intolerance, if that’s possible.
Sensitivity is often used by the average Jane to indicate that she knows that she just doesn’t do well with a particular food, but she doesn’t quite know what to call it. The medical community has picked up on this and run with it in the form of gluten sensitivity. They don’t know what to call non-celiac gluten reactions, so now we are starting to hear them called gluten sensitivities.
Fortunately, in this context, the proper word is being used. However, that is only because the word sensitivity is so broad that it covers absolutely everything. In fact, it also covers celiac disease, which is logically a type of sensitivity to gluten. There’s nothing wrong with that, but we need to be clear about what the word sensitivity means.
Making sense of it all
At this point you have a much better idea about the confusion behind the words allergy, intolerance, and sensitivity. That’s helpful, but if we’re going to educate the world about our reactions to food then we need a consistent, scientific, and meaningful language with which to converse about it. We need a foundation on which we can build. Otherwise these topics are going to continue to dwell in the cellar of our medical system.
And finally, someone has taken care of this problem. And no, it wasn’t me. Although I’d love to take credit for it, I’m just the town crier. Two panels of experts, one in Europe and one in the U.S., each came out with position papers on exactly this subject in 2001. (1, 2)
Their conclusions were nearly identical. First they started with the word sensitivity. Sensitivity is an umbrella term. It encompasses all food reactions. Food sensitivities are then be broken down into two major categories – immune reactions, and non-immune reactions.
All immune reactions are essentially a type of allergy. These are then further subdivided by the mechanism underlying the immune reaction (allergy). This is where it gets a little technical because some knowledge of the immune system is required. However, it helps us to categorize different types of allergies. For example, we have IgE reactions, IgA reactions, IgG reactions, etc. It is important to note Celiac disease has clearly been categorized as an allergy, which is logical.
On the other side we have non-immune reactions. These include issues such as lactose intolerance, sulfite reactions, MSG sensitivity, etc. It’s a broad category with a lot of poorly understood reactions. Some are enzyme deficiencies, but others are simply reactions for which the mechanism is unknown.
This breakdown of food reactions was published over 10 years ago. Unfortunately, it seems that not many people have been paying attention to the standards that were developed. The time has come for us to do just that. Without a clear language we will continue to talk circles around the issue of food sensitivities, the public will continue to be confused, and doctors will continue to work under the false assumption that they know what it is they are talking about.
Please take the time to use these words properly and to help educate others on how to use them properly. A lot more than semantics is at stake. The health of half the population is tied to these issues. Together we can help educate the public and the medical profession, and make the world a much better place in which to eat.
Johansson, S. G., et. al. A Revised Nomenclature for Allergy. A European Academy of Allergy and Clinical Immunology (EAACI) position
statement from the EAACI nomenclature task force. Allergy, 2001, V. 56, pg 813–824.
Steve L. Taylor, Ph.D. and Susan L. Hefle, Ph.D., Scientific Status Summary, Food Allergies and Other Food Sensitivities, A publication of the
Institute of Food Technologists’ Expert Panel on Food Safety and Nutrition. SEPTEMBER 2001 • VOL. 55, NO. 9