what is a food intolerance?

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(creativecommons)

Let’s start by looking at some examples of food intolerance.

There are two very good examples, one of which everyone has heard of, and the other, most are familiar with as well.

Let’s first consider lactose intolerance.

Lactose intolerance is well understood to be a deficiency in the enzyme needed to digest lactose. Lactose is a sugar in milk. If you don’t produce enough of the enzyme, called lactase, then you can’ t digest lactose and you end up with gas, bloating, and abdominal discomfort when you ingest milk products. It’s about as simple as that. You can buy lactose-free milk, and you will be fine. You can also buy the enzyme and take it with your food, and it will help you digest milk products and you’ll be fine.

Note however that lactose intolerance has nothing to do with the immune system. It doesn’t produce inflammation. It doesn’t cause any real damage. It’s definitely not life threatening. It’s just very uncomfortable and perhaps embarrassing.

Now let’s turn to the second example, gluten intolerance. Gluten intolerance does not involve an enzyme deficiency. Gluten intolerance is an immune reaction. And in the case of celiac disease it results in an autoimmune reaction. Antibody production is also involved, but these are not the IgE antibodies we noted when discussing the traditional view of allergy. These are IgA and IgG antibodies.

Gluten intolerance also involves other parts of the immune system beyond these antibodies. As you may already know, gluten intolerance is connected to hundreds of different symptoms. You can have digestive problems, skin problems, neurological problems, psychological problems, weight problems, etc. This list goes on and on.

As you can now can the use of the word ‘intolerance’ in lactose intolerance is something completely different than the use of ‘intolerance’ in gluten intolerance. You have probably already guessed it, but there is no scientific definition for the word intolerance. It means the same thing in this context as it does anywhere else in the English language. It’s just a very broad word that means that things aren’t working out well.

This is a big problem. And I am very sensitive to this. (Or is that intolerant of it?) If the word doesn’t really mean anything, or the medical system uses it in two very different ways, then people will get confused. And that is part of the reason that many people, including many doctors, don’t appreciate the significance of gluten intolerance – because they equate it to lactose intolerance.

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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.

Food Sensitivity

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.
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(img thanks to northernsun.com)

Yesterday we discussed what exactly an allergy (and food allergy) is. Today, we’re going to explore what exactly an intolerance is.

Intolerance

Intolerance is much easier to define. I’ll bet that is what you’re thinking. Or, maybe by now you’re starting to wonder?

Let’s look at some examples of food intolerance. There are two very good examples, one of which everyone has heard, and the other, most are familiar with as well. Let’s first consider lactose intolerance.

Lactose intolerance is well understood to be a deficiency in the enzyme needed to digest lactose. Lactose is a sugar in milk. If you don’t produce enough of the enzyme, called lactase, then you can’ t digest lactose and you end up with gas, bloating, and abdominal discomfort when you ingest milk products. It’s about as simple as that.

You can buy lactose-free milk, and you will be fine. You can also buy the enzyme and take it with your food, and it will help you digest milk products and you’ll be fine.

Note however that lactose intolerance has nothing to do with the immune system. It doesn’t produce inflammation. It doesn’t cause any real damage. It’s definitely not life threatening. It’s just very uncomfortable and perhaps embarrassing.
(more…)