Common food intolerances

What is food intolerance?

Food intolerance is a broad term used when the body has difficulty digesting a particular food. Food intolerance can describe a broad range of adverse reactions to food including stomach pain, bloating, gas, diarrhoea, constipation, skin rashes and headaches.

Food intolerances are sometimes confused with food allergies.

Is food intolerance the same as a food allergy?

Food intolerance is different from food allergy. Food allergy is where proteins in particular foods trigger an immune response after ingestion. Some immune reactions will be rapid such as peanut allergy. Other allergies may see a delayed response, such as gluten allergy. An allergic reaction can vary from mild to severe. About 60% of allergies appear during the first year of life.

Food intolerance is an adverse reaction to food that is not mediated by the immune system and can be caused by any (nonprotein) food component. Food intolerance is much more common than food allergy. Some people may have an intolerance to lactose in cows milk due to decreased levels or an absence of the enzyme lactase. In contrast, a person allergic to cows milk protein (more common in infants and young children) will have an immune reaction after ingesting cows milk.

Common food intolerances

Surveys show that up to an estimated 25% of Australians believe they have a food intolerance.

Some of the more common food intolerances include:

• Lactose — If you are unable to digest lactose, you may experience abdominal bloating, pain, diarrhoea, nausea and/or gas after eating dairy products, due to low levels of lactase, the enzyme needed to breakdown lactose (the sugar in milk) into absorbable components. Avoiding foods that contain lactose or using an over the counter medicine to help you absorb lactose may help. Speak to your health professional for more information.

• FODMAP’s — FODMAPs are a group of sugars, including fruit sugars, that are not completely digested or absorbed by the intestine. They are in a wide range of foods and eaten every day without issue. Still, some people, already have a sensitive gut wall and can react to FODMAPs. When these sugars reach the small intestine, they move slowly, attracting water. When they pass into the large intestine, they are fermented by gut bacteria, producing gas, bloating and pain in sensitive individuals.

• Salicylates — Salicylates are compounds found naturally in a wide variety of herbs, spices, fruits and vegetables. The vast majority of people can eat salicylate-containing foods without problems. However, they can trigger hives and other symptoms in people with salicylate sensitivity. High salicylate foods include strawberries, raspberries, spices, honey and coffee.

• Food Additives — Food additives including sulphites (additive code E220–E227 on food labels) and benzoates (E210-E219) are part of a wide variety of natural and artificial additives used to colour, preserve and process food and these may trigger symptoms in susceptible people.

• Flavour enhancers — Flavour enhancers such as MSG (monosodium glutamate) (E621-E623, E627, E635) can cause intolerance reactions, such as headache in sensitive people.

• Histamine — Histamine is found naturally in many foods, including canned tuna, some cheeses, fermented foods and wines. Histamine intolerance is a result of histamine accumulation and histamine degradation issues in the body. In people with histamine intolerance, histamine in food can cause headaches, rashes, stomach pains, flushing, diarrhoea or vomiting.

If you suspect that you may have a food intolerance, keep a food and symptom diary for a few weeks to see if any patterns emerge. Record everything you eat and drink, and the times and duration of your symptoms, even if they appear unrelated. If you’re suspicious of a particular food, you could also try avoiding it for two weeks to see if symptoms improve and then reintroduce it to see if symptoms recur. Before excluding any foods from your diet long term, discuss your symptoms with your healthcare professional and work out an individualised diet plan to help you avoid nutritional deficiencies.

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