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Do you know the difference between a food allergy and intolerance? Thought not – they are
often confused due to their overlapping symptoms. “A food allergy involves the immune
system and can be life threatening; while food intolerance is generally a feeling of
“unwellness” associated with a food, with no immune system involvement and therefore is
lifestyle threatening (symptoms include diarrhea, headache, nausea, abdominal pains)”, says
Dr Adrian Morris, Allergy Specialist from the Cape Town Allergy Clinic

The most common allergies are milk, hen’s egg, wheat (gluten), soya, peanuts and
fish/shellfish. Your immune system mistakenly sees the small protein particle as an
“invader” (allergen), causing the release of “fighters” (antigens). Minute traces of offending
foods can trigger histamine release and you can end up with anaphylactic shock: a severe
allergic reaction resulting in loss of consciousness or death. You see why it’s crucial to know
the difference?

Food Allergies
If you eat: Milk
You feel: Facial swelling, breathing difficulty, skin reactions, headaches, gastrointestinal
symptoms. Rarely anaphylaxis.
Because: Your body’s immune response is triggered by the Whey (lactoglobulin) or Casein
protein in milk.
Do this: Read food labels carefully – whey, casein or lactose, indicates the presence of milk.
Substitute milk with soy or rice milk and cheese with goat’s cheese.
If you eat: Egg
You feel: Skin reactions, breathing difficulty, gastrointestinal symptoms, headaches.
Because: Egg proteins (more commonly egg white proteins) trigger your immune reactions.
Do this: Avoid food containing egg. Hidden sources include baked products, sauces,
mayonnaise, nougat or marshmallows. On food labels, lecithin, globulin, albumin or
ingredients starting with “ovo” or “ova” indicates the presence of egg.

If you eat: Bread, rye, wheat.
You feel: Skin reactions, breathing difficulty, gastrointestinal symptoms, anaphylaxis.
Because: Your body reacts to one or more of the proteins found in wheat, often gluten.
Do this: Eat rice, potatoes, sweetpotatoes and corn, or bread, cereals and pastas made
from corn-, potato-, soy- and rice-flour.
“Semolina and couscous are wheat products, as is all bread and pasta (unless stated wheatfree)”,
says dietitian Marthie Leech.

If you eat: Peanuts
You feel: Facial swelling, airway constriction, gastrointestinal disturbances, or severe
Because: The protein particles in peanuts are seen as invaders and trigger an immune
Do this: A life-threatening allergy – so tell people that you’re allergic to peanuts, and wear a
Medic-Alert band. Read food labels: avoid ‘vegetable protein’. If in doubt, don’t eat it!

If you eat: Fish or Shellfish
You feel: Skin reactions, airway constriction, gastrointestinal disturbances, facial swelling,
Because: The protein particles in fish are highly allergy provoking.
Do this: “Fish are quite different to shellfish. Bony fish (cod, hake, tuna etc) are not the
same as crabs (prawn, crayfish, shrimp) and snails (Black mussels, oysters, clams), they
contain completely different allergens”, says Dr Morris. Therefore determine your specific
culprit with skin prick tests by your doctor. Once determined, avoid restaurants where fish
is served from the same kitchen as your steak.

Dr Morris says “There is no link between fish and iodine allergy; fish do not contain enough
iodine to cause an allergic iodine reaction. This is a uniquely South African myth.”

If you eat: Soy
You feel: Facial swelling, runny nose, abdominal pain, breathing difficulty, anaphylaxis.
Because: The soy protein is mistakenly seen as harmful and your immune system then
releases histamine and other chemicals into your bloodstream, leading to allergic
Do this: Read food labels and avoid hydrolyzed vegetable protein, lecithin, MSG, vegetable
–oil, –gum and –starch. When in doubt, opt for fresh and unprocessed foods.

Food Intolerance
Due to the lack of required enzymes, general gastrointestinal discomfort occurs. Hilda
Lategan, dietitian specialising in allergies says: “Most patients I see with symptoms related
to food intolerance are often more stressed out with probably a more weakened immune

If you eat: Milk or dairy
You feel: Bloating, cramping, frothy diarrhea.
Because: You are deficient in the Lactase enzyme needed to digest lactose, the sugar in
milk/milk products.
Do this: Limit dairy and opt for lactose free milk. Cheese and yoghurt are often better
tolerated due to partial fermentation.

If you eat: Eggs
You feel: Bloating, cramps, diarrhea
Because: Poorly digested egg ends up in the colon, with gastrointestinal symptoms as a
Do this: Read all food labels: lecithin, globulin, albumin or ingredients starting with “ovo” or
“ova” indicates the presence of egg. Hidden sources include baked products, sauces,
mayonnaise, nougat or marshmallows.

If you eat: Bread, rye, wheat, pasta, barley
You feel: Bloating, cramping, diarrhea, constipation, headache, skin reactions, mouth
Because: The protein gluten irritates your small intestines and hinders the production of
digestive enzymes.
Do this: Eliminate gluten from your diet for two weeks, then reintroduce it. Should your
symptoms reappear, opt for gluten-free foods and alternate with low-gluten containing
foods: couscous, rye and oats.

If you eat: Peanuts
You feel: Gastrointestinal symptoms, headaches.
Because: Nuts are poorly digested by your body, resulting in undigested nut particles
ending up in your colon with consequent gastrointestinal symptoms.
Do this: Usually a small amount can be tolerated every now and then. Avoid completely if
the intolerance is severe.

If you eat: Fish or fish products
You feel: Gastrointestinal symptoms (especially bloating)
Because: Poorly digested fish ends up in your colon where fermentation takes place, causing
severe gastrointestinal discomfort.
Do this: Determine what fish causes most of your symptoms by means of elimination – Hake
is often best tolerated. Your dietitian can help with elimination diets.

If you eat: Soy products
You feel: Bloatedness, cramps.
Because: Your body is unable to digest the soy protein, note that this may be accompanied
by an intolerance to milk protein.
Do this: Small amounts can usually be tolerated but in some cases total avoidance of soy
and milk products is needed.

*Consult your dietitian for a personalised approach
© René Jv Rensburg, 2011.

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