Definitions
'Food hypersensitivity' is an umbrella term which includes food allergy and food intolerance.
Food allergy is defined as an immunological hypersensitivity which occurs most commonly to food proteins such as egg, milk, seafood, shellfish, tree nuts, soya, wheat and peanuts. Its biological response mechanism is characterized by an increased production of IgE (immunoglobulin E) antibodies.
A food intolerance on the other hand does not activate the individual's immune response system. A food intolerance differs from a food allergy or chemical sensitivity because it generally requires a normal serving size to produce symptoms similar to an IgE immunologic response. While food intolerances may be mistaken for a food allergy, they are thought to originate in the gastrointestinal system. Food intolerances are usually caused by the individual’s inability to digest or absorb foods or food components in the intestinal tract. One common example of food intolerance is lactose intolerance.
- Metabolic food reactions are due to an inborn or acquired errors of metabolism of nutrients such as in diabetes melitus, lactase deficiency, phenylketonuria and favism. Toxic food reactions are caused by the direct action of a food or additive without immune involvement.
- Pharmacological reactions are generally to low molecular weight chemicals which occur either as natural compounds such as salicylates, amines, or to artificially added substances such as preservatives, coloring, emulsifiers and taste enhancers including glutamate (MSG). These chemicals are capable of causing drug-like (biochemical) side effects in susceptible individuals.
- Toxins may either be present naturally in food or released by bacteria or from contamination of food products.
- Psychological reactions involve manifestation of clinical symptoms caused not by the food but by emotions associated with the food. The symptoms do not occur when the food is given in an unrecognizable form. Although an individual may have an adverse reaction to a food, this is not considered a food intolerance.
Elimination diets are useful to assist in the diagnosis of food allergy and pharmacological food intolerance. Metabolic, toxic and psychological reactions should be diagnosed by other means.
Read more about this topic: Elimination Diet
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