Elucidating allergy/intolerance confusion….

Last week we had a meeting with the lovely Ceres PR who will be working with us on promoting the FreeFrom Food Awards this year – and one of the things they asked us to outline for them in our briefing was areas of confusion in ‘freefrom’ and allergy/intolerance.

Not a problem, I thought, a couple of quick sentences – until I actually came to think about it. At which point I realised that the whole subject was fraught with confusion, both in terms of what freefrom/allergy/intolerance actually mean – and what they are called. So, for everyone’s benefit….

• ‘FreeFrom’ – a relatively loose term applied to any product (not only food) that is ‘free of’ whatever it is that you do not want to eat/put on your skin/use on your loo etc.

Those who are intolerant of gluten think it only applies to gluten-free foods, those who have a dairy problem think it only applies to dairy-free foods, those who have multiple allergies/ intolerances think that ‘freefrom foods’ will be free of all of their allergens and get quite upset when they are not!

‘FreeFrom’ is not a ‘marque’ and has no legal or regulatory status. There is no governing or policing body for freefrom.

However, the term has been widely adopted by the food industry as a ‘cover all’ term for ‘dietary’ foods that are gluten/wheat/dairy/nut etc free. It is also now starting to be used for foods that are free of other ingredients which are perceived to be unhealthy  (such as additives) and, by extension, even for ‘ethical’ foods – fair trade, organic, low food miles, animal friendly etc.

• Allergy  / intolerance

The medical definition of food allergy is an immediate immune system reaction sparked by the binding of an IgE antibody to a mast cell thereby causing a release of histamine.

The medical definition of  food intolerance is a delayed reaction to a food which does not involve the immune system, the symptoms of which are extremely varied and can be behavioural/psychological as well as physical.

These definitions tend only to be understood by the medical profession – and not by all of them!!

The average food intolerance sufferer thinks of him/herself as a food allergy sufferer which explains the huge divergence between the ‘official figures’ for food allergy (1-2% of the population) and the popular perception (30-40% of the population). Dietitians, in particular, get very exercised about this…..

• Cow’s milk allergy and lactose intolerance

1. Cow’s milk allergy is an immune response (see allergy above) to one or more proteins in cow’s milk – can be fatal.

2. Cow’s milk intolerance is a food intolerance (see intolerance above) to some or all the constituents (not necessarily proteins) in cow’s milk.

3. Lactose intolerance is not, strictly speaking, an intolerance at all but a deficiency of the enzyme lactase which digests the lactose sugar in milk. (In lactose intolerance the undigested lactose sugar ferments in the gut giving the typical digestive symptoms of lactose intolerance.)

Lactose intolerance has nothing to do with cow’s milk allergy and although it is possible to suffer from both, they are totally separate conditions.
Very few outside the medical profession understand the differences so the three terms are used indiscriminately.

• Coeliac disease, gluten sensitivity/intolerance, wheat allergy, wheat intolerance

1. Coeliac disease is an autoimmune condition in which the protein fraction, gliadin, found in wheat, barley and rye, causes the villi or fronds which line the small intestine to atrophy thereby preventing the sufferer absorbing nutrition from what they eat and preventing its proper digestion. It can have wide ranging symptoms many of which may be digestive, but need not be. It is thought to affect around  1 in 70 of the population although it is also thought to be heavily under-diagnosed.

2. Gluten sensitivity/intolerance. This is an intolerance (see above) to the gluten which is found in all grains. It is a ‘new’ intolerance in that its existence is only just coming to be recognised; it may, in some degree or other, be very common.

3. Wheat allergy – an allergy (see above) to one or several of the proteins in  wheat.

4. Wheat intolerance – an intolerance, see above, to one or several of the constituents (not necessarily proteins) of wheat. This appears to be most common in relation to highly processed, high-gluten flours and products made from them.

All four conditions are commonly confused.

• Dairy / eggs

Eggs are not a dairy product although many people think they are – I have never been able to get my head around why they should!!
Strictly speaking dairy products only refer to cow’s milk products although the term is often taken to refer to all animal milk products (goat, sheep, camel, mare, donkey etc etc)

• Butter

Strictly speaking ‘butter’ refers only to churned animal milk but it is used in common parlance in other contexts – cacao/cocoa butter, coconut butter, shea butter, nut butters etc – which have nothing to do with cow’s or animal milk. However, the terminology causes a great deal of confusion amongst those who think they might be dairy/milk/cow’s milk intolerant.

• ‘Milk’

The term should only refer to cow’s milk or at least to animal milks. However, for convenience it is also used in general parlance (not  in ingredients lists or on food labels) for almost any drink which is white(ish) and can be used for similar purposes as cow’s milk eg. soya milk, rice milk, coconut milk, oat milk, spelt milk etc

• Nut/peanut allergies

1. Peanuts are not tree nuts but legumes – eg fruits which grow and ripen in a pod – so being peanut allergic does not mean that you will be tree nut allergic or vice versa – although some people can be allergic to both.

2. Tree nuts include  walnut, almond, hazelnut, cashew, pistachio, and Brazil nuts of which cashews, Brazils and hazelnuts are usually thought to cause the most serious allergic reactions.

3. Although coconut are treenuts they are not usually considered to have a high allergy risk.

4. Seeds – pine nuts, pumpkin seeds, sunflower seeds, sesame seeds etc. These are not nuts and, although you can be allergic to any/all of them and you can have both a nut and a seed allergy, the fact that you are allergic to nuts does not mean you will be allergic to seeds and vice versa.

Hope you are now somewhat wiser….  If not – for more information check out:

The articles on FreeFromFoodsMatter for more on ‘freefrom’
The articles on the food allergy/intolerance section of Foods Matter for more than you will ever want to know about food allergy/intolerance!
The articles in the cow’s milk allergy sections and the lactose intolerance section of FoodsMatter
Our CoeliacsMatter site for anything you want to know about coeliac disease, gluten sensitivity or wheat allergy.
The peanut/treenut section of FoodsMatter for related articles.