Millions of people in this country can’t eat multiple foods due to allergies and intolerances — and in some cases, eating the wrong food can be deadly. By A.K. Whitney

I could murder my best friend in under five minutes with the contents of the second shelf of my refrigerator.

That’s right. I said murder.

The second shelf is where I keep an assortment of nuts. I have pine nuts for pesto, slivered almonds for green beans and pastry, hazelnuts for that gianduia ice cream I keep meaning to make, and walnuts to pair with goat cheese for salad.

But I would never make any of those dishes for my best friend, because she has a severe allergy to tree nuts. We’re not just talking hives or an itchy mouth here, we’re talking anaphylactic shock, where your throat closes up suddenly and you can’t breathe. Even a sliver of almond can kill you by strangling you from the inside.

The only way to prevent death from anaphylaxis is to shoot the patient full of adrenaline (my best friend never travels anywhere without her EpiPen, which delivers a big enough dosage so she can breathe again, then get herself to a hospital, STAT!), or, if no adrenaline is available, cut a hole in her trachea below the swelling. Sounds fun, huh?

The scary thing is, my best friend is one of half a dozen friends and acquaintances I know who don’t do well with nuts. Of those, half are at risk for anaphylaxis. Half (though not the same half) are also allergic to peanuts. (Peanuts are not actually nuts, but legumes. And wild rice is not rice, but a kind of marsh grass. But I digress…)

I also have several friends who are allergic to shellfish. One of these is a restaurant reviewer, and he has told me he occasionally tries shellfish dishes anyway. Luckily, he is not prone to anaphylaxis, but I still can’t make up my mind whether he is insane or really dedicated to his craft. Then there is my friend who is allergic to beef, and my friend who is allergic to chocolate.

These friends are among the 12 million Americans estimated by the Food Allergy & Anaphylaxis Network to have an allergy. If that figure seems low, it’s because there is a difference between food allergies and food intolerances. The FAAN defines it as follows: “Food intolerance, unlike a food allergy, does not involve the immune system and is not life-threatening. A food allergy occurs when the immune system reacts to a certain food. The most common form of an immune-system reaction occurs when the body creates immunoglobulin E (IgE) antibodies to the food. When these IgE antibodies react with the food, histamine and other chemicals (called “mediators”) are released, causing hives, asthma, or other symptoms of an allergic reaction.”

Common intolerances include lactose intolerance and gluten intolerance. Gluten intolerance is the major contributor to Celiac disease. Celiac disease affects more than 2 million Americans, maybe more, since it is often difficult to diagnose. The National Institute of Diabetes and Digestive and Kidney Diseases estimates that 30 to 50 million Americans are lactose intolerant, and that Asians, African Americans and American Indians are most prone to it. (A quick aside about lactose intolerance: I will forever associate this condition with Meg Ryan. That’s because of the 1995 film “French Kiss,” where her character enjoys some delicious French cheese, only to pay for it horribly later.)

Living with an allergy or intolerance is obviously not fun. You constantly have to be on your guard, read labels very carefully, and always worry when eating a meal you haven’t cooked yourself because you don’t know what’s in it. I confess to always being nervous when I go out with either of my two friends with the deadly nut allergy. I try to keep in mind where the nearest ER is, and I solemnly back them up when they tell the server about their allergy. I try not to be a pain about it, but have been told it’s appreciated, since both these friends have encountered plenty of skepticism over the years. My best friend tells stories of well-meaning relatives getting offended when she would not accept a nutty treat.

Then there are those terrifying people who think people with allergies or intolerances are lying, and so try to debunk them by sneaking the food in. I remember a memorable letter to either Dear Abby or Ann Landers, where a woman with a deadly allergy had overheard a woman in their social circle saying she didn’t believe the letter writer, and was going to trick her into eating the food at the next potluck. Luckily, Abby (or perhaps Ann) was horrified, and counseled the writer to never eat anything the so-called friend offered—ever.

Fortunately, allergy and intolerance awareness, at least in this country, is increasing. Food manufacturers are labeling more, and restaurants are trying to accommodate diners. Still, not everyone is allergy and intolerance savvy, so in the interest of being servicey here at FemiNoshing, I will now break down these various ailments for you.

FOOD ALLERGY FAQs:

What is a food allergy? A food allergy happens when your immune system has a reaction to a seemingly innocuous food protein. In other words, it treats something that’s not technically poisonous as if it were poison. Because of this, pretty much most foods can cause an allergic reaction in someone if their immune system decides to malfunction. The most common allergens, however, include tree nuts, peanuts, and shellfish. What, you didn’t wonder why the airlines no longer serve nuts?

How do I know if I’m allergic? According to FAAN: “Symptoms may include one or more of the following: a tingling sensation in the mouth, swelling of the tongue and the throat, difficulty breathing, hives, vomiting, abdominal cramps, diarrhea, drop in blood pressure, loss of consciousness, and even death. Symptoms typically appear within minutes to two hours after the person has eaten the food to which he or she is allergic.”

Is there a cure? Nope, but some lucky people outgrow it. Unfortunately, nut allergies tend to be lifelong ailments and actually worsen over time.

What can I do to avoid an attack? Don’t eat the food! But, members of FAAN caution, it is not a great idea to cut a major food group from your diet. To make sure you get the nutrients you need, you should consult a doctor or dietitian about non-allergy-inducing substitutes. Also, be very wary of prepared food — you never know when an allergen may be lurking. Luckily, there is a lot more awareness now, and manufacturers put warning labels on foods that may have been cross-contaminated.

How do I diagnose my allergy? Doctors diagnose allergies by doing one of two tests. One is a blood test; the other involves putting a drop of the possible allergen on a needle and then pushing the needle into the top layer of skin. If an irritated bump forms, you may be allergic.

What is lactose, and why am I intolerant? Lactose is a simple sugar found in milk. In order to digest lactose, the small intestine must produce an enzyme called lactase. In lactose intolerant people, the small intestine does not produce enough, or any, lactase.

How do I know I’m lactose intolerant? According to the NIDDKD: “Common symptoms, which range from mild to severe, include nausea, cramps, bloating, gas, and diarrhea. Symptoms begin about 30 minutes to 2 hours after eating or drinking foods containing lactose. The severity of symptoms depends on many factors, including the amount of lactose a person can tolerate and a person’s age, ethnicity, and digestion rate.”

Is there a cure? No, but take comfort in the fact that you are far from alone. Most of the world’s population resides in Asia, where most people are lactose intolerant. The NIDDKD also estimates that most of us stop producing as much lactase after the age of two.

How do I avoid an attack? You can buy lactase tablets, which will give you the needed enzyme. Also, most grocers stock special low-lactose milk. Many lactose intolerants find it easier to digest aged cheeses, and finally, some people find they can digest smaller portions, so you just have to find your way.

How do I diagnose my lactose intolerance? Doctors have several tests, including ones that measure the hydrogen in your breath (from undigested lactose fermented by bacteria), glucose in your blood (lactase breaks down lactose into galactose, then your liver turns it into glucose) and finally, the lactic acid (again, those lovely bacteria!) in your stool.

What is celiac disease? Celiac disease is a digestive illness that affects the lining of the small intestine, destroying its ability to absorb nutrients. The illness is triggered when the person who has it eats gluten. Gluten is a protein found in wheat, rye, and barley.

How do I know if I have celiac disease? Celiac disease is really hard to diagnose, because it has a lot of symptoms — everything from bone loss to joint pain to infertility to depression (see the NIDDKD site for more). In fact, many digestive illnesses, including colitis and Crohn’s, seem hard to diagnose. You almost have to be a teenage girl doing her own lab work to figure out what you have.

Is there a cure? Only if you avoid gluten for the rest of your life. Then, your intestines have a chance to heal. Depending on the damage, that may take a long time.

What do I avoid? Bread, pasta, cereal — anything made with wheat, rye, or barley. The problem is that it doesn’t stop there. Lots of products you wouldn’t think contain gluten do, like soup, candy, hot dogs, and soy sauce. Like with allergies, reading labels is key.

A.K. Whitney is a Los Angeles-based writer and contributing editor to Sirens.

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Tags: Allergies, feminoshing, health, Intolerances

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