Food intolerances and food sensitivities result when the gastrointestinal tract has a difficult time digesting, or breaking down, certain foods. Unlike allergies that involve the immune system and can cause severe reactions, intolerances and sensitivities are not life threatening. However, they can still result in bothersome digestive symptoms that can create fear or avoidance towards certain foods.
Common food intolerances/sensitivities include:
- Lactose: A sugar found in milk and other dairy products, caused by a lack of lactase enzyme.
- Gluten: A protein in wheat, barley, and rye, caused by a sensitivity or difficult time digesting this protein; different from Celiac disease which is an autoimmune condition.
- Fructose: A sugar found in fruits, honey and some processed foods that when ingested in high amounts can be poorly tolerated for some.
- Histamines: Naturally occurring chemicals found in higher amounts foods that have been aged, cured, or fermented foods, tomatoes, avocado, spinach, chocolate, soy products, wine and not so fresh fish.
Causes and Symptoms
Symptoms of food intolerances/sensitivities will generally occur a few hours after ingesting the trigger food. Symptoms often result when an individual is unable to make enough or any of a particular enzyme required to digest a food. Digestive symptoms can vary in severity and may include:
- Abdominal pain or bloating
- Excessive gas
- Diarrhea or constipation
- Nausea
Steps to Navigate Food Intolerances
Managing food intolerances can feel overwhelming, restrictive and confusing to navigate, especially when dealing with multiple food intolerances. Total avoidance of whole food groups can result in overly restricted dietary patterns and be a risk for nutrient deficiencies, developing disordered eating behaviors and put limits on engaging in social activities around food. It is important to work to create a balanced diet that supports your health while addressing your individual needs. Some steps to consider include:
- Identify Your Triggers
Work with a registered dietitian to identify your potential food triggers. This might involve:
- Food and symptom journaling: tracking food intake and GI symptoms for 1-2 weeks can provide insights into what foods may be a trigger for GI symptoms. Be cautious with prolonged food and symptom tracking as this can lead to heightened food preoccupation.
- Elimination Diets: Temporarily removing specific foods and reintroducing them gradually to observe reactions. Be cautious of overly restrictive elimination diets like low FODMAP unless navigating it with a trained registered dietitian or consider a customized approach to elimination with just one specific food at a time.
- Testing: Consider breath tests for lactose or fructose intolerance. Be cautious of IgG food sensitivity testing as this is not a validated method of measuring food intolerances or sensitivities and may cause someone to unnecessarily eliminate foods.
- Explore Substitutions
The good news is that there are plenty of substitutions for common trigger foods:
- Use lactose-free or plant-based milk alternatives if you’re lactose intolerant.
- Choose gluten-free grains like rice, quinoa, or oats certified gluten-free.
- Try enzyme supplements to aid in the breakdown of lactose, histamines or fiber containing foods.
- Focus on Nutrient Balance
Plan meals and snacks that focus on a variety of food groups to minimize the likelihood of becoming deficient in a particular nutrient like calcium, vitamin D, fiber, or others.
- Plan Ahead
Navigating food intolerances while dining out or traveling can be stressful. Look up restaurant menus ahead of time, communicate your needs clearly, and consider packing safe foods that travel well as a back up plan.
Building a Positive Relationship with Food
Managing food intolerances can feel restrictive at times. Try to focus on what foods are well tolerated rather than what you’re avoiding. Sometimes foods that have been avoided due to perceived intolerances can be incorporated back in slowly with the support from a registered dietitian. Experiment with new recipes and flavors to keep your meals exciting and satisfying. Engage in mindfulness based activities during meal times to help support digestion through the gut-brain connection. With the right tools and resources, navigating food intolerances becomes less about restriction and more about balance and discovery.
