Dietitians Dish: Is it food allergy or food intolerance?

By Susan Sizemore
July 17, 2012 at 2:17 a.m.

Susan Sizemore

Susan Sizemore

If your body reacts to food or a food component, you may have a food intolerance - not a food allergy. Food intolerances may allow one to consume the food in small quantities. In contrast to a food allergy, one needs to eliminate the problem food from the diet altogether. Unlike food allergies, food intolerances usually don't involve the immune system.

However, they prompt many of the same symptoms: nausea, diarrhea and abdominal cramps. Intolerances happen when the body can't adequately digest a certain component of a particular food or perhaps a digestive enzyme is deficient.

One particular food intolerance is lactose intolerance. Lactose is a natural sugar that occurs in milk or milk products. Most of us produce the lactase enzyme in quantities that adequately digest the amount of lactose in milk or foods containing milk.

If the enzyme is not produced, the lactose is not digested and then ferments in the small intestine. This is the culprit for the uncomfortable symptoms of cramping, nausea, gas, abdominal pain and diarrhea.

A milk allergy is all together different. An allergic reaction occurs when one reacts to the protein component, such as casein in milk. People with milk allergies usually must avoid all milk products. Conversely, people with intolerances can eat dairy products in varying amounts.

If you have been diagnosed as lactose intolerant, remember, it is not an all-or-nothing condition. It is a matter of knowing your personal tolerance. Rather than avoid milk and milk products, know your tolerance level. Needlessly eliminating milk and dairy foods may pose nutritional risks.

Dairy foods and milk are important sources of calcium, protein, vitamins A and D, riboflavin and many other important nutrients. Calcium is abundant in dairy foods. It is important for growing and maintaining strong bones. This is important for baby's growth and bone maintenance for the elderly.

Tips for tolerance are to choose calcium-rich foods that are naturally low in lactose, such as aged cheeses. When cheese is made, the curds are separated from the whey. Most lactose is in whey. Aged cheeses, such as Swiss, colby, gouda and cheddar, lose most of their lactose during processing. Yogurt and buttermilk are easier to digest because the active, or friendly, bacteria helps digest the lactose.

If you are severely lactose intolerant, be a detective. Read the labels to note ingredient terms, such as whey, whey protein concentrate, lactose, milk, dry milk solids, in order to avoid these foods. Lactose-reduced or lactose-free milk are another option.

If your doctor has diagnosed you with lactose intolerance, consult a registered dietitian for assistance in planning a diet that is adequate in calcium and that also controls the lactose in your food choices.

Susan Sizemore is a registered and licensed dietitian at DeTar Healthcare Systems. Send questions or comments to



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