Transcript Dietary Guidelines for Food Allergies and Food Intolerances

Diet and Health Guidelines for Food
Intolerances
Presented by
Janice Hermann, PhD, RD/LD
OCES Adult and Older Adult Nutrition Specialist
Food Allergy
 A food allergy is an adverse reaction to a food
or food component that involves the immune
system
 A food allergen is the part of a food to which
a person is allergic
 Often an incompletely digested protein
What Happens With A Food Allergy
 When someone eats a food they are allergic
to, the food allergen stimulates the immune
system to release antibodies
 The antibodies cause body cells to release
other substances, which cause allergic
reactions
Food Intolerances
 Some people have adverse reactions to foods
that do not involve the immune system
 These are referred to as "food intolerances“
they are not food allergies
Causes of Food Intolerances
 Food intolerances may be caused by:
 Enzyme deficiencies
 Reactions to chemicals in foods
 Sulfur
 Digestive diseases
Metabolic Intolerances
 A metabolic intolerance is when the body
cannot adequately digest a portion or
component of a food
 For example lactose intolerance and gluten
intolerance
Lactose Intolerance
 People with lactose intolerance cannot digest
(breakdown) lactose in milk
 Lactose is a disaccharide (sugar) in milk
 Lactose is digested by the enzyme lactase into
two monosaccharides, glucose and galactose,
which can be absorbed by the small intestine
Lactose Intolerance
 If there is not enough lactase, the lactose is
goes undigested the intact lactose moves into
the large intestine and is fermented by
normal bacteria found in the large intestine
 The amount of lactase produced tends to
decrease in adulthood
 Incidence of lactose intolerance varies for
different populations.
Symptoms Of Lactose Intolerance
 Symptoms include cramps, bloating,
intestinal gas, diarrhea and nausea
 Severity of symptoms varies with the
amount of lactose consumed and degree of
intolerance
 Symptoms appear from 15 minutes to
several hours after eating foods or
beverages containing lactose
Is Lactose Intolerance A Milk Allergy?
 A milk allergy is an allergic reaction to the
protein components in milk, not the lactose in
milk
 People with milk allergy usually must avoid all
milk products. People with lactose intolerance
can use certain dairy products that are low in
lactose
How Much Lactose
 Amount of lactose allowed depends on the
degree of lactose tolerance
 Many can tolerate 6 grams lactose (1/2 C milk)
 Many can tolerate fermented products such as
yogurt and acidophilus milk
 Hard cheeses and cottage cheese may be tolerated
because most of the lactose is removed with whey
How Much Lactose
 Many foods contain small amounts of lactose,
for example breads, dry cereals, cold cuts,
cream soups, salad dressings, candy, cookies,
drink mixes, and sugar substitutes
 Most people can handle the small amount of
lactose in these foods
How Much Lactose
 Very sensitive people need to check food
labels carefully for:
 Milk
 Whey
 Lactose
 Nonfat milk solids
 Dry milk solids
 Curds
Cheese
 Margarine
 Sweet or sour cream
Lactobacilus
 Many people can use commercially prepared
milk products that have been treated with an
enzyme (lactobacilus) that breaks down
lactose
 Alternatively, people can take enzyme tables
with meals or add enzyme drops to their milk
 Example: Lact-aid, Dairy-ease, Lactinex
Gluten Intolerance
 Gluten is a protein found in wheat, rye, and
barley or derivatives of these grains such as
malt
 Some individuals cannot tolerate the gliadin
fraction in gluten
Gluten Intolerance
 Gluten intolerance is also referred to as celiac
disease, celiac-sprue, nontropical sprue or
gluten sensitive enteropathy
 Individuals do not outgrow gluten intolerance
Symptoms Of Gluten Intolerance
 As a result of gliadin intolerance the
intestinal lining is flattened which results in
reduced food absorption, diarrhea,
steatorrhea (fat in the stool), bloating, loss
of appetite, muscle wasting, weight loss and
can lead to progressive malnutrition
Symptoms Of Gluten Intolerance
 Lactose intolerance may temporarily occur
secondarily to gluten intolerance
 However, lactose containing foods can be
returned to the diet within a short time
Gluten Intolerance
 Gluten containing grains
 Wheat
 Rye
 Barley
 Oats
 Although oats is gluten-free, the use of oats is
controversial due to contamination with wheat
during processing
 A limited intake of oats (40 to 60 g/day) is
currently considered acceptable
Gluten Intolerance
 Non-gluten containing grains
 Tapioca
 Corn flour
 Corn starch
 Rice flours
 Potato starch
 Potato flour
 Soy flour
Gluten-Free Flour Substitute
 Gluten-free flour mix
Rice flour
6 cups
Potato starch 2 cups
Tapioca flour
1 cup
Food Additive Intolerances
 Although most individuals consume a wide
variety of food additives each day, only a
small number have been associated with
intolerances to food additives
Yellow No. 5 or Tartrazine Sensitivity
 Yellow No. 5 is a food color additive
 Although rare, yellow dye No. 5 may cause
hives in some individuals
 Whenever Yellow No. 5 is added to a food, it
should be listed on the product food label
Carmine Sensitivity
 Carmine is an extract of the cochineal insect
used as a bright red dye in a number of
products
 Occasional reactions to carmine used as a
food coloring have been reported
 If carmine is added to a food it should be
listed on the product food label
Monosodium glutamate (MSG)
 MSG is a flavor enhancer
 MSG is the sodium salt of glutamic acid, an
amino acid found naturally in all protein
 A few people report mild and short-lived
reactions after eating MSG
 If MSG is added to a food it is listed on the
label as monosodium glutamate
Sulfites
 Sulfites are used to preserve color of foods
and inhibit microorganism growth
 Some people develop shortness of breath or
fatal shock shortly after exposure to sulfites
 Sulfites can produce severe asthma attacks in
sulfite-sensitive asthmatics
Sulfites
 FDA banned the use of sulfites on fresh fruits
and vegetables (except potatoes) intended to
be sold to consumers raw
 Sulfites added to all packaged and processed
foods must be listed on the product label
Aspartame
 Some people have complained of adverse
reactions to aspartame
 However, in clinical studies aspartame has not
shown allergic reactions
 FDA concluded there is no evidence of a
cause and effect between aspartame and
sensitivities reported