A Guide to Food Allergy Etiquette

A Guide to Food Allergy Etiquette

You've probably noticed, but there are a growing number of people with food problems. This could be a food intolerance, a food sensitivity, or even a very serious, life-threatening food allergy. I am one of them. Maybe you are too.

But maybe it's not you. And you may now be exposed daily to people talking about their avoidance of foods at work, in stores that advertise the latest allergy-free products, and even told not to bring your favorite foods to schools or potlucks for a small minority who might have an adverse reaction to such foods. SO annoying, right? But seriously, does that make you angry?

Let me just tell you, no one has problems with food. Parents don't choose to let their sons or daughters go into anaphylactic shock when exposed to peanuts, dairy products, or other random foods that normally seem completely harmless. In fact, it's something all of us parents fear. While you bitch about peanut butter, can you imagine the fear that a parent watching their child not accidentally ingest or even come into contact with the food that could land them in the hospital or worse, in school or in school? In a far less serious example, I didn't choose to break out in painful acne all over my back every time I ate dairy. And others chose not to experience terrible gas and bloating when eating foods with gluten, sugar, soy, etc. I know that sometimes it seems like people are using food avoidance as a diet or other regimen aside from a true food allergy, but give them the benefit of the doubt. All of us in a second home would choose to be able to eat whatever we wanted if we had the ability. Oh how I would love to eat a piece of cheesecake without paying a price. Or really, just to have a simple latte. Or buy a thick chocolate chip cookie full of good quality butter. Great, now my mouth is watering and I'm digressing.

You may be wondering what the differences are between food allergies, food intolerances, and food sensitivities. Let me break it down real quick so you can better see where people are coming from.

Food allergy: This is by far the most serious. This is an immunomodulated reaction related to the IgE antibody. These reactions usually occur within minutes of eating a food and can range from simple skin rashes to more serious symptoms such as hives, vomiting or anaphylactic shock.

Food sensitivity: These responses are modulated by non-IgE antibodies or T cell responses and are typically delayed. Reactions can occur hours after consuming a food up to 3 days later. It can be extremely frustrating trying to figure out which foods are the actual culprits. So be patient with your poor friends or family members who are still trying to solve the problem. Better yet, tell them about Mediator Release Testing. In these cases, the symptoms are rarely life-threatening, but can include things like digestive problems/IBS, headaches/migraines, body aches, fatigue, eczema, and a variety of other ambiguous symptoms that could amount to a “feeling bad.”

Food intolerance: This is the result of the body's inability to properly break down a food due to a deficiency in an enzyme or other body process that normally allows you to digest and assimilate that food in a normal way. The simplest example is lactose intolerance. If the enzyme lactase, produced in the small intestine, is missing, people cannot efficiently break down the lactose in dairy products. The undigested lactose enters the intestines and then produces unpleasant gas and bloating. Avoiding dairy products or taking oral lactase usually solves the problem.

Celiac disease: I feel the need to mention this one because it's not one of the above, but it's common. You may know that those with celiac disease need to eat a gluten-free diet, but that's not because gluten is an allergy. It's because gluten causes an autoimmune disease. The presence of gluten signals certain antibodies to damage the villi of the small intestine, making it an attack against the “self.” The destruction of these villi, which are the absorptive surfaces of the small intestine, ultimately leads to malabsorption of nutrients and a variety of comorbidities. Even the slightest trace of gluten can trigger these events.

Regardless of the type of food problem a person has, I think the common frustration among people is what to do about it or how to help. First of all, there's nothing you can do about it. People's food problems are people's food problems. What you can do to help is be accommodating.

Do you know how many times I've heard people in my office say to me, "Danielle, I just don't want to be a burden to anyone?" Then they go and eat the food of family and friends who they know are getting sick. What I'm saying is that many people would rather make themselves sick than have you think badly of them for bringing up a food issue. I know it may seem easy to just not eat, but have you ever seen someone give you the eye for not eating at a party? It's even worse if you're thin. And twice as bad when it comes to family. People hate the non-eater. It's a no-win situation.

To address food sensitivity/food allergy/food intolerances, you must first ask. When was the last time you asked at an invitation or in a group if there were any food allergies you should be aware of? And even if you did, have you ever thought that a vast majority of them don't even mention their avoidance out of politeness?

Second, do a little research on these food groups. How many people do you know who are gluten free? You can find gluten-free options and products at your grocery store. To avoid this, do a little reading online about common foods. Discuss the problem with these specific friends to learn more. Trust me, they'll appreciate that you asked and maybe even share why they avoid certain foods in the first place.

Third, take it seriously. Remember that even a small bite of allergenic foods can cause serious symptoms in some people. For example, as I mentioned, people with celiac disease can NOT have gluten. Even contamination from foods processed in the same facility as wheat can lead to malabsorption and inflammation in the small intestine. Over time, this type of damage can lead to vitamin/mineral deficiencies and even cancer. It's serious. Other people with gluten sensitivity can get away with a touch of gluten here or there. You just never know the severity, so you ask.

Finally, try not to be offended. Even if the dish you so carefully created for your allergy-suffering friend seems perfect in every way, try not to be offended if he still can't eat it. I've been there in both ways. I've had people create dairy-free meals for me, only to seemingly forget that butter is dairy (admittedly, I still eat it and suffer the consequences). On the other hand, I have created meals or baked goods for others where I may have remembered to accommodate some of their allergies but unfortunately forgot one. It happens. Get over it and enjoy the company.

Now I know this isn't a perfect science and there will still be frustration, anger and annoyance when dealing with people's food issues, but hopefully if we are more aware and sensitive to the people around us we can all get along a little better. Next time you bring a dish to work, consider making something gluten-free. Maybe prepare something vegan. The possibilities are endless. Take stock of those around you and think about how you can be more accommodating. You will be amazed at how much your efforts are appreciated.

Inspired by Danielle VenHuizen