A Guide to Food “Allergy” Etiquette

Likely you’ve noticed, but there are a growing number of people with food “issues.” It might be a food intolerance, a food sensitivity, or even a very serious, life threatening food allergy. I’m one of them. Maybe you are too.

But maybe you are not. And maybe you are now daily exposed to people talking about their food avoidances in the work place to stores promoting the latest in allergy-free products, and are even told not to bring your favorite foods to schools or potlucks for the sake of a small minority that might have an adverse reaction to such foods. SO annoying, right? But seriously, does this make you angry?

Just let me tell you, no one chooses to have food issues. Parents do not choose for their sons or daughters to go into anaphylactic shock when exposed to peanuts, dairy or any other random foods that might normally seem completely benign. In fact, it’s something all of us parents fear. While you are grumbling about peanut butter, can you imagine the fear of that parent praying their child does not accidentally ingest or even come in contact with the food that could land them in the hospital, or worse, while they are at school or out in the world? In a far less serious example, I did not choose to break out in painful acne all over my back every time I eat dairy. And others did not choose to experience terrible gas and bloating when eating foods with gluten, sugar, soy, etc. I know sometimes it may seem that people are using food avoidance as a diet or other regimen apart from a true food allergy, but give them the benefit of the doubt. All of us in a second flat would choose to be able to eat anything we desired if given 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 high quality butter. Great, now my mouth is watering, and I digress.

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

Food Allergy: This is by far the most serious. This is an immune-modulated reaction related to the IgE antibody. These reactions usually occur within minutes of eating a food and can range from something as simple as a mouth rash to more serious symptoms such as hives, vomiting, or anaphylactic shock.

Food Sensitivity: These reactions are modulated by non-IgE antibodies or T-cell reactions and are typically delayed in nature. The reactions may occur hours after eating a food up to 3 days later. It can be extremely frustrating to figure out which foods are the actual culprits so have some patience with your poor friends or family members who are still trying to sort it out. Better yet, tell them about Mediator Release Testing. In these cases the symptoms are rarely life threatening but can include things such as digestive issues/IBS, headaches/migraines, body aches, fatigue, eczema, and a host of other ambiguous symptoms that might equate to “feeling lousy.”

Food Intolerance: This is the result of the body’s inability to correctly break down a food due to some deficiency in an enzyme or other body process that would normally allow you to digest and assimilate that food in a normal manner. The easiest example is lactose intolerance. When the enzyme Lactase, produced in the small intestine, is lacking, people cannot break down the lactose in dairy products efficiently. The undigested lactose goes into the intestines and then produces unpleasant gas and bloating. Avoiding dairy or taking oral Lactase usually solves the problem.

Celiac Disease: I feel the need to mention this one here because it is none of the above but commonly encountered. You may know that those with Celiac Disease must be on a gluten free diet, but that is not because gluten is an allergy. It’s because gluten causes an autoimmune disorder. The presence of gluten signals certain antibodies to damage the villi of the small intestine, making it an attack against “self.” The destruction of these villi, which are the absorptive surfaces of the small intestine, eventually produce malabsorption of nutrients and a host of co-morbidities. Even the smallest trace of gluten can trigger these events.

Irregardless of the type of food issue a person has, I think the common frustration among folks is what to do about it or how to help. Well first of all, there is nothing you can do about it. People’s food issues are people’s food issues. What you can do to help is be accommodating.

Do you know how many times I’ve heard people say to me in my office, “Danielle, I just don’t want to be a burden to anyone.” So then they’ll go, eating the food of family and friends, that they know will make them sick. What I’m saying is that many people would rather make themselves sick than have you think ill 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 anything at a party? It’s even worse if you are thin. And doubly worse if it’s around family. People hate the non-eater. It’s a no-win situation.

Being accommodating to food sensitivity/food allergy/food intolerance sufferers first requires you to ask. When was the last time you asked on an invite or in a group if there were any food allergies to be aware of? And even if you did, have you ever though that a large majority of them don’t even mention their avoidances simply out of politeness?

Secondly, do a little research on these food groups. How many people do you know that are gluten free? Check out your grocery store for gluten free options and products. Do a little reading online about common foods to avoid. Discuss the issue with these particular friends to learn a little more. Trust me, they will appreciate you asking and might even share why they are avoiding certain foods in the first place.

Thirdly, take it seriously. Remember that even a little bite of allergenic foods for some people can provoke serious symptoms. As I mentioned before, sufferers of Celiac Disease, for example, can have NO gluten. Even the contamination from foods processed in the same facility as wheat can cause malabsorption and inflammation in their small intestine. Over time this sort of damage can lead to vitamin/mineral deficiencies and even cancer. It’s serious. Other people with gluten sensitivity may be able to get away with a touch of gluten here or there. You just never know the severity, so ask.

Lastly, 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 take offence if they still can’t eat it. I’ve been there, in both respects. I’ve had people create dairy-free meals for me only to have seemingly forgotten that butter constitutes dairy (admittedly I still eat it and suffer the consequences). On the flip side I’ve created meals or baked goods for others where I may have remembered to accommodate a few of their allergies but unfortunately forgot about one. It happens. Get over it and enjoy the company.

Now I know this is no perfect science and there will still be frustration, anger and annoyance when dealing with people’s food issues, but hopefully we can all get along a little bit better just by being more aware and sensitive to those around us. Next time you bring a dish to your work potluck or church event, consider making something gluten free. Maybe prepare something Vegan. The options are endless. Take stock of those around you and think about how you can be more accommodating. You will be amazed how much your efforts are appreciated.