Food intolerance

As a food intolerance or food intolerance reaction (English: adverse food reaction), the following reactions are designated according to food intake following definition of the European Academy of Allergy and Clinical Immunology ( EAACI ) in 1994:

  • Toxic reactions: food poisoning
  • Non- toxic reactions non- immunological reactions enzymatic intolerances
  • Pharmacological intolerances
  • Intolerance to food additives
  • IgE - independent ( IgA or IgG - mediated): Celiac Disease

In the strict sense of the term, and in particular the designation used interchangeably food intolerance detected only incompatibility reactions without toxic and / or allergic background.

Epidemiology

It is estimated that approximately one suffering from a food intolerance to two percent of all people. Notwithstanding this number give in surveys in 10-20 % of people that they themselves think to suffer from food intolerances.

Pathophysiology

Toxic reactions

Toxic reactions after ingestion grounded in a general for the systemic toxicity of individual food components.

Non-toxic reactions

Non-toxic reactions are based on an individual's body's sensitivity to food components. A distinction is made in immunological and non- immunological reactions.

Immunological reactions

Immunological reactions, commonly referred to as food allergy, intolerance reactions are occurring individually, their symptoms after repeated allergen contact ( sensitization) occur. After the underlying pathological mechanisms, a distinction two forms.

Non- immunological reactions

After the underlying pathomechanisms three types of intolerance must be distinguished which neither toxic nor have an allergic background.

  • Resorptionsbedingte intolerances (Transporter Defects )
  • Fructose malabsorption ( intestinal fructose intolerance )
  • Enzymatic intolerances ( enzymopathies )
  • Lactose intolerance
  • Hereditary fructose intolerance
  • Galactose intolerance (see also galactosemia )
  • Histamine Intolerance
  • Sucrose intolerance
  • Sorbitintoleranz
  • Pharmacological food intolerance
  • Biogenic amines ( tryptamine in tomatoes, phenylethylamine in chocolate, tyramine in aged cheeses and chocolate, serotonin in bananas and nuts)
  • Glutamate ( glutamate intolerance)
  • Caffeine
  • Pseudo-allergic reactions to food additives
  • Lectins ( eg, contained in beans)
  • Salicylates in apples or apricots, but acetylsalicylic acid used in painkillers
  • Preservatives (e.g., benzoic acid)
  • Acidulants (e.g., citric acid, acetic acid)
  • Certain medications (see intolerance (medicine) )
  • Dyes (eg, tartrazine ),
  • Emulsifiers (e.g., lecithin),
  • Sulfites

Symptoms

In most cases, food intolerances show on the skin and mucous membranes. However, lung, gastrointestinal system (20%) and cardiovascular system (10 %) may be affected.

The main symptoms are:

  • Pruritus, flushing, urticaria, angioneurotic edema
  • Rhinoconjunctivitis, hoarseness, cough, asthma
  • Itching and swelling of the mouth or in the larynx
  • Nausea, vomiting, colic, diarrhea
  • Tachycardia, hypotension, extrasystoles
  • Flare-up of atopic dermatitis

Therapy, prevention

The treatment of choice is to avoid the foods made ​​responsible. In high risk infants who can not be breast-fed exclusively at the breast for various reasons, there is limited evidence that prolonged administration of infant formula from hydrolysed proteins food intolerances reduce (allergies in infancy and childhood in general, and the incidence of cow's milk allergy in particular) can. However, further well-designed studies to final clarification is required.

In the hospital sector ( not empirically provable effective ) have been abandoned in favor of today's conventional light normal diet ( or gastroenterological basic diet ) organ-related foods forms ( colon, gall bladder, liver, stomach and pancreas diets). According to a 1978 by the German Society for Clinical Nutrition and Dietetics carried out on over 2000 non- selektionierten clinic patient survey is omitted those foods that triggered more than 10 percent of respondents complaints.

These are ( in brackets the number of times the figures in percent):

  • Legumes ( 30.1 )
  • Cucumber salad ( 28.6 )
  • Fried foods ( 22.4 )
  • White cabbage ( 20.2 )
  • Carbonated beverages ( 20.1 )
  • Kale ( 18.1 )
  • Fatty foods ( 17.2 )
  • Peppers ( 16.8 )
  • Sauerkraut ( 15.8 )
  • Onions ( 15.8 )
  • Wirsing ( 15.6 )
  • Hard-boiled eggs ( 14.7 )
  • Coffee beans (12.5 )
  • Mayonnaise ( 11.8 )
  • Smoked ( 10.7 )
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