Food Intolerances vs Food Allergies
By Keren Granit
If you’re an expat living in Bangkok, navigating dietary needs for your child can sometimes feel like an overwhelming task. The city offers a tantalizing array of flavors and cuisines, but what happens when your child’s body seems to rebel against certain foods?
Understanding the difference between a food intolerance and a food allergy is essential in managing your child’s health, ensuring they stay safe while enjoying the culinary richness of their surroundings.
THE BASICS: WHAT ARE FOOD INTOLERANCES AND FOOD ALLERGIES?
Food intolerances and food allergies often get mixed up, but they stem from different mechanisms in the body. Food allergies involve the immune system. When a child with a food allergy consumes or comes into contact with the offending food, their immune system reacts as if the substance is harmful, triggering a cascade of symptoms that can range from mild to severe.
On the other hand, food intolerances do not involve the immune system. Instead, they are usually related to the digestive system’s inability to properly process certain foods. While intolerances can cause discomfort and disrupt daily life, they are not life-threatening.
Differentiating between these two can help parents seek the appropriate care and interventions for their child.
SIGNS AND SYMPTOMS TO WATCH OUT FOR
Food intolerances
Food intolerance symptoms may take hours or even days to appear. They include:
- Bloating and gas
- Abdominal pain or cramps
- Diarrhea or constipation
- Headaches or migraines in some cases
For example, lactose intolerance—a common condition where the body lacks the enzyme lactase to digest milk sugars—is prevalent in many Asian populations. This means some children might experience discomfort after consuming dairy products, such as Thailand’s popular milk teas or creamy desserts.
Food allergies
Allergic reactions can manifest differently depending on the type of antibodies that are produced when the body is exposed to the allergen. Some are known as IgE-mediated reactions and occur within minutes of exposure to the allergen. Others can be delayed, developing hours to weeks after exposure. These are called non-IgE mediated reactions. Symptoms can include:
- Skin reactions: Hives, swelling, or eczema
- Respiratory issues: Wheezing, coughing, or difficulty breathing
- Gastrointestinal symptoms: Vomiting, diarrhea, or abdominal pain
- Anaphylaxis: A severe, potentially life-threatening reaction that requires immediate medical attention
Common allergenic foods for children include peanuts, tree nuts, milk, eggs, soy, wheat, fish, and shellfish. Thailand’s cuisine often incorporates many of these allergens, making vigilance crucial for families.
DIAGNOSING THE ISSUE
Proper diagnosis is the cornerstone of effective management. If you suspect your child has a food allergy or intolerance, consulting a healthcare professional is essential. Start by keeping a detailed food diary to track what your child eats and any symptoms that follow. This can provide valuable clues for your doctor or dietitian.
For food allergies, tests like the skin prick test or specific IgE blood tests can help identify allergens. It’s important to note that these tests should always be interpreted by a qualified healthcare provider, as false positives and negatives can occur.
Food intolerances, however, are often diagnosed through an elimination diet. This involves removing suspected foods from the child’s diet under professional supervision and gradually reintroducing them to identify the culprits.
MANAGING FOOD INTOLERANCES AND ALLERGIES
Food intolerances
For food intolerances, the focus is on minimizing or avoiding the problematic food while ensuring your child’s diet remains balanced and nutritious. For instance:
- Opt for “free from” options: For lactose intolerance, choose lactose-free milk or plant-based alternatives like almond, soy, oat, or rice milk. Many supermarkets in Bangkok now carry a wide range of these products. For gluten intolerance or sensitivity you may find gluten-free options less widely available in Thailand as in Western countries, but you can still find rice-based noodles, breads, and other products to suit your child’s needs.
- Monitor portions: Some intolerances, like those to fructose or certain food additives, may be dose-dependent, meaning small amounts might be tolerated without issue.
Food allergies
If your child has a diagnosed food allergy, avoiding the allergen is crucial. For families living in Bangkok, this can be particularly challenging due to language barriers and the widespread use of common allergens in Thai cuisine. Here are some practical tips:
- Learn the language: Familiarize yourself with the Thai words for relevant allergens.
- Carry an allergy card: A card in Thai explaining your child’s allergy can be a lifesaver when dining out.
- Be prepared: Always have an epinephrine auto-injector (sometimes known by the brand name EpiPen)—if prescribed—and know the location of the nearest hospital.
- Cook at home: Preparing meals at home allows you full control over ingredients.
EMOTIONAL CONSIDERATIONS FOR YOUR CHILD
Managing food allergies or intolerances isn’t just about the physical aspects; it’s also essential to address the emotional impact. Children can feel isolated or different if they can’t eat the same foods as their peers. Encourage open communication and educate them about their condition in an age-appropriate way.
Empower your child by involving them in meal planning and preparation. For example, let them pick out safe ingredients at the market or help prepare their school lunch. This fosters a sense of control and helps them build lifelong skills.
BUILDING A SUPPORTIVE COMMUNITY
As an expat in Bangkok, finding a supportive community can make a world of difference. Many international schools are well-versed in accommodating dietary restrictions, but it’s still worth engaging with the school to ensure they understand your child’s needs. Bangkok also has a growing number of online forums and expat groups where you can connect with other parents facing similar challenges.
KNOWLEDGE IS POWER
Understanding the difference between food intolerances and food allergies, as well as recognizing their symptoms, empowers parents to take proactive steps. While managing these conditions can be daunting, especially in a foreign country, knowledge and preparation go a long way. Bangkok’s vibrant food scene doesn’t have to be off-limits; with the right tools and awareness, your child can safely enjoy a wide variety of flavors and experiences.
Navigating these challenges can be overwhelming, but professional guidance can provide clarity and support. As a registered dietitian, I can attest to the fact that seeking advice when needed can help create a safe and nurturing environment for children to thrive.