Dubai: While physical reactions to foods are common, a growing number of residents in the UAE are suffering from functional gastrointestinal disorders (FGID).
The symptoms to food intolerances and food allergies are similar and may overlap, however the causes behind the reactions are different.
Dr Vito Annese, consultant gastroenterologist at Valiant Clinic pointed out that FGID conditions are very frequent in Western countries, affecting two out of 10 individuals. “Prevalence of FGID is also increasing in the Middle East with an estimate of seven to 15 per cent of people suffering for them — probably because of lifestyle and dietary changes,” he explained.
There is little scientific data on how common these problems are in the Gulf region although one study of children in Asia, suggested a prevalence ranging from 3.4 per cent to 11.1 per cent, said Dr Annese.
He said that rising FGID conditions in the UAE are characterised by chronic and recurring symptoms such as bloating and diarrhoea.
“Symptoms include headache, rashes, diarrhoea, nausea, vomiting, bloating, flatulence, and abdominal pain/discomfort. They can occur in variable combinations and severity, and sometime are exacerbated by stress and psychological factors,” said Dr Annese.
The most common food intolerances include histamine, with high contents found in chocolate, nuts, matured cheese, and ready meals — and lactose, found in milk and diary products.
Sulphites is another common food intolerance, found in dried fruit, canned goods and wine, while fructose is found in honey, and fruit juices.
Dr Annese also referred to FODMAP, found in food which are rich in fermentable carbohydrates such as garlic, onion and wheat. “Symptoms are usually triggered when an individual takes more than their personal limit of the intolerant food. Such symptoms vary widely but are never life-threatening,” he added.
In the case of frequent symptoms, an intolerance is carefully investigated by documenting specific foods and reducing their intake in terms of frequency and quantity to minimise symptoms. However, a complete avoidance is never necessary, said Dr Annese.
More patients complaining from food reactions in the UAE are claiming to be intolerant to what was thought to be household staple such as bread, milk, and cheese, nutritionist Sara Al Mahayni told Gulf News.
“Supermarkets have devoted “free from” sections that are growing day by day. We don’t know if it’s a genuine rise in allergies or it’s caused by a perception that “free from” is healthier,” she said.
Along with common symptoms of food intolerances, Al Mahayni said that consuming certain foods can exacerbate an existing condition — most commonly irritable bowel syndrome (IBS).
“It is important to note that there are many available tests that claim they can diagnose food intolerances but there is no convincing evidence to support these claims, therefore these tests are not recommended as diagnostic tools,” she said.
She pointed out the only way to know if a person is suffering from a food intolerance, would be to monitor their symptoms and the food they eat.
“This is usually done through elimination diet which focuses on eliminating the suspected food item from the diet for around 2-6 weeks where symptoms are observed and recorded. If the symptoms improve then the suspected food is reintroduced to see if the symptoms come back, which will indicate a problem with that particular food,” said Al Mahayni.
After much investigation, the appropriate dietary plan is prescribed based on the results.
Do you have a food allergy or a food intolerance?
Dubai: After enjoying a nice meal or taking a bite from your friends dessert, you might start to experience a physical reaction. Many people are not able to tell if the reaction is a result of a food intolerance or a food allergy.
Dr Vito Annese, consultant gastroenterologist at Valiant Clinic, described a true food allergy as a one that causes an immune system reaction, which affects numerous organs in the body with the production in most cases of specific antibodies (Immunoglobulin E).
“It can cause a variety of symptoms, sometimes severe enough to become life-threatening (i.e. angiooedema),” he said.
Out of 20-30 per cent of a population reporting to be allergic, the presence of food allergy can be ascertained in 6-8 per cent of children under five years of age and 3-4 per cent of adults.
However, it is believed that the prevalence of food allergies in infancy is increasing, sometimes being reported in up to 15-20 per cent of children, said Dr Annese.
The foods most likely to provoke allergies are milk, nuts, eggs, fish, wheat, soya and some fruits such as strawberries.
“Possible causes are reduced frequency and duration of breast feeding and increased hygiene,” said Dr Annese. He further explained that common food allergies in infancy are those to milk and eggs and usually tend to wane over time. However, common food allergies in adults are those to nuts and seafood and usually persist for the whole life.
When it comes to food intolerance, symptoms are generally less serious and often limited to digestive symptoms. In the minority of cases there may be a genetic defect such as that of lactase leading to lactose intolerance, or an enzymatic defect such as histamine, that may manifest in childhood, but is more often reported in adult populations.
Important terms:
Food Allergy: an immune system response to a harmless food protein, due to the creation of immunoglobulin E (IgE) antibodies causing the release of histamines which will result in an allergic reaction with symptoms such as itchy rash, difficulty in breathing, and in some cases anaphylaxis which could be life-threatening.
Food intolerance: does not involve the immune system but rather difficulty in digesting certain foods and having unpleasant reaction to them causing symptoms such as abdominal pain, bloating, and diarrhoea.
