Food Allergies, Celiac Disease and Gluten Sensitivity

By Rachel Begun, MS, RDN
gluten free spelled out on cutting board


It can be quite confusing when one person avoiding gluten can't eat French fries prepared in a shared fryer, but another will take a small bite of bread pudding. The array of terminology used only adds to the confusion: allergy, intolerance, sensitivity, celiac disease.

No matter what term is being used, the important rules of thumb for keeping your friends and family safe is to listen carefully to their needs, ask questions if you're unsure and confirm their requests.

Food Allergies

With food allergies, the body triggers an attack against the problem food, resulting in immediate symptoms such as itching, swelling and hives. For many, more severe symptoms occur such as trouble breathing and swallowing, a drop in blood pressure and loss of consciousness. Death can and does occur. While any food can cause a reaction, 90% of all reactions are from eight foods: milk, wheat, eggs, soy, fish, shellfish, nuts and peanuts.

People with food allergies must avoid the offending foods, even miniscule amounts. A past exposure may have been mild, but future contact with the allergen can result in a stronger and, potentially life-threatening, response.

Celiac Disease

Celiac disease is an autoimmune disorder in which the body's immune system elicits an attack on the intestines when gluten is eaten. While the symptoms are not immediately life-threatening, they can be quite debilitating. Continuous exposure to gluten can result in serious long-term health conditions, even for those who don't experience outward symptoms.

People with celiac disease need to avoid gluten 100%, including miniscule amounts introduced through cross-contact.

Non-Celiac Gluten Sensitivity

Non-celiac gluten sensitivity (also known as gluten sensitivity) is neither an allergic nor autoimmune response. The symptoms often overlap with those of celiac disease, but something different is going on in the body. While symptoms negatively affect quality of life, the intestines are not damaged and we don't know yet if there are long-term health consequences to eating gluten.

Because we don't know if there are long-term health consequences to continuous exposure, individuals with gluten sensitivity make their own decisions about what kind of gluten-free diet they wish to follow. Some choose to completely avoid gluten, while others may be more lenient in their efforts to avoid risk of cross-contact.

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