Food Allergies Celiac Disease and Gluten Sensitivity

Contributors: Rachel Begun, MS, RDN and Sarah Klemm, RDN, CD, LDN
gluten free spelled out on cutting board

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It can be confusing when a person avoiding gluten won’t eat french fries prepared in a shared fryer, since this may not automatically be thought of as a source of gluten. The different words used to describe gluten avoidance may also add to the confusion: allergy, intolerance, sensitivity, celiac disease.

No matter the term used, to keep friends and family safe, listen carefully to their needs. Ask questions if you're unsure and confirm their requests.

Food Allergies

With food allergies, the body’s immune system goes into attack when a problem food is eaten. Typically, this results in immediate symptoms like itching, swelling and hives. For many individuals, more severe symptoms are also a risk. Trouble breathing and swallowing, a drop in blood pressure, loss of consciousness and even death may occur. While any food can cause an allergic reaction, 90 percent of food allergic reactions in the United States are from eight foods: milk, wheat, eggs, soy, fish, shellfish, nuts and peanuts. Sesame has also recently been identified as the ninth major food allergen in the U.S., and food labels will be required to reflect it as an obvious ingredient in 2023.

People with food allergies must avoid the offending foods, even in small amounts. While a past exposure may have been mild, future exposures can result in stronger and even life-threatening responses.

Celiac Disease

Celiac disease is an autoimmune disorder. The body's immune system attacks the small intestine when gluten is eaten. While the symptoms are not immediately life-threatening, they can be devastating. Continuous exposure to gluten can result in serious long-term side effects, even for those who don't experience noticeable symptoms.

People with celiac disease need to avoid gluten . This includes small amounts that can be spread through cross-contact.

Non-Celiac Gluten Sensitivity

Those with non-celiac gluten sensitivity (or simply, NCGS) have symptoms that overlap with celiac disease. However, there isn’t a test currently to diagnose NCGS, so it is often determined after celiac disease and a wheat allergy have been ruled out. Symptoms negatively affect quality of life. Recent research suggests the intestines may be damaged for those with gluten sensitivity, too. Treatment for NCGS also requires a gluten-free diet.

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