4 Things Nobody Tells You About Food Allergies

4 It Involves a Lot of Poop

As soon as a person finds out that another person can't eat a certain food, one of their first questions is inevitably: "So what happens if you do eat it?" Because the subject usually comes up when everyone's ordering food, this question is often posed in restaurants, right around the time that everyone is digging into their fondue. And that's unfortunate, because the answer usually involves messy bodily fluids.

I think friends ask this naive question because not many people understand the difference between food intolerance and food allergy. Food intolerance means your body just can't digest a certain food, while an allergy means that your immune system decides to react against it. Food intolerance is like one of those parties where you enter the room and everyone just turns their back and ignores you. Food allergies are like those parties where you step in the door and the entire crowd rises up and throws you out and then beats you up on the pavement outside.

So if you eat a food you're allergic to, the result will probably look like other types of allergies: hives, itchiness, and bits of you starting to swell up. I discovered I had a shellfish allergy after I ate a bunch of shrimp and my throat started to close up and I thought I was going to die. But my body did seem to digest the shrimp just fine, so least I would have died with some amount of dignity.

Food intolerance, on the other hand, usually isn't medically threatening, but the reactions are mostly localized in the digestive system, which means they're likely to involve things like diarrhea, constipation, and a lot of other stuff no one really wants to talk about over dinner. And some food allergies can also involve gross stomach problems as well. So next time you're at a restaurant and someone mentions that they're lactose intolerant, don't ask what happens when they eat lactose or you'll never want to look at cheese again.

Then there's the fact that ...

3 The Media Hate You

Let's pretend that scientists recently did a study on pollen allergies. As part of this pretend study, they put a bunch of pollen under microscopes and discovered that it was covered with teensy little bugs. The pretend-scientists removed the tiny bugs, put the bug-free pollen in a room with allergy sufferers, and found that nobody reacted. How would you expect the media to report this? The headlines would probably say something like "Pollen Allergies Actually Caused by Tiny Bugs," or "Pollen Not to Blame for Hay Fever," or maybe "IMMIGRANTS BRING DEADLY POLLEN BUGS ACROSS THE U.S.-MEXICO BORDER." You wouldn't expect the media to declare that "pollen allergies" were completely fake all along.

But that's exactly what happened when a study this year looked at people suffering from intestinal problems that they attributed to gluten intolerance. After a three-week dietary experiment, the scientists concluded that the poop-troubled subjects' problems couldn't be linked to whether the food they were eating had gluten in it. Instead, the scientists theorized that these people's intestinal distress was probably caused by fermentable short chain carbohydrates, also known as FODMAPs. FODMAPs are pesky little motherfuckers that are not absorbed easily by the small intestine and can cause particular trouble for people with problems like IBS and Crohn's disease. FODMAPs pop up in wheat, barley, and rye, and these also happen to be the three most popular gluten-containing grains in the Western diet.

In other words, people with IBS are probably going to feel better on a gluten-free diet; they're just wrong about why they feel better. They're mixing up the bad effects of one weird food part with the bad effects of a different type of food part that often occurs alongside it. Pretty simple. You'd think the news would report it like that, right?

Why is the media so eager to push these headlines? Probably because a lot of people are really invested in mocking gluten-free diets and other food issues, and those people can be counted on to click on those headlines and share them with their friends because ... other people's choices in bread make them angry, I guess? I'm not talking about poking fun at people who jump on diet bandwagons without doing any research and for no discernible health reason. I did that myself, and I regret it now, because jokes like that just seem to encourage the other folks out there who think that "gluten-free" labels are part of a communist plot to destroy their freedom. And maybe they think that way because ...

2 No One Has a Clue What's Going On

Over the last few decades, food allergies and intolerance have been skyrocketing like a rocket that's going up into the sky really really fast. Twenty years ago, you wouldn't find little notes on your packet of peanuts warning that the packet may contain peanuts. And even 10 years ago, you'd have as much luck finding a gluten-free aisle in a supermarket as you would an aisle devoted to weight-loss tapeworms. Sometimes people blame these changes on increased diagnosis of food issues. Other times, if they're feeling uncharitable, they blame them on spoiled First World people who don't have any other problems and have to spend all their excess worry-energy concentrating on whether they can tolerate rye bread.

Luckily, science has been able to test this "First World problems" theory, at least to some extent. Scientists from the Mayo Clinic decided to investigate the rising incidence of celiac disease, the autoimmune condition that's the most common cause of gluten sensitivity. They got their hands on a bunch of frozen blood samples collected from recruits at an Air Force base in Minneapolis between 1948 and 1954, which were still frozen and waiting like Captain America for their chance to do good for the future.

The Mayo Clinic guys tested these biological time capsules for antibodies that indicate celiac disease, then compared them to blood samples from modern men of a similar age. They found that the antibodies weren't just more common in the present-day samples, they were almost five times more common. And since it's highly unlikely that the Air Force guys' blood gained sentience while it was frozen and decided to cut gluten out of its diet just to get attention, we can only conclude that there's a real physical reason that's making some people's intestines hate bread.

But if the increase isn't in people's heads, then what the hell is causing it? Rising celiac rates have been variously blamed on new wheat strains that came out of the Green Revolution, antibiotic use, food additives, and people just plain eating more wheat flour. But for now it's still a mystery. What is clear is that celiac disease really has arisen like a monster from a swamp, so maybe we should accept that there's a legitimate reason that other food issues have gone up as well. And maybe it's time for those stand-up comedians to find some new material.

But a lot of people don't think that way. I know this because ...

1 People Get Angry at You in Public

Not long ago, I was enjoying the merrymaking at a local hot-air balloon festival. Wishing to withstand the ennui that always creeps up at the end of balloon festivals, I went to buy an alcoholic beverage and double-checked with the guy selling novelty wine drinks to see if there was anything in them that I couldn't drink. I had to do this, because most of the drinks that people call "wine coolers" are really full of beer, a malt beverage that will ruin the balloon festival of anyone with gluten sensitivity. The guy running the stand asked why I needed to know, and I told him. As soon as the word "gluten" came out of my mouth, he started yelling about how it was a dumb question and that no wine in the history of the world had ever contained gluten. So of course I told him that his mom contained gluten, and then the balloon police were called, and they embarked on a high-speed hot-air balloon chase around the town, and I may have made some of that last part up.

Most food-industry people are wonderful about dietary restrictions, but there's a small minority who are really angry that they have to sometimes tell people what's in their food. Like Damian Cardone, a chef who gained media attention after boasting on Facebook that he'd served high-gluten dishes to gluten-free diners at his restaurant. It turned out that he was lying and was actually employed as a waiter, but his attitude doesn't exactly inspire confidence. When you consider that for some people, accidentally consuming gluten can mean hospitalization, you can understand why shit like this might make them nervous.

Listen, food-service workers who get mad about this: I know that some restaurant patrons spend 10 minutes asking if the sushi is gluten-free and then go and put wheat-containing soy sauce on it because they don't understand what gluten is. I know that medical diets are sometimes used by people to get attention or to lose weight. It doesn't matter. It's your job to know what's in your food and to tell people about it if they ask. It doesn't matter if it's a person with allergies, or the Muslim guy wanting to know if the fondue has bacon in it, or my own personal belief system that abhors the eating of things that are yellow. You do your job, I give you a bigger tip, and everyone's happy. Except for the poor unsaved folks who are still eating yellow.

C. Coville has a Twitter here and a Tumblr here.