From allergies to sensitivity

Allergic diseases have become increasingly common in recent decades. However, it would be wrong to describe all intolerances as “allergies.” Food allergies in particular are not as common as many people believe. However, breads and other baked goods also contain a myriad of substances that can trigger allergies.

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Allergies – what exactly are they?

Allergy literally means an “overreaction” of our body against foreign substances from the environment. These substances are almost always proteins. The allergy is therefore an exaggerated response by the body to harmless foreign proteins.

The substances that trigger the allergic reaction are called allergens. The effect of allergens is largely dose-independent, meaning that even the smallest amounts can trigger severe reactions in sensitized individuals. In principle, almost all foods can also trigger allergies, but most do so very rarely. Only water, salts and sugar, minerals, trace elements and vitamins are completely risk-free – because we could not live without them!

The predisposition to develop an allergy is largely influenced by heredity. The severity of the reaction also depends on the amount of antibodies present and on the current physical and mental condition. Allergies can occur at any age, but are much more common in children and young adults.

How common are allergies?

Around 2 out of 100 adults are allergic to one or more foods, while around 5% of young children are allergic. Inhalation allergies such as pollen, house dust (mites) or animal hair are much more common. In total, about 25% of people have some type of allergy.

Precisely because of the risk of allergies, all ingredients in packaged food, in particular the “potent” allergens, must be declared. For additives with complicated chemical names, there are so-called E numbers (standardized throughout Europe), from which allergy sufferers can immediately identify the problematic substance.

In addition to the general declaration requirement, food legislation contains special provisions for foods that are more likely to cause allergies or intolerances. For our industry, these are gluten-containing grains (wheat, rye, spelt, original spelt, einkorn, emmer, kamut, barley, triticale, oats, green spelt), milk, eggs, peanuts and hard-shell fruit (nuts, almonds and pistachios) as well as sesame, celery, mustard and sulphites.

Allergies to baked goods

The trigger for a grain allergy is usually wheat flour. Wheat contains various proteins that are considered allergens. Coeliac disease, which is caused by wheat protein (= gluten) but is not an allergy, should not be confused with wheat allergy. The symptoms may initially be similar in both diseases: diarrhea, intestinal bloating, etc.However, in contrast to celiac (also known as sprue), the intestines of people with wheat allergies remain healthy. Wheat allergies also theoretically require a wheat-free diet, which is not easy in our culture because wheat is found in virtually all baked goods, pasta, muesli mixes and many ready-made products. Affected individuals stick to other cereals such as oats, barley, corn, millet, rice, rye, and buckwheat.

Switching to gluten-free products is not always useful because they still contain other proteins in addition to gluten. The same goes for other cereal allergies to rye and barley. Lupine flour has recently also been recognized as a particularly potent allergen.

Clinical picture of celiac disease

Celiac disease is a serious chronic intestinal disorder that affects people with a genetic predisposition to gluten, which is found in various types of grain. This gluten protein damages the intestinal mucosa with flattening of the intestinal villi and thus leading to severe nutritional disorders. Gluten is found in wheat and related grains, as well as in rye and barley.

In the past, the disease was almost exclusively found in children. In recent decades, however, it has become clear that adults are also affected at approximately the same frequency. The incidence is estimated at 5 to 10 cases per 1000 people.

Symptoms and treatment

The symptoms, which are often quite different, can start at any age. Depending on the type of disease, patients suffer from chronic diarrhoea, flatulence, frequent abdominal pain, and weight loss, chronic anemia, fatigue, and even exhaustion and depression. Celiac disease is one of the few diseases that can only be treated through diet. Therefore, the only thing that works is sticking to a strict gluten-free diet for life. Consistent adherence to a gluten-free diet usually leads to a complete normalization of the intestinal mucosa and thus to a normal and healthy life.

Non-celiac gluten sensitivity (NCGS)

Some people experience symptoms after eating gluten-containing foods, which are also known from celiac disease or wheat allergy. These include abdominal pain, flatulence or diarrhea, but also other complaints such as headaches, chronic fatigue, muscle cramps, bone and joint pain, weight loss, skin rashes or depression. If both celiac disease and/or wheat allergy have been ruled out in these people, there is a high degree of suspicion of so-called non-celiac gluten sensitivity (NCGS). It is neither a celiac disease nor a food allergy, and the mechanisms that trigger these symptoms are mostly unclear. The treatment of NCGS is a gluten-free diet. Unlike celiac disease, it is not a lifelong, strict diet, but a treatment of symptoms as long as the symptoms persist. Gluten-free flours and foodstuffs are available in grocery stores and are specially labeled.

Source:
Allergies and food intolerances, SBC brochure, 4th edition 2021

Written, edited and published by: Richemont Centre of Excellence