An Individualized Approach to Food Allergy and Intolerance Management


This presentation was made possible due to an unrestricted educational grant from Metro.

This presentation, by Amy Chow, RD was done at CDHF’s #TrendingNow: Putting the Biggest Gut Health Trends under the Microscope November-January 2022.

Learning Objectives:

  • To understand the differences between food intolerances and food allergies
  • To understand the role of dietary interventions and management of food intolerances and allergies
  • To understand the limitations around food allergy testing
  • To appreciate a person-centred, individualized approach to manage food allergies and intolerances
  • To appreciate evidence-based guidance from a dietitian on the processes of elimination and food reintroduction 

What are the differences between food allergy and intolerance? A food allergy is the reaction that involves your immune system. Your immune system is reacting to a food protein or the allergen that you have ingested. And so symptoms can range from rash, hives, vomiting, diarrhea and can lead to anaphylaxis, which can be a life threatening condition.

There are many different types of food allergies, and they’re usually classified based on the pathway that they’re involved in. So, IgE mediated allergies, mixed IgE/cell mediated allergies and non IgE mediated allergies. Some examples would be your milk and soy protein allergy, your oral allergy syndrome, EoE, and FPIES.

Whereas food intolerance do not involve your immune system. It is not life threatening and oftentimes involves your digestive system. So, a lot of symptoms like bloating, cramping, diarrhea, excessive gas, for example. And some example would be lactose intolerance, so your body isn’t able to break down lactose completely, fructose intolerance and IBS symptoms.

These are the lists of priority food allergens in Canada, and they account for about 90 per cent of allergic reactions. So, we have eggs, milk, mustard, peanuts, shellfish, fish, sesame seeds, soy, tree nuts, wheat and triticale and sulphites. Sulphites are not a true food allergy, but they do cause food allergy symptoms in people who are sensitive to them, so that’s why they’re included in this list. In terms of priority food allergies, it’s important to note this list because these foods needs to be labelled under the common names under the enhanced labelling law in Canada, making it easy for people to locate and avoid certain food allergens and find safe options for them.

About the Speaker:

Amy Chow, RD offers private nutrition consultation in the specialized areas of food allergy and food intolerance management for children and adults. She has 10 years of experience as a registered dietitian and has served as a pediatric and allergy dietitian at HealthLink BC.