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medicine and director of al-
lergy and immunology at the
Ohio State University Wexner
Medical Center. “If you have
such symptoms after a meal,
see your physician or an al-
lergist,” Ogbogu says.
This is especially crucial if
you have a reaction after eat-
ing shellfish. “It’s rare to de-
velop an anaphylactic allergy
to most foods as an adult, but
shellfish is the exception,”
says Manish Ramesh, M.D.,
Ph.D., director of the Food
Allergy Center at the Monte-
fiore Medical Center in the
Bronx and Scarsdale, N.Y.
(Anaphylaxis is a life-threat-
ening reaction that causes
difficulty breathing and a
loss of consciousness.)
Food allergies are more
likely to occur in those who
have other allergic condi-
tions. “People who have
environmental or seasonal
allergies, eczema, or asthma
are at an increased risk,”
Ramesh says.
Among adults, shellfish
is the most prevalent food
allergy, but milk, eggs, soy,
peanuts, and tree nuts are
also common offenders.
Food intolerances or sensi-
tivities usually don’t involve
the immune system. “A food
intolerance occurs in the
digestive system because
it’s the inability of your
body to break down certain
substances,” Ramesh says.
Experts don’t understand all
of the mechanisms involved,
but they have found the most
prevalent one: dairy.“When you’re lactose
intolerant, your body isn’t
producing enough of the en-
zyme that breaks down the
sugar in milk,” Ogbogu says.
The condition becomes more
common as you age. In the
U.S., an estimated 117 million
adults and children 10 and
older are lactose intolerant.
The signs of intolerance
are most often digestive,
such as gas, bloating, diar-
rhea, and cramping.
“The symptoms can vary
in intensity depending on
how sensitive you are to the
food,” Ramesh says. When
the only symptom is diges-
tive—such as vomiting—food
poisoning could be to blame.Diagnosis and
Treatment
Because a food allergy could
land you in a hospital, it’s
important to get an accurate
diagnosis. Doctors use a skin
or blood test (or both) to
confirm an allergy. “The two
are often interchangeable,
and it depends on the food
and who’s doing the testing,”
Ramesh says.
During a skin test, drops of
allergen extracts are applied
to your skin, which is then
pricked. If you’re allergic
to the food, a raised bump
will usually appear within
15 minutes. A blood test mea-
sures levels of an antibody
called IgE that is produced in
response to allergens.
If the tests are incon-
clusive, the doctor may
have you try an oral foodDairy, nuts, shellfish, and wheat are the most
common foods that cause adverse reactions. But
cutting them from your diet may rob your body
of calcium, protein, fiber, and omega-3 fatty acids.
Here, Jen Bruning, M.S., R.D.N., L.D.N., a spoke-
person for the Academy of Nutrition and Dietetics,
explains how to replace them.OMEGA-3 FATTY ACIDSThese may help protect
against heart disease.
If you can’t eat omega-
3-rich fish and shellfish,
load up on walnuts, and
chia and flaxseed.CALCIUMThis nutrient is abundant
in dairy, and it’s crucial
for maintaining your
teeth and bones. Milk-
free calcium-rich sources
include dark, leafy
vegetables, such as
broccoli rabe and collard
greens; fish with soft
bones, such as sardines
and canned salmon;
and fortified orange juice
and almond milk.PROTEINThis macronutrient helps
your body make bones,
muscles, cartilage, skin,
and blood. It also helps
keep hormones and
enzymes functioning
properly. If you’re limiting
dairy or cutting out
seafood, eat lean meats,
beans, peas, nuts, seeds,
and whole grains to
ensure that you’re getting
enough protein.FIBERGoing gluten-free?
“Choose grains like oats,
quinoa, and sorghum
to replace some of
the fiber in your diet,”
Bruning says. Legumes,
vegetables, and fruits are
also rich in the nutrient.
Fiber boosts bowel health
and regularity, and may
help lower cholesterol
and control blood sugar.Smart Swaps for
Problem Foods
CR.ORG GUIDE TO WELLNESS 15