Intolerances and Allergies: understanding the differences

Photo by Lidye on Unsplash

The food-hypersensitive consumer includes people who have food allergies, food intolerances and coeliac disease – which have all seen a significant increase in cases over the last few years.

An allergic reaction occurs when the body’s immune system reacts to a particular substance (allergen) as if it’s harmful. Food allergens are generally harmless to most people, but when a person develops a food allergy the body reacts. Reactions can vary from mild – such as a rash, stomach-ache, and vomiting – to more severe reactions such as swelling of the throat and mouth, or an anaphylactic reaction which requires immediate attention. Allergic reactions happen immediately after eating, drinking or, for some sufferers, even simply touching the allergen.

A food intolerance, however, refers to a difficulty digesting certain foods and having an unpleasant physical reaction. Reactions can vary from mild, such as bloating or tummy ache, to more severe gastric cramps or vomiting that may last a couple of days. Contrary to an allergic reaction, an intolerance reaction usually happens a few hours after eating the food.

Coeliac disease is a severe intolerance caused by the immune system attacking and damaging the gut when food containing gluten is consumed. It is an autoimmune disorder primarily affecting the small intestine which can result in long-term health issues, such as the body not being able to absorb the nutrients and vitamins from the food. Like other food intolerances, reactions will occur soon after eating food containing gluten.

Food allergies can start at any age, and whilst children often grow out of allergies such as eggs and milk, some allergies can continue into adulthood. Conversely, allergic reactions can start unexpectedly as an adult. In any case, for an allergy sufferer is very important to eliminate any allergens completely from their diet. 

There is no medication to ‘cure’ food allergies, only to calm down symptoms; antihistamines for mild allergic reactions and AAI devices to stop anaphylactic reactions, which are serious and life-threatening. Once allergens have been identified, it is important to understand the severity of the reactions and plan meals that eliminate the relevant allergens completely from the diet. 

Sometimes children can be encouraged to tolerate certain allergens under strict medical supervision to build a resistance to the allergy; this is common with milk allergies and the process is known as the “The Milk Ladder Challenge”. This approach is taken because mild allergic reactions in childhood could become more severe in adulthood, so the idea is to try and treat it early.

Food intolerances are often misunderstood, with assumptions that food intolerances do not cause unpleasant reactions and sufferers being mistaken for ‘fussy eaters.’ Sometimes a food intolerance sufferer can slowly re-introduce the food in very small amounts to try to encourage the body to accept the food again. 

The food hypersensitive consumer is not a passing trend; the numbers are increasing, and the list of dietary requirements is becoming more complex.

If we understand the issues faced by this consumer group and listen to their needs, we will be in a much better position to provide suitable menus which are safe and varied enough for them to enjoy.


Making the right choices over Christmas turkey – and nut roast

Photo by Jeffrey F Lin on Unsplash

I have worked in the catering industry for over 30 years. I have experienced busy kitchens during the festive period and the frantic preparations both in the kitchen and front of house. I have managed a very busy catering team and completely understand the last-minute bookings, the stress of organising functions during busy periods of the year. I recognise that the increasing numbers of customers with specific dietary requirements adds to the stress and makes everything more complicated …

However my own daughter started to react to certain food groups at the age of 14 years old. Her dietary needs changed considerably and if she ate the wrong food, she was very ill. She is now 20 years old and does not want or expect special treatment, she just wants to eat out safely with family and friends. My perception of allergen management changed, I now provide advice, training and support for food businesses and I can offer a unique perspective as a professional caterer and parent of a young adult with food allergies.

As a caterer during the festive season, the days of offering a nut roast and a menu with limited options have long gone. In today’s world if you provide a nut roast on your menu, you will be required to declare all the allergens (nuts) in bold for that dish and for each dish on the menu. The chef will also need to prepare the nut roast in a separate area to reduce the risk of cross-contamination, or better still eliminate the risk and take it off the menu! It’s just not worth the risk as many nut allergy sufferers will react immediately if nuts are present (airborne allergy).

The menu options today for vegetarians will include a wide range of fresh, tasty vegetables and pulses which may also be suitable for guests with food allergies. Although a word of warning – the current trend for plant based vegan food will offer a wide range of options, however as peanuts are part of the legume family, we are already seeing an increase in allergies to lentils, chick peas and peas.

What about a traditional Christmas dinner? The stuffing in the turkey, the gravy, the pigs in blankets, are they gluten free? Milk/lactose is often a hidden ingredient, what was used on the honey glazed carrots just honey or is melted butter added? Brandy butter sauce, sulphites in dried fruits – is it even safe to go out for Christmas dinner if you have a food allergy?

In order to ensure that all your customers feel confident and relaxed whilst dining in your restaurant you must listen to your customer’s requests during the booking stage. 

  • Make notes in the booking diary and communicate to your team. 
  • Reassure your guests that you can cater for their dietary requests and talk to them about their allergies. 
  • Ensure that the chefs and restaurant manager always ensure that a pre-service brief is held before each service. 
  • Good communication is vital so that the chefs and FOH teams work together and follow strict allergen procedures.
  • If using temporary staff during the busy period, ensure that they have had some allergen training as if an incident occurs, your reputation is at stake as well as the health of the customer.
  • Plan the Christmas meal carefully and check the ingredients. Many stocks and sauces are now free from the #top14allergens. 
  • To reduce the risk, eliminate as many allergens as possible from the ingredient list. Cook meals using fresh ingredients. 
  • Ensure that the allergen file is accurate and up to-date. 
  • Alternatively use an electronic recipe management system which can be updated immediately if any ingredients change.
  • Ask yourself- If I have an allergy “Can I eat here?” Can recipes be adapted easily to suit a range of dietary requests.?
  • Do you have strict allergen procedures in place to reduce the risk of cross-contamination as far as possible? A busy working kitchen is not a sterile factory environment, but with care and planning the risk can be reduced.
  • Talk to your customer and be honest. Understand the severity of their allergy and respect their decisions. A customer with a severe, life-threatening allergy is depending on you to provide food which is safe for them to eat. 
  • Try to put yourself in your customer’s position. They don’t want to make a fuss; they just want to enjoy the occasion and they need to trust you- remember it’s not their fault!!

Food Safety Management and Food Allergen Management must be part of the culture – “It’s what we do around here”.

This is not something extra, this is part of the daily routine to ensure that our customers with dietary requests feel safe and confident. Pre-planning, communication and excellent Food Allergen Management procedures will ensure that the busy catering festive season will be successful.  

Have a very busy, stress-free, safe Christmas and New Year!

‘Their duty of care is to provide safe food to the customer’

Where Pret went wrong.


I was asked for my take on the recent deadly allergy issues at Pret by the Food Consultants Society, and the whole sad episode has highlighted some important issues.

As I told the FCSI, a lack of understanding of allergens is at the heart of the issue.

“A person with an allergy will have to check every ingredient on every product, so by not giving the correct information it puts everybody at risk. I don’t think they thought it through.”

Read more here.