Food Allergy and Intolerance

Online Training
Module 1 Transcript

Effects that allergies have in the body

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Module 1 Transcript

Contents

Lesson 1: Introduction 3
Module objectives 3
Lesson 2: Food hypersensitivity 3
More information 3
Food allergy 3
More information 4
Food intolerance 5
More information 5
Coeliac disease 6
Lesson 3: Anaphylaxis 7
Cause 7
Symptoms 7
What to do if someone has anaphylaxis 8
More information 8
Lesson 4: Knowledge check 8
Question 1 8
Question 2 9
Question 3 9
Lesson 5: Summary 9
Take the test 10

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 Module 1 Transcript

Lesson 1: Introduction
An increasing number of people need to avoid eating certain types of food because
they are allergic or intolerant to them.
Watch our food hypersensitivity video where we explain what food allergy, food
intolerance and coeliac disease are.

Module objectives
This module explains the types of symptoms people with food hypersensitivity may
experience. These vary from mild symptoms to life-threatening emergencies, such as
anaphylaxis.
After working through this module, you will be able to:

• understand the risks of someone with a food hypersensitivity ingesting food

which may cause a reaction
• explain the difference between a food allergy, a food intolerance and coeliac
disease
• understand what to do if someone has anaphylaxis

Lesson 2: Food hypersensitivity

The term food hypersensitivity is used to describe people who experience an adverse
physical reaction to food, which is otherwise harmless. This includes the conditions of
food allergy, food intolerance and coeliac disease.

More information
For further information, visit the allergy and intolerance section of the FSA website.

Food allergy

Cause
A food allergy is when the body’s immune system (which is the body's defence
against infection) mistakenly treats the protein in food as a threat. The body responds
to this threat by releasing a number of chemicals in the body. These chemicals cause
the symptoms of an allergic reaction (see below).
People with a food allergy can react differently when they are exposed to allergens.
The type and severity of the reaction depends on a number of factors including the
individual, the severity of their allergy, the amount of allergen they’ve been exposed

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to and other factors such as exercise, lack of sleep or medication, which can
increase an individual’s sensitivity.
Very small amounts of allergens can cause severe adverse reactions. The most
severe and potentially life-threatening reaction to an allergen is anaphylaxis.

Symptoms
The most common symptoms of an allergic reaction include:

• tingling or itching in the mouth

• a raised, itchy red rash (hives) – in some cases, the skin can turn red and
itchy, but without a raised rash
• swelling of the face, mouth (angioedema), throat or other areas of the body
• difficulty swallowing
• wheezing or shortness of breath
• feeling dizzy and lightheaded
• feeling sick (nausea) or vomiting
• abdominal pain or diarrhoea
• hay fever-like symptoms, such as sneezing or itchy eyes (allergic
conjunctivitis)

More information
Food allergies are divided into three types, depending on symptoms and when they
occur.

IgE-mediated food allergy

This type of allergy is the most common. It is triggered by the immune system
producing an antibody called immunoglobulin E (IgE). Symptoms can appear from
minutes up to two hours after eating the allergen. There is a greater risk of
anaphylaxis with this type of allergy.

Non-IgE-mediated food allergy

This allergy is often difficult to diagnose, as symptoms take much longer to show
(up to several hours). It is not caused by IgE antibodies but by other components
of the immune system.

Mixed IgE and non-IgE-mediated food allergies

Some people may experience symptoms from both types of allergies. This is
known as mixed IgE and non-IgE-mediated food allergies.

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For more details on food allergy, visit the NHS website:

Link: https://www.nhs.uk/conditions/food-allergy/symptoms/

Food intolerance

Cause
A food intolerance is more common than a food allergy. Food intolerances are
thought to affect 1 in 10 people. Food intolerances do not involve the immune
system. Instead, a food intolerance involves the digestive system and can cause
difficulty digesting certain foods leading to symptoms such as abdominal pain, gas
and diarrhoea. Those who are affected often rely on allergen labelling to avoid the
foods that make them ill.

Symptoms
In general, people who have a food intolerance tend to experience:

• tummy pain, bloating, wind and/or diarrhoea

• skin rashes and itching
While reactions caused by a food intolerance are not life-threatening, the effects can
take a long time to resolve, sometimes lasting for days or weeks. When managing
food safety within their business, FBOs need to treat allergies and intolerances
equally, as consumers react to different levels of food.
For more information on food intolerance, visit the NHS website.

More information
The following information provides a summary of adverse food reactions.

Immune mediated
(food allergy and coeliac disease)

• IgE mediated (for example, acute urticaria oral allergy syndrome)

• non-IgE mediated (for example, food protein-induced enteropathy,
coeliac disease)
• mixed IgE and Non-IgE mediated (for example, eosinophilic
gastroenteritis)
• cell mediated (for example, allergic contact dermatitis)

Non-immune mediated
(primarily food intolerances)

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• metabolic (for example, lactose intolerance)

• pharmacologic (for example, caffeine)
• toxic (for example, scombroid fish poisoning)
• other - idiopathic/undefined (for example, sulphites)

Coeliac disease

Cause
Coeliac disease is a serious auto-immune condition triggered by consuming gluten,
which leads to damage of the gut lining. This has a severe impact on a person’s
ability to absorb nutrients from food. Gluten are proteins found in wheat, rye, barley,
oats, spelt and kamut (a commercial name for Khorasan wheat).
It is worth nothing that oats do not naturally contain gluten. However, oats are often
produced with other cereals containing gluten, which mean there is a risk of cross-
contamination. Oats also contain avenin, which is a protein similar to gluten, but
research has shown most of those with coeliac disease can tolerate uncontaminated
oats, although a small number may still be sensitive.
For more information and advice on oats, visit the Coeliac UK website.

Symptoms
Symptoms of coeliac disease can range from mild to severe and include:

• bloating
• diarrhoea
• nausea
• wind
• tiredness
• constipation
• anaemia
• mouth ulcers
• headaches
• weight loss
• hair loss
• skin problems
• short stature
• depression
• infertility
• joint or bone pain
Some symptoms may be confused with irritable bowel syndrome (IBS) or gluten
intolerance, while other symptoms may be related to stress or ageing. Therefore, it

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can be difficult to get an accurate diagnosis. Following a gluten-free diet can stop the
symptoms.
It is important to note that allergies to specific cereals such as wheat, barley and rye,
should not be confused with a gluten intolerance or coeliac disease as the proteins
responsible for triggering an adverse physical reaction are different for food allergy
and thus, should be considered separately.
The cereal(s) containing gluten in a ‘gluten-free’ product will have significantly
lowered levels of gluten (20 parts per million or less). However, the product will still
contain the cereal specific allergen (such as wheat, barley or rye).
Therefore, such a product will be safe to eat for a consumer with a gluten intolerance
or coeliac disease, but not for a consumer with allergies to the specific cereal used in
the product.
For example, a ‘gluten-free’ beer which used wheat as an ingredient will be safe to
consume for a consumer who has coeliac disease, but not for a consumer who is
allergic to wheat.

More information
For more information on labelling requirements for gluten-free products, see our
module on voluntary labelling.
For more information on coeliac disease visit Coeliac UK website.

Lesson 3: Anaphylaxis

Cause
Someone who has a food allergy can go into anaphylactic shock when their body’s
immune system mistakenly treats the protein in food as a threat.

Symptoms
Anaphylaxis is a potentially life-threatening allergic reaction. The symptoms of
anaphylaxis include:

• persistent cough
• vocal changes
• breathing difficulties – such as fast, shallow breathing
• wheezing
• a fast heartbeat
• feeling lightheaded or faint

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• confusion and anxiety

• clammy (sweaty) skin
• collapsing or losing consciousness
There may also be other symptoms, including an itchy, raised rash (hives); feeling or
being sick; swelling (angioedema) or stomach pain.

What to do if someone has anaphylaxis

If someone has symptoms of anaphylaxis, the NHS advises that you should:
1. Use an adrenaline auto-injector if the person has one – but make sure you
know how to use it correctly first
2. Call 999 for an ambulance immediately (even if they start to feel better) –
mention that you think the person has anaphylaxis
3. Remove any trigger if possible
4. Lie the person down flat – unless they are unconscious, pregnant or having
breathing difficulties
5. Give another injection after 5-15 minutes if the symptoms do not improve
and a second auto-injector is available
If you are having an anaphylactic reaction, you can follow these steps yourself if you
feel able to.

More information
For more details on the symptoms of anaphylaxis and what to do if someone has an
anaphylactic reaction, see the NHS website.
For more information on adrenaline auto-injectors visit the Government website.
The Anaphylaxis Campaign factsheets provide more information on anaphylaxis and
adrenaline.

Lesson 4: Knowledge check

You can check your understanding of this module by taking this short quiz. If you
have any difficulties in completing this, we recommend that you review the module.

Question 1
Which of the following is not a category of food hypersensitivity?
Select one answer:
1. Food allergy

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2. Food intolerance
3. Coeliac disease
4. Food poisoning
Take a moment to think about it.
The correct answer is 4: Food poisoning

Question 2
Allergic reactions can be serious enough to lead to death.
Is this statement True or False?
Take a moment to think about it.
The correct answer is: True

Question 3
What is anaphylaxis?
Select one answer:
1. A severe and potentially life-threatening allergic reaction
2. A mild allergic reaction
Take a moment to think about it. The correct answer is 1: A severe and potentially
life-threatening allergic reaction.

Lesson 5: Summary
This module has looked at how food allergies and food intolerances can affect
the body of those with food hypersensitivity.
You should now be able to:

• understand the risks of someone with a food hypersensitivity ingesting food

which may cause a reaction or intolerance
• explain the difference between a food allergy, a food intolerance and
coeliac disease
• understand what to do if someone has anaphylaxis
If you are unsure about any of these areas, go back and reread the relevant
section(s) of this module.

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Take the test

You have now completed the learning for module 1 and can take the module test. If
you wish to take the test later, you can find a link on the main course menu. Once
you have successfully completed and passed all 6 module tests, you will be able to
download your course certificate.

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