Food Allergies and Intolerance: What You Need to Know

Published April 16, 2022

People experiencing food allergies or intolerance are often incorrectly described as “fussy” or “picky” eaters by those from the non-disabled or neurotypical world. Many food allergies and intolerance issues aren’t just a matter of taste preference: these are medical conditions that −  when not properly handled − can lead to death.

But what is the difference between a food allergy and food intolerance? And how does the Americans with Disabilities Act (ADA) address this? Furthermore, what do people who interact with those experiencing a food allergy or food intolerance need to know for safeguarding purposes?

Food allergy

According to the Food Allergy Research Education organization, a food allergy occurs when an individual’s immune system overreacts to a food protein − often in proteins that are harmless to others.

The eight most common sources of food allergens in the United States are milk, egg, peanut, tree nuts, soy, wheat, fish, and shellfish. Those – other than shellfish – just happen to be some of the most common ingredients in the nation’s food supply chain.

Food allergies can develop in children and in adults. Currently, more than 32 million Americans are affected by one or more food allergens.

Food intolerance

While it may seem that food intolerance is the same as a food allergy, it is not.

According to Segen’s Medical Dictionary, “the term food intolerance has been mistakenly regarded as a synonym of food allergy, but unlike food intolerances, food allergies are predictable.”

It seems to be a bit of a fine line when a person with a disability – who perhaps is unable to communicate through neurotypical vocal methods – is experiencing food-related distress. However, it is important to note the chronic nature of a food intolerance versus the severe, histamine-driven nature of a food allergy. According to the Food Intolerance Institute, food intolerance is "the result of the body being unable to completely process all the elements in food, leaving behind partially digested proteins and sugars."

The Americans with Disabilities Act and food

The medical differences are important, but what does this mean in terms of federal law designed to protect the rights of those experiencing food issues?

The ADA, as originally passed in 1990, identifies a person with a disability as someone who has an impairment (either physical or mental) that substantially limits major life activities such as eating and breathing and going to school. In 2008, ADA was amended to include conditions such as food allergies or food intolerances.

This legal definition of a food-related disability, for lack of a better term, has significant implications.

For educators 

Peanut allergies in the classroom have garnered significant press in recent years. The same is true for latex allergies. But beyond these two most common classroom allergen/intolerance issues is an alarming increase in other food allergens.

Between 1997 and 2011, the federal Centers for Disease Control and Prevention documented a 50 percent overall increase in all food allergies among children including an increase in soy and whey protein. Both of which are common ingredients in school breakfast and lunch programs.

Today, one in 13 kids has some sort of food allergen or intolerance. That’s two kids per classroom, which means monitoring to prevent children from ingesting something harmful has become an even more pertinent task. This is especially true in light of the fact that 25 percent of severe food reactions among children in the school setting are first-time reactions affecting children with no previous diagnosis.

Educators can provide support by learning to recognize food allergy and food intolerance-related symptoms in children and providing clear and transparent feedback with caregivers and parents. 

Food allergy symptoms can include but are not limited to, swollen lips, tongue, or eyes, itchiness, rash or hives, nausea, vomiting, diarrhea, congestion, hoarse voice, trouble swallowing, wheezing, or difficulty breathing, dizziness, and mood change or confusion. 

The CDC's rundown on food allergies for teachers provides a comprehensive guide on food allergy and intolerance symptoms in children. 

For employers

The ADA requires that employers provide reasonable accommodation for people with diagnosed food allergies unless doing so puts an unreasonable burden on the employer.

For instance, a company that prohibits employees from eating at their desks may have to modify that rule for an employee who cannot be near nuts. An employer may even need to prohibit certain foods from being in some spaces. In such a case, prior written notification to all employees would be appropriate, as well as notice postings at the entrances and exits of the facility.

The Job Accommodation Network has extensive guidance regarding food allergy and intolerance-related accommodations in the workplace. Obviously, a work-from-home option can resolve the food issue, but not all occupations fit that model.

For parents

Parents have the responsibility to monitor their children's diet, restrictions, and needs. And while their child’s needs cannot be discriminated against, those needs cannot place an undue burden on the organization or violate the rights of another disabled individual. Perhaps the most important role that parents play in helping their children takes us back to the beginning of this article: Advocating, educating, and raising awareness of their child's needs.

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