How the papers got it wrong on food allergy and intolerance. Again

My first post on February 14th explained how a press release from the University of Portsmouth about their Wheat Hypersensitivity Report, which was commissioned by the Flour Advisory Bureau, a body representing the British flour and milling industry, was faithfully translated into news stories in several of the nationals – despite the fact that the Report’s key claim relied on data almost twenty years old and – as I hope to show in future posts – of questionable current relevance.

Rebecca Smith, medical editor of the Telegraph, we start with your news story.

“One in five adults think they are allergic to food, with most stating a wheat intolerance as the problem.”
“However, when they are actually tested just two per cent have a genuine allergy or intolerance, a report from the University of Portsmouth said.”

Who is ‘they’ in this second line? All adults? Or the one in five adults who think they are allergic? The reader might assume the latter, but it’s actually the former. According to the Lancet prevalence study of 1994, 20% of the population think they have a food allergy or intolerance, and yet only 2% of the population actually do.

I’ll come back to an unpleasant consequence of this lack of clarity in a future post.

It’s also worth noting that in the same 1994 study, the food which the most people claimed caused symptoms was… chocolate. Wheat was not in the top ten, and sat behind the likes of citrus fruit and tomatoes. Just 0.9% reported a sensitivity to it.

Next up, the Mail’s piece, by Fiona Macrae. At least their headline represents the figures presented to them correctly – pity about the ‘all in the mind’ dramatics.

Those inverted commas puzzle me. Who is saying 90% of food allergies ‘are all in the mind’? Nobody in the article (or press release) is credited with these words.

Are they all in the mind? Consider this: if 20% of people have a sore throat and think they have influenza but when tested only 10% of those people really do, would the remaining 90% with merely a common cold have it ‘all in the mind’?

We cannot be surprised that the general public are unable to differentiate between food allergy, food intolerance and food hypersensitivity – not least because experts and medical bodies sometimes disagree over their definitions and classification too. People don’t understand immunology or gastroenterology. They conflate indigestion and maldigestion. They speculate about belly troubles. They call their guts their stomachs.

We can’t punish them because of this. Some people feel they react adversely to one or more foods. Some will be wrong, some will be right. Some call it allergy, some intolerance, some “it’s sort of an allergy, but maybe just a bit of intolerance or tummy trouble”.

What they’re telling you is that they don’t feel well. Telling them it’s ‘all in the mind’ is damaging, is my view, and can only serve to deter people with possibly embarrassing – and potentially serious – bowel symptoms, for instance, from seeing their doctors.

But perhaps I’m wrong and it in fact makes them get a bloody grip.

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