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A Clinical Pharmacist’s Guide To Lactose And Gluten Intolerances In Malta

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In today’s world, food intolerances such as lactose or gluten have seemingly become even more common, to the point that we probably all know someone that battles with one.

As an estimate, food intolerances are said to affect up to 20% of the population in Malta. 

With Malta having its’ first gluten and lactose-free week last month as an attempt to raise more awareness on these issues, Lovin Malta has now teamed up with a qualified nutritionist to answer your pertinent questions.

Lovin Malta spoke with Dr Elena Zarb, who is a clinical pharmacist practising at Brown’s pharmacy, to learn more about the differences between allergies and intolerances. 

So let’s start with the basics, what’s the difference between an allergy and an intolerance?

“A food allergy is when the immune system overreacts after the consumption of certain foods. Symptoms occur immediately after the exposure and might be life-threatening. Common symptoms include wheezing, itching, hives, and swelling of the mouth or other areas of the body,” Zarb explained.

“Food intolerance symptoms are detrimental but not life-threatening, they are usually delayed and in some cases might take up to 72 hours to appear.”

“Food intolerance refers to the difficulty in digesting certain foods, resulting in individuals showing adverse reactions to foods within their diet,” she said.

Let’s hear more about gluten and lactose intolerances, and coeliac

“Gluten is the protein found in wheat and some other cereal grains including barley and rye. A person who suffers from gluten intolerance experience symptoms following consumption of gluten-containing products, unlike Coeliac disease, gluten does not cause any damage to the intestinal lining in an individual that is intolerant to gluten,” she explained.

“Coeliac disease is an autoimmune disorder, where the individual’s immune system attacks the intestinal lining on the consumption of gluten,” she said. 

“Dairy product intolerance is defined as a difficulty in breaking down casein, cow’s milk protein, and any other animal-derived milk products. Lactose and casein are 2 different components of milk. Casein is the main protein in milk whilst lactose is the sugar found in milk. Both intolerances are common and cause several unpleasant symptoms,” Zarb said.

Some of the signs and symptoms of food intolerances

According to Zarb, food intolerance symptoms are often associated with but are not limited to gastrointestinal symptoms, including;

1. Bloating

2. Diarrhoea

3. Constipation,

4. Headache

5. Migraine

6. Fatigue

7. Itching

8. Weight control problems

9. Water retention

So, you think you’re intolerant to something – what’s next?

“The best way to diagnose food intolerance is by doing a food intolerance test. A food intolerance test is a quick diagnostic test that identifies foods responsible for the symptoms,” she said.

“An inappropriate approach to the correct identification of food intolerances can lead to inappropriate diets with severe nutritional deficiencies, thus a food intolerance test followed up with an adequate nutritional guide will improve quality of life whilst minimizing nutritional gaps.”

“Following the identification of certain food intolerances, the health professional will provide a nutritional guide on which foods one is to reduce or eliminate and how to exchange them with similar foods,” Zarb explained.

“Symptoms can be reversed by eliminating the food one is intolerant to for a short period of time. Avoidance of the symptom-triggering food is the cornerstone for the treatment of intolerances. After three months, slow reintroduction of the symptom-triggering food in the diet may improve tolerance to the food.”

More awareness is needed

Zarb also expressed that while awareness has increased over the past years, noting the increase of intolerance-friendly food at supermarkets, more is needed among the population.

“Supermarkets introduced vast ranges of products for individuals with different intolerances, while main restaurants amended and added to their menu dishes ideal for the said individuals,” she said. 

“More awareness and support are certainly needed since most people feel stressed and anxious when they identify intolerance and find it difficult to change their diet to improve the symptoms,” she concluded.

Do you know anyone that thinks that they might be suffering from food intolerances? Send them this article! 

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Sasha is a content creator, artist and podcast host interested in environmental matters, humans, and art. Some know her as Sasha tas-Sigar. Inspired by nature and the changing world. Follow her on Instagram at @saaxhaa

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