By Michael J. Critelli | MakeUsWell Newsletter,
“I am gluten sensitive.” “I cannot eat beans.” “Fruit does not agree with me.” These statements often reflect real experiences. Someone eats a food, feels uncomfortable, and understandably wants to prevent that discomfort from happening again.
The problem begins when a useful observation becomes a complete explanation. Naming the food associated with symptoms does not necessarily identify what caused them, or establish that every form and quantity of that food will produce the same result.
This tendency can also be reinforced by healthcare providers who, when confronted with symptoms that point to a condition like lactose intolerance, use one or more of the four U.S. ICD-10-CM diagnosis coding system E73 codes. This diagnosis may be correct, but it is often not sufficiently informative.
We like simple diagnoses because they offer clarity and a course of action. Avoid the offending food, and the problem should disappear. But foods are complex combinations of proteins, carbohydrates, fats, and other substances. Our responses also depend on quantity, preparation, the rest of the meal, and our underlying health. A label can help us organize an investigation. It can also end that investigation prematurely, leaving us with restrictions broader than the evidence supports. It may also cause consumers to conclude incorrectly, without clinical validation, that they have other broad allergies or sensitivities.
Consider gluten sensitivity. A person stops eating wheat bread and pasta, experiences less bloating, and concludes that gluten was responsible. Yet removing wheat also removes fructans, fermentable carbohydrates that can produce digestive symptoms in susceptible people.
In a controlled study of 59 people with self-reported nonceliac gluten sensitivity, fructans produced more symptoms, while gluten did not differ from placebo. This does not mean gluten sensitivity is imaginary. It means that feeling better without wheat does not, by itself, identify gluten as the cause.
The distinction matters because different explanations lead to different choices. Someone reacting to wheat’s fructans may also experience discomfort from onions or garlic. Calling each reaction a separate food sensitivity could obscure a shared mechanism.
Conversely, understanding the carbohydrate involved may allow a person to make more precise choices about portions and foods. The objective should be to identify the smallest necessary restriction, while preserving as much nutritional variety and enjoyment as possible.
Fruit provides another example. “I cannot tolerate fruit” treats an enormous category as though its members were interchangeable. They are not. The amount of fructose, its balance with glucose, and the presence of sugar alcohols such as sorbitol can influence digestive responses. A small serving may be comfortable while a larger serving causes symptoms. One fruit may be tolerated while another is troublesome. The relevant question is therefore more specific than whether fruit is good or bad for that individual.
Preparation can change the picture as well. Some people who experience an itchy mouth after eating raw apples have pollen-food allergy syndrome: their immune systems recognize food proteins resembling pollen proteins. They may tolerate cooked apples because heating changes those proteins. “Apple allergy” captures part of the experience but may omit an important distinction. This remains an allergic condition requiring appropriate assessment; the lesson is that the form of the food can matter alongside its name.
Sometimes the apparent precision comes from a test. Commercial food sensitivity panels may provide long lists of foods supposedly responsible for symptoms, creating an impression of scientific certainty. However, food-specific IgG testing has not been validated for diagnosing food sensitivity.
IgG can reflect ordinary exposure or tolerance rather than a harmful reaction. A detailed report is not necessarily a reliable explanation. It can encourage people to eliminate nutritious foods they were eating comfortably before receiving the results.
None of this justifies dismissing symptoms. The discomfort is real even when its explanation remains uncertain. Nor should it encourage people with confirmed celiac disease or serious food allergies to experiment casually. Those conditions require specific precautions. The challenge is to respect the person’s experience while keeping the explanation open to examination. We can believe someone who says, “This meal made me feel ill,” without assuming we already know which ingredient or biological process was responsible.
A better investigation asks: What exactly was eaten? How much? How was it prepared? What else accompanied it? Which symptoms occurred, how quickly, and how consistently? With appropriate professional guidance, those questions can turn a broad prohibition into a more useful understanding.
The larger lesson extends beyond nutrition. Labels are valuable when they help us see patterns. They become limiting when they substitute for curiosity. In food intelligence, our goal should be to help people discover what works for their particular bodies and circumstances, then make informed choices with confidence. A diagnosis should advance that learning, not bring it to an early close.