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Review
. 2023 Nov 30;15(23):4969.
doi: 10.3390/nu15234969.

Myths and Facts about Food Intolerance: A Narrative Review

Fabiana Zingone  1   2 , Luisa Bertin  1   2 , Daria Maniero  1 , Michela Palo  1 , Greta Lorenzon  1 , Brigida Barberio  2 , Carolina Ciacci  3 , Edoardo Vincenzo Savarino  1   2
Affiliations
Review

Myths and Facts about Food Intolerance: A Narrative Review

Fabiana Zingone et al. Nutrients. .

Abstract

Most adverse reactions to food are patient self-reported and not based on validated tests but nevertheless lead to dietary restrictions, with patients believing that these restrictions will improve their symptoms and quality of life. We aimed to clarify the myths and reality of common food intolerances, giving clinicians a guide on diagnosing and treating these cases. We performed a narrative review of the latest evidence on the widespread food intolerances reported by our patients, giving indications on the clinical presentations, possible tests, and dietary suggestions, and underlining the myths and reality. While lactose intolerance and hereditary fructose intolerance are based on well-defined mechanisms and have validated diagnostic tests, non-coeliac gluten sensitivity and fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) intolerance are mainly based on patients' reports. Others, like non-hereditary fructose, sorbitol, and histamine intolerance, still need more evidence and often cause unnecessary dietary restrictions. Finally, the main outcome of the present review is that the medical community should work to reduce the spread of unvalidated tests, the leading cause of the problematic management of our patients.

Keywords: FODMAP diet; food intolerance; fructose intolerance; lactose intolerance; sucrase-isomaltase complex; wheat hypersensitivity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Main causes of reaction to specific food intake in intolerant individuals. Created with BioRender.com (accessed on 1 November 2023).
Figure 2
Figure 2
Food containing FODMAPs. Created with BioRender.com (accessed on 29 November 2023).
Figure 3
Figure 3
The top-down approach low-FODMAP diet. Created with Biorender.com. (accessed on 24 November 2023).
See this image and copyright information in PMC

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Grants and funding

This research received no external funding.