At one time or another, you’ve probably come across someone who is lactose intolerant and might experience some unpleasant gut symptoms if they have dairy. Maybe it’s you – food intolerances are estimated to affect up to 25% of Australians.

Meanwhile, cow’s milk allergy is one of the most common food allergies in infants and young children, affecting around one in 100 infants.

But what’s the difference between food allergies and food intolerances? While they might seem alike, there are some fundamental differences between the two.

What is an allergy?

Australia has one of the highest rates of food allergies in the world. Food allergies can develop at any age but are more common in children, affecting more than 10% of one-year-olds and 6% of children at age ten.

A food allergy happens when the body’s immune system mistakenly reacts to certain foods as if they were dangerous. The most common foods that trigger allergies include eggs, peanuts and other nuts, milk, shellfish, fish, soy and wheat.

Mild to moderate signs of food allergy include a swollen face, lips or eyes; hives or welts on your skin; or vomiting. A severe allergic reaction (called anaphylaxis) can cause trouble breathing, persistent dizziness or collapse.

What is an intolerance?

Food intolerances (sometimes called non-allergic reactions) are also reactions to food, but they don’t involve your immune system.

For example, lactose intolerance is a metabolic condition that happens when the body doesn’t produce enough lactase. This enzyme is needed to break down the lactose (a type of sugar) in dairy products.

Food intolerances can also include reactions to natural chemicals in foods (such as salicylates, found in some fruits, vegetables, herbs and spices) and problems with artificial preservatives or flavour enhancers.

Symptoms of food intolerances can include an upset stomach, headaches and fatigue, among others.

Food intolerances don’t cause life-threatening reactions (anaphylaxis) so are less dangerous than allergies in the short term, although they can cause problems in the longer term such as malnutrition.

We don’t know a lot about how common food intolerances are, but they appear to be more commonly reported than allergies. They can develop at any age.

It can be confusing

Some foods, such as peanuts and tree nuts, are more often associated with allergy. Other foods or ingredients, such as caffeine, are more often associated with intolerance.

Meanwhile, certain foods, such as cow’s milk and wheat or gluten (a protein found in wheat, rye and barley), can cause both allergic and non-allergic reactions in different people. But these reactions, even when they’re caused by the same foods, are quite different.

For example, children with a cow’s milk allergy can react to very small amounts of milk, and serious reactions (such as throat swelling or difficulty breathing) can happen within minutes. Conversely, many people with lactose intolerance can tolerate small amounts of lactose without symptoms.

There are other differences too. Cow’s milk allergy is more common in children, though many infants will grow out of this allergy during childhood.

Lactose intolerance is more common in adults, but can also sometimes be temporary. One type of lactose intolerance, secondary lactase deficiency, can be caused by damage to the gut after infection or with medication use (such as antibiotics or cancer treatment). This can go away by itself when the underlying condition resolves or the person stops using the relevant medication.

Whether an allergy or intolerance is likely to be lifelong depends on the food and the reason that the child or adult is reacting to it.

Allergies to some foods, such as milk, egg, wheat and soy, often resolve during childhood, whereas allergies to nuts, fish or shellfish, often (but not always) persist into adulthood. We don’t know much about how likely children are to grow out of different types of food intolerances.

How do you find out what’s wrong?

If you think you may have a food allergy or intolerance, see a doctor.

Allergy tests help doctors find out which foods might be causing your allergic reactions (but can’t diagnose food intolerances). There are two common types: skin prick tests and blood tests.

In a skin prick test, doctors put tiny amounts of allergens (the things that can cause allergies) on your skin and make small pricks to see if your body reacts.

A blood test checks for allergen-specific immunoglobulin E (IgE) antibodies in your blood that show if you might be allergic to a particular food.

Food intolerances can be tricky to figure out because the symptoms depend on what foods you eat and how much. To diagnose them, doctors look at your health history, and may do some tests (such as a breath test). They may ask you to keep a record of foods you eat and timing of symptoms.

A temporary elimination diet, where you stop eating certain foods, can also help to work out which foods you might be intolerant to. But this should only be done with the help of a doctor or dietitian, because eliminating particular foods can lead to nutritional deficiencies, especially in children.

Is there a cure?

There’s currently no cure for food allergies or intolerances. For allergies in particular, it’s important to strictly avoid allergens. This means reading food labels carefully and being vigilant when eating out.

However, researchers are studying a treatment called oral immunotherapy, which may help some people with food allergies become less sensitive to certain foods.

Whether you have a food allergy or intolerance, your doctor or dietitian can help you to make sure you’re eating the right foods.

Victoria Gibson, a Higher Degree by Research student and Research Officer at the School of Nursing, Midwifery and Social Work at the University of Queensland, and Rani Scott-Farmer, a Senior Research Assistant at the University of Queensland, contributed to this article.

Jennifer Koplin, Group Leader, Childhood Allergy & Epidemiology, The University of Queensland and Desalegn Markos Shifti, Postdoctoral Research Fellow, Child Health Research Centre, Faculty of Medicine, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Globally, the rates of common sexually transmissible infections (STIs) are increasing among people aged over 50. In some cases, rates are rising faster than among younger people.

Recent data from the United States Centers for Disease Control and Prevention shows that, among people aged 55 and older, rates of gonorrhoea and chlamydia, two of the most common STIs, more than doubled between 2012 and 2022.

Australian STI surveillance data has reflected similar trends. Between 2013 and 2022, there was a steady increase in diagnoses of chlamydia, gonorrhoea and syphilis among people aged 40 and older. For example, there were 5,883 notifications of chlamydia in Australians 40 plus in 2013, compared with 10,263 in 2022.

A 2020 study of Australian women also showed that, between 2000 and 2018, there was a sharper increase in STI diagnoses among women aged 55–74 than among younger women.

While the overall rate of common STIs is highest among young adults, the significant increase in STI diagnoses among midlife and older adults suggests we need to pay more attention to sexual health across the life course.

Why are STI rates rising among older adults?

STI rates are increasing globally for all age groups, and an increase among midlife and older people is in line with this trend.

However, increases of STIs among older people are likely due to a combination of changing sex and relationship practices and hidden sexual health needs among this group.

The “boomer” generation came of age in the 60s and 70s. They are the generation of free love and their attitude to sex, even as they age, is quite different to that of generations before them.

Given the median age of divorce in Australia is now over 43, and the internet has ushered in new opportunities for post-separation dating, it’s not surprising that midlife and older adults are exploring new sexual practices or finding multiple sexual partners.

It’s also possible midlife and older people have not had exposure to sexual health education in school or do not relate to current safe sex messages, which tend to be directed toward young people. Condoms may therefore seem unnecessary for people who aren’t trying to avoid pregnancy. Older people may also lack confidence negotiating safe sex or accessing STI screening.

Hidden sexual health needs

In contemporary life, the sex lives of older adults are largely invisible. Ageing and older bodies are often associated with loss of power and desirability, reflected in the stereotype of older people as asexual and in derogatory jokes about older people having sex.

With some exceptions, we see few positive representations of older sexual bodies in film or television.

Older people’s sexuality is also largely invisible in public policy. In a review of Australian policy relating to sexual and reproductive health, researchers found midlife and older adults were rarely mentioned.

Sexual health policy generally targets groups with the highest STI rates, which excludes most older people. As midlife and older adults are beyond childbearing years, they also do not feature in reproductive health policy. This means there is a general absence of any policy related to sex or sexual health among midlife or older adults.

Added to this, sexual health policy tends to be focused on risk rather than sexual wellbeing. Sexual wellbeing, including freedom and capacity to pursue pleasurable sexual experiences, is strongly associated with overall health and quality of life for adults of all ages. Including sexual wellbeing as a policy priority would enable a focus on safe and respectful sex and relationships across the adult life course.

Without this priority, we have limited knowledge about what supports sexual wellbeing as people age and limited funding for initiatives to engage with midlife or older adults on these issues.

How can we support sexual health and wellbeing for older adults?

Most STIs are easily treatable. Serious complications can occur, however, when STIs are undiagnosed and untreated over a long period. Untreated STIs can also be passed on to others.

Late diagnosis is not uncommon as some STIs can have no symptoms and many people don’t routinely screen for STIs. Older, heterosexual adults are, in general, less likely than other groups to seek regular STI screening.

For midlife or older adults, STIs may also be diagnosed late because some doctors do not initiate testing due to concerns they will cause offence or because they assume STI risk among older people is negligible.

Many doctors are reluctant to discuss sexual health with their older patients unless the patient explicitly raises the topic. However, older people can be embarrassed or feel awkward raising matters of sex.

Resources for health-care providers and patients to facilitate conversations about sexual health and STI screening with older patients would be a good first step.

To address rising rates of STIs among midlife and older adults, we also need to ensure sexual health promotion is targeted toward these age groups and improve accessibility of clinical services.

More broadly, it’s important to consider ways to ensure sexual wellbeing is prioritised in policy and practice related to midlife and older adulthood.

A comprehensive approach to older people’s sexual health, that explicitly places value on the significance of sex and intimacy in people’s lives, will enhance our ability to more effectively respond to sexual health and STI prevention across the life course.

Jennifer Power, Associate Professor and Principal Research Fellow, Australian Research Centre in Sex, Health and Society, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.