Differentiate between a true food allergy and a food intolerance.

• A. Food allergy is immune-mediated; food intolerance is also immune-mediated.
• B. Food allergy is non-immune-mediated; food intolerance is immune-mediated.
• C. Food allergy is immune-mediated; food intolerance is not immune-mediated and often involves enzyme deficiencies or sensitivity.
• D. Both conditions are identical in mechanism.

Answer: (C)

The key idea is whether the body’s immune system is involved. A true food allergy triggers an immune response to a food protein, most often mediated by IgE antibodies. This can cause rapid symptoms affecting the skin, GI tract, or airways and can lead to serious reactions like anaphylaxis. A food intolerance, on the other hand, is not immune-mediated. It usually results from issues such as enzyme deficiencies or metabolic sensitivities—for example, lactose intolerance occurs when lactase enzyme is lacking, leading to digestive symptoms without an immune attack. In short, allergy = immune-driven; intolerance = non-immune, often enzyme-related.