NTP Food Sensitivities & Allergies 3 — Questions and Answers
Question 1: Which enzyme deficiency is responsible for lactose intolerance?
- Sucrase
- Lactase (Correct answer)
- Maltase
- Amylase
Correct answer: Lactase
Lactase breaks down lactose into glucose and galactose; its deficiency allows undigested lactose to be fermented by gut bacteria, causing GI symptoms.
Question 2: The 'Big 9' major food allergens in the US include all of the following EXCEPT:
- Sesame
- Corn (Correct answer)
- Peanuts
- Shellfish
Correct answer: Corn
Corn is not among the FDA-recognized Big 9 allergens, which include milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, soybeans, and sesame.
Question 3: Mast cell activation disorder (MCAD) differs from classical food allergy because it can be triggered by:
- Only the Big 9 allergens
- A wide range of foods, chemicals, and physical stimuli without IgE involvement (Correct answer)
- Only gluten-containing foods
- Exclusively nightshade vegetables
Correct answer: A wide range of foods, chemicals, and physical stimuli without IgE involvement
MCAD involves mast cell degranulation from diverse triggers including temperature, stress, and various foods without requiring IgE sensitization.
Question 4: FODMAPs worsen symptoms in IBS because they:
- Trigger IgE-mediated reactions
- Are fermented by gut bacteria producing gas and osmotic fluid shifts (Correct answer)
- Damage intestinal villi directly
- Stimulate excessive stomach acid
Correct answer: Are fermented by gut bacteria producing gas and osmotic fluid shifts
Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols draw water into the bowel and are fermented, causing bloating and altered motility.
Question 5: Which test is considered the gold standard for diagnosing food allergies?
- IgG food sensitivity panel
- Skin prick test
- Double-blind placebo-controlled food challenge (Correct answer)
- Hair analysis
Correct answer: Double-blind placebo-controlled food challenge
The DBPCFC eliminates bias and is the most clinically reliable method to confirm or rule out a true food allergy.
Question 6: Histamine intolerance differs from true food allergy primarily in that it involves:
- Antibody-mediated immune responses
- Impaired histamine degradation by DAO or HNMT enzymes (Correct answer)
- Mast cell IgE sensitization
- Complement system activation
Correct answer: Impaired histamine degradation by DAO or HNMT enzymes
Histamine intolerance results from reduced activity of diamine oxidase (DAO) or histamine N-methyltransferase (HNMT), allowing histamine accumulation.
Question 7: Which nutrient most directly supports the production of secretory IgA in the gut?
- Vitamin D (Correct answer)
- Zinc
- Vitamin A
- Magnesium
Correct answer: Vitamin D
Vitamin D receptors on immune cells regulate sIgA production; deficiency is associated with impaired mucosal immunity and increased antigen penetration.
NTP Food Sensitivities & Allergies 3
Which enzyme deficiency is responsible for lactose intolerance?