Probably up to 10% of the population have true food allergy, but as many as 50-90% of people who believe they have food allergy may not. An accurate diagnosis is important so the condition can be managed properly when appropriate, but not needlessly.
One way I explore the “heart of health” is attending CME -continuing medical education- conferences. All physicians do, to stay current on medical information and maintain licensure and board certification.
One of the most informative lectures I heard recently was about food allergy, a topic often discussed in the lay literature and media. Much of that discussion is based on personal experiences and opinions which, while interesting, may not be scientifically valid.
I welcomed the chance to hear from an expert to help me counsel my patients. I also have a personal interest since my grandson has food allergies; when he visits me, I have to be careful not to feed him foods he may react to.
The speaker, Kirsten Bennett, Ph.D is a registered dietitian (RD) who specializes in counselling patients with food allergies. She presented data from research studies as well as from her clinical practice, and I’m sharing some of what she said with you.
What is food allergy?
You may assume that any symptom due to eating a food is an allergy but there are many ways food can make us sick, including allergy, intolerance, toxic effects, and infection.
Dr. Bennett explained that the difference between food allergy and food intolerance. (The other two will not be discussed here)
Allergy– immune mediated, that is it involves the immune system with the production of antibodies after exposure to a food; celiac disease is due to food allergy.
Intolerance– does not involve the immune system, no antibodies are produced; this occurs in lactose intolerance.
Some foods such as wheat and milk can cause both allergy and intolerance.
Mil and wheat can cause allergy and intolerance.
So how do you know the difference? You can’t, without an appropriate medical evaluation, so it is important to see a physician if you suspect food allergy.
Probably up to 10% of the population have true food allergy, but as many as 50-90% of people who believe they have food allergy may not. An accurate diagnosis is important so the condition can be managed properly when appropriate, but not needlessly.
What causes food allergy?
The BIG 8 cause 90% of food allergy. These are
Milk
egg
peanut
fish
shellfish
soy
wheat
tree nut
eggs
milk
peanuts
Symptoms of food allergy
Almost any symptom can occur with allergy but the most common are
Rash with or without itching
Swelling of the face, lips, eyes
Watery, itchy eyes
Nasal drainage and/or congestion
Hoarse voice
Cough, wheezing, difficulty breathing
Nausea, vomiting, diarrhea
Dizziness, fainting
Low blood pressure, fast heart beat
Feeling of “impending doom”
How to diagnose food allergy
Although blood and skin testing may be needed, the history is the first and most important step to identify food allergy. The evaluation may start with the answers to these 9 questions-
What are the symptoms?
What food was eaten that may have caused the symptoms and was it eaten before?
How much of the food was eaten?
Was the suspect food cooked or raw?
Has the food ever been eaten without symptoms?
Was else was the person doing or ingesting at the same time, such as exercise, medications, etc.?
Have the symptoms occurred without eating the food?
How were the symptoms treated and how long did they last?
by David Stukus, MD,Assistant Professor of Pediatrics in the Section of Allergy/Immunology at Nationwide Children’s Hospital, in Columbus Ohio.
Goals in managing food allergies
Allow the child (or adult) to live as normal a life as possible while avoiding foods that might cause allergic symptoms.
The fear of a serious food allergic reaction can cause a family to forgo normal activities and keep a child isolated. Dr. Bennett suggested these tactics to minimize food allergy anxiety.
Read food labels carefully to avoid inadvertently eating foods that cause allergy.
At home
Cook as a family ; Learn how to cook meat and other protein foods
Take children grocery shopping and engage them in food selection
Use at least 3 elements of the plate model for meal planning
Gather together and celebrate food and eating together
Practice manners and table talk
Make the home kitchen a safe sanctuary
Enjoy the food journey
Travel
Take foods along that are safe
Identify possible allergy risks in travel itinerary -Restaurants
At school
What does the school staff and administration know about food allergies?
Start a conversation Provide reference materials or community resources
Be prepared for an emergency allergic reaction. Anaphylaxis
The greatest danger of any allergy is anaphylaxis, a life threatening allergic reaction which impairs breathing and heart function.
Minutes matter with heart emergencies
Anyone who cares for a person with food allergy needs to know what to do in case of a reaction. Schools and work places should have a plan for dealing with such emergencies.
Create and Maintain an Action Plan for school/work-
an individualized Health Care Plan – which includes strategies for food avoidance
Create and Maintain an Emergency Plan Food Allergy Emergency Action Plan -Include specific actions to be taken in the event of accidental or purposeful ingestion of the allergenic food
Maintain a current and back-up supply of emergency medication
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I am a family physician who loves to write about the HEART of HEALTH. On my blog, Watercress Words, I inform and inspire us in healthy living. My ideas come from my training, experiences, medical practice, personal life, and medicine in the media. There's always something new and interesting to explore in the world of health and medicine.
View all posts by Aletha Cress Oglesby, M.D.
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