Food Reactions

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Food Reactions

• A diverse spectrum

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Food reactions

• Immunological
• IgE
• Non-IgE T cells, macrophages
• Non-immunological
• Pharmacological- drug-like dose dependent
• Enzyme deficiencies
• Food poisoning- Toxic

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Immunological Reactions
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Non-Immunological Reactions
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Prevalence of food allergy

• IgE mediated allergy
• 1-2.5 of adults
• 6-8 of children
• The incidence of other types of food reactions is
  not known

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Systems affected

• Gastrointestinal
• Respiratory
• Skin
• Cardiovascular
• General-Anaphylaxis

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Respiratory reactions

• Throat tightness
• Wheezing, asthma
• Shortness of breath
• Repetitive coughing
• Cyanosis- turning blue
• Nasal congestion
• Runny nose
• Cough

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Gastrointestinal symptoms

• Itching, tingling, swelling lips, mouth
• Tongue Throat swelling
• Angio-oedema (swelling, puffiness)
• Nausea
• Vomiting
• Diarrhoea
• Abdominal pain, cramps
• Colic , reflux

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Skin reactions

• Pruritus itching
• Flushing
• Urticaria rash
• Angio-oedema- tissue swelling
• Eczema/dermatitis
• Itchy eyes and ears

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Cardiovascular

• Hypotension low blood pressure
• Shock
• Syncope- fainting
• Arrhythmia irregular heartbeat
• Chest pain

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Most common allergenic foods

• Milk
• Wheat
• Egg
• Soy
• Peanut
• Tree nuts
• Fish shellfish
• Any foods can theoretically trigger allergies

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Cross-reactions may occur

• Wheat and other grains
• Soy and other legumes
• Cows milk horse, sheep, goats milk
• Different tree nuts
• Nuts and peanuts
• Pollen some fruit
• Latex and avocado, kiwi, chestnut, banana

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Anaphylaxis food inducedFoods most commonly
implicated

• Eggs
• Wheat
• Milk
• Peanuts
• Fish
• Shellfish
• Nuts

• Celery
• Seeds
• Legumes
• Guar gum
• Rice
• Many others

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Exercise induced Anaphylaxis

• Anaphylaxis occurring after exercise, when
  certain foods are eaten prior or after exercising
• Common culprits Wheat,cereals, celery,
  fruit,vegetables, shellfish

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Anaphylaxis be prepared

• Carry Epinephrine and learn how to use it
• Always treat first, then review, never wait and
  see
• Know how to find help fast
• Have an emergency action plan
• Follow your doctors instructions
• Only eat safe foods
• Let others know about your condition
• Be prepared, anxiety can cause similar symptoms

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Watch out for may contain

• may contain implies careless manufacturing
  preparation practices
• may contain only reduces the manufacturers
  legal risks
• Avoid foods manufactured on shared equipment
• Dont assume restaurants are able to prevent
  cross-contamination

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Peanuts a case to consider

• If you react to peanuts
• Dont ever trust nuts they could be de- and
  re-flavoured peanuts
• Peanuts are widely used in the food industry
• It only takes a minute grain to react
• Ask others to be considerate

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Immunological reactions- IgE

• IgE mediated reactions
• Onset minutes to several hours
• Mast cells, basophils
• Histamine, prostaglandins, leukotrines
• Vasodilation, mucous secretion, smooth muscle
  contraction, influx of inflammatory cells

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Immunological reactions- non-IgE

• Non-IgE mediated reactions
• T-cells
• Macrophages
• Cytokines

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Food Intolerances

• Enzyme deficiencies
• Food poisoning
• Intestinal fermentation
• Food aversions
• Pharmacological reactions- reactions to chemicals
  in foods or additives. Reactions are dose
  dependent and can be cumulative.

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Diagnosis

• Skin prick test for IgE reactions
• RAST- blood test for IgE to foods
• Elimination diet and food challenges
• Challenges should not be done where there is a
  risk of anaphylaxis
• Challenges require backup emergency treatment
  facilities

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Hidden allergen avoidance

• Study the pages on different foods to familiarize
  yourself with all the possible sources of hidden
  food allergens
• Always read food labels
• Eat less processed foods
• Choose fresh, simple foods

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Do the right thing

• Dont just restrict your freedom of eating a wide
  variety of foods
• Do seek professional help to investigate the
  symptoms you have.
• The cause may not always be what you think!
• Remember- it can take up to 36-48 hours for some
  reactions to develop even longer in some
  conditions