Food Allergies

1
Food Allergies HFA4C
2
Discussion

• What is a food allergy?
• Who gets a food allergy?
• Most common food allergies
• Symptoms
• How is it diagnosed?
• How can you avoid food allergies?
• Tips to prevent allergies
• What to do if there is a reaction.

3
What is a food allergy?

• An immune reaction that occurs after eating a
  certain food
• Also known as a food hypersensitivity
• Autoimmune disease
• Elicits an abnormal immune response to a harmless
  food substance
• Antibodies are released to fight the allergen
• Allergen is usually a protein

4
Classification of Allergies

• Allergic reactions are classified into
  non-IgE-mediated, IgE-mediated or mixed response
• Non-IgE
• Slower in onset, primarily gastrointestinal
  reactions
• IgE mediated
• Causes histamine and other chemicals to be
  released which trigger allergy symptoms
• Rapid in onset, symptoms include anaphylaxis
  urticaria

5
Symptoms

• Allergy symptoms can occur seconds to hours after
  ingestion of the allergen
• Most common symptoms
• swelling, sneezing, nausea, GI distress

6
(No Transcript)
7
How are food allergies diagnosed?

• Physician
• Medical history, physical exam
• Skin test
• Lab tests
• Oral food challenge
• Elimination diet
• Double-blind food challenge

8
Foods most commonly associated with allergic
reactions
9
Frequently allergenic foods

• Most common food allergies in young children
• Milk (casein, whey)
• Eggs
• Wheat (gluten)
• Soy
• Peanuts
• Tree nuts
• Shellfish
• Most common food allergies in older children
  adults
• Fish
• Shellfish
• Peanuts
• Tree nuts

10
Food Allergy vs Food Intolerance

• Reactions to food consist of a variety of
  reactions to food or food additive ingestion
• Usually not allergenic and caused by food
  intolerance
• Symptom-inducing food properties
• Metabolic disorders
• Bacterial food contamination

11
Variability in Prevalence

• Determination of the exact prevalence is
  difficult
• Considerable variation in data collection
• Self-reporting,
• physician assessment,
• skin tests, IgE levels
• However, self-reports indicate that food allergy
  incidences are on the rise
• Food allergy in infants are most common

12
(No Transcript)
13
Who is allergic?

• About 3 to 8 percent of children have reaction
• Only 1 to 2 percent have true food allergies
• Children usually grow out of sensitivity by age 4
  (not peanuts, tree nuts, shellfish)
• About 1 to 2 percent of adults

14
Food Allergies

• PEANUT
• Milk
• Egg
• Tree Nuts
• Fish
• Shellfish
• Wheat
• Soy

15
Peanut Allergy

• Peanut sensitization does not conclude an allergy
• About 95 of sensitized individuals are not
  clinically allergic
• Attracted the most attention because it is
  relatively common, typically permanent and often
  severe
• Significantly increased globally in the past
  decade
• 2-3x as common

16
Peanut AllergyAge of Introduction

• Sensitization to peanuts typically occurs at an
  early age, therefore such patients are more
  likely to react at first exposure
• No conclusive evidence has been found to support
  the theory that the allergy is developed in utero
• Food allergy manifests most commonly in infancy,
  peaking at 1 year of age and declining by age 3
• Recommendations only in place for at-risk infants

17
New Research

• Peanut allergies increasing
• Peanut exposure, in peanut butter, reduces severe
  reaction
• Peanut vaccine
• Link in food allergies and asthma
• Roasting peanuts may increase allergic properties
• FDA proposing a gluten-free label

18
Milk Allergy

• 2.5 of children younger than 3
• Develops in first year of life
• Most children will outgrow it
• Baby Formula
• Hidden Sources deli meats, non dairy items,
  canned tuna fish, restaurant foods and sauces

19
Egg allergy

• Affect approximately 1.5 of young children
• Likely to be outgrown
• Most allergic reactions associated with egg
  involve the skin
• Hidden sources coffee drinks with foam topping,
  soft or hard pretzels, cooked pasta, egg
  substitutes.
• Vaccines

20
Tree nut allergy

• 1.8 million Americans
• Allergic are among the leading causes of fatal
  and near-fatal reactions to foods
• Tree nuts walnuts, almond, hazelnuts, coconuts,
  cashews, pistachios, and Brazil nuts
• Tend to have a lifelong allergy
• Hidden sources Salads and salad dressing,
  barbecue sauce, breading for chicken, pancakes,
  meat-free burgers, pasta, honey, fish dishes, pie
  crust, mandelonas (peanuts soaked in almond
  flavoring), mortadella (may contain pistachios)

21
Fish and shellfish allergy

• 2.3 of Americans
• Salmon, tuna, and halibut
• Avoid all varieties
• Lifelong
• Avoid seafood restaurants
• Asian restaurants-fish sauce
• Read ingredient lists
• Avoid areas where fish is being handled or cooked
• Hidden Sources Salad dressing, Worcestershire
  sauce, bouillabaisse, imitation fish or
  shellfish, meatloaf, barbecue sauce (some are
  made from Worcestershire)

22
Wheat allergy

• Common in children
• Often confused with celiac disease
• IgE-mediated response to wheat protein
• May tolerate other grains
• Symptoms range from mild to severe
• Sources baked goods (wheat flour), pasta, sauces
  thickened with flour, cereals, crackers
• Substitute with amaranth, barley, corn, oat,
  quinoa, rice, rye, tapioca

23
Soy allergy

• More common food allergies in babies and children
• Major ingredient in food products
• Hard to avoid
• Dietitian should be consulted
• Symptoms typically mild
• Hidden sources baked goods, canned tuna,
  cereals, crackers, infant formulas, peanut
  butter, sauces, and soups.
• Typically can tolerate soybean oil

24
Can some individuals be allergy-prone?

• Patients reacting to greater numbers of
  allergenic epitopes experienced more severe
  allergic reactions to smaller doses
• Children with egg /or milk allergies more
  susceptible
• Peanut-allergic patients do not usually react to
  other legumes such as green beans, lima beans,
  navy beans
• 95 of peanut-allergic patients can tolerate soy

25
Hidden Allergens

• Eggs baked goods, noodles
• Milk pies, cheese
• Soy baked goods, candy, tv dinners
• Wheat flours, soup mixes, snacks
• Peanut candy, baked goods, ice cream
• Fish seafood flavors
• New food labels should help

26
(No Transcript)
27
How a child describes a reaction

• Put hands to mouth, pull or scratch tongues,
  voices may change
• Food is too spicy
• My tongue is hot, something is poking it
• My mouth is tingly, itches, or feels funny
• My tongue feels full, my throat feels thick

28
treatment options
29
Curing Food Allergies

• There is currently no cure for food allergies
• The current recommendation is to avoid the
  allergen
• Promising treatments on the way

30
Summary Comments

• Food allergy is an autoimmune response often
  mistaken for food intolerance
• Peanut allergy appears to be increasing
• Genetic, environmental and immunological
  influences
• Recent studies have led to improved diagnoses,
  management and patient education
• Numerous approaches to treatment are underway

31
(No Transcript)