Food Allergies

23 August 2016

When food allergies complicate the daily life

As it has been seen over the years, food allergies (specifically to certain proteins) continue to develop in the world’s population; children being mainly affected by these food allergies even from an early age. Consequently, all foods can be responsible for a food allergy, which makes the task of determining the source complicated. When allergies are multiple in the same individual, the latter then having cumulative allergies to various foods, and even suffering from cross-allergies (the patient is allergic to foods that differ in their forms but are in fact very close to the protein family to which they belong), the challenge is daily.

There are food groups that are more conducive to the development of allergies than others. We particularly have in mind:

  • Cow’s milk and all derived products (yogurt, cheese …) whose major allergens are the beta-lactoglobulin, the albumin and the casein, this type of allergy affecting mostly infants.
  • Eggs whose main allergens are the albumin and the ovomucoid.
  • Peanut (peanut, peanut butter …)
  • Nuts (walnuts, hazelnuts, cashews …)
  • Gluten, hence the ” fashionable ” gluten-free foods popularized especially by famous stars from the sport world (Novak Djokovic among others)
  • Fish and shellfish
  • Soy
  • Fruits (strawberries …)

The list is not exhaustive because everything is potentially allergenic.
We now understand that the diagnosis of an allergy to one or more foods complicates the lives of both parents and the adults. Spending time in the supermarket to check the composition of foods, banning vacuum- processed products, frozen food and premade meals … all of this requires a real organization in order to exclude the source of the allergy especially when we know that there are often traces of the main allergens just described to you when these products are produced in an industrial context. The food industry is increasingly required, legally speaking, to provide clear label information about its products. In fact, food allergies cannot be taken lightly; the risk of death from anaphylactic shock is significant.

We also have to make a difference between intolerance and food allergy, food intolerance being the result of the digestive system having difficulty assimilating some foods, unlike the true food allergy with regards to the patient’s immune system with notable differences in symptoms, not as severe as in a food intolerance (diarrhea, intestinal pain …) and much more serious in an allergy (including angioedema with very serious respiratory distress)

Causes, symptoms and prevention of food allergies

Causes are multifactorial:

  • The genetic pathway is not to be excluded; the family history may explain the occurrence of an allergy in children if either the father or the mother is also suffering from a serious or a less serious allergy. (Food allergy or not elsewhere)
  • Our lifestyle is also an important factor; our hyper-sanitized societies do not help the immune system to fit our diet. Our body is less exposed, it being less tolerant when in the presence of unknown micro organisms.
  • An increasingly industrial and less healthy diet / food with the addition of coloring agents, food preservatives, antioxidants, texturing agents … harmful for our health.
  • The growing presence of GMOs in our food with excessive and counter-productive selection of varieties of plants, thus creating new plant species; therefore new and much more allergenic proteins. (Especially in their concentration)
  • A premature diversification phase in a baby’s diet; breast milk plays a protective role for the first 6 months of the child’s life. The introduction of new foods, other than milk, must be done between the 4th and the 6th month of the baby’s life.
  • Air pollution also affects the propensity of the body to be more easily allergic to its environment, but also to foods.

Symptoms of food allergies

If the ingestion of food causing the allergy is the major cause of the latter, direct contact as well as inhalations when cooking for example can cause an allergic reaction just like the simple consumption of that food.
The amount of allergen absorbed or present in the food triggering allergic reaction depends on the individual. This explains why some allergic reactions occur by the mere presence of the allergenic food on the worktop or kitchen utensils, the allergen is then found in minute amounts in the prepared meal but enough for the body to react more or less violently. The allergen can even switch from one individual to another by a simple kiss (various dramatic events relate this situation especially when the new lover is not aware of his girlfriend’s allergy and vice versa)

Symptoms appear quickly, even immediately, but they can also take a few hours before we can see the first physical signs of food allergy.

The following signs are distinguished in particular:

  • A skin reaction through the occurrence of red skin rash, itching, eczema patches and urticaria on the whole body.
  • Respiratory symptoms through symptoms close to asthma, cough, rhinitis …
  • symptomatic swelling (edema) of the lips, face, tongue, palate …
  • a gastrointestinal involvement through nausea, stomach cramps, diarrhea …
  • Very serious complications if they are not managed very quickly, with possible anaphylactic shock for the patient (the body has an extremely intense reaction to allergen), the angioedema also being very feared for causing throat swelling which can lead to the suffocation of the person if first aid is not carried out in the shortest possible time.

Therefore, prevention is required

Even the slightest doubt should push you to see a doctor because there are no small or insignificant allergies and all this to successfully remove from the affected person’s diet all foods causing allergy hence the need to identify the agent or allergens through a comprehensive allergy assessment.

The elimination diet under the advice of an allergist is the best preventive treatment but who says allergy has to automatically last a lifetime? In fact, in children, some allergies will simply vanish away!

Pregnant women prone to allergies are advised to avoid consumption of allergenic foods and as I have been able to clarify, practice a later food diversification in the baby.

Screening, the key in food allergies

There are several types of tests to highlight a food allergy:

  • The patch tests by direct contact with the skin where the allergens are suspected to be. The skin will react or not to these patches while highlighting the patient’s allergy.
  • The prick tests, the allergen is administered under the skin through a painless shot / injection.
  • The challenge test involves administering to the patient some food suspected of causing the issue under strict medical supervision. All these skin tests will be made after a prior careful discussion with the allergist who will monitor the patient’s eating habits.
  • A blood test we do and that will allow in laboratory to assay the IgE antibodies in the blood, the IgE or the immunoglobulin E which are specific antibodies created by the immune system when the latter is subjected to an external aggression. In case of allergy, the IgE antibodies level increases considerably.
  • * A blood test that will allow to assay (through the basophil activation test (recent test) or TAB) what we call basophils to trigger the release of histamine, the latter being the source of all the symptoms of the allergic reaction.

What are the available treatments?

There is no specific treatment, the doctor will prescribe:

  • A specific diet eliminating the food or the foods in question.
  • An auto-injector pen that the allergic patient should always carry in case of anaphylactic shock for an emergency epinephrine injection (adrenaline)
  • Drug therapy to combat the symptoms if they appear particularly through antihistamines.

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