Food Allergies - Managing Your Allergies: Allergies
Content provided by the Faculty of the Harvard Medical School
Food allergies
True food allergies affect children more than adults, with two million (8%) U.S. children affected, versus 2% of adults. Several food types can cause anaphylaxis. About 90% of food allergies in children are caused by the proteins in a handful of foods — cow’s milk, eggs, peanuts, soy, fish, shellfish, tree nuts (such as walnuts, Brazil nuts, and cashews), and wheat. Of these, peanuts are currently getting a lot of attention.
Peanuts, peanuts everywhere!Peanuts, an inexpensive source of dietary protein, have found their way into many food products. Peanuts have also become one of the world’s most allergenic foods. Scientists estimate that around 1.5 million Americans suffer from peanut allergies. Moreover, peanuts are one of the prime triggers of anaphylactic shock and each year are responsible for approximately 50–100 deaths — many of them children — as a direct result of eating peanuts. Terrifying though this sounds, it’s important to keep peanut panic in perspective. Most people with allergies to peanuts, including children, will not experience a severe anaphylactic reaction. And some children will eventually outgrow their peanut hypersensitivity. It appears that the ability of peanuts to cause a reaction depends on how they are prepared. One study suggests that roasting peanuts seems to enhance their allergenic potential. On the other hand, peanut butter seems to be less allergenic than actual peanuts. Given the murkiness that surrounds the causal agent, it’s not surprising that parents of children with peanut allergies are worried. Concern about allergic reactions to peanuts — and other foods — has caused schools to review some of their customs, such as birthday celebrations. In some schools, children celebrate with birthday books and party favors rather than foods that might contain risky ingredients. In the same vein, many airlines no longer serve bags of peanuts lest the opening of the bags releases an undue amount of peanut dust into the air. |
Food allergies run in families, and their onset in childhood suggests the individual is in line to develop other allergies, especially atopic dermatitis. But the good news is that 85% of children outgrow their allergies to cow’s milk, eggs, soy, and wheat by the time they’re five years old. The same isn’t true for peanut, tree nut, and seafood allergies, which children typically don’t outgrow. Indeed, adolescents and asthmatic young adults who have a food allergy to peanuts, tree nuts, or seafood are the ones most likely to die from fatal anaphylaxis.
Diagnosing food allergies
Food allergies are diagnosed by way of a careful study of the nature of the symptoms, their timing in relationship to eating certain foods, and whether this relationship pattern is repeated. Skin tests and blood tests for specific IgE can be helpful, as can keeping a diary of the time and date foods were eaten and the subsequent symptoms. Skin and blood tests for IgE against specific foods only detect true food allergies — that is, reactions from IgE. The tests don’t detect other kinds of immunologic reactions or food intolerances, which may require other tests. Examples include tests for antibodies to gliadin in the blood for celiac disease, biopsies of the gut for eosinophilic gastroenteritis, and the lactose hydrogen breath test for lactose intolerance. Also, certain foods cause trouble not by provoking a reaction themselves, but by aggravating other digestive problems.
Treating food allergies
The principal approach to treatment is avoiding the foods that trigger the reaction. This is easier said than done because of the difficulty of identifying the foods and then eliminating them. Allergens can be found in all sorts of places — for example, the peanut butter in your friend’s special barbecue sauce, nuts used as sausage stuffing, or traces of ingredients from one dish transferred unintentionally to another during preparation in the kitchen.
You’ll need to read and interpret food packaging labels because it takes only a small amount of an allergen to launch a full-blown attack. Be extra careful when eating out. Try to choose simple foods without complex sauces. Restaurants have become more savvy about food allergies and much more helpful to individuals who suffer from them. Ask the waiter to check with the chef to make sure the foods you are allergic to are not minor ingredients in the food you order. And remember: If you are at risk for a severe reaction, never leave home without your EpiPen.
If you or a family member have food allergies, the Food Allergy and Anaphylaxis Network is a source of reliable information.
| Last updated: | August 21, 2006 |
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| Reviewed By: | Faculty of Harvard Medical School |
Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
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