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Food Allergy: Facts & Fiction
- A food allergy is the immune system's reaction to a certain food, when the body creates IgE antibodies to that food. When these IgE antibodies react with the food, histamine and other chemicals (called mediators) are released from various cells within the body. These mediators cause hives, asthma, or other symptoms of an allergic reaction.
- Eight foods cause 90% of all food allergic reactions. They include: milk, egg, wheat, peanut, soy, tree nuts, fish, and shellfish.
- There is no cure for food allergies. Strict avoidance (by reading ingredient listings all the time) is the only way to prevent a reaction.
- Children with asthma and food allergies are at increased risk for a severe reaction.
- Symptoms can include: vomiting, diarrhea, cramps, hives, swelling, eczema, itching or swelling of the lips, tongue or mouth, itching or tightness in the throat, difficulty breathing, or wheezing.
- Allergic symptoms can begin within minutes to 1 hour after ingesting the food.
- Milk is the most common cause of food allergies in children. Other foods most commonly cited are eggs, wheat, peanut, soy and tree nuts.
- Peanuts, nuts, fish, and shellfish commonly cause the most severe reactions.
- Up to 5 percent of children have food allergies.
- Most children outgrow their allergy, although an allergy to peanuts and tree nuts is considered lifelong.
How Little Does It Take?
- As little as 1/2 a peanut can cause a serious reaction for severely allergic individuals.
- Some severely milk-allergic children can have a reaction if milk is splashed on their skin.
- Being kissed by someone who has eaten peanuts for example, can cause a reaction to severely allergic individuals.
- Anaphylaxis is a sudden severe potentially life-threatening allergic reaction. It can be caused by food allergy, insect stings, or medications.
- Although any food can potentially cause anaphylaxis, peanuts, nuts, shellfish, fish and eggs are foods that most commonly cause this reaction.
- As little as 1/5 of a teaspoon of the offending food has caused death.
- Symptoms can include hives, swelling (especially of the lips and face), difficulty breathing (either because of swelling in the throat or an asthmatic reaction), vomiting, diarrhea, cramping, and a fall in blood pressure. Symptoms can appear in as little as 5 to 15 minutes.
Food Allergy Myths
- Myth: A recent study showed that up to 25 percent of adults believe they have food allergies. Scientific studies show, however, that only 1 to 2 percent of adults truly have a food allergy.
- Myth: Food allergies are not real. Not true. An allergic reaction involves the body's immune system. In the case of food allergy, the immune system misinterprets a food as a harmful invader and releases histamine and other chemicals to protect the body from harm. Symptoms can include hives, vomiting, diarrhea, and respiratory distress.
- Myth: Food allergies should not be taken seriously. Every year more people die of food allergic reactions, than allergic reactions caused by insect stings. Food allergies must be taken seriously.
- Myth: Food additives and artificial flavors cause the majority of food allergic reactions. Contrary to common belief, natural foods account for the majority of allergic reactions. The foods that most commonly cause reactions are: peanuts, milk, eggs, wheat, soy, tree nuts (almonds, walnuts, pecans, etc.), fish, and shellfish. These foods may appear in foods as ingredients or under the listing of natural flavors.
What Is The Difference Between Food Allergy And Food Intolerance?
Many people think the terms food allergy and food intolerance mean the same thing; however, they do not. A food intolerance is an adverse food-induced reaction that does not involve the immune system.
Lactose intolerance is one example of a food intolerance. A person with lactose intolerance lacks an enzyme that is needed to digest milk sugar. When the person eats milk products, symptoms such as gas, bloating, and abdominal pain may occur.
A food allergy occurs when the immune system reacts to a certain food. The most common form of an immune system reaction occurs when the body creates immunoglobulin E (IgE) antibodies to the food. When these IgE antibodies react with the food, histamine and other chemicals (called mediators) cause hives, asthma, or other symptoms of an allergic reaction.
Are There Allergy Injections For Food Allergy?
Currently, no allergy injection treatment is approved by the Food and Drug Administration (FDA - the federal agency that regulates allergy extracts sold for diagnosis and treatment), the American Academy of Allergy Asthma & Immunology, or the American College of Allergy, Asthma & Immunology (two professional societies for allergists) for the treatment of food allergy. However, research is being conducted in this area.
Is There Any Medication That Can Be Taken To Prevent Food Allergies?
At this time, no medication available can prevent food allergies. Strict avoidance of the allergy-causing food is the only way to prevent a reaction. However, medications (epinephrine, antihistamines) can be given to control symptoms after a reaction occurs.
What Is The Difference Between A Prick Skin Test And A Blood Test Or RAST Test?
The prick skin test or a blood test (such as the RAST, or radioallergosorbent test) are commonly used to begin to determine if an allergy exists. A prick skin test is usually cheaper and can be done in the doctor's office.
The doctor places a drop of the substance being tested on the patient's forearm or back and pricks the skin with a needle, allowing a tiny amount to enter the skin. If the patient is allergic to the substance, a wheal (mosquito bite-like bump) will form at the site within about 15 minutes.
A RAST requires a blood sample from your childís arm. The sample is sent to a medical laboratory where tests are done with specific foods to determine whether your child has IgE antibodies to that food. The results are usually received within one week.
Which Test Is Better?
Although both tests are reliable, there are instances where one is better than the other. Many doctors use a RAST for young children or for patients who have eczema or other skin problems that would make it difficult to read the results of a prick skin test. The results of either test are combined with other information, such as a history of symptoms and a food challenge, to determine whether a food allergy exists.
Managing Food Allergies in the School Cafeteria
It is understandable that parents of allergic children would be concerned about their child eating in the cafeteria where hundreds of children are eating foods that may cause them harm. However, eating with friends is an important part of fitting in and provides opportunities for learning how to socialize with other children.
What Can School Staff And Parents Do To Manage Food Allergies In The School Cafeteria?
Most food-allergic children bring their lunch from home. However, according to the guidelines set by the USDA Child Nutrition Division in charge of school lunches, school food service staff is required to provide substitute meals to allergic students if their doctor sends in written instructions certifying the child's allergy, what foods are to be avoided, and safe substitutions.
To handle the growing number of allergic students, some schools create peanut- or milk-free tables in the cafeteria. Establish a no-food trading policy that may help prevent reactions from occurring. Most children's reactions occur because they ate something given to them by a well-meaning friend. It is common for the allergic student's friends to avoid bringing in those foods so everyone can eat together.
To make eating in the cafeteria both safe and enjoyable for their children, parents may review the menu and select safe foods their child can eat. Parents may then relay that information to the child and cafeteria staff.
The following suggestions can easily be adapted to the needs of the student and teacher.
- Teach your child what foods cause a reaction and the importance of avoiding them.
- Role play situations that may come up; help your child feel comfortable avoiding temptation or peer pressure.
- Before the school year begins, schedule a meeting with your child's teachers, school administrators, counselor, nurse, cafeteria personnel and office staff. Explain to this "team" what foods cause a reaction, what precautions to take, what emergency procedures to follow, how to read labels and lunch time considerations.
- Keep team members informed of allergy or medication changes. Provide them with the name and phone number of three emergency contacts, including your Pediatricianís office number.
- Ask your child's doctor to complete a medical information form. If medication is needed to control allergic reactions, be sure the school team knows how and when to administer it.
- Highlight allergy information in bright ink on all forms, or copy the forms onto brightly colored paper, so it stands out.
- Tell your child where medications are stored at school.
- Review emergency precautions periodically.
- Review plans for activities that may involve food, i.e. parties or arts and craft projects, with the teacher on a monthly basis so that your child can safely participate in all activities.
- Keep a supply of snacks at school and check the supply and freshness periodically.
American Academy of Allergy, Asthma & Immunology
American Dietetic Association
The Food Allergy Network
10400 Eaton Place, Suite 107
Fairfax, VA 22030-2208