What Is the Confusion Over Food Allergies?
by Lisa DiFalco
With all the gluten-free products on the market and school prohibitions protecting those with peanut allergies, it is likely that someone you know may have been diagnosed with a food allergy. According to the Centers for Disease Control and Prevention, 4 percent of adults and an estimated 4 to 6 percent of children have been diagnosed with food allergies. Food allergy symptoms are commonly found in babies and children, but anyone may have to contend with a food allergy.
However, there is some debate over whether or not people have food allergies, have a food sensitivity or something else altogether. A new report highlighting the issues surrounding food allergies was published in Pediatrics on July 24th.
Healthcare professionals, nurses and educators can help food allergy sufferers and those with food sensitivities understand how to approach their specific condition. Learn more about food allergies and the confusion surrounding the topic.
What Are Food Allergies?
When the immune system has a protective response when dealing with a food or food substance, individuals have developed a food allergy. Food allergies often run in families, and research exists that suggests a child with a peanut allergy has younger siblings with the allergy. Individuals with food allergies can experience mild or more severe symptoms from the same food on different occasions. Anaphylaxis is the most severe allergic reaction that can occur. This reaction can be fatal and requires prompt treatment with an epinephrine injection.
90 percent of adverse reactions are due to eight types of food. These foods are:
- Tree nuts;
- Milk; and
Symptoms can involve multiple systems of the body, including the respiratory tract, cardiovascular system, gastrointestinal tract and skin. Symptoms include:
- Stomach cramps and vomiting;
- Difficulty breathing;
- Trouble swallowing;
- Shock or circulatory collapse;
- Swelling of the tongue;
- Feeling faint or dizzy;
- Weak pulse; and
A reaction may occur within minutes, and the majority of symptoms occur within the first two hours after ingestion. Delayed reactions are also known to happen. Children with food allergies may outgrow the condition, and individuals at any age may develop a food allergy to foods they have previously consumed without an issue.
The Confusion About Food Allergies
A new report from the American Academy of Pediatrics suggests some doctors may have difficulty diagnosing food allergies, and people often do not understand what constitutes a food allergy. Dr. Scott Sicherer, lead author of the AAP report and head of pediatric allergy and immunology at Mount Sinai Hospital, said:
“If you ask someone on the streets if they have a food allergy, there’s a good chance they’ll say ‘yes.’”
However, true food allergies trigger an immune system response. Other adverse reactions may occur from eating a certain food but should not be viewed as a food allergy. Sicherer continued:
“Some people may have an intolerance, such as lactose intolerance. Sometimes it’s a reaction due to food poisoning. Some people may just have a hard time eating a big meal.”
An accurate diagnosis of a food allergy helps patients reduce associated expenses, such as having to carry an EpiPen or auto-injector of epinephrine. Some doctors do not realize that additional tests may be necessary to accurately diagnose a food allergy. In an AAP report, 38 percent of primary care doctors believed that blood tests or skin-prick tests were enough to make a diagnosis of a food allergy. Sicherer said that individuals who test positive for allergy triggers on these tests may not actually have symptoms when contacting or ingesting the substance. Allergy specialists perform a food challenge, and this is viewed as the gold standard when it comes to food allergy testing. The patient consumes a small amount of a particular food repeatedly over a specified period of time. Allergic reactions are noted. The food challenge is not needed when children or adults already have a history of symptoms pointing to a culprit food, and they also test positive for that allergen on a skin or blood test.
Parents who suspect their child has a food allergy should talk to their pediatrician, according to Sicherer. For some, a visit to an allergy specialist is recommended for an accurate diagnosis. For individuals who test positive, this specialist should be involved in their care.
Treatment for Food Allergies
For those with food allergies, the best way to avoid triggering an allergic reaction is to avoid the foods or food substances known to cause the reaction. When patients come in contact with such culprit food, over-the-counter or prescribed antihistamines can be used to reduce mild symptoms. Antihistamines fall far short and are not to be used in the treatment of severe allergic reactions. In such a case, an emergency room visit or injection of epinephrine is needed. Many people carry epinephrine autoinjectors (Adrenaclick or EpiPen) with them if they are susceptible to experiencing a severe reaction to certain foods.
Other treatments to potentially reduce food allergy symptoms include:
- Early exposure;
- Oral immunotherapy; and
- Anti-IgE therapy.
These methods are still being studied. Some treatments like oral immunotherapy show some promising initial results. Anti-IgE treatments are experimental, and additional research needs to be performed on associated drugs. Some success has been seen in high-risk children who consumed peanut protein on a regular basis. These children were significantly less likely (70 to 86 percent) to develop an allergy to peanuts.
A primary care physician can prescribe medication to reduce allergic symptoms for those with food allergies. Understanding more about how to diagnose food allergies and when additional testing is needed for an accurate diagnosis can reduce the burden on those with food sensitivities and digestive issues and ensure they get the treatment and support needed for their specific issues. Physicians, allergy specialists and nurses can help themselves or those they serve by learning more about the prevalence of food allergies and the testing and treatment options for patients with food allergies.