Does your food bite back? - food allergies

American Fitness, March, 1999 by Mary Hubbard

What you can do about food allergies.

When you take a bite of food does it sometimes bite you back? This happens to millions of people every day. A stomachache, runny nose, hives or migraine headaches are only some of the ways your food can "bite back" if you have a food allergy. The symptoms can vary greatly, and it often takes a good detective to find the culprit.

How widespread is the problem? Thirty percent of all adults feel they are allergic to one or more foods, according to a recent study by the Food Allergy Network. Doctors specializing in allergies tell us the true number is much lower. Children are much more likely to suffer from food allergies than adults, but they frequently "outgrow" their allergies (perhaps due to maturation of their intestines and immune systems). Approximately 8% of children from birth to age 14 suffer a food allergy, compared to only 2% of adults. It is also reassuring to know that 75% of all food allergies are caused by only three foods: milk, eggs and peanuts. Another 15% can be attributed to soy products, tree nuts (like walnuts and pecans), wheat (in everything from bread to pasta), fish and shellfish.

What causes an allergy to occur? In a true food allergy, a portion of the food (usually a protein) is seen as a dangerous foreign invader (an allergen) by the body, which then produces antibodies (specifically IgE) to fight it. As this battle rages, a variety of symptoms can occur, such as itching, hives, stomach cramps or nausea, swelling of the mouth or throat and often breathing problems. Symptoms can vary from person to person and different foods can cause different symptoms in any given individual.

You should know for certain if you have a food allergy. Don't just assume you have one. You may give up a delicious, nutritious food unnecessarily (or give up the wrong food). You need to have an allergy test. There are two main methods to determine if you produce IgE antibodies in response to specific foods. Skin testing is the preferred method because it is simple, more sensitive, less expensive and more closely related to actual symptoms. Either a scratch or prick skin test (PST) is preferred because it is relatively painless and unlikely to cause a serious reaction. A small drop of extract from the suspected food is applied and the skin is then lightly scratched with a specialized needle. Another method involves injecting a small amount of the suspected food just under the skin. If you do indeed have the IgE antibody, a mosquito bite-like bump will occur at the site within 15 to 20 minutes. This test is reliable for ruling out food allergies. Having a reaction to the test does not necessarily mean you will react to the food, however.

The next step is to have a food challenge test where you are given foods over a period of time-some containing the suspect and others not-to confirm the allergy's existence. You can start the process of searching for personal food allergies by keeping a food diary. Write down everything you eat and drink for a few weeks to see if there is any evidence of a specific food or ingredient causing your reaction. Take the diary with you when you visit your doctor.

Most symptoms (runny nose, headaches and hives) can vary in degree from mild to moderate, but the greatest danger comes from ANAPHYLA-S or anaphylactic shock. This is a violent reaction involving many parts of the body simultaneously. Severe symptoms begin almost immediately (within minutes) and may include difficulty breathing, feelings of impending doom, swelling of the mouth and throat, difficulty swallowing, a dangerous drop in blood pressure and subsequent unconsciousness. The afflicted person should be taken immediately to a hospital emergency room, even if they are appear to be improving. Once a person has experienced such a reaction, medication should be carried at all times (in the form of injectable epinephrine) in case of a future attack.

Avoiding the problematic food is the only way to prevent a reaction. Because the most common food allergens are used in many food products, you must become an ace detective. The new food labels have made it easier for people to identify the ingredients used. You will probably face the greatest difficulty when eating in restaurants. Learn to be politely assertive when asking about the ingredients in menu items and avoid anything you are not absolutely certain about. "Better safe than sorry" should be your new motto. Also, you don't necessarily have to give up your favorite foods. Learn new ways to prepare meals without using the foods or ingredients that cause you discomfort.

Unfortunately, food allergies seem to be increasing. Perhaps this is because children are introduced to common food allergens (cow's milk and peanut butter, for example) at earlier ages and soy is used more widely as an inexpensive protein supplement in a variety of processed foods. Although no drug is on the horizon to prevent food allergies, allergy shots are more likely to be developed as scientists learn to identify food allergens.