How to cope with food allergies and Intolerances
"What is food to one man may be fierce poison to
others," wrote Lucretius. Anyone who has developed
hive, diarrhea, or other troubling symptoms after eating
a certain food can testify to this ancient philosopher's
words. Fortunately, it's possible to design a
diet that won't cause unpleasant reactions.
Common questions about food allergies and intolerances
What are the symptoms of a food allergy?
Food allergies—like other types of allergies—are
caused by faulty triggers in the immune system. They
usually happen when the body's immune system mistakenly
thinks something in a food—usually a protein—is a potential
invader. In defense, the immune system releases chemicals
that cause unpleasant, and sometimes, life-threatening
symptoms.
Allergic reactions occur very quickly—typically within
a few minutes to one hour after ingesting an offending
food. Symptoms vary and may include:
- itching or tingling in the mouth, lips, or throat
- trouble swallowing or a tight feeling in the throat
- asthma-like symptoms, such as trouble breathing,
coughing, or wheezing
- runny nose
- stomach pain, diarrhea, vomiting, or nausea
- hives or a skin rash
- swelling of the face or other parts of the body.
In babies, food allergies can cause diarrhea, bloody
stools, and trouble sleeping.
Some people with food allergies experience a severe
reaction known as anaphylaxis. When this potentially
deadly reaction occurs, the symptoms mentioned above
become severe. In some cases, blood pressure may drop,
and the person may faint. Anaphylaxis requires immediate,
emergency treatment.
Who tends to get food allergies?
Food allergies usually run in families that already
have allergies—even to things other than food. Many
people with asthma or allergic skin reactions also tend
to get food allergies
Food allergies can occur in people of all ages, but
they are more common in children. About 3 to 8% of children
have allergic reactions to foods, compared to only 1
to 2% of adults.
However, many more people mistakenly believe they
or a loved one has a food allergy. Experts say that
many people who think they have a food allergy actually
have a food intolerance. An intolerance is an abnormal—but
non-allergic—response to a food or an additive.
What else besides food allergies can cause reactions
to foods?
One possible culprit is food poisoning. If other
people also got sick after eating the offending food,
it usually means that contaminated food is to blame.
It's also easy to confuse a food allergy with another
abnormal reaction to food—a food intolerance. Both conditions
share some of the same symptoms, including nausea, diarrhea,
and stomach cramps.
Food intolerances are fairly common. For example,
many people have lactose intolerance, or trouble digesting
the sugar that's in milk and most dairy products. When
they drink milk, they have gas, bloating, cramps, and
sometimes diarrhea.
Other people feel sick if they eat foods with histamine,
a natural substance found in cheese, some wine, and
certain types of fish. Some food additives, including
dyes, sulfites, and monosodium glutamate (MSG), also
can trigger reactions in some people.
What's the difference between food intolerances and
food allergies? Unlike allergies, intolerances are not
triggered by the immune system.
The causes of intolerances vary. For instance, people
with lactose intolerance have low amounts of the enzyme
lactase, which is needed to digest dairy products. In
some cases, food intolerances stem from unpleasant memories
associated with a food.
Sometimes it takes some sleuthing to determine whether
you have a food allergy, as well as what food is causing
your symptoms.
What foods are people most commonly allergic to?
Adults are most commonly allergic to:
- shellfish, such as shrimp, lobster, crab, and crayfish
- peanuts and tree nuts
- fish
- eggs
Children tend to have allergies to:
The foods that cause the most severe allergic reactions
are peanuts, nuts, and shellfish.
Do you ever get over food allergies?
Children sometimes outgrow allergies in a few years.
Some allergies tend to disappear more than others do.
Allergies to milk and soy are more likely to fade. This
is especially true if children avoid foods that trigger
their symptoms.
Adults aren't as fortunate. Food allergies that develop
after childhood usually last a lifetime.
Can food allergies affect behavior?
It's a myth that food allergies can make children
hyperactive. On the other hand, food allergies can make
children feel sick, which may affect how they act.
How are food allergies and intolerances usually treated?
People with food allergies are usually told to avoid
the problem food. The same is true for people with food
intolerances.
Beyond that, treatment depends on how severe your
problem is. You may need to see an allergist, a doctor
who specializes in allergies.
Unfortunately, there's no medicine you can take to
prevent an allergic reaction. But there is medicine
to help you if you accidentally eat something you shouldn't.
For instance, antihistamines can help hives, sneezing,
and runny nose. These are available over-the-counter
and by prescription.
If you tend to develop anaphylaxis or have severe
allergic reactions, your doctor may order a syringe
or a pen-like device filled with epinephrine for you.
You will need to inject yourself with this if you think
you are getting a severe reaction. Even if you seem
OK after taking epinephrine for a severe reaction, you
need to go to the hospital right away because your symptoms
might come back.
If you have severe reactions, you also should wear
a medical alert bracelet or necklace that says you have
a food allergy. And always carry your medicine with
you.
Can you prevent food allergies?
Some experts think you may be able to prevent food
allergies in children by taking special steps during
infancy. If you, your spouse, or any of your children
have food allergies, you might consider the following
strategies with future children:
- Breastfeeding for at least six months may help prevent
food allergies in your child, although not all studies
prove this. If you are not breastfeeding your child,
ask your pediatrician if hypoallergenic formulas are
right for you.
- Ask your doctor when it is best to start giving your
child certain foods, such as eggs, milk, and peanuts.
Some experts believe that giving certain foods to your
youngster too early may cause him or her to develop
allergies.
Allergy Sleuthing: How to Determine Which Food Is
the Problem
If you suspect that you or your child has a food
allergy, you must track down the culprit. The first
step often involves considering some detailed questions.
When you develop symptoms, ask yourself:
- Did the reaction come on within an hour after eating?
- Has this happened before, after eating this food?
- Was my child or I the only person who got sick?
- Was the food properly prepared and cooked?
- Did allergy medicines help clear up hives, a stuffy
nose, and other symptoms, if applicable?
If you answered yes to all of these questions, you
may have a food allergy. Other possible causes of food
reactions are food intolerances and food poisoning.
To help track down the food culprit, write down everything
you eat for one or two weeks. Record what symptoms you
have and how long after eating they show up. Share this
with your doctor. This, plus tests, can help your doctor
find the cause of your problem.
Your doctor also may put you on an elimination diet
to see if you have a food allergy. In this kind of diet,
you avoid the food, and if symptoms go away, you probably
have a food allergy. If you eat the food under your
doctor's supervision and the symptoms come back, then
the food allergy is confirmed. However, people with
severe reactions cannot try an elimination diet because
it is too dangerous.
Another way to find the cause of your problem is
through allergy testing. A common method is the scratch
skin test. An allergist places a food sample on the
skin and scratches the skin with a needle. If the skin
becomes red or swollen, you probably have an allergy.
Blood tests and other methods also may be used to
determine if you have a food allergy.
Design a Healthy Diet that Allows You to Live Symptom
Free
People with food intolerances can sometimes consume
small portions of the problematic food. For instance,
those with lactose intolerance can usually drink one
or two glasses of milk a day. Milk is easier to digest
with a meal. In addition, some high-calcium dairy foods,
such as hard cheeses and yogurt, seem to cause fewer
symptoms of lactose intolerance.
People with food allergies are usually advised to
avoid the food completely. This is particularly important
for people with severe allergic reactions. These people
can develop a severe reaction after ingesting even a
tiny amount of the offending food. For instance, 1/44,000
of a peanut may trigger a reaction in severely allergic
people.
Tips for Avoiding Problem Foods
- Find out exactly what you need to avoid. People who
are allergic to shrimp often are allergic to other types
of shellfish, such as crab and lobster. In contrast,
people with peanut allergies can usually consume peanut
oil safely. That's because the protein in peanuts that
typically causes allergies gets removed when peanut
oil is made.
- Ask your doctor for a complete list of ingredients
that you need to avoid. If you need to avoid eggs, you
should also avoid foods listing albumin, or egg white,
in their ingredients. If milk makes you sick, watch
out for products that contain casein, sodium caseinate,
lactoglobulin, and nougat.
- Carefully read ingredient lists on food labels. Even
seemingly safe products might contain offending foods
or additives. For example, even plain chocolate candies
can contain traces of nuts if made with equipment that
was also used to make nut products.
- Beware of any vague terms on food labels. If you
don't know what something means call the manufacturer
to find out. If a product doesn't have a label, don't
eat it.
- When dining out, ask what's in an entrée before ordering
it.
- If not everyone in your house follows the same food
restrictions, you may want to keep a separate cutting
board, dishes, utensils, and other equipment to prepare
only your meals. When you have the kitchen to yourself,
you may want to cook several meals at a time and freeze
them. This reduces the risk of your meals coming in
contact with other foods that family members might have.
- Ask your doctor for "allergy-free" recipes and other
resources, such as support groups, that may help.
- When several foods must be avoided, it is smart to
ask a dietitian for help. A dietitian can help you develop
a safe, balanced diet. Even highly allergic infants
and children can have healthy diets while avoiding certain
foods.
Additional Tips for Parents of Children with Food
Allergies
-
If your child has severe reactions to food, talk
to your child's teachers, babysitters, and others. Tell
them what symptoms they should look for. Give them your
child's medicine and show them how to use it. You should
also write down a list of foods that your child must
avoid at school. Let the teacher know your child won't
be able to eat food brought in by others.
-
If your child is old enough, teach her what foods
to avoid.
-
Pack safe treats for your child to have during special
events at school. If your child receives a wrapped treat
at school, have her bring it home to "trade" for a safe
treat that she loves.
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