Category: Food Allergy  

Food Allergies: General Information

Food allergies often cause itching of some form—either the mouth and throat while the food is ingested or the skin sometime later. Within minutes or hours, hives, nausea/vomiting, diarrhea/cramps, wheezing, coughing, chest/throat tightness, shortness of breath or a drop in blood pressure may occur. Food allergies are also sometimes related to pollen allergy, an entity known as Oral Allergy Syndrome. The severity of someone’s reaction is mostly determined by how sensitive they are to a given food and the amount of the allergen ingested. More severe reactions may occur in asthmatics and those taking certain blood pressure medications (beta blockers or ACE inhibitors). Also alcohol and aspirin/NSAIDS enhance more allergen absorption and often lead to more severe reactions.

In young children, the most common causes of food allergy are dairy, eggs, fish, soy and peanuts. Egg and milk allergies are frequently outgrown. Peanut allergy is usually lifelong and can be severe and sometimes fatal. Deaths from food allergy occur every year and usually occur in those who are known to be allergic. Fatalities from food allergy are more likely to occur if there is a delay in the administration of emergency medical care [or self-administration of epinephrine (EPIPEN)] and in those with asthma.

While there is no cure at this time for food allergies, a number of novel medications are undergoing clinical trials. The best treatment for food allergy is avoidance. We suggest that you educate yourself about the foods to which you are allergic.  A wealth of information is available on FARE (Food Allergy Reseach and Education).  This is a non-profit organization with educational materials, recipes and warnings about mislabeled processed foods.

Cross-contamination sources 

  • In  Restaurants:
    • Nuts and nut oils in salad dressings and sauces
    • Milk, egg, wheat or peanut butter in sauces or marinades
    • Butter added at the end of grilling
    • Eggs in casseroles or to bind ground meats
    • Fish used in sauces
  • At Grocery:
    • Bulk foods/bins
    • Deli section (shared slicer)
    • Bakery section (shared cookie sheets)

Foods are related to each other genetically.  Therefore an allergy to one food might lead to allergic reactions to similar foods (whether or not these foods look alike).  For a helpful list of potentially crossreacting foods, see the food family list at this website.

When dining out, especially in a restaurant where your language is not spoken, it is important to communicate with the staff about your food allergy.  Restaurant cards in multiple languages are recommended when eating out or traveling or you may make your own card.

You should also know that there are many non-allergic reactions to food. These include certain stomach diseases, enzyme deficiencies, infections or toxins.

  • Gastrointestinal Disease- ulcers or irritable bowel syndrome
  • Food Intolerance-enzyme deficiency
    • Dairy products cause bloating, cramping and gas due to lactose intolerance in persons lacking lactase.
    • Alcohol may cause flushing (commonly in Asians) due to Alcohol Dehydrogenase deficiency
  • Food poisoning causing vomiting and/or diarrhea occurs when bacteria contaminate food
  • Syndromes. Chinese Restaurant Syndrome (MSG) may be associated with flushing or headache but not life-threatening allergies.
  • Celiac Disease-also known as gluten sensitive enteropathy is a genetic disease that may cause many chronic symptoms

You might want to listen to an audio podcast of Dr. Stadtmauer’s interview about food allergy on Skeptically Speaking.

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