Tag: Food allergies

Coping with food allergies

The Asthma and Allergy Foundation of America has published the results of a new study

I can’t remember not having allergies to foods. My mother says they began immediately, when “normal” formulas with dairy made me ill so I was put on soy. (I hated that soy so much I can still remember the taste and to this day will not even try soy milk or other such products  – YEEYUCKKK!) But  colic, rashes, vomiting can be pretty persuasive for food allergy diagnosis.

I learned early, though, how good dairy tasted.  My mother’s father, who would babysit me, was always convinced he knew better than anyone else. He believed allergies were nonsense and some cheese or milk couldn’t hurt me.  So he’d give me bits of cheese from his sandwiches as I played on the floor nearby.  And I would soon begin to “get sick” – hives, rashes, crying, stomach ache.  All too often, by the time Mom got there from work, the allergic reactions had turned into asthma (although he never admitted to a connection between the foods and the reaction).

It didn’t take long for me to make the connection between being so sick and the foods I craved.  I didn’t understand why everyone else could eat ice cream, but I had to have popsicles or non-dairy sherbet.  Why everyone else at a party could eat pizza, but if I did, I’d be sick all night and likely  for days afterward.

I couldn’t eat oranges! Just the release of the citrus oil from the skin of an orange being cut or peeled 1500 feet away – the opposite end of a large house – would cause sneezing, watery eyes.  And within just a few minutes (despite staying at the other end of the house), I’d have a small rash on my skin and the inside of my mouth would feel like it had been filled with blisters.  Benedryl, here I come.

And those were just the highlights.  It has often felt like it would  be easier to list what I could eat, instead of everything I was allergic to, or had bad reactions to.

But over the years I learned all sorts of ways to cope.

There were the safe foods – no reaction, at least so far.  Reactions are not in a steady-state; they can change slowly, evolve, sometimes suddenly just stop.  And new ones start.

Problematic foods – those which I can have a small amount of, if I am not sick or running any worrying symptoms (like peak flows decreasing, other allergic symptoms causing problems, any infections…).  I can eat oranges now, in small amounts.

And Hell No foods – the ones that have caused severe reactions or anaphylaxis in the past, or that are related to foods that have triggered severe reactions.

I learned to adapt recipes, initially from my mother, then by studying cookbooks and learning how to exchange certain ingredients.  But I also learned how to avoid things.  For a while, oranges were a no-no, so I didn’t even buy them. I could eat peanuts and pecans as a child, but in my 20s I developed severe reactions to peanuts and most tree nuts (but oddly, not almonds that have been blanched.)  I’ve been allergic to peas since childhood, but just a few weeks ago was served some sugar snap peas (I thought they were a different sort of green beans).  No reaction – probably because of the Xolair (but I’ve promised my allergist I will not seek them out).  I learned to read ingredient labels compulsively when I was younger, and am careful about new, processed foods.

Now I’m allergic to most legumes – peas, chickpeas, peanuts, lentils are out.  But I can eat most kinds of beans, which are also legumes. Go figure.

Restaurants are rarely a problem, but they can be a serious one – sometimes chefs or waiters are careless.  And there is nothing like having an anaphylactic reaction to spoil a nice dinner.  Or ruin a promising new relationship.

Food Allergies and the Emotional, Social and Financial Impact

 

Learning to manage asthma and allergies as a child or an adult

 

Scientific American August 2019 How to Prevent Food Allergies

Claudia Wallis is an award-winning science journalist whose
work has appeared in the New York Times, Time, Fortune and the
New Republic. She was science editor at Time and managing editor
of Scientific American Mind.

If You Give a Baby a Peanut

Feeding infants allergenic foods may be
the key to preventing allergies
By Claudia Wallis

Few things are more subject to change and passing fancies than dietary advice. And that can be true even when the advice comes from trusted health authorities. A dozen years ago the standard recommendation to new parents worried about their child developing an allergy to peanuts, eggs or other common dietary allergens was to avoid those items like the plague until the child was two or three years old. But in 2008 the American Academy of Pediatrics (AAP) dropped that guidance, after studies showed it did not help. And in its latest report, issued in April, the AAP completed the reversal—at least where peanuts are concerned. It recommended that high-risk children (those with severe eczema or an allergy to eggs) be systematically fed “infant-safe” peanut products as early as four to six months of age to prevent this common and sometimes life-threatening allergy. Children with mild or moderate eczema should receive them at around six months.

These are not whimsical changes. They match advice from a federal panel of experts and reflect the results of large randomized studies—with the inevitable cute acronyms. One called LEAP (Learning Early About Peanut Allergy), published in 2015, found that feeding peanut products to high-risk infants between four and 11 months old led to an 81 percent lower rate of peanut allergy at age five, compared with similar babies who were not given that early exposure. Another trial, known as EAT (Enquiring About Tolerance), published in 2016, found that after parents carefully followed a protocol to begin feeding peanut protein, eggs and four other allergenic foods to healthy, breastfed infants between three and six months of age, the babies had a 67 percent lower prevalence of food allergies at age three than did a control group. The results were strongest for peanuts, where the allergy rate fell to zero, compared with 2.5 percent in the control group. Egg allergies also fell, but the AAP is waiting for more data on eggs, says Scott Sicherer, a professor of pediatrics, allergy and immunology at the Icahn School of Medicine at Mount Sinai and an author of the April report. “We don’t want to tell people to do something where there isn’t really good evidence.”

How food allergies develop and why they have become so commonplace remain dynamic areas of research. Both the allergies and eczema (a major risk factor) have been on the rise. A 2010 study by Sicherer and his colleagues found that the prevalence of childhood allergies more than tripled between 1997 and 2008, jumping from 0.6 to 2.1 percent.

A leading theory about how these allergies develop and the role of eczema has been proposed by Gideon Lack, a professor of pediatric allergy at King’s College London and senior author of both LEAP and EAT. The “dual allergen exposure hypothesis” holds that we become tolerant to foods by introducing them orally to the gut immune system. In contrast, if a child’s first exposure is through food molecules that enter through eczema-damaged skin, those molecules can instigate an allergic response. Research with mice strongly supports this idea, whereas in humans the evidence
is more circumstantial. Lack points out that peanut allergy is more prevalent in countries where peanuts or peanut butter is popular and widespread in the environment, mustard seed allergy is common in mustard-loving France and buckwheat allergy occurs in soba-loving Japan. “Parents are eating these foods, then touching or kissing their babies,” Lack suggests, “and the molecules penetrate through the skin.”

A modern emphasis on hygiene may also contribute, Lack notes: “We bathe infants and shower young children all the time, very often once a day or more, which you could argue breaks down the skin barrier.” Researchers are examining whether applying barrier creams such as CeraVe can help stave off food allergies.

Eight foods account for 90 percent of food allergies: cow’s milk, eggs, fish, shellfish, tree nuts, peanuts, wheat and soybeans. Some scientists believe this is so because these foods contain proteins that are unusually stable to digestion, heating and changes in pH and are therefore more likely to cause an immune response.

Early dietary exposure is now the confirmed preventive strategy for peanuts and, pending more research, perhaps the other foods, although this is more easily said than done. In EAT, parents had to get their babies to swallow at least four grams per week of each of the allergenic edibles, and many found it to be challenging. As Lack observes, “It’s just not part of our culture to feed solids to very young babies.”

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