Allergies: What Are They?

Blog #1: What are food allergies?  What are common sources of food allergies?  How does one test for food allergies?    

     At a young age, I experienced health-scares when my brother began to develop chest pain that sent him into the emergency room several times.  Although I had been through this process before with my diabetic brother, my family was terrified that he was dealing with something serious.  We all felt that it had to be bad if my brother, Brian, was complaining as frequently as he did and acting as scared as he was.

      When he started to experience these problems at the age of twenty-three years old, he changed.  He became scared of having these panic attacks while driving or while being alone, so he resorted to living at home and staying in his room to avoid these “anxiety attacks.”  If my mom and I were going out he would come, despite it being shopping; one of the activities that he hated.  Despite trying to stay with family, however, he continued to experience these attacks.

       He went through multiple emergency rooms and specialized doctors before coming to realize that his attacks were caused by food allergies, unusual responses to food that were caused by his immune system.  After doing a food allergy test, he was able to determine some of the foods that were causing these attacks: peanuts, corn, wheat, avocado, and banana.  Ultimately, after identifying these foods and eliminating them from his diet, he returned to his original self.

      Food allergies, the culprit for his sickness, affect many people around the world.  In these individuals, the food allergen is treated like a foreign substance within the body rather than a source of nourishment (“Food Allergies-What Happens”).  In attempts to protect the body, antibodies attack the allergen, releasing histamine.  The histamine will cause a myriad of symptoms, which can be seen among individuals.  Within the individual, the amount of food allergen consumed at a sitting and their tolerance to the food allergen predicts the severity of the reaction. 

     Different tolerances and different food allergens may bring more difficulty to the lives of others afflicted with food allergies.  In the world, there are more than 160 foods that can cause allergic reactions in food allergies (United States).  Although wheat, eggs, milk, peanuts, tree nuts, soy, fish, and shellfish cause 90% of all food allergies, there are several others that may seem odd or surprising to most (United States).  These miscellaneous food allergens may include, but are not limited to, corn, banana, chestnuts, kiwis, avocado, red meat, coriander, celery, cinnamon, saffron, and mustard (Collins).  With that being said, it is very important to determine what one is allergic to if food allergies are suspected.

     If food allergies are suspected, one should go to a specialized doctor called an allergist, as my brother did.  The food allergist will help to diagnose a food allergy using medical history, and by performing a skin prick or blood test (“Diagnosis & Testing”).  During the skin prick test, the allergist will put a solution containing the food allergen on the forearm or back and scratch the skin so that the solution can enter below the surface (“Skin Prick Tests”).  After thirty minutes of waiting, the allergist will differentiate whether a food allergy is present by looking for a white bump surrounded by red itchy skin.  By doing this with multiple food solutions, the allergist may differentiate between the problematic foods and the safe foods. ** The other test that may be done, a blood test, may also be done to determine which foods are problematic.

     Despite the uses for the skin prick and blood tests, other tests may be required if an allergist is unable to determine the food allergen.  If this occurs, the allergist may suggest the oral food challenge (“Oral Food Challenge”).  During this testing, the allergist will feed small, measured doses of the suspected food to the patient and observe for any signs of reactions.  If no reactions are observed, the food will continue to be given in increasing amounts, until a reaction is seen.  If a reaction is seen, the allergist may diagnose food allergies and determine the proper treatment for the patient.

The allergist may also suggest a trial elimination diet, a test associated with less risk than the oral food challenge test.  Unlike the oral food challenge, in which the food is given in increasingly higher amounts, the food elimination diet focuses on eliminating specific foods and monitoring one’s health (“Trial Elimination Diet”).  If no symptoms are seen within this period of time, the allergist may then suggest to reintroduce the food and to determine whether symptoms return.  If they return, a food allergy is confirmed, and appropriate treatment is determined.

    Once a food allergy is confirmed, it is important to prepare for an allergic reaction, and to take several precautions in regards to one’s diet.  Despite the needs of many individuals to do so, only eight main allergens are clearly identified on the food label, making it difficult to decode food labels.  They need to decode many of the ingredient label lists to determine any derivatives of these foods and to eliminate some mainstream products, such as bread, cereal, baked goods, yogurt, granola bars, frozen yogurt, and other commercialized products from their diet.  Although many chose to restrict these foods from their diets, others may practice with experimentation to determine one’s sensitivity to foods and how much could be consumed without having a reaction. *** Therefore, by identifying what one is allergic to, one can understand what their limitations are and what to look for in mainstream products.

**Just as a side note, testing for multiple allergens at a time was one of the reasons my brother passed out during this test!

*** After much experimentation, my brother has decided that quantities of less than 2% are adequate for all of his allergies except for peanut.  This allows him to eat out with more freedom than many other food-allergy sufferers.

Blog #2: What are symptoms?  How do children describe symptoms?  What are methods used to prevent allergies in children?  How should introduce foods to children?

     Before my brother was given an official diagnosis of food allergies, he experienced multiple allergic reactions.  During these reactions, which would occur thirty minutes after a meal or snack, he would experience chest pain, faintness, and major stomach pain.  Although he thought he was going to die at times, once we were able to determine what his allergies were and how to avoid them, his symptoms resolved.

    Although symptoms related to food allergies vary among individuals in their manifestation and severity, there are common symptoms that are observed during an allergic reaction.  Following the ingestion of a food allergen, one many experience one or more of the following symptoms: an itching of the mouth, vomiting, diarrhea, abdominal pain, hives or rash, tightening of the throat, nasal congestion, sneezing, slight cough, odd taste in mouth, uterine contractions, difficulty breathing, or a drop in blood pressure (“Symptoms”; “Food Allergies: Symptoms, Diagnosis, Prevention, and Treatment”).  If any of these symptoms are recognized, they may be used in order to diagnose food allergies and determine the correct form of treatment to avoid future reactions.

      Since many of these symptoms are used to diagnose food allergies, it is important to recognize them and discuss them with a doctor.  Thus, it becomes a complexity when dealing with children who are unable to correlate the way in which they feel to the foods that they eat.  In order to determine these reactions within children, certain words need to be interpreted by adults.  In describing an allergy, children may suggest that the food is spicy, that their tongue is hot or tingling, or that their lips feel tight.  They may also suggest that they feel like there are bugs in their ears, bumps in their throat, or itching in their tongue.  By understanding different ways that children explain their symptoms, food allergies can be properly diagnosed (“Symptoms”).

      With this being said, there are many precautions that can be taken during pregnancy, and while breastfeeding to prevent the development of food allergies.  Although these instructions have been changed over the years, the newest guide repels the statement that highly allergenic foods should be avoided during pregnancy and breastfeeding (American Academy of Allergy, Asthma & Immunology).  The guide also emphasizes the importance of breastfeeding for at least four months of age, instead of giving infant formula, in attempts to reduce the onset of a milk protein allergy.  If infant formula is necessary, however, the guide suggests a hydrolyzed formula rather than a soy or amino acid formula.  Therefore, there are many precautions that may be taken when pregnant or breastfeeding to prevent food allergy development in newborns.

     Food allergies may also be prevented during the introduction of foods.  Although these instructions have also been changed over the years, the newest guide should be utilized.  When introducing foods, the guide suggests providing single-ingredient foods one at a time, every three to five days in order to determine if any allergic reactions occur (American Academy of Allergy, Asthma & Immunology).  The guide also establishes the point to introduce highly allergenic foods, such as dairy, egg, soy, wheat, peanut, tree nuts, and fish between the ages of four and six months old (American Academy of Allergy, Asthma & Immunology).  Therefore, there are several measures that should be taken to prevent food allergies when introducing foods to a baby.

     Despite measurements taken to avoid allergies, food allergies continue to be established within children and adults.  Once established, there are several manifestations that may occur that include the throat, gastrointestinal tract, or the mouth.  These symptoms are oftentimes scary and uncomfortable, resulting in the avoidance of the food.  Despite avoidance of the food, many chose to experiment with their tolerance level to determine the amount of food allergen that they could have without experiencing a reaction.

     By experimenting with one’s tolerance level, one may be able to normalize one’s diet and prevent themselves from feeling too restricted.  In this way, my brother has experimented with his food allergies and has determined the amounts that he feels most comfortable with.  By understanding the amounts that are safe for him to consume, grocery shopping becomes easier and much less expensive.  Therefore, although there are many preventative measures that may be taken, once established, it is important to determine one’s tolerance or to practice strict avoidance of the food.

Works Cited

American Academy of Allergy, Asthma & Immunology. Preventing Allergies: What You Should Know About Your Baby's Nutrition. N.p.: American Academy of Allergy, Asthma & Immunology., 2014. Print.

"Food Allergies: Symptoms, Diagnosis, Prevention, and Treatment." NIH MedlinePlus Spring 2011: 24-25. Web. 12 Oct. 2014. <http://www.nlm.nih.gov/medlineplus/magazine/issues/spring11/articles/spring11pg24-25.html>.

"Symptoms." FARE. Food Allergy Research & Education, Inc., n.d. Web. 10 Oct. 2014. <http://www.foodallergy.org/symptoms>.

Blog #3: Prevention of Allergic Reactions, Treatment, and Research Related to Food Allergies

    I never realized how time-consuming grocery shopping could be until my brother was diagnosed with food allergies at the age of 23 years old.  Going into the store for simple foods such as ketchup, bread, and yogurt turned into a long production.  Each nutritional label was read from top to bottom to look for any food components or derivatives that he had become allergic to.  Products that contained corn in the form of dextrose, corn syrup, cornstarch, corn flour, or any derivatives of corn were instantly tossed to their respective spots on the shelves. Commercialized products such as Gatorade, “normal” Heinz ketchup, and pretzels were usually left behind for the next customer to buy.  Ultimately, the natural and organic aisle became the one most frequented, despite being more expensive.  Although we were able to find products that he can consume safely, his food allergies impact his activities and that of the family.

     In order to prevent allergic reactions to food, my family must take several precautions into account at home, family events, grocery stores, and when eating out.  To prevent reactions to food, we buy whatever foods we can without corn, peanut, banana, avocado, or wheat: any of the foods he is allergic to.  Once we return from the grocery store, we are then challenged by the question of what to make for a meal.  Oftentimes, we make simplified dishes such as chicken with vegetable and cooked sweet potato rather than following recipes.  However, if we chose to make a recipe, we often look online for a “safe” recipe or modify the ingredients so that he can safely consume the meal.  If we need to go to any family events, we typically bring a food dish, or ask other family members for the ingredients within the dish to determine whether or not he can consume it safely.   If a family gathering is at a restaurant, however, we find ourselves more limited, as many foods are made out of corn in American society.  As you can see, food becomes a rather difficult aspect when grocery shopping, eating out, or at family events when you or your loved ones are afflicted with food allergies.

     Despite our own troubles, many other families dealing with more severe allergies and with younger children are likely to take more precautions than us.  Besides reading labels carefully, many parents need to focus on safe practices when eating at home, restaurant, or at school.  In order to prevent allergic reactions at home, many parents choose to ban these foods from their household entirely.  Doing this may be upsetting among siblings, but is ultimately the best decision to make in order to prevent cross-contamination.  These families may also practice frequent hand-washing, before and after eating, and frequent cleaning of countertops.  Additionally, as an added precaution, parents may separate safe and unsafe foods within their pantries, so that a child may easily pick a product off the shelf that is allergy-safe (“Avoiding Cross-Contamination in Your Home”).      Ultimately many measures are taken at home to help the child deal with his or her food allergies.

       Despite many measures taken at home, there are additional precautions that must be taken within a restaurant or at school.  In these environments, it is nearly impossible to control what foods are prepared within kitchens or eaten by other children during lunchtime.  In order to prevent allergic reactions at restaurants, most families call the restaurant beforehand to determine whether or not there were allergy-free foods available.  If there are allergy-free foods available, they may also ask about the practices and safety measures taken by the restaurant to prevent cross-contamination.  When a restaurant is decided on, other precautions such as warning the chef of the allergy should be performed.  Despite limited control in this situation, there are many actions being taken to comfort the families and individuals that have food allergies.   Recently, in attempts to better control the environment within a restaurant, lawmakers have recently been conceptualizing a bill to increase the training at restaurants to reduce allergic reactions (Thompson).

       Unlike at restaurant outings, parents are unable to be there to guide their child within the school environment.  In attempts to reduce allergic reactions, parents typically prepare their child before going to school.  They make appropriate allergy-free meals that are satisfying and fun, so that the child is compelled to eat his or her own meal rather than their friend’s meal.  Parents of these children may also choose to bake products for the class in substitution for the treats provided during snack-time.  In doing so, they may look at sites such as http://www.kidswithfoodallergies.org/recipes/allergy-friendly-recipes.php, which allows one to choose a recipe free of milk, peanut, egg, soy, gluten, wheat, fish, or shellfish.  They may also get ideas from sites such as http://blog.foodallergy.org/category/allergy-friendly-recipes/ (see recipe below).  Therefore, there are many situations that parents should be aware of within the home, restaurant, and home to eliminate any allergic reactions.

     Although there are many precautions to avoid an allergic reaction, sometimes an allergen is ingested.  If any allergic reactions occur, they may be treated with antihistamines, oral or topical steroids, or an epinephrine auto-injector, depending on the severity of the allergic reaction (“Food Allergy Symptoms, Causes, Treatment-What is the Treatment for a Food Allergy?”).  While mild to moderate symptoms may be treated with antihistamines and oral or topical steroids, severe symptoms must be treated with an epinephrine injector and then within the hospital.  At the hospital, the individual may need to be further treated based on the severity of the reactions.  Oftentimes, this includes steroid treatment to reduce inflammation, or asthma medication to relieve breathing symptoms.  With this being said, it is important to acknowledge the severity of one’s food allergy to determine the best treatment for an allergic reaction.

     Despite treatments, there have been multiple research attempts to cure food allergies.  Like many other diseases, food allergies have been the subject to many clinical trials that have been done on humans and on animals to determine their effectiveness.  Recently, clinical trials have focused on clinical trials either resulting in desensitization, a temporary “fix,” or tolerance, a “permanent fix” for food allergies.  Two of these trials, oral immunotherapy and sublingual immunotherapy, have been successful in desensitizing the patient to the food allergen, giving them temporary relief (“FARE Research Overview”).  Despite these successes, researchers are looking into further therapeutic approaches based on tolerance.  By looking at other approaches, scientists hope to provide a permanent solution to food allergies, and continue to provide hope for the families and individuals who are suffering.

Recipes:

1. Romaine Lettuce Sandwich Wraps (Milk-free, Egg-free, Tree nut-free, Peanut-free, Wheat-free, Soy-free, Fish-free, Shellfish-free)

1. Romaine lettuce
2. Lunch meat of choice
3. Honey mustard or other condiments
4. Carrots
5. Fruit

Cut romaine lettuce into bread-sized pieces, and fill with lunchmeat and condiments of your choice.

1. Banana Pancakes (Milk-free, Egg-free, Wheat-free, Peanut-free, Soy-free, Tree nut-free, Fish-free, Shellfish-free)

• 1 1/2 cups oat flour
• 1 T. sugar
• 1 tsp. baking powder
• 1/4 tsp. salt
• 1 1/4 cups orange juice
• 1 T. oil
• 1 tsp. vanilla extract
• 1 1/2 T. water, 1 1/2 T. oil, 1 tsp. baking powder, mixed together
• 1 1/2 cups banana, chopped

Heat nonstick griddle or skillet over medium heat. In medium bowl, combine all ingredients, except banana. Stir well. Fold in banana. Spoon 1/3 cup batter for each pancake onto griddle or skillet. Cook until top bubbles and edges are browned. Flip and cook until done. Top with Cinnamon Syrup.

Cinnamon Syrup

• 3/4 cup light corn syrup*
• 1 tsp. ground cinnamon
• 1 tsp. vanilla extract
• 1 tsp. lemon juice

In small saucepan over low heat, cook corn syrup until thoroughly heated. Add remaining ingredients. Mix well. Pour warm syrup over pancakes or waffles.

*Since my brother is allergic to corn, we would just provide him with Vermont maple syrup, which does not contain any corn product.

Works Cited

"Allergy-Friendly Recipes." FARE Blog. Food Allergy Research & Education, Inc., n.d. Web. 12 Oct. 2014. <http://blog.foodallergy.org/category/allergy-friendly-recipes/>.

"Avoiding Cross-Contamination In Your Home." Food Allergy Resources. Kids With Food Allergies, n.d. Web. 12 Oct. 2014. <http://www.kidswithfoodallergies.org/resourcespre.php?id=65>.

"FARE Research Overview." FARE. Food Allergy Research & Education, Inc., n.d. Web. 12 Oct. 2014. <http://www.foodallergy.org/research/overview>.

"Food Allergy Symptoms, Causes, Treatment - What Is the Treatment for a Food Allergy? - MedicineNet." MedicineNet. N.p., n.d. Web. 12 Oct. 2014. <http://www.medicinenet.com/food_allergy/page9.htm#what_is_the_treatment_for_a_food_allergy>.

"Safe Eats Recipes." Kids With Food Allergies Foundation, n.d. Web. 12 Oct. 2014. <http://www.kidswithfoodallergies.org/recipes/allergy-friendly-recipes.php>.

Thompson, Mara. "Michigan Senate Passes Food Allergy Bill." UpNorthLive. Cunningham Broadcasting Corporation, 2 Oct. 2014. Web. 12 Oct. 2014. <http://www.upnorthlive.com/news/story.aspx?id=1104795#.VC7LYGOa8kM>.