Food allergies

While it is not possible to predict with certainty who will develop a food allergy, certain factors can increase the likelihood, including:

Risk Factors During Pregnancy:

• Tobacco smoke: Exposure to tobacco smoke can heighten the risk of developing food allergies.
• Unbalanced diet: A poor maternal diet has been linked to an increased risk of childhood asthma and other allergic conditions.

Risk Factors During Birth:

• Cesarean section: Babies born via cesarean section may have a higher chance of developing food allergies.

Risk Factors After Birth:

• Gut microbiota: Specific bacterial strains in the gut may play a role in the development of food allergies.
• Infections: Early childhood infections can alter immune system development, potentially raising the risk of allergies.
• Timing of solid food introduction: Introducing solid foods to a child’s diet after 7 months may increase the likelihood of food allergies or intolerances.

Other Risk Factors:

• Family history of allergies: Having a family member with an allergic condition can raise the risk of food allergies in children.
• Infant eczema: Skin breaks, such as those caused by eczema, can allow allergens to enter the body, increasing the chances of developing a food allergy.
• Vitamin D deficiency: Insufficient levels of vitamin D may contribute to the development of food allergies.
• Advanced glycation end-products (AGEs): High levels of AGEs, found in cooked meats, oils, and cheeses, may trigger immune responses leading to food allergies.

Additional Risk Factors:

• Age: Food allergies are more commonly seen in children, especially in infants and toddlers.
• Asthma: Food allergies often co-occur with asthma, and people with food allergies may have a higher risk of developing asthma and rhinitis.
• Race: Racial differences have been noted in the prevalence of food allergies, with some groups being more susceptible.
• Sex: Males are generally at a higher risk for developing food allergies compared to females.

The diagnosis of food allergies involves a combination of clinical history, patient examination, and various lab tests to identify the specific allergens. These steps include:

• Patient History and Examination: A detailed clinical history and physical examination are the initial methods for diagnosing food allergies. This includes reviewing the patient’s diet, documenting when the first and last allergic reactions occurred, and understanding the symptoms related to food allergies.
• Laboratory Tests:

Skin Prick Test (Puncture or Scratch Test):

This test is used to check for immediate allergic reactions to multiple allergens at once. It is commonly done on the forearm of adults and on the upper back of children.

Serum-Specific IgE Test:

Formerly known as RAST (Radioallergosorbent Testing), this test measures the level of IgE antibodies produced in response to a specific allergen. It is preferred when a skin prick test is unsuitable or unavailable.

Atopy Patch Test (APT):

This test evaluates delayed-type hypersensitivity reactions and is useful in diagnosing certain allergic conditions.

Other Tests:

• Oral Food Challenge (OFC): This is the definitive test for diagnosing food allergies. During this test, the patient consumes small amounts of the suspected allergen under medical supervision. The doctor monitors for any allergic reactions after each dose.
• Endoscopy and Biopsy: While not typically used for diagnosing food allergies, these procedures may be employed to diagnose non-IgE-mediated allergic conditions.

Prevention of Food Allergies

Managing food allergies can be challenging, but prevention is often the best approach. Prevention strategies are divided into primary and secondary prevention:

• Prevention During Pregnancy: Food allergies can sometimes develop in the womb, and unborn babies may be sensitized to foods their mothers consume. Although it is suggested that maternal diet may influence food allergies, there is limited evidence to suggest that altering the mother's diet during pregnancy or breastfeeding can effectively prevent food allergies in infants.
• Prevention During Infancy: Several strategies can help reduce the risk of food allergies in infants:
• Age of Solid Food Introduction: Introducing solid foods earlier, as early as 4 months, has been linked to a reduced risk of food allergies.
• Supplements: Supplementing with fish oil after birth may lower the risk of food sensitization and allergic reactions in infants, offering a potential strategy for allergy prevention.

Prevention for Older Children and Adults

Preventing food allergies in older children and adults involves several strategies:

• Avoiding Allergens: This is crucial, although it can be challenging. Some allergens are easier to avoid than others, but when complete avoidance is difficult, minimizing contact with the allergen can help.
• Following Medication Plans: Medications prescribed by your doctor can be effective in managing the symptoms of allergic reactions.
• Keeping a Food Diary: Recording what you eat, the timing of symptoms, and what helps alleviate them can assist you and your healthcare provider in identifying potential triggers or factors that exacerbate your symptoms.
• Eating 2 Hours Before Exercise: Since some food allergies can be triggered by physical activity, it’s a good idea to eat at least two hours before exercising to reduce the risk of an allergic reaction.

Specialists to Consult

Food allergies can lead to serious reactions that may require urgent medical attention. Always be prepared to seek emergency care if a severe allergic reaction occurs. The following healthcare professionals can help manage food allergies:

• General Physician
• Allergist
• Immunologist
• Dietician
• Pediatrician

An allergist is a doctor specializing in the diagnosis and treatment of allergies, while an immunologist focuses on diagnosing and managing immune system disorders.

Currently, there is no cure for food allergies, and the only effective treatment is the complete avoidance of the offending food(s). Once a food allergy is diagnosed, it is essential to eliminate the allergen from the diet.

In Case of Accidental Exposure

For severe allergic reactions (anaphylaxis) caused by accidental exposure to a food allergen, the first-line treatment is an adrenaline (epinephrine) injection. It should be administered intramuscularly into the thigh.

Medications for Managing Symptoms

Several medications are available to manage the symptoms of food allergies, including:

• Antihistamines: These can help alleviate gastrointestinal symptoms, hives, sneezing, and a runny nose.

• Bronchodilators: These are used to relieve asthma symptoms, but they are not effective in preventing an allergic reaction if taken before consuming the triggering food.

Food allergies can lead to serious complications that affect both children and adults, including:

• Anaphylaxis: A severe, life-threatening reaction that can cause the airways to constrict, making breathing difficult.

• Respiratory Distress: Exposure to allergens can trigger respiratory issues such as asthma or rhinitis in some cases.

• Heart Attack: In rare instances, food allergies, especially those triggered by exercise, can manifest as cardiovascular symptoms, including heart attacks.

While food allergies can be annoying, mild cases typically do not lead to significant issues. In addition to conventional treatments, several alternative therapies have been found to offer benefits for managing food allergies. Some of these include:

Chinese Herbal Therapies

Research indicates that a specific herbal formula (FAHF-2) used in traditional Chinese medicine could be a promising treatment for food allergies. This approach is not limited to a single food allergen and may be used to address multiple food allergies.

Acupuncture

Acupuncture involves inserting thin needles into the body at specific points to relieve various symptoms. This practice can help support the immune system and alleviate symptoms associated with food and seasonal allergies.

Homeopathy

Homeopathy focuses on correcting the immune system's responses rather than suppressing or altering them. It has shown effectiveness in helping individuals with allergic reactions and allergic conditions.

The most effective way to prevent allergic reactions is to avoid the triggering food entirely. While treatment options are limited, they can be quite helpful. For mild reactions, some home remedies may alleviate symptoms:

• Ginger (Adrak): Known for its digestive properties, ginger can help relieve stomach discomfort, indigestion, gas, bloating, and cramping caused by allergenic foods.
• Probiotics: Probiotics can support a balanced gut microbiome, which may help manage food allergies by preventing or treating symptoms.
• Lemon (Nimbu): Rich in vitamin C, lemon acts as an antioxidant, supporting immune function and protecting against infections.
• Green Tea: Packed with antioxidants, green tea can help reduce inflammation. Studies suggest that it may inhibit mast cell activation and block histamine release, offering relief for allergy symptoms.
• Carrots (Gajar): Carrots are high in beta-carotene, an antioxidant that can enhance immune cell function and activity.

For most individuals, food allergies do not significantly impact their quality of life. With the right adjustments and knowledge of how to manage emergencies, individuals can lead a normal life. Some helpful strategies for managing food allergies include:

Always Check Food Labels

• Read every food label carefully to ensure there are no hidden allergens such as milk proteins or wheat byproducts. It's important to be vigilant, as manufacturers often change ingredients, and allergens may be included in new formulations.

Be Cautious When Cooking

• Maintain separate utensils and cooking tools for the allergic individual. Clean all items thoroughly with hot, soapy water to avoid cross-contamination.

Be Extra Careful When Dining Out

• While dining out, inform the restaurant staff, including the chef or manager, about any food allergies before ordering. Mistakes in food preparation can lead to accidental exposure.

Wear a Medical ID Bracelet

• A medical ID bracelet can provide critical information about the person's food allergies. Always carry the necessary medication, including an epinephrine auto-injector, and ideally, two doses.

Know What to Do During an Allergic Reaction

• In case of a severe allergic reaction, take the following steps:
• Call the local emergency medical number immediately.
• Check if the individual has an epinephrine auto-injector and administer the medication by pressing it against the thigh.
• Have the person lie down and remain still.
• Loosen tight clothing and cover the person with a blanket.
• If there's a risk of choking or vomiting, turn the person onto their side.
• Position the individual in the Trendelenburg position (lying flat with their legs elevated) to enhance blood flow to the heart.
• If the person is not breathing or showing signs of movement, begin CPR, performing chest compressions at a rate of about 100 per minute.