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Diet and Health Guidelines for Food Allergies Presented by Janice Hermann, PhD, RD/LD OCES Adult and Older Adult Nutrition Specialist Who Has Food Allergies 3-5% of young children are diagnosed with a food allergy Most childhood food allergies appear early in life and are usually outgrown 1-2% of the adult population have a food allergy Who Has Food Allergies Although anyone can develop a food allergy, the ability to become allergic tends to be inherited Many people who have food allergies also have asthma, or show sensitivities to inhaled allergens such as dust, pollen and animal dander What Is A Food Allergy A food allergy is an adverse reaction to a food or food component that involves the immune system A food allergen is the part of a food to which a person is allergic Often an incompletely digested protein What Happens With A Food Allergy When someone eats a food they are allergic to, the food allergen stimulates the immune system to release antibodies The antibodies cause body cells to release other substances, which cause allergic reactions Food Allergy Symptoms Allergic reactions can be immediate or delayed Allergic reactions to foods usually occur within minutes to 24 hours after eating an offending food In very sensitive people, even touching or inhaling the offending food may produce an allergic reaction Food Allergy Symptoms Food allergy reactions vary from person to person, as well as within the same person The same food can produce totally different symptoms in different people, as well as varying symptoms within the same person Food Allergy Symptoms Food allergy symptoms usually fall into three areas: Skin Reactions Nose, Throat and Lung Reactions Stomach and Intestinal Reactions Skin Reactions Types of reactions Swelling of lips, mouth, tongue, face or throat Hives Rashes Itching Skin redness With oral allergy syndrome Hives, swelling and itching confined to the mouth and throat and usually result after consumption of raw fruits and vegetables Nose, Throat and Lung Reactions Types of reactions Sneezing Nasal congestion Runny nose Chronic cough Shortness of breath or other breathing difficulties such as asthma Stomach and Intestinal Reactions Types of reactions Nausea Abdominal pain and bloating Vomiting Diarrhea Cramping Gas Severe Allergy Reactions Most food allergic reactions are mild, but a small number of food-allergic individuals have severe reactions that can be life-threatening Anaphylaxis is rare, but can be a possibly fatal food allergy reaction Anaphylaxis Different parts of the body may experience food allergy reactions at the same time Reactions can progress rapidly and may include: Itching Hives Sweating Throat swelling Breathing difficulties Lowered blood pressure Unconsciousness Even death Have A Plan People who have severe allergic reactions need to recognize early symptoms and have a plan for handling emergency situations May carry epinephrine for self-injection and warning medical alter bracelets or necklaces in case they become unconscious Importance of Diagnosis Properly diagnosing food allergies is important Proper diagnosis can help avoid unnecessary dietary restrictions Parents may limit their children’s food intakes unnecessarily unless properly diagnosed Proper diagnosis can also help avoid accidental exposure to allergens Proper Diagnosis Diagnosis requires a thorough medical history, physical examination, and laboratory tests Having symptoms is not a diagnosis Symptoms exactly like those of an allergy many not be caused by one Proper Diagnosis Methods for diagnosis Skin-prick test Antibody blood testing Oral Food Challenges Elimination Diets RAST or ELISA Radioallergosorbent test (RAST) or enzyme- linked immunosorbent assay (ELISA) are reliable skin-prick testing and antibody blood testing for diagnosing allergies Proper Diagnosis Food changes and elimination tests should be conducted only under medical supervision Unreliable Methods Two unreliable methods for diagnosing food allergies are cytotoxic testing and symptom provocation testing, where a dose of the food extract is placed under the tongue or injected Most Common Food Allergies Food allergies can occur to almost any food, but most allergic reactions are caused by a limited number of foods milk eggs wheat fish shellfish soy peanuts tree nuts like walnuts Living With A Food Allergy The only proven treatment for a food allergy is to avoid the offending food An elimination diet must be carefully developed and be personalized to take into account the ability of an individual to tolerate an allergic food Living With A Food Allergy Using an elimination diet for 1-2 years may promote outgrowing a food allergy Some food allergies, particularly to peanuts, nuts, fish and shellfish can last a lifetime Living With A Food Allergy No drugs are available to treat food allergies Allergy shots, which are useful in desensitizing some people to pollen and other environmental allergens, are not recommended to treat food allergies and may be dangerous Living With A Food Allergy People with food allergies need to learn about food composition and how to read labels Many foods may contain the allergen Many terms used to describe food components Milk Allergy Milk and milk products are a common ingredient in many foods so food labels need to be checked carefully Milk Allergy Foods containing milk or milk products Milk Acidophilus, buttermilk, chocolate milk, evaporated milk, condensed milk, sweetened condensed milk, malted milk, *Goat’s milk protein similar to cow’s milk protein, may cause similar symptoms, not a recommended substitute Cheese Ice cream Sherbet Yogurt Custard Pudding Eggnog Milk Allergy Foods containing milk or milk products Cream, half & half cream, light cream, whipping cream Sour cream, sour cream solids, sour cream dressing Butter, butter oil, butter fat, artificial butter flavor Nougat Mellorine Curds Semi-sweet chocolate, milk chocolate Caramel, creamed, carob candies Milk Allergy Terms for milk products Casein Rennet casein Amonium caseinate Calcium caseinate Magnesium caseinate Potassium caseinate Sodium caseinate Casein hydrolysate Milk protein hydrolysates Protein hydrolysate Milk Allergy Terms for milk products Lactose Lactablumin Lactalbumin phosphate Lactoglobulin Lactulose Milk protein Whey Whey protein concentrate Whey protein hydrolysate Sweet whey Delactosed whey Milk Allergy Ingredients potentially containing milk or milk products Caramel flavoring Bavarian cream flavoring Coconut cream flavoring Brown sugar flavoring Butter flavoring Natural flavoring Simplesse® Egg Allergy Eggs and egg proteins are common ingredient in many foods so food labels need to be checked carefully Because flu vaccines are prepared using egg embryos, people with egg allergies need to check with their physicians before being vaccinated Egg Allergy Eggs or foods containing egg products Eggs, egg white, egg yolk Dried eggs, frozen eggs, powdered eggs, egg solids Egg substitutes Imitation egg product Béarnaise sauce Hollandaise sauce Eggnog Mayonnaise Meringue Simplesse® Egg Allergy Terms for egg or egg products Albumin Apovitellin Avidin Egg lecithin Flavoprotein Globulin Livetin Lysozyme Ovalbumin, conalbumin Ovomucin Wheat Allergy Wheat is a common ingredient in many foods so food labels need to be checked carefully Wheat Allergy Wheat or wheat products Atta wheat flour Bal ahar Bread flour Bulgur Cake flour Cereal extract Courscous Cracked wheat Durum Durum flour Wheat Allergy Wheat or wheat products Enriched flour Farina High protein flour Kamut flour Laubina Leche alim Malted cereals Minchin Multi grain breads Multi grain flours Wheat Allergy Wheat or wheat products Puffed wheat Red wheat flakes Rolled wheat Semolina Shredded wheat Soft wheat flour Spelt SuperArmine Triticale Vital gluten Wheat Allergy Wheat or wheat products Vitalia macaroni Wheat protein powder Wheat bran Wheat germ Wheat gluten Wheat meal Wheat pasta Wheat protein Wheat starch Wheat tempeh Wheat Allergy Wheat or wheat products White flour Whole wheat berries Whole wheat flour Winter wheat flour Wheat Allergy Ingredients potentially made from wheat Hydrolyzed vegetable protein Vegetable starch Starch Gelatinized starch Modified starch Modified food starch Vegetable gum Peanut Allergy Some people with peanut allergies have severe reactions, including anaphylaxis, to the smallest quantities of peanuts Although peanut allergy is not ordinarily associated with other nut allergies, people may be advised to avoid all nuts due to potential cross-contamination Peanut Allergy Peanuts, peanut products, foods containing peanuts Beer nuts Eggrolls Ground nuts High protein food Hydrolyzed plant protein Hydrolyzed vegetable protein Marzipan Mixed nuts Nougat Peanut Allergy Peanuts or peanut products Peanuts Peanut flour Peanut soup Peanut butter Peanut oil Peanut flakes Peanut Allergy Products that may contain peanuts Pie crusts Cheese cake crusts Chocolate candy Ice cream Baked goods Sauces Chili Candy