Chandigarh ,Amrita Gill, M.Sc.II Environmental Science, PU : Milk ,eggs, wheat, are some basic food items what if they produce severe anaphylaxis , dermatitis , rhinitis like reactions in our body.Yes these are the symptoms of an allergy that is Food allergy.Food allergy is an immune system response of human body which is mistakenly considered as harmful.
It is an ingestant allergy, type 1 hypersenstivity immuno reaction of the immune system.Some food substances are capable of eliciting an immune response as antigens.The immune responses thus initiated by these antigens are protective or lead to hypersensitivity states or lead to tolerance .In case of food allergens it is the hpersenstivity response.
It is estimated that up to 14 million Americans have food allergies and the status is rising.Six to eight percent of children under the age of 2 or 3 have food allergies and nearly 5 percent of adults have them.Its more prevalent in children then in adults.Food allergy in the pediatric age group is distinct from that in adults in several features including incidence ,certain clinical manisfestations, the causative food allergen , diagnostic procedures, management, and prognosis.
All of the symptoms of food allergy occur within a few minutes to an hour of eating. A food allergy can initially be experienced as an itching in the mouth and difficulty swallowing and breathing. Then, during digestion of the food in the stomach and intestines, symptoms such as nausea, vomiting, diarrhea, and abdominal pain can start. Incidentally, gastrointestinal symptoms the allergens are absorbed and enter the blood stream. When they reach the skin, allergens can induce hives or eczema, and when they reach the lungs, they can cause asthma. As the allergens travel through the blood vessels, they can cause lightheadedness, weakness, and anaphylaxis, which is a sudden drop in blood pressure. Anaphylactic reactions are severe even when they start off with mild symptoms, such as a tingling in the mouth and throat or discomfort in the abdomen. They can be fatal if not treated quickly.
While more than 160 foods can cause allergic reactions in people with food allergies, the law identifies the eight most common allergenic foods. These foods account for 90 percent of food allergic reactions, and are the food sources from which many other ingredients are derived.
The eight foods identified as the food allergens are:
Fish (e.g., bass, flounder, cod)
Crustacean shellfish (e.g. crab, lobster, shrimp)
Tree nuts (e.g., almonds, walnuts, pecans)
Milk:Milk allergy can cause a variety of smptoms, infant ma suffer from diarrhea,and youn child may suffer from rhinitis , hives or eczma.It is the protein present in milk which causes the allergy.Milk has many different protein fractions , but casein and whey are the most allergy causing.both are present in cow’s and buffalo’ milk. the whey fraction, contains lactoalbumin and beta -lactoglobulin, causes the most reactions. Idividuals who are allergic to only whe , may tolerate the goats milk,powdered milk,evaporated cow’s milk as the whe protein is changed by the heating process.Whereas in case of casein allergy one has to avoid the cow’s milk , goat milk, powdered or evaporated or boiled milk, curds butter, margarine, cookies ,breads etc. all milk items..Even the nondiary creamers, imitation processed cheese, sour cream, and soyabean based ice cream may contain casein.Labels like lactose, caseinate , potassium caseinate,casein , lactoglobulin, curds oghurt, wheys ,milk solids, must be avoide.
Substitutes .Fruit juices, vegetable water, oat milk, pure broth for sauces and gravies instead of milk.
EGGS:Egg is probably the second most common food allergy,with egg whites causing the most problems.The most severe food allergy reaction is called anaphylaxis one of the symptoms and is an emergency situation requiring immediate attention and treatment with Epinephrine.And one comman symptom is cramps in the stomach.eggs are found in most of the processed foods.In cooking, eggs are also used as an emulsifier.Most people find it necessary to strictly avoid any item containing eggs, including:Albumin, Apovitellin ,Cholesterol free egg substitut(e.g. Eggbeaters) Dried egg solids, dried egg Egg, egg white, egg yolk Egg wash, Eggnog ,Fat substitutes ,Globulin,Livetin ,Lysozyme ,Mayonnaise ,Meringue, meringue powder ,Ovalbumin ,Ovoglobulin ,Ovomucin ,Ovomucoid ,Ovotransferrin ,Ovovitelia ,Ovovitellin ,Powdered eggs ,Silici albuminate ,Simplesse ,Trailblazer ,Vitellin ,Whole egg .
Ingredients that sometimes include egg are
Suggestions:xanthum gums, gluten , gelatins,egg free baking powder, thickening creams,starch, shortenings.
WHEAT: Signs and symptoms of wheat allergy range from mild to severe and can include skin reactions, congestion and digestive issues. Rarely, wheat allergy can cause anaphylaxis, a life-threatening reaction. Within wheat proteins prolamins are called gliadins and glutelins are called glutenins. These two protein groups form the classic glutens. The list of allergens extend beyond the classic gluten proteins.Person suffering from wheat allergy must avoid breads, cakes, cookies, pastreis,flours. Ingredients that indicate the wheat are all purpose flour, bran , bread crumbs,bread flour, bulgar,cake flour,cracked wheat flour,cracker meal and crumbs durum, enriched flour, farina flour, gluten flour, graham crackers and crumbs, graham glour, malt, malt syrup, pastry flour,phosphated flour,selmolina,wheat, ahear flour, wheat germ, wheat starch, white flour, whole wheat flour.
Suggestions: Wheat free products should be taken at a lower temperature .oats , barley, corn , rice can be taken.Potato flour is made from cooked potaoes and is a thickener in sauces.Soyabean flour, tapoica flour is the starch made from the fleshy root of the bitter mnnios or cassava plant.it is best used as a thickner or for small cookies.arrowoot starch can be derived from the arrowoot plants.Buckwart flour for making pancakes and breads.Amaranth can also be usedto prepair recipes for hpoallergic individuals.
FISH AND SHELLFISH :Most experts will agree that there is no cross-reactivity between fish and shellfish. But there are children allergic to both. Also called Seafood allergy It is a hypersensitivity to dietary substances from shellfish, scaly fish, or crustaceans, causing an overreaction of the immune system .Individuals might be allergic to one kind of fish, and yet have no allergic reaction to another.
The fish and shellfish allergy necessitates not eating in seafood restaurants at a minimum. And may include not eating where fried foods are prepared if fish and shellfish are on the menu.
For the shellfish allergic, stay away from all shelled fish: crab, lobster, shrimp and snails.Also mollusks (clams and oysters) should be avoided.Vitamins such as Glucosamine Chondroitin are contraindicated for the shellfish allergic. Most brands will have a warning on their label. Dishes to look out for include paella, bouillabaisse, gumbo (a Tex Mex dish), frito misto (a mixed fried fish dish from the Mediterranean coast), and fruits de mer (seafood). Oriental food tends to contain lots of different kinds of fish at once, and chopped pieces can be difficult to spot.
Surimi (a processed seafood product) is usually made from white fish but may contain shellfish extract. Surimi can be present in processed foods such as pizza toppings.
Caesar salad dressing normally contains anchovies. Worcestershire sauce may.
Caponata, a traditional sweet and sour Sicilian relish, can contain anchovies.
Kedgeree is made with rice and fish.
Fish sauce is a common ingredient in the Far East. Terms to look out for are Nuoc Mam and Nam Pla.
Fish sauce can be made with shellfish as well as fish.
Patum Peperium . Menhaden is a type of fish caught along the Atlantic coast. It is used in products such as vitamins, soap, lipstick, paint, insect spray, and waterproofing. Check the ingredient lists on ready-made Oriental sauces, pastes and prepared meals. In fact check the ingredient lists of all food for unexpected ingredients.
SOYABEANS:People who are allergic to soy protein may have an extreme allergic reaction and go into anaphylactic shock (anaphylaxis).Soy allergy can also result in urticaria, rash, redness (inflammation due to immune system response) diarrhoea, stomach pain, worsening of eczema, asthma
and severe itching of the skin.
As soya protein has a high nutritional content and many functional properties, it is used as an ingredient in a variety of foodstuffs. Soya protein can for example be found in hamburgers, fishcakes, pizza, bread and other baked goods. Many replacement products for individuals with milk allergy and coeliacs are based on soya. Soya sauce, miso, tofu and tempe are also made from soya beans.Soya milk, soya cheese and soa milk, Vegetarian food, foreign meals and health-food products more commonly contain soya protein than typical Norwegian foodstuffs.Since soya protein is used in increasingly more foodstuffs, it is important to read the food ingredients carefully.one should not take hydrolysed vegetable protein (HVP) and Lecithin.
suggestions:Avoid all foods mentioned above and Ingredients one should use caution with are soya protein, soybean (curd, granules) soybean butter
soy protein (concentrate, isolate) miso, soya beans, tofu, vegetable protein and soya sauce, soy albumin, soy fiber, soy flour, soy grits, soy milk, soy nuts, soy sprouts,canned chicken broth vegetable broth, gum, and starch may contain soya.
PEANUTS AND TREENUTS: Peanuts aren’t actually a true nut; they’re a legume (in the same family as peas and lentils). But the proteins in peanuts are similar in structure to those in tree nuts. For this reason, people who are allergic to peanuts can also be allergic to tree nuts, such as almonds, Brazil nuts, walnuts, hazelnuts, macadamias, pistachios, pecans, and cashews.Reactions like red, bumpy rashes (hives), eczema, or redness and swelling around the mouth or face,belly cramps, nausea, vomiting, or diarrhea,runny or stuffy nose, itchy, watery eyes, and sneezing to the triggering of asthma with coughing and wheezing. A person may feel lightheaded or faint.
Some of the highest-risk foods for people with peanut or tree nut allergy include:
Cookies and baked goods. Even if baked goods don’t contain nut ingredients, it is possible that they came into contact with peanut or tree nuts through cross-contamination. it’s safest to avoid store-bought or bakery cookies and other baked goods.
Candy. Candies made by small bakeries or manufacturers (or homemade candies) may contain nuts . Ice cream , soft-serve ice cream, custard, or yogurt places because the same dispensing machine is often used for lots of different flavors. Buy tubs of ice cream at the supermarket and be sure they’re made by a large manufacturer and the labels indicate they’re safe.
Asian, African, and other cuisine. African and Asian (especially Thai and Indian) foods often contain peanuts or tree nuts. Mexican and Mediterranean foods may also use nuts.
Sauces. Many cooks use peanuts or peanut butter to thicken chili and other sauces.
AVOIDENCE is the best mangement, treatment and prevention of food allergy. "simple avoidence "can be confounding to the physician and disappointing to the patient when unlisted ingredients are included in the foods.In severe cases or multiple sensitivities ,pharmacological intervention needs to be considered.For this the classic antihistamine, oral cromolyn, cromolyn like variants, nonsteroidal -anti- inflammatory agents,corticostreoids,IgE blocking peptides,immunotherapy and hypersensitization , as suggested by the physician is heplful.