Diet and Health Guidelines for Food Allergies

Presented by Janice Hermann, PhD, RD/LD

OCES Adult and Older Adult Nutrition Specialist

Who Has Food Allergies3-5% of young children are diagnosed with a

food allergyMost childhood food allergies appear early in life

and are usually outgrown 1-2% of the adult population have a food

allergy

Who Has Food AllergiesAlthough 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 AllergyA 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 allergicOften an incompletely digested protein

What Happens With A Food AllergyWhen 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 SymptomsAllergic reactions can be immediate or

delayedAllergic 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 SymptomsFood allergy reactions vary from person to

person, as well as within the same personThe same food can produce totally different

symptoms in different people, as well as varying symptoms within the same person

Food Allergy SymptomsFood allergy symptoms usually fall into three

areas:Skin ReactionsNose, Throat and Lung ReactionsStomach and Intestinal Reactions

Skin ReactionsTypes of reactions

Swelling of lips, mouth, tongue, face or throatHivesRashesItchingSkin redness

With oral allergy syndromeHives, swelling and itching confined to the mouth

and throat and usually result after consumption of raw fruits and vegetables

Nose, Throat and Lung ReactionsTypes of reactions

SneezingNasal congestionRunny noseChronic coughShortness of breath or other breathing difficulties

such as asthma

Stomach and Intestinal ReactionsTypes of reactions

NauseaAbdominal pain and bloatingVomitingDiarrheaCrampingGas

Severe Allergy ReactionsMost 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

AnaphylaxisDifferent parts of the body may experience

food allergy reactions at the same timeReactions can progress rapidly and may

include:Itching Breathing difficulties Hives Lowered blood

pressureSweating UnconsciousnessThroat swelling Even death

Have A PlanPeople 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 DiagnosisProperly diagnosing food allergies is

importantProper diagnosis can help avoid unnecessary

dietary restrictions Parents may limit their children’s food intakes

unnecessarily unless properly diagnosedProper diagnosis can also help avoid accidental

exposure to allergens

Proper DiagnosisDiagnosis 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 DiagnosisMethods for diagnosis

Skin-prick testAntibody blood testingOral Food ChallengesElimination Diets

RAST or ELISARadioallergosorbent test (RAST) or enzyme-

linked immunosorbent assay (ELISA) are reliable skin-prick testing and antibody blood testing for diagnosing allergies

Proper DiagnosisFood changes and elimination tests should be

conducted only under medical supervision

Unreliable MethodsTwo 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 AllergiesFood allergies can occur to almost any food,

but most allergic reactions are caused by a limited number of foods

milk shellfisheggs soywheat peanutsfish tree nuts like walnuts

Living With A Food AllergyThe only proven treatment for a food allergy

is to avoid the offending foodAn 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 AllergyUsing an elimination diet for 1-2 years may

promote outgrowing a food allergySome food allergies, particularly to peanuts,

nuts, fish and shellfish can last a lifetime

Living With A Food AllergyNo drugs are available to treat food allergiesAllergy 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 AllergyPeople with food allergies need to learn

about food composition and how to read labelsMany foods may contain the allergenMany terms used to describe food components

Milk AllergyMilk and milk products are a common

ingredient in many foods so food labels need to be checked carefully

Milk AllergyFoods containing milk or milk products

MilkAcidophilus, 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 CheeseIce creamSherbetYogurtCustardPuddingEggnog

Milk AllergyFoods 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 flavorNougatMellorineCurdsSemi-sweet chocolate, milk chocolateCaramel, creamed, carob candies

Milk AllergyTerms for milk products

CaseinRennet caseinAmonium caseinateCalcium caseinateMagnesium caseinatePotassium caseinateSodium caseinateCasein hydrolysateMilk protein hydrolysatesProtein hydrolysate

Milk AllergyTerms for milk products

LactoseLactabluminLactalbumin phosphateLactoglobulinLactuloseMilk proteinWheyWhey protein concentrateWhey protein hydrolysateSweet wheyDelactosed whey

Milk AllergyIngredients potentially containing milk or

milk products Caramel flavoringBavarian cream flavoringCoconut cream flavoringBrown sugar flavoringButter flavoringNatural flavoringSimplesse®

Egg AllergyEggs 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 AllergyEggs or foods containing egg products

Eggs, egg white, egg yolkDried eggs, frozen eggs, powdered eggs, egg solidsEgg substitutesImitation egg productBéarnaise sauceHollandaise sauceEggnogMayonnaiseMeringueSimplesse®

Egg AllergyTerms for egg or egg products

AlbuminApovitellinAvidinEgg lecithinFlavoproteinGlobulinLivetinLysozymeOvalbumin, conalbuminOvomucin

Wheat AllergyWheat is a common ingredient in many foods

so food labels need to be checked carefully

Wheat AllergyWheat or wheat products

Atta wheat flourBal aharBread flourBulgurCake flourCereal extractCourscousCracked wheatDurumDurum flour

Wheat AllergyWheat or wheat products

Enriched flourFarinaHigh protein flourKamut flourLaubinaLeche alimMalted cerealsMinchinMulti grain breadsMulti grain flours

Wheat AllergyWheat or wheat products

Puffed wheatRed wheat flakesRolled wheatSemolinaShredded wheatSoft wheat flourSpeltSuperArmineTriticaleVital gluten

Wheat AllergyWheat or wheat products

Vitalia macaroniWheat protein powderWheat branWheat germWheat glutenWheat mealWheat pastaWheat proteinWheat starchWheat tempeh

Wheat AllergyWheat or wheat products

White flourWhole wheat berriesWhole wheat flourWinter wheat flour

Wheat AllergyIngredients potentially made from wheat

Hydrolyzed vegetable proteinVegetable starchStarchGelatinized starchModified starchModified food starchVegetable gum

Peanut AllergySome 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 AllergyPeanuts, peanut products, foods containing

peanutsBeer nutsEggrollsGround nutsHigh protein foodHydrolyzed plant proteinHydrolyzed vegetable proteinMarzipanMixed nutsNougat

Peanut AllergyPeanuts or peanut products

Peanuts Peanut flourPeanut soupPeanut butterPeanut oilPeanut flakes

Peanut AllergyProducts that may contain peanuts

Pie crustsCheese cake crustsChocolate candyIce creamBaked goodsSaucesChiliCandy