If you've flown on a plane in the last five years, you know peanut allergies are a big deal. For some people, exposure to nothing more than peanut dust can lead to anaphylaxis, a life-threatening condition that includes such symptoms as swelling of the throat, difficulty breathing, low blood pressure and unconsciousness. That's why you now receive little bags of pretzels—if you're lucky enough to get a snack in these cost-cutting times.
Even so, it might seem extreme to limit peanuts, if food allergies afflict just a small percentage of the traveling public. But food allergies are on the rise; researchers at Duke University found that peanut allergies doubled between 1997 and 200
And because food allergies can dramatically affect quality of life, there's even a magazine, Living Without, commonly sold in natural foods stores, that offers lifestyle tips and recipes for people with food allergies.
Peanuts are just one of eight common food allergens, all of which are proteins. Others include milk, eggs, tree nuts, fish, shellfish, soy and wheat. Food additives, such as BHA and BHT, certain dyes, monosodium glutamate, nitrates and nitrites, parabens and sulfites, are another source of allergic reaction that are often overlooked. Reactions can be mild, moderate or severe, says Dr. Marianne Frieri, director of allergy and immunology at Nassau University Medical Center in East Meadow, N.Y. "It could be anything from an itchy mouth to severe anaphylaxis."
What's the difference?
A true food allergy involves the immune system and can result in hives, eczema, difficulty breathing or gastrointestinal symptoms such as nausea, cramping, vomiting, diarrhea, bloating or flatulence. All these reactions are the result of the body responding to proteins in food as potential threats, activating the immune system and releasing antibodies called immunoglobin E. The IgE then stimulates the body's cells to release histamines, which bring about inflammation, an allergic reaction. "It's generally immediate," says Suzanne Myer, a naturopathic physician in Seattle who specializes in food allergies. "They ingest a peanut and they have anaphylaxis."
food sensitivity, on the other hand, does not involve the immune system but merely triggers what some physicians consider a pharmacological response—an unpleasant set of side effects, similar to a drug reaction. People with sensitivities to coffee, for example, may get the jitters, while those who don't tolerate cheese or chocolate well may develop headaches. Other symptoms include joint inflammation and acne. "The mechanism is not really that well known," Myer says. "A lot of food sensitivities just fall into 'unexplained.'"
People can also be sensitive to components in food, Myer says. A person who gets headaches after eating avocados, cheese and chocolate doesn't necessarily have multiple food allergies but may just be sensitive to the amines present in all of them.
One of the most common food sensitivities is lactose intolerance. Those affected don't produce lactase, the enzyme required to break down lactose, the protein in milk. Researchers estimate 25 percent of Americans are lactose intolerant, while wheat and gluten intolerance affect 15 percent of Americans.
To determine if a person has a true food allergy, physicians can perform a skin-prick test or a blood test known as the RAST, which tests for IgE presence immediately after exposure to a specific food. Another blood test, the ELISA/ACT, measures delayed responses to foods and is often used to test for food sensitivities. Myer finds its usefulness limited. "There are a lot of false positives," she says. "But you can tell when you look at a person. They have circles under their eyes and they have a lot of symptoms." Myer uses an elimination diet to determine specific sensitivities. "That's kind of the gold standard."
How it begins
While researchers don't know for sure why food allergies are increasing, they do know how food allergies develop. According to La Leche League, early and frequent exposure to a given food increases its likelihood of becoming an allergen. The organization says that breastfeeding reduces allergies because the baby isn't exposed to common allergens in cow's milk or soymilk. Breastfed babies also have the benefit of mom's antibodies—found in abundance in colostrum, an early component of mother's milk—to support their still-developing immune systems.
Genetic predisposition and alcohol and drug abuse are other possible factors in the development of food allergies, Myer says. "If you get out of balance, there's more harmful bacteria than good bacteria. It's just hard for your gut to digest and work well."
Myer thinks the modern lifestyle is one reason for the rise in food allergies. "People are under a lot of stress, which contributes to leaky gut," a condition in which the gut lining becomes inflamed, spaces develop between the cells of the gut wall, and undigested food, bacteria and other toxins leak in. The body reacts to this by producing antibodies—an allergic response.
Frieri, who edited Food Hypersensitivity and Adverse Reactions (CRC, 1999), agrees that "changes in our diet and environment" might be partly to blame, especially when people change their diet radically, perhaps to lose weight. "When you change your diet you're changing your gastrointestinal system," she says. Frieri notes there's a parallel increase in other kinds of allergies, too. "Allergic disorders such as asthma are on the rise; nasal allergies are on the rise," she says. "Asthma and food allergy have a link. The other link is atopic dermatitis, which is eczema—and that's on the rise."
Dealing with it
Sometimes, children simply outgrow food allergies. This occurs up to 20 percent of the time in children who have a peanut allergy, and in 9 percent of those allergic to tree nuts. Until that happens, however, allergicconsumers need to carefully avoid any foods that might contain troublesome proteins. "Avoidance is tough because of hidden ingredients," Frieri says. "There's milk in hot dogs."
That task should be a little easier now, thanks to the federal government's new regulation, implemented in January, which requires food manufacturers to clearly state on a product's label whether it includes any component of the eight major allergens. That means consumers no longer need a science background to know that if they're allergic to eggs, they should stay away from products with albumin in the ingredients list—the label must clearly state "contains eggs."
Sometimes, it's helpful to know that entire categories of foods may not be off limits. A study in the December 2005 issue of the Journal of Allergy and Clinical Immunology found that people who are allergic to fish can probably tolerate some species without adverse effects. Among the species less likely to induce hives: halibut, flounder, tuna and mackerel. Cod, salmon, pollack, herring and wolfish had higher allergenicity.
The good news for consumers is that the medical community is moving beyond simple avoidance strategies and finding proactive ways to stimulate the immune system while it's still immature and reduce the development of food allergies. The good news for retailers is that these techniques involve natural product standbys, such as probiotics and polyunsaturated fatty acids, such as omega-3s.
"I have all my clients take probiotics. I'm a big believer in them," Myer says, though she recommends them in supplement form because dairy forms like yogurt are likely to trigger reactions in many people.
Camel's milk is also thought to decrease food allergies, according to researchers at Ben-Gurion University of the Negev in Beer Sheva, Israel, who found that eight children who drank camel's milk had a reduction of symptoms within 24 hours, and elimination of symptoms within four days. Foods high in quercetin, such as rooibos tea, apples and onions, may also help.
The best news of all? Myer says, "Once you figure out what you're sensitive to, your gut can really heal."
Natural Foods Merchandiser volume XXVII/number 4/p. 22, 26