(Republished with permission from the St. Louis Post-Dispatch. This article originally ran in the Health & Fitness section on Monday, September 5, 2005)
By Harry Jackson Jr.
Of the Post-Dispatch
If you haven’t had a meal of shrimp and then awakened with your skin on fire, or had a glass of milk and an hour later found yourself with a horrible stomachache, count yourself lucky. Millions of Americans aren’t so fortunate. They suffer from food allergies.
The reaction can range from minor skin rashes to life-threatening anaphylactic shock.
For allergy sufferers, know that your misery has a lot of company. Federal agencies report that:
- Approximately 2 percent of adults and 5 percent of infants and young children in the United States suffer from food allergies.
- Each year, about 30,000 people require emergency treatment and 150 to 200 people die because of allergic reactions to food.
- Eight major foods or food groups – milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soybeans – account for 90 percent of food allergies.
What is a food allergy?
The mechanism for food allergies is the same as for environmental allergies: The immune system mistakes something you eat for a dangerous invader and attacks. In the confusion, the antibodies attack the body, too.
Unlike environmental allergies – pollen, dust and so forth – there’s no cure or even relief for food allergies.
Once you identify something that makes you sick, the remedy is simple: Don’t eat it. “You can’t take a pill and then go out and have a shrimp dinner,” said Dr. H. James Wedner, professor of medicine at Washington University School of Medicine.
But often, you don’t know that the food culprit is in what you are eating. For instance, an ice cream parlor may mix your strawberry ice cream next to where they mixed pistachio ice cream. If you are allergic to nuts, that could cause a reaction.
All it takes is coming in contact with a protein from the food that your body sees as an invader. Highly allergic people can get reactions even from smelling certain foods, doctors say.
A growing problem
The incidence of food allergies has grown exponentially in the past 30 years, and experts don’t really know why.
What they fear is that while the number of people with food allergies continues to grow, so do the sources of places to get allergens – foods that will cause a reaction.
And with the prevalence of prepared foods, allergens can lurk in some unlikely places. In 1999, a study in Minnesota and Wisconsin found that 25 percent of foods failed to list peanuts or eggs as ingredients. The Food and Drug Administration says the number of recalls caused by unlabeled allergens rose to 121 in the 2000 from about 35 a decade earlier.
You can develop new allergies at any age. As your body changes, so will its idiosyncrasies. A doctor’s diagnosis, a skin-prick test, a personal history and a family history can help you pinpoint your allergies.
Allergy vs. intolerance
Food allergies often get the blame when food intolerance is the problem. Intolerance refers to when the body doesn’t properly process food. That’s why doctors stress getting tested by an allergist.
One common condition is lactose intolerance – when the body doesn’t make enough of the enzyme needed to digest milk products. The result is about the same as food poisoning.
“People have milk allergies, but by far the biggest problem adults have is lactose intolerance,” said Wedner of Washington University.
Some foods, such as certain sorts of fish and cheese, have enough histamine to make the body believe it’s having an allergic reaction when it’s not. The way to tell, says Dr. Mark Dykewicz, assistant professor of medicine at St. Louis University, is by getting tested or observing the obvious.
“What most people think is food allergy is not,” Dykewicz said. “Unless there’s a consistent experience, you may find it difficult without getting an allergy assessment to learn what you’re allergic to.
“Obviously, in the case of someone who every time they eat shrimp they have problems, it’s enough to stay away from shrimp.”
Doctors might have people keep journals of their eating and illnesses. Sometimes that’s enough. Otherwise, doctors say, the only way to determine an allergy is to be tested.
Skin testing involves using an extract of common or suspected allergens that is pricked into the skin to see if a reaction occurs.
The next method is to check suspect foods one by one in the doctor’s office. Patients get either a small portion of the food or a placebo and then wait for 30 minutes or so. If there’s no reaction the portion is increased. Eventually, doctors will know whether the food causes the allergic reaction.
Dr. Rosa Kincaid, a medical doctor who runs a holistic practice, routinely takes an eating history from patients. Sometimes she finds the food itself is the problem, sometimes she finds the additives are a problem. Often, she has success telling patients to avoid foods with artificial flavors and preservatives, she said.
She also has some patients use an “elimination diet.”
“Make a list of the food you crave, that you must have, and then for three weeks totally eliminate those things from your diet,” she said.
“Then, reintroduce the foods. (If) you haven’t had symptoms in 14 days and you eat some chips and the symptoms come back,” it’s a sign that the food is causing the problem, she added.
Hidden allergens
Even conventional practitioners are wary of food additives and labels, because they don’t adequately describe the presence of some allergens, the experts said.
With the proliferation of prepared foods, food labels were supposed to provide information to help people be aware of what they’re eating.
However, food manufacturers use some cryptic labeling. For example, “potassium caseinate” is a milk product. Most words that start with “lac” are from milk. Albumin is from eggs. Gluten is from wheat. Fructose is from corn.
“And then we find ‘natural flavors’ and ‘natural colors’ on food labels,” said Dykewicz.
When trying to diagnose an allergy or food intolerance, Dykewicz says, he often must go through the corporate legal office and then sign a nondisclosure agreement to identify food additives that might be harming his patients.
Reporter Harry Jackson Jr.
E-mail: hjaxson@post-dispatch.com
Phone: 314-340-8234
Copyright 2005 St. Louis Post-Dispatch, Inc.