Allergy Free Shop Educational Series - The "Big Eight"
The Allergy Free Shop exists not only to provide parents and caretakers with allergen-free foods and products for those with food allergies and sensitivities, but also to provide educational information that can help provide guidance and product options to those just beginning their research and education about specific food allergies affecting their children.
Prevalence And Treatment Of Food Allergies
To begin with, any food protein which triggers an allergic response is termed a "food allergen." It is estimated that up to 12 million Americans have food allergies or reactions to food allergens, and the prevalence is rising. Six to eight percent of children under the age of three have food allergies and nearly four percent of adults have them.* And food allergies cause roughly 30,000 emergency room visits and 100 to 200 deaths per year in the United States.**
Treatment consists of either immunotherapy/desensitization, or in many cases avoidance, in which the allergic person avoids all forms of contact with the food to which they are allergic. Although there are promising areas of food allergy research, including anti-IgE antibody and specific oral tolerance induction, as of now there is no "cure" (other than immunotherapy) for many people with food allergies. Individuals diagnosed with a food allergy may choose to carry an autoinjector of epinephrine (such as a Twinject or EpiPen), wear some form of medical alert jewelry, or (with the guidance of their doctor) develop an emergency action plan. This is due to the potential serious reactions that are possible to many people with food allergies.
Common Symptoms of Food Allergy Reactions
The most common type of food allergy reaction is called a "Classic immunoglobulin-E (IgE)-mediated" or Type-1 Immediate-Hypersensitivity Reaction. These allergic reactions have an acute onset (from seconds to one hour) and may include symptoms such as Angiodema, or soft tissue swelling, usually involving the eyelids, face, lips, tongue, larynx and trachea, which can obstruct the upper airway and make breathing difficult; hives; nausea, vomiting, diarrhea, stomach cramps and/or abdominal pain; wheezing; scratchy or itchy mouth, throat, eyes or skin; nasal congestion; shortness of breath and difficulty swallowing.
In very serious cases the reaction can progress to Anaphylaxis, which is a severe, whole-body allergic reaction which requires immediate medical attention and response, and that can even result in death without acute medical intervention.
Anaphylaxis, or "Anaphylactic Shock", is defined as a systemic reaction involving several different bodily systems, and includes hypotension, or a sudden drop in blood pressure, a loss of consciousness, and the shutdown of vital bodily functions as the individual goes into shock. Many different food allergens have been reported as triggers for Anaphylaxis, but the most common allergies associated with this type of reaction are peanuts, nuts, egg, milk and seafood.
Potential Causes And Types of Food Allergy Reactions
Food allergy has been diagnosed in all types of individuals, but is thought to develop more easily in patients who display atopic syndrome. Atopic syndrome is a common combination of diseases in people who exhibit "localized, and immediate, hypersensitivity to allergens" through eczema, allergic conjunctivitis and rhinitis, and asthma. A family history of allergic diseases is often indicative of atopic syndrome, and these combinations of allergic reactions are strongly correlated to family heredity.
Conditions caused by food allergies are classified into 3 groups according to the mechanism of the allergic response. The first is the "classic" response described above, the IgE-mediated reaction, or Type-I Immediate-Hypersensitivity Reaction.
The second category is called "IgE or non-IgE mediated" eosinophilic esophagitis, gastritis and gastroenteritis reactions, which refers to acute inflammation of the esophagus, stomach or intestines caused by reactions to allergens by white blood cells, which control mechanisms associated with allergy and asthma. The last category is includes other "non-IgE mediated" reactions, such as milk-soy protein intolerance (MSPI); or conditions like food protein induced enteropathy (a pathology of the intestines), found in the common condition of Coeliac Disease, which is an adverse immune reaction to the protein gluten.
The Big Eight Food Allergies
The term "Big Eight" refers to the most common food allergies.*** They account for over 90% of the food allergies found in the United States. They are:
Egg Allergy
Dairy Allergy
Peanut Allergy
Tree Nut Allergy
Seafood Allergy
Shellfish Allergy
Soy Allergy
Wheat Allergy
Outside the U.S. the list of top allergens tends to vary somewhat from country to country, but milk, eggs, fish, shellfish, peanuts, tree nuts, sesame, soy and wheat tend to be in the top 10. Allergies related to seeds, especially sesame, appear to be rising in most countries. There are also other more rare food allergies, including corn, rice, flour, various vegetables and fruit allergies and even red meat allergy, among others.
There are other conditions which can require food allergen avoidance but are not technically allergies, such as lactose intolerance, which is actually an enzyme deficiency, not an allergy; various causes of irritable bowel syndrome (IBS); or rarer conditions such as C1 esterase inhibitor deficiency, or hereditary Angiodema. We will address some of these conditions in upcoming blogs.
Diagnosis Of Food Allergy
If you suspect a food allergy, the best method for diagnosing the condition is by visiting an allergist. The allergist will review the patient's history and the symptoms or reactions that have been noted after food ingestion. If the allergist feels the symptoms or reactions are consistent with food allergy, he/she will perform allergy tests, which may include skin prick testing (Non-IgE mediated allergies cannot be detected using this method, however), which can provide quick and usually conclusive results, diagnostic blood tests (also not effective for Non-IgE mediated allergies), or food challenges, often conducted in a hospital environment due to the potential risk of Anaphylaxis. Other tools for diagnosis of eosinophilic or non-IgE mediated reactions can include endoscopy, colonoscopy and biopsy.
This Educational Series
There are various strategies and theories regarding prevention and treatment of many food allergies, and as we continue through our educational series on the "Big Eight," we will focus on each food allergy separately, addressing the potential causes, relevant statistics, prevalent scientific opinion and research, and the treatment for each of the individual allergy categories. We will also provide information and links to our new and existing food choices and other products that we offer at Allergy Free Shop that address each specific allergen. Through this informational series, we hope that we can help you better understand - and respond - to your child's individual allergy-free needs!
In our next "Big Eight" post: Peanut Allergy.
* National Institute of Allergy and Infectious Diseases (July 2004), National Institutes of Health. pp. 35.
** Food Allergy Facts and Statistics. Food Allergy & Anaphylaxis Network. 2007.
*** "Food Allergy Facts & Figures". Asthma and Allergy Foundation of America. March 28, 2007.
Prevalence And Treatment Of Food Allergies
To begin with, any food protein which triggers an allergic response is termed a "food allergen." It is estimated that up to 12 million Americans have food allergies or reactions to food allergens, and the prevalence is rising. Six to eight percent of children under the age of three have food allergies and nearly four percent of adults have them.* And food allergies cause roughly 30,000 emergency room visits and 100 to 200 deaths per year in the United States.**
Treatment consists of either immunotherapy/desensitization, or in many cases avoidance, in which the allergic person avoids all forms of contact with the food to which they are allergic. Although there are promising areas of food allergy research, including anti-IgE antibody and specific oral tolerance induction, as of now there is no "cure" (other than immunotherapy) for many people with food allergies. Individuals diagnosed with a food allergy may choose to carry an autoinjector of epinephrine (such as a Twinject or EpiPen), wear some form of medical alert jewelry, or (with the guidance of their doctor) develop an emergency action plan. This is due to the potential serious reactions that are possible to many people with food allergies.
Common Symptoms of Food Allergy Reactions
The most common type of food allergy reaction is called a "Classic immunoglobulin-E (IgE)-mediated" or Type-1 Immediate-Hypersensitivity Reaction. These allergic reactions have an acute onset (from seconds to one hour) and may include symptoms such as Angiodema, or soft tissue swelling, usually involving the eyelids, face, lips, tongue, larynx and trachea, which can obstruct the upper airway and make breathing difficult; hives; nausea, vomiting, diarrhea, stomach cramps and/or abdominal pain; wheezing; scratchy or itchy mouth, throat, eyes or skin; nasal congestion; shortness of breath and difficulty swallowing.
In very serious cases the reaction can progress to Anaphylaxis, which is a severe, whole-body allergic reaction which requires immediate medical attention and response, and that can even result in death without acute medical intervention.
Anaphylaxis, or "Anaphylactic Shock", is defined as a systemic reaction involving several different bodily systems, and includes hypotension, or a sudden drop in blood pressure, a loss of consciousness, and the shutdown of vital bodily functions as the individual goes into shock. Many different food allergens have been reported as triggers for Anaphylaxis, but the most common allergies associated with this type of reaction are peanuts, nuts, egg, milk and seafood.
Potential Causes And Types of Food Allergy Reactions
Food allergy has been diagnosed in all types of individuals, but is thought to develop more easily in patients who display atopic syndrome. Atopic syndrome is a common combination of diseases in people who exhibit "localized, and immediate, hypersensitivity to allergens" through eczema, allergic conjunctivitis and rhinitis, and asthma. A family history of allergic diseases is often indicative of atopic syndrome, and these combinations of allergic reactions are strongly correlated to family heredity.
Conditions caused by food allergies are classified into 3 groups according to the mechanism of the allergic response. The first is the "classic" response described above, the IgE-mediated reaction, or Type-I Immediate-Hypersensitivity Reaction.
The second category is called "IgE or non-IgE mediated" eosinophilic esophagitis, gastritis and gastroenteritis reactions, which refers to acute inflammation of the esophagus, stomach or intestines caused by reactions to allergens by white blood cells, which control mechanisms associated with allergy and asthma. The last category is includes other "non-IgE mediated" reactions, such as milk-soy protein intolerance (MSPI); or conditions like food protein induced enteropathy (a pathology of the intestines), found in the common condition of Coeliac Disease, which is an adverse immune reaction to the protein gluten.
The Big Eight Food Allergies
The term "Big Eight" refers to the most common food allergies.*** They account for over 90% of the food allergies found in the United States. They are:
Egg Allergy
Dairy Allergy
Peanut Allergy
Tree Nut Allergy
Seafood Allergy
Shellfish Allergy
Soy Allergy
Wheat Allergy
Outside the U.S. the list of top allergens tends to vary somewhat from country to country, but milk, eggs, fish, shellfish, peanuts, tree nuts, sesame, soy and wheat tend to be in the top 10. Allergies related to seeds, especially sesame, appear to be rising in most countries. There are also other more rare food allergies, including corn, rice, flour, various vegetables and fruit allergies and even red meat allergy, among others.
There are other conditions which can require food allergen avoidance but are not technically allergies, such as lactose intolerance, which is actually an enzyme deficiency, not an allergy; various causes of irritable bowel syndrome (IBS); or rarer conditions such as C1 esterase inhibitor deficiency, or hereditary Angiodema. We will address some of these conditions in upcoming blogs.
Diagnosis Of Food Allergy
If you suspect a food allergy, the best method for diagnosing the condition is by visiting an allergist. The allergist will review the patient's history and the symptoms or reactions that have been noted after food ingestion. If the allergist feels the symptoms or reactions are consistent with food allergy, he/she will perform allergy tests, which may include skin prick testing (Non-IgE mediated allergies cannot be detected using this method, however), which can provide quick and usually conclusive results, diagnostic blood tests (also not effective for Non-IgE mediated allergies), or food challenges, often conducted in a hospital environment due to the potential risk of Anaphylaxis. Other tools for diagnosis of eosinophilic or non-IgE mediated reactions can include endoscopy, colonoscopy and biopsy.
This Educational Series
There are various strategies and theories regarding prevention and treatment of many food allergies, and as we continue through our educational series on the "Big Eight," we will focus on each food allergy separately, addressing the potential causes, relevant statistics, prevalent scientific opinion and research, and the treatment for each of the individual allergy categories. We will also provide information and links to our new and existing food choices and other products that we offer at Allergy Free Shop that address each specific allergen. Through this informational series, we hope that we can help you better understand - and respond - to your child's individual allergy-free needs!
In our next "Big Eight" post: Peanut Allergy.
* National Institute of Allergy and Infectious Diseases (July 2004), National Institutes of Health. pp. 35.
** Food Allergy Facts and Statistics. Food Allergy & Anaphylaxis Network. 2007.
*** "Food Allergy Facts & Figures". Asthma and Allergy Foundation of America. March 28, 2007.
Labels: allergens, allergy free, anaphyaxis, dairy allergy, food allergy, peanut allergy, tree nuts allergy, wheat allergy
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