This is the time of year that many parents begin the annual search for day or vacation camp options for their children. And while many parents spend time analyzing recreational activities or educational content, parents of children with food allergies or asthma have one more major item to consider when picking the right camp for their kids.

Following a few simple tips can help parents or guardians choose the right environment for their allergic loved ones.

Start with Research

First, decide what type of camp you and your children want. There are many options!
Are you interested in a day camp, or an overnight one? What about extended stay programs?

And what is the focus of the camp? Popular themes include art, sports, music, religious-based and general activity camps.

You can research most camps and summer programs online. Attend camp fairs or open houses to gather more detailed information.

Create a List of Questions for the Camp Director

What experience have they had (if any) with food allergic campers?

Is a health care professional or nurse available at all times? What are their credentials?

Is there a hospital or medical facility nearby in case of emergencies? Transportation?

Where will medications be kept, and who is trained to give them?

After You’ve Chosen a Camp

Continually educate your child about allergy management, reading labels and self advocacy

Prominently mention food allergies in all camp registration paperwork

Speak directly with camp director, medical staff and cooks

Provide up-to-date medication, clearly labeled

Other Things to Remember

Inquire about ANY food-related activities and events, such as craft projects – you may be surprised what you learn!

Bringing your own food and snacks is always an option

Keep in mind that “peanut free” has many definitions, and is not a guarantee

Another good thing to inquire about, regardless of any medical considerations, is the camper-to-staff ratio. Of course the lower the ratio, the better! And don’t be afraid to ask for references; well-established camps and other summer programs can probably provide them. Try to find families that deal with similar allergies and talk with them.

With the proper planning and preparation, your child can have a great, memorable time this summer – learning new things and making new friends – without the worry of food allergy reactions!

Labels: allergens, allergy free, anaphylactic, food allergy, peanut allergy, summer camp

One question that we often hear from the parents of food allergic children is: Why have food allergies become so common these days?

That’s a difficult question, though many researchers are working hard for the answer. There are a variety of scientific theories that are currently being discussed. One potential cause could be the relatively recent introduction of genetically modified foods.

Genetically modified crops (GMOs) were introduced in the U.S. in the early 1990s, and foods created from these crops hit our supermarkets shortly thereafter. These crops have modified genes that allow them to grow faster, bear more fruit or even create their own insecticide. In layman’s terms, this engineering is the process of taking genes from one strain of an animal, plant, virus or bacteria, etc. and then inserting them into another, with the goal of reproducing characteristics of the original host species in the receiving species.

One example is a specific soybean variety genetically modified to be virtually immune to the popular Roundup herbicide, a chemical which kills almost any other plant. Of course, we consumers are then eating these modified soybeans.

How good are these foods for the human immune system? No one really knows! But some preliminary research studies have linked genetically modified foods with the creation of food protein antibodies in mice.

Another theory is called the “hygiene hypothesis” – which basically says that because we keep our homes, schools, other public places, and general environment too clean, we don’t give our immune systems something “worthy” to work on. The result is that our immune systems turn on themselves, and create problems such as the peanut protein, for example.

The hypothesis gained some credibility in the late 1980s, when health researchers compared the rates of allergies and asthma throughout the newly unified Germany.
Researchers assumed that the children growing up in the communist East, a poorer, dirtier environment, would suffer from more allergy and asthma than youngsters in the West, with its cleaner and more modern environment.

Actually, the opposite was found to be true. Children in the polluted areas of East Germany had lower allergic reactions and fewer cases of asthma than children in the West.

This is in line with the hypothesis, which suggests that when the human immune system lacks practice fighting bacteria and viruses, perhaps from an overly sanitary lifestyle, the system then overreacts to harmless substances like pollen.

In addition to a less sanitary environment, East Germany families tended to be larger, and rely more on the use of daycare for young children, two more factors that could attribute to their children being exposed to more microbes and potential irritants.

And there are many other potential culprits for the increase in food allergies – such as overall genetics, eating allergic foods during pregnancy, or use of vaccines in children. But there are no clear-cut or obvious reason(s) for the increases in food allergies, and for now these are just educated guesses, and nothing more.

We hope that science and medical research can one day unlock the mystery of food allergies, and how we can potentially treat or even cure them sometime in our future. Until then, the only completely reliable defense is avoidance…so the Allergy Free Shop will be here to provide the most up to date information and the allergy free foods and products that you need to keep your loved ones safe.

Labels: allergens, allergic reaction, allergy free, anaphylaxis, big eight, food allergen, food allergy, ingredients, peanut allergy, peanut proteins, wheat allergy

At the Allergy Free Shop, we not only cater to the specific needs of those with food allergies, but also to those individuals with dietary requirements due to other medical conditions. One of these conditions is Celiac Disease, an autoimmune disorder of the small intestines. It can occur in people of all ages, from early infancy to adulthood, and is also known by a number of other names such as sprue or gluten enteropathy. Sometimes it is spelled "coeliac" disease.

The condition is caused by a reaction to gluten proteins found in wheat and similar crops, such as barley and rye. Some individuals even react to oats. And while the disease is caused by a reaction to wheat proteins, it is important to note that it is not the same as wheat allergy.

Direct causes of the disease are not completely understood, though the timing of an infant’s exposure to wheat, barley or rye may be related to the development of the condition. Currently, most experts believe the best time for exposure is at the age of four to six months. Breastfeeding until the introduction of these grains is also believed to reduce the risk of the disease.

Upon exposure to wheat proteins, the immune system of the affected individual reacts with the small-bowel tissue, causing inflammation. This chronic inflammation can damage the lining of the small intestines, and prevent the absorption of nutrients. Symptoms typically include chronic diarrhea and fatigue, and a "failure to thrive" in young children.

Blood tests are usually the first line of diagnosis for those suspected of Celiac Disease, and a growing number of asymptomatic people are being diagnosed due to increased screening.

Experimental treatments are currently being studied, such as the development of genetically engineered wheat, but at present the only effective treatment is a life-long gluten-free diet. No medication exists as of now that will prevent the body from attacking the intestines when gluten is present.

Strict adherence to the diet allows the intestines to heal, leading to resolution of all symptoms in most cases. Since ready-made products often contain traces of gluten, some celiacs may find it beneficial or necessary to cook meals from scratch. The good news is that a gluten free diet may be able to reduce or eliminate the heightened risk of other health problems, such as osteoporosis and intestinal cancer, which are associated with Celiac Disease.

The Allergy Free Shop has over 700 products that are gluten free, including Schar Ladyfingers for making delicious tiramisu, or Ener-G white tapioca loaf.

Labels: allergens, allergic reaction, allergy free, big eight, celiac, food allergen, food allergy, gluten, wheat allergy

Over 12 million Americans have a food allergy, and this number is rising. One clear example, the number of children with peanut allergies recently doubled over a 5-year period. Scientists aren't completely sure why the numbers are increasing, and are working hard to find out. But many would agree that more robust research budgets are needed to study all aspects of food allergies, including treatment and prevention.

And the stakes are high, since Americans currently make 30,000 visits to the emergency room for food allergy every year. Thankfully, one thing that research has demonstrated is that immediately injecting epinephrine - a hormone which suppresses the immune system - into the thigh muscle is the best treatment for severe allergy reactions and anaphylaxis.

Teens and young adults are at highest risk for fatal allergic reactions to food, often because they aren't in the presence of a mindful parent, or perhaps that they tend to consume food more quickly. By studying teens' behaviors, researchers have identified ways to decrease their risk through food avoidance and education, by teaching them to identify the signs of anaphylaxis, to carry epinephrine at all times and to be able to properly inject it.

Anaphylaxis can occur with many different symptoms, and can develop in just a few minutes or hours later. The most common symptoms are usually hives or general itchiness, flushing skin and/or swelling of the lips, tongue or throat. Shortness of breath, abdominal pain or vomiting, and feelings of lightheadedness (due to drop in blood pressure) are other common signs.

If you have a teen with food allergies, or a child that will soon be a teenager, they should know to avoid certain foods, and hopefully feel comfortable asking questions and reading labels. It is equally important that you take the time to go over these symptom details and the proper identification and treatment of acute reactions. And make sure they always have epinephrine available to them at all times.

Yes, this may mean some ongoing inquiries or continual education for your child. But remember, many teens and young adults feel as if they are invincible and/or don’t always plan ahead, so these reminders could save their life!

Labels: allergens, allergic reaction, allergy free, anaphylaxis, big eight, dairy allergy, food allergy, peanut allergy, tree nuts allergy, wheat allergy

The Allergy Free Shop exists to provide parents and caretakers with allergen-free foods and products for those with food allergies and sensitivities. We also strive to provide resources that help to provide guidance to those just beginning their education about specific food allergies affecting their children.

Prevalence & Prognosis

Tree Nut Allergy is a hypersensitivity to dietary substances from tree nuts, causing an overreaction of the immune system which may lead to severe physical symptoms for millions of people.

Tree nut allergies occur mainly, but not exclusively, in children. They are usually treated with an exclusion diet and vigilant avoidance of foods that may be contaminated with tree nuts or nut particles and/or oils.

Common tree nuts include cashews, almonds, pecans and walnuts. It should be noted that tree nut allergy is slightly different from peanut allergy because the type(s) of nuts that cause the allergic reactions are not the same. Peanuts are actually considered legumes, whereas tree nuts are classified as dry fruits.

The symptoms of peanut allergy and nut allergy can be the same, but a person with tree nut allergies may not necessarily be allergic to peanuts, and vice versa. For a frame of reference, research by Mount Sinai School of Medicine shows there is a 30 to 60% chance a child with a peanut allergy will develop a tree nut allergy as well. As with all food allergies, it is possible to "outgrow" tree nut allergy.

Tree Nut Avoidance

Similar to other allergies, the most severe nut allergy reaction is called anaphylaxis, and is an emergency situation requiring immediate attention and treatment with epinephrine. A strict exclusion diet and vigilant avoidance of foods that may contain or be contaminated with tree nut allergens is the only 100% effective treatment.

Some people also wonder if other common food products are classified as tree nuts, such as coconut, nutmeg or water chestnuts. The answer is no, although it is possible to be allergic to these food items on their own. (Coconut has even been determined to be a tree nut by the FDA for the purposes of labeling, but does not cross react with tree nuts allergies.)

Allergy Free Shop offers a wide variety of foods that are Tree Nut Free. Some of our best sellers are Orgran’s Vanilla Outback Animals and Itsy Bitsy Bears, as well as No Nuttin’s Semi-Sweet Chocolate Chips, and Vermont Nut Free’s yummy chocolate covered pretzels. Our entire line of Tree Nut Free products can be found here.

Our goal is to provide you with a wide variety of allergy-free products for you and your children, a place where you can find EVERYTHING that you need in one place. And with ongoing vigilance, and armed with an understanding of your child's or loved one's food allergy, you CAN avoid exposure and reactions to Tree Nut allergens!

Labels: allergens, allergic reaction, allergy free, anaphylaxis, big eight, food allergy, ingredients, peanut proteins, tree nuts allergy

The Allergy Free Shop exists to provide parents and caretakers with allergen-free foods and products for those with food allergies and sensitivities. We also strive to provide resources that help to provide guidance to those just beginning their education about specific food allergies affecting their children.

Just in time for New Year’s Eve celebrations, and also perhaps a large plate of cocktail shrimp, our next allergy profile is Shellfish.

Prevalence & Prognosis

Shellfish allergy is one of the most common food allergies. When referring to this allergy, "shellfish" refers to all marine animals with shells, such as clams, oysters, crabs, lobster and shrimp, as well as octopus and squid.

Those that have shellfish allergy may have an allergic reaction to only certain kinds of shellfish, or an allergy to ALL shellfish.

Shellfish allergy is different than many other food allergies because it occurs primarily in adults and older children, as opposed to infants/younger children. But it can appear at any age, and can be caused by foods that had been previously eaten without any problems. Many people who develop a reaction to shellfish allergens will not lose or "outgrow" the allergy later in life.

Avoiding Shellfish

Seafood allergies are usually treated with an exclusion diet and vigilant avoidance of foods that may be contaminated with shellfish or fish ingredients and/or oils. As with all food allergies, reading labels is a must!

Of course, any restaurant that serves or specializes in seafood should be approached very cautiously or avoided completely. Allergic individuals also need to be especially careful with fried foods. Many restaurants use the same oil to fry shrimp, chicken and French fries. Keep in mind that "imitation" shellfish may still actually contain allergens, as manufacturers often add small bits of real shellfish for flavoring. (Imitation shellfish is often sold for strictly financial reasons, not allergy-related ones.)

Another unique characteristic of shellfish allergy is that allergic reactions may result when the susceptible person is not even consuming the allergenic substance, but by exposure to vapors resulting from cooking of seafood or even preparation or handling.

Other products which often are comprised of shellfish are glucosamine and Omega 3 supplements. Allergy Free Shop offers a wide variety of foods and dietary supplements that are Shellfish Free. Some of our best sellers are the Hero Nutritional line of supplements such as Slice of Life Omega 369, and children’s Yummi Bears multivitamins.

Our goal is to provide you with a wide variety of allergy-free products for you and your children, a place where you can find EVERYTHING that you need in one place. And with ongoing vigilance, and armed with an understanding of your child’s or loved one’s food allergy, you CAN avoid exposure and reactions to Shellfish allergens!

Labels: allergens, allergy free, big eight, food allergy, shellfish allergy

The Allergy Free Shop exists to provide parents and caretakers with allergen-free foods and products for those with food allergies and sensitivities. We also strive to provide resources that help to provide guidance to those just beginning their education about specific food allergies affecting their children.

Prevalence

Dairy allergy is one of the most common in young infants, with 2-3% of children under three years of age allergic to cow's milk proteins. It is now standard procedure for a doctor to suggest not giving an infant cow's milk until they are at least 12 months old. Be careful of giving your child formulas with milk products in them, especially if milk allergy runs in your family. Many infant formulas that claim to be milk-free do in fact have derivatives of milk in them.

Chronic gastrointestinal distress, vomiting and severe diarrhea are all symptoms of milk allergy. Hives, swelling and other allergic reactions may accompany the reaction. Breastfeeding is generally the best alternative if allergies run in your family. If you have already started on formula, try a soy based formula instead. Some of the soy formulas do have a significant amount of iron in them which may also be upsetting to your child. There have been conflicting studies linking soy formula to peanut allergies. It may be necessary to try out several formulas before finding a good match. Watch out for "lactose-free" labels, because that's not necessarily an indication of a milk-free product.

It should also be noted that lactose intolerance is not milk allergy. Instead, it is a problem in the digestive system caused from not producing enough of the lactase enzyme to break down the lactose sugar into simpler sugars. People who experience lactose intolerance have the crampy, abdominal pain that can turn into nausea and diarrhea. Lactose intolerance can be lifelong or temporary - especially following an intestinal illness, or even a round of antibiotics. In the US, lactose intolerance is most common among African Americans, Asians and Native Americans.

Prognosis

If your child is allergic to milk, don’t despair, as most children do in fact grow out of their milk allergy. Virtually all infants who develop a cow’s milk allergy do so in the first year of life, with almost 80% "outgrowing" their milk allergy by the age of 16. The bad news, however, is that the prognosis for a child with milk allergy appears to be worse than it was 20 years ago. Now only do kids have more allergies, but a growing number do not outgrow their allergies, and those who do, do so later than before. Doctors have found that a child’s blood levels of milk (and egg) antibodies - the immune chemicals produced in response to allergens - were a reliable predictor of disease behaviors. The higher the level of antibodies, the less likely it was that a child would outgrow the allergy any time soon.

But until tests confirm this, or more likely - accidental ingestion with no adverse reaction whatsoever - it is certainly best to stay away from milk and milk products entirely. 60% of cow's milk-allergic infants experience IgE-mediated reactions, or the more classical "immediate" reactions affecting the skin (hives and eczema), gastrointestinal tract (crampy abdominal pain and vomiting), and the respiratory tract (nasal congestion, sneezing and wheezing). Nearly 25% of these milk-allergic infants retain their sensitivity into the second decade of life, and 35% go on to develop other food allergies.

Non IgE-mediated milk allergy affects primarily the gastrointestinal tract resulting in a number of different allergic disorders: milk-induced enterocolitis syndrome, proctocolitis syndrome, allergic eosinophilic esophagitis, etc., which can lead to poor growth and failure to thrive. There is a chance your child will test negative to dairy on an allergy test, yet still show symptoms of an allergy. In this case, the non-IgE milk-allergy may be at play, or lactose intolerance may be the culprit.

More recently diagnosed food allergies, for still-unknown reasons, behave more unpredictably and more aggressively than cases diagnosed in the past. Some doctors believe we may be dealing with a different kind of disease process than we did 20 years ago. Why this is happening is an unknown at this point.

Avoiding Milk Products

Reading labels is a must for a milk-allergic child! The Food Allergy Labeling Consumer Protection Act (FALCPA) was passed in 2004, requiring that labels be marked such that a 7 year old could read and understand the ingredients and that all allergens be declared even if they are in the spices or flavoring. For more information on this important law, please see: http://www.foodallergy.org/Advocacy/labeling.html

Of course, milk is in virtually all cheeses, butter, creams and yogurt. The lactose free milks do still have milk protein, so avoid them. They are made such that the lactose-intolerant individual can digest them, but are not made for the milk-allergic. Stick with milk substitutes, such as soy and rice milk.

Casein and whey are other names that milk can be called on a label. There are other names that also indicate the presence of milk, and your allergist can provide for you a complete list of milk products and ingredients to avoid.

Some other advice on eating at restaurants: you may want to avoid Mexican restaurants (too great a chance that grated cheese can cross-contaminate), Italian restaurants (same for parmesan cheese), Chinese (lactose is in many of the sauces), and breakfast restaurants (milk and butter are often used on the griddles).

Also be on the lookout for lactose in many popular inhalers, used in these medications to bulk up tiny medication particles. Other medicines (such as 10 mg tablets of Singulair) contain lactose which can adversely affect the milk allergic. Many over the counter medications also contain lactose, so make sure you read the label prior to purchase! Talk with your pharmacist should you have questions.

Allergy Free Shop offers a wide variety of foods that are Dairy Free. Some of our best sellers are Enjoy Life's Boom Choco Boom dairy-free chocolate bars, Vance's Dari Free chocolate powder, and Home Free dairy-free chocolate chip cookies. You can view our entire stock of over 700 Dairy Free foods and beverages here.

Our goal is to provide you with a wide variety of allergy-free products for you and your children, a place where you can find EVERYTHING that you need in one place. And with ongoing vigilance, and armed with an understanding of your child's or loved one’s food allergy, you CAN avoid exposure and reactions to Milk allergens!


Hugh A. Sampson, M. D., "Food Allergy News", The Food Allergy & Anaphylaxis Network (FAAN), June 2004.

Johns Hopkins Children's Center, Science Daily, December 2007.

Justin Skripak, M.D., Jessica Savage, M. D., Elizabeth Matsui, M.D., Journal of Allergy and Clinical Immunology, November and December 2008.

Labels: allergens, allergic reaction, allergy free, big eight, dairy allergy, food allergy, ingredients

The Allergy Free Shop exists to provide parents and caretakers with allergen-free foods and products for those with food allergies and sensitivities. We also strive to provide resources that help to provide guidance to those just beginning their education about specific food allergies affecting their children. This series focuses on the "Big Eight" - the eight most prevalent food allergies found in the U.S. Most are very common in other parts of the world as well. They are Peanut Allergy, Egg Allergy, Dairy Allergy, Tree Nut Allergy, Seafood Allergy, Shellfish Allergy, Soy Allergy and Wheat Allergy.

One of the most potentially dangerous allergies in both children and adults is peanut allergy. In very serious cases the reaction to peanut proteins in allergic individuals can progress to anaphylaxis - a severe, whole-body allergic reaction which requires immediate medical attention and response.

Those with peanut allergy are hypersensitive to the proteins found in whole peanuts, peanut particles and peanut-based oils. This causes an overreaction of the body's immune system, which in a small percentage of people may lead to severe allergic response and potentially life-threatening physical symptoms. It should be noted that peanut allergy is distinct from allergies related to tree nuts, but the majority of those allergic to peanuts are also allergic to other nuts, like walnuts, cashews or brazilnuts.

The Body's Reaction To Peanuts

After initial exposure, the body reacts to the peanut proteins by generating IgE antibodies, which then will attach to most of the mast cells with the next exposure to peanuts. The IgE signal then tells the cells to flood the body with histamines and other mediator chemicals, which causes the allergic reaction. Reactions to peanuts or peanut proteins can happen within a few minutes, or hours after exposure. Initial symptoms often include wheezing, a tingling or itchy sensation on the lips, tongue or in the throat, sneezing, feelings of light headedness and or warmth and flush skin. Vomiting, diarrhea, hives, angioedema (swelling of the lips, face, throat and skin) and asthma attacks can all occur.

Without acute medical treatment, symptoms can quickly progress to bronchospasm, or obstruction of the lower and/or upper airway, and hypotension, a sudden drop in blood pressure. This may lead to full anaphylactic shock, with potential heart failure and even death.

Causes And Prevalence

The exact cause of the development of peanut allergy is unknown, but similar to many other food allergies, it is believed to have a strong genetic component, and is more likely to develop in children who have 1st-degree relatives with atopic disease (other allergies). Other factors, such as race, also play a role; Native Americans in particular seem less prone to develop peanut allergy.

It is not believed that exposure to peanuts during pregnancy or during breast-feeding is a cause of peanut allergies, though some studies have found that delaying the introduction of peanut products with children can potentially increase the risks of developing a peanut allergy.*

The Asthma and Allergy Foundation estimates that peanut allergy is the most common cause of food-related death. However, deaths from peanut allergy reactions are still relatively rare; about 100 people per year die from peanut allergies. It should be noted that asthmatics that also have peanut allergy are more likely to develop life-threatening reactions.

Prevalence among children and adults is roughly the same, about 1%. But as with many other food allergies, peanut allergy seems to be on the rise in children in the United States. The number of young children affected with peanut allergy doubled between 1997 and 2002, although about 25% of children with a peanut allergy will eventually outgrow it.**

Treatment Of Peanut Allergy

There have been recent studies that have attempted to de-sensitize children to peanut allergens by exposure to minute, but escalating doses of peanut protein, and has met with some success. But it should be noted that currently there is no confirmed treatment to cure, or prevent, allergic reactions in those with the allergy that are exposed to peanuts.

An exclusion diet, with strict avoidance of peanuts and peanut protein containing products, is the only sure way to avoid allergic reactions. This can be difficult, since some products that you might not expect to contain peanut proteins - such as chocolate and other candies, ice cream, crackers, chili and spaghetti sauce - may in fact contain them. The ubiquity of peanut containing foods in our diet makes avoidance difficult. This makes accidental ingestions and reactions fairly common. For this reason, it is highly recommended that both children and adults with peanut allergy carry epinephrine injectors in case of anaphylaxis.

Allergy Free Shop offers a wide variety of foods that are Peanut Free. Some of our best sellers are Vermont Nut Free Milk Chocolate Skippers, Orgran Outback Animals, and the Enjoy Life Boom Choco Boom Rice Milk Chocolate Bar. You can view our entire stock of over 600 Peanut Free foods and beverages here.

Our goal is to provide you with a wide variety of allergy-free products for you and your children, a place where you can find EVERYTHING that you need in one place. And with ongoing vigilance, and armed with an understanding of your child's or loved one's food allergy, you CAN avoid exposure and reactions to these specific food allergens!

* Food allergy advice may be peanuts, Science News magazine, Dec 6 2008

** Great Ormond Street Hospital for Children NHS Trust and UCL Institute of Child Health, Peanut Allergy - Family Factsheet

Labels: allergens, allergic reaction, allergy free, anaphyaxis, anaphylactic, angioedema, food allergy, ingredients, peanut allergy, peanut proteins

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.

Labels: allergens, allergy free, anaphyaxis, dairy allergy, food allergy, peanut allergy, tree nuts allergy, wheat allergy

Many families will leave the cooking and cleaning to others this Thanksgiving holiday, and be dining at restaurants or other people's homes instead. But failure to establish a clear line of communication between patron and establishment when dining out or with your host when eating with friends and family, along with surprise ingredients sometimes found in traditional dishes, are frequent causes of allergic reactions. And sometimes even clear communication can result in errors, such as restaurant staff that provide answers to ingredient questions with incomplete or inaccurate information.

If your family is planning on dining out this year, know how to avoid high risk situations. Here are some examples:

Creative Chefs

Thanksgiving is a holiday filled with traditional dishes - ones that many have known and loved for years. But never assume that a dish contains only traditional ingredients. In an effort to add new or unique flavors to dishes, chefs will often experiment with other surprise ingredients, so don't be caught off-guard when ordering. For example, many whipped potato side dishes contain walnuts in them. Other examples of unexpected ingredients sometimes found in traditional Thanksgiving dishes:

- Cranberry sauce: pecans, wheat
- Gravy: peanut butter, soy, Worcestershire sauce (fish)
- Mashed potato: cheese, cream cheese
- Pumpkin pie: peanut butter
- Stuffing: almond, crab, oysters, shrimp
- Sweet potato casserole: eggs, milk, pecans, walnuts

Buffet Style Restaurants

As is always the case, you can avoid problems by steering clear of help yourself dining styles, where serving utensils are sometimes shared between dishes or food is accidentally dropped into other food containers. If you do find yourself in a buffet style restaurant, work with the manager and order from the menu instead. If you are in someone's home, make arrangements to serve yourself first.

Fried Foods

You should avoid fried foods, as they are often all prepared in the same cooking oil. For example, if a fryer was used to fry shrimp, and the same oil is later reused to fry chicken, the chicken will then contain shrimp protein, and could cause an allergic reaction in someone who is allergic to shrimp.

Desserts

A study of allergic reactions to peanuts or tree nuts in restaurants found that 43% of the reactions were caused by desserts*. For example, many wait staff may not have an all-inclusive knowledge of which desserts contain nuts, and may incorrectly inform you that an item is nut-free. Often the best choice is to avoid eating desserts completely while dining out. Instead, have a special allergen-free - and worry-free - dessert or treat waiting for you when you return home!

Establish Clear Communication

In the same study, it was found that of 106 individuals with known food allergies who suffered allergic reactions while dining out, only 45% gave prior notification about the allergy to the dining establishment*. And for at least 83 (78%) of these 106 reactions, someone in the establishment knew that the food contained the allergen as an ingredient; in 50% of these incidents, the food item was "hidden" (in sauces, batter, dressings, etc.), making visual identification impossible. So be sure to inform wait staff, and ask questions! Also be sure to keep your medications, such as an EpiPen, on hand just in case. And remember, these tips can also be applied to any other traditional dishes you may encounter throughout the year.

With some preparation and by following these tips, you can help assure yourself of an allergy-free Thanksgiving holiday. So that most importantly, you can enjoy this special time with friends and family!

*Furlong, Terence J., M.S.; The Journal of Allergy and Clinical Immunology; 01-NOV-2001; 11692117 (PubMed ID)

Labels: allergens, allergy free, dairy allergy, dining out, ingredients, peanut allergy, Thanksgiving, traditional dishes, tree nuts allergy, wheat allergy