Early January is always a time for New Year's resolutions. And one annual goal for the parents of a food allergic child is to get through another year without any serious reactions. Here are some tips to help you accomplish that goal in 2010.

Tip 1 – Read labels.

If there is one skill that food allergic parents and individuals themselves must get good at, it's reading labels. Foods manufactured since January 2006 are required to clearly list the Big Eight food allergens that we have been discussing in previous blogs. But beware of hidden allergens, often found in non food items. Example: Some lotions contain "Arachis oil", which is derived from peanuts.

Items that are part of larger package are often marked "Not Labeled for Individual Sale," and the entire list of ingredients should be found on the original container or box.

And always read the label, even for items you have bought or consumed before. Ingredients and formulations can change over time. If you’re not sure of every ingredient that went into the item, don't eat it!

Tip 2 – Continue to educate family and friends.

Don't assume that since you told Aunt Edna years ago that little Tommy was allergic to wheat that she has taken the time to ensure that every item she serves or that he may be exposed to won't contain the allergen. Continually educate and remember: no one will be as diligent about your child’s allergy as you are.

When dining with others, you might consider providing all the food for the entire meal – for either your child individually or for the whole gathering, if feasible. Or simply skip the food issue altogether by spending special time with family and friends in nonfood-related activities.

Tip 3 – Closely monitor children while eating out.

Many smaller children will put whatever is in front of them into their mouth, and many accidental exposures are simply caused by not paying close enough attention. If possible, use a high chair or booster sear with a tray if a child’s allergens are being served.

For young children or infants, consider an item of clothing like our Star Alert shirt that tells others that your child has food allergies, to prevent well-meaning sharing.

Using these tips, and others you will find within the Allergy Free Shop website and other online resources (like the Mayo Clinic), you can create techniques and methods to ensure that your food allergic child can remain reaction free in 2010!

Labels: allergy free, anaphyaxis, big eight, dining out, food allergen, food 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. 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