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Food allergy and intolerance

Somepeoplearesensitivetoparticularfoodslikenuts,shellfishandcereals.Thesymptomsoffood allergycanincludebreathingproblems,stomachupsetsandskinrashes.Theyarecausedbyan immunesystemresponseorachemicalreactioninthebody.Someseverefoodallergiescanbelife threatening.Professionaldiagnosisisimportant,becauseothermedicalconditionsmaysharethe samesymptoms. Mostreactionstofoodareactuallyfoodintolerance.Aboutonein20childrenandonein100adults havefoodallergies.

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Allergy is on the increase

Allergiesingeneralareontheincreaseworldwideandfoodallergieshavealsobecomemore common,particularlypeanutallergyinpreschoolchildren.About60percentofallergiesappear duringthefirstyearoflife.Cowsmilkallergyisoneofthemostcommoninearlychildhood.Most childrengrowoutofitbeforetheystartschool.

Food allergy can be inherited

Childrenwhohaveonefamilymemberwithallergicdiseases(includingasthmaoreczema)havea 20to40percenthigherriskofdevelopingallergy.Iftherearetwoormorefamilymemberswith allergicdiseases,theriskincreasesto50to80percent.

Allergy is an immune response

Allergiesareanoverreactionofthebodysimmunesystemtoaspecificpartofafood,usuallya protein.Theseproteinsmaybefromfoods,pollens,housedust,animalhairormoulds.Theyare calledallergens.Thewordallergymeansthattheimmunesystemhasrespondedtoaharmless substanceasifitweretoxic.

Food intolerance is a chemical reaction

Foodintoleranceisachemicalreactionthatsomepeoplehaveaftereatingordrinkingsome foods;itisnotanimmuneresponse.Foodintolerancehasbeenassociatedwithasthma,chronic fatiguesyndromeandirritablebowelsyndrome(IBS).Foodintoleranceismuchmorecommon thanfoodallergy.

Symptoms can be similar

Itcanbedifficulttotellthedifferencebetweenthesymptomsoffoodallergyandfoodintolerance. Usually,symptomscausedbyfoodallergydevelopverysoonafterconsumingthefood,but,while symptomscausedbyfoodintolerancecanbeimmediate,theymayalsotake12to24hoursto develop. Foodintolerancereactionsareusuallyrelatedtotheamountofthefoodconsumed.Theymaynot occuruntilacertainamount(thresholdlevel)ofthefoodiseaten,butthisamountvariesforeach person. Thesymptomsoffoodallergyandintolerancecanalsobecausedbyotherconditions,soits importanttoseeyourdoctorforamedicaldiagnosis.

Symptoms of food intolerance

Symptomsoffoodintolerancecaninclude:

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Nervousness,tremor Sweating Palpitations Rapidbreathing Headache,migraine Diarrhoea Burningsensationsontheskin Tightnessacrossthefaceandchest Breathingproblems-asthma-likesymptoms Allergy-likereactions.

Symptoms of food allergy

Thesymptomsoffoodallergycanbelifethreatening.Commonsymptomsinclude: Itching,burningandswellingaroundthemouth Runnynose Skinrash(eczema) Hives(urticariaskinbecomesredandraised) Diarrhoea,abdominalcramps Breathingdifficulties,includingwheezingandasthma Vomiting,nausea.

Affected body parts

Varioussitesonthebodycanbeaffectedbyanallergicreactiontofood,including: Eyesitching,watering Nosestuffiness,sneezing Mouthitching,swelling Throatswelling Digestive systemstomachpains,vomiting,diarrhoea Skinrashes,suchashives(urticaria)oratopicdermatitis Lungsasthma,morecommoninchildrenthanadults Central nervous systemheadache,irritability,fatigue,convulsions.

Anaphylactic shock is life threatening

Anaphylaxis,oranaphylacticshock,isasevereallergicreactionthatneedsurgentmedical attention.Peanuts,othernuts,insectstingsandsomemedicinesarethemostcommonallergens thatcauseanaphylaxis.Withinminutesofexposuretotheallergen,thepersoncanhavepotentially life-threateningsymptoms,whichinclude: Difficultornoisybreathing Swellingofthetongue Swellingortightnessinthethroat Difficultytalkingorahoarsevoice Wheezeorpersistentcough Lossofconsciousnessorcollapse Becomingpaleandfloppy(inyoungchildren).

Severalfactorscaninfluencetheseverityofanaphylaxis,includingexercise,heat,alcohol,the amountoffoodeaten,andhowfoodispreparedandconsumed. Topreventsevereinjuryordeath,apersonwithanaphylaxisrequiresaninjectionofadrenalin. Injectionsofadrenaline,whichcanbegivenbythepersonthemselvesortheirfamilyorcarer,are availableonprescriptionordirectlyfromapharmacy.

Common causes of food allergy

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Nuts,eggs,milkorsoycauseabout90percentoffoodallergies.Peanutallergyisoneofthemost commonallergiesinolderchildren.Thesefoodscommonlycauseallergies: Eggs Peanuts Milk Othernuts Sesame Gluten Fish Grains,suchasrye,wheat,oats Soy Molluscs,suchasoysters,mussels,clam,squidandoctopus Crustaceans,suchaslobster,prawn,crab,shrimp Fruit,berries,tomato,cucumber,whitepotatoormustard Foodadditiveslikebenzoates,salicylates,MSGandsulphitederivatives.

Common causes of food intolerance

Thefoodsthattendtocauseintolerancereactionsinsensitivepeopleinclude: Dairyproducts,includingmilk,cheeseandyoghurt Chocolate Eggs,particularlyeggwhite FlavourenhancerssuchasMSG(monosodiumglutamate) Foodadditives Strawberries,citrusfruitsandtomatoes Wine,particularlyredwine Histamineandotheraminesinsomefoods.

Finding the allergen

Whensymptomsappearwithinafewminutesofeatingtheparticularfood,itmakespinpointing theallergenaneasytask.However,ifthecauseisunknown,diagnostictestsmaybeneeded,such as: Keepingafoodandsymptomsdiarytocheckforpatterns Removingallsuspectfoodsfortwoweeks,thenreintroducingthemoneatatimetotest forreactions(exceptincasesofanaphylaxis).Thismustonlybedoneundermedical supervision Skinpricktestsusingfoodextracts Blood(RAST)tests.

Avoiding the food

Theeasiestwaytotreatafoodallergyorintoleranceistoeliminateitfromthediet.Sometimes, thebodycantoleratethefoodifitisavoidedforatime,thenreintroducedinsmalldoses, particularlyforfoodintolerances.Beforeyoueliminatefoodsfromyourdiet,seekadvicefroma doctoranddietitian.

Preventing food allergy in children

Allergypreventioninchildrenisanactiveareaofresearch.Findingstodateindicatethat: Prenatalthereisnoconclusiveevidencethatavoidingallergensinpregnancywillhelp preventallergiesinyourchild. Postnatalexclusivebreastfeedingduringthefirstfourtosixmonthsappearstoprotect againstthedevelopmentofallergiesinearlychildhood.Exposuretocigarettesmokeand startingsolidsearlycanincreasetheriskofdevelopingallergiesinearlychildhood. Breastfeedingifababyisknowntobeallergictoaparticularfood,abreastfeeding mothershouldavoideatingthatfood.

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Soy formulastudieshaveshownthatusingsoymilkformuladoesnotpreventthe developmentofallergiesinchildren. Partially hydrolysed formulathesearecowsmilkbasedandhavebeenprocessedto breakdownmostoftheproteinsthatcausesymptomsininfantswhoareallergictocows milk.Theyreducetheriskofdevelopingeczemaandcowsmilkallergyininfancyandearly childhood.

Severe food allergy in children

Althoughanaphylaxisisrare,itdoesposeariskforsomepeople,includingchildren.Since2008, alllicensedchildrensservicesandschoolsinVictoriaarerequiredtohaveananaphylaxis managementpolicyinplace. Banningparticularfoodsisnotrecommendedasitcancreateasenseofcomplacencyandis difficulttomonitorandenforce.Abetterapproachistoeducatestaff,studentsandthecommunity abouttherisksassociatedwithanaphylaxisandputstrategiesinplacetominimiseexposureto knownallergens.

Tips to avoid foods that may cause allergies

Toavoidallergicfoods,learnthetermsusedtodescribethesefoodsonfoodlabels,forexample: Milk proteinmilk,non-fatmilksolids,cheese,yoghurt,caseinates,whey,lactose Lactosemilk,lactose Eggeggs,eggalbumen,eggyolk,egglecithin Glutenwheat,barley,rye,triticale,wheatbran,malt,oats,cornflour,oatbran Soysoybeans,hydrolysedvegetableprotein,soyproteinisolate,soylecithin Salicylatesstrawberries,tomatoes.

Food laws and labels

SinceDecember2002,theAustralia New Zealand Food Standards Coderequiresfoodlabelsto declarecertainfoodsandcertainsubstancesinfoods,including: Cerealsthatcontainglutenandglutenproducts Crustaceaandtheirproducts Eggsandeggproducts Fishandfishproducts Milkandmilkproducts Nutsandsesameseedsandtheirproducts Peanutsandsoybeansandtheirproducts Addedsulphitesinconcentrationsof10mg/kgormore Royaljelly,presentedasfoodorpresentinfood,beepollenandpropolis.

Thesefoodsmustbedeclarediftheyare: Usedasaningredient Partofacompoundingredient Afoodadditiveorpartofafoodadditive Aprocessingaidorpartofaprocessingaid.

Where to get help

Yourdoctor AnAccreditedPractisingDietitian,contacttheDietitiansAssociationofAustralia NutritionAustraliaTel.(03)96505165 BetterHealthChannelhasproducedarangeofrecipesforpeoplewithspecialdietary requirements.

Things to remember

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Afoodallergyoccurswhentheimmunesystemreactstoaharmlessfoodasifitwere toxic. Foodintoleranceoccurswhenthebodyhasachemicalreactiontoeatingaparticularfood ordrink. Thesymptomstoafoodallergyorintoleranceareoftensimilar,butfoodintolerancesdo notcauseseverereactionssuchasanaphylaxis. Learntoreadfoodlabelssoyoucanavoidfoodsthatcauseallergies.

This page has been produced in consultation with, and approved by:

AustralasianSocietyofClinicalImmunologyandAllergy(ASCIA)
Contentonthiswebsiteisprovidedforeducationandinformationpurposesonly.Information aboutatherapy,service,productortreatmentdoesnotimplyendorsementandisnotintendedto replaceadvicefromyourdoctororotherregisteredhealthprofessional.Contenthasbeen preparedforVictorianresidentsandwiderAustralianaudiences,andwasaccurateatthetimeof publication.Readersshouldnotethat,overtime,currencyandcompletenessoftheinformation maychange.Allusersareurgedtoalwaysseekadvicefromaregisteredhealthcareprofessional fordiagnosisandanswerstotheirmedicalquestions. Forthelatestupdatesandmoreinformation,visitwww.betterhealth.vic.gov.au Copyight 1999/2012StateofVictoria.ReproducedfromtheBetterHealthChannel (www.betterhealth.vic.gov.au)atnocostwithpermissionoftheVictorianMinisterforHealth. Unauthorisedreproductionandotherusescomprisedinthecopyrightareprohibitedwithout permission.

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