Food Allergy vs. Food Sensitivity: Know the Difference for Better Health
1) Introduction to Food Allergy
vs. Sensitivity
Food allergies and food
sensitivities are two distinct forms of unpleasant dietary reactions. A food
allergy is induced by the immune system, whereas a food sensitivity or
intolerance is triggered by the digestive system.
a) Definition of Food Allergy and Food Sensitivity
Food allergies are
immune-mediated reactions to specific foods. When your immune system recognizes
a protein in your diet as an invader, it responds by generating antibodies to
combat it. Food allergies cause skin reactions such as hives, swelling, and itching,
as well as anaphylaxis, which causes trouble breathing, wheezing, dizziness,
and, in severe cases, death.
Food sensitivity or intolerance,
on the other hand, is caused by an inability to metabolize or digest a food.
Food sensitivity symptoms include gas, bloating, diarrhea, constipation,
cramps, and nausea. Food sensitivities and intolerances are more frequent than
food allergies, although they are not fatal.
b) Historical Perspective on Food
Allergies and Sensitivities
Food allergies and sensitivities
are a concept that has evolved over time. Charles Richet invented the term
anaphylaxis in the early twentieth century and linked it to food sensitivities.
Anaphylaxis is a severe allergic reaction that can occur quickly and result in
death. Richet's discovery of anaphylaxis indicated that immune reactions might
have negative consequences, and it gave the first proof that an immune response
could both inflict damage and give protection against disease.
Due to inadequate sensitivity,
most allergists rarely used in vitro food-specific IgE levels in their food
allergy work-up until the mid-1990s. Specific IgE to allergen extracts and
specific IgE to allergen components are two in vitro assays for food allergy.
For many years, specific IgE (sIgE) testing has been used to diagnose food
allergies. Using a threshold of 0.35 kU/L, however, sIgE testing shows
excellent sensitivity but low specificity for diagnosing food allergies. This
means that, while the test can correctly identify people who have food
allergies, it can also yield false-positive findings for people who do not have
allergies.
Advances in the understanding of
food allergies and sensitivities, as well as improvements in diagnostic
procedures, have occurred in recent years. For example, the basophil activation
test is increasingly being utilized in clinical settings to diagnose food
allergies. Furthermore, research into medicines such as oral and sublingual
immunotherapy shows promise for better treatment of food-induced anaphylaxis.
It should be noted that the
natural history of food allergies differs depending on the allergen. Many food
allergies that develop in children are outgrown later in life, while a small
percentage of food allergies remain throughout adolescence and adulthood.
Understanding the natural course of food allergies can help clinicians diagnose
food allergies and decide whether to undertake food allergy resolution
evaluation.
c) Immunological Basis of Food
Allergies and Sensitivities
Food allergies are a type of
atopic disorder that can be divided into three types: those that are IgE
mediated, those that are mediated by both IgE-dependent and IgE-independent
pathways (mixed), and those that are not IgE mediated. Sensitization to food
allergens causes incorrect inflammatory immune responses to typical foods in
people with food allergies.
Food sensitivities, on the other
hand, are not caused by the immune system. They are caused by causes such as a
lack of enzymes required to digest a specific food, reactivity to food
additives or preservatives, pharmacological variables such as coffee or other
chemical sensitivity, and sensitivity to sugars naturally found in certain
foods.
d) Epidemiology of Food Allergies
and Sensitivities
Food allergy and sensitivities
are a rising global concern, affecting people of all ages, races,
nationalities, and socioeconomic backgrounds. Food allergies are caused by an
aberrant immunological reaction to certain proteins in food, whereas food sensitivities
and intolerances involve the digestive system and are often milder.
Food allergies have become more
common in recent years, with new research indicating that they impact a rising
number of infants, children, and people worldwide. Milk, eggs, fish, shellfish,
peanuts, tree nuts, wheat, and soybeans account for 90% of allergy reactions.
Food allergies are more frequent in youngsters, with a 5-8% prevalence in
children under the age of three. However, new data show that an even larger
percentage of adults are affected, with an estimated 10.8% of US adults
suffering from a food allergy.
Food sensitivities and
intolerances are more widespread than food allergies and have a wide range of
symptoms. Food sensitivity symptoms can include gas, bloating, diarrhea,
constipation, cramps, and nausea. Food intolerances typically affect mainly the
digestive system and create less severe symptoms than food allergies. Food
allergies and sensitivities or intolerances must be distinguished because the
management and potential health effects of each illness varies dramatically.
To summarize, the epidemiology of
food allergies and sensitivities is a complicated and dynamic area, with an
increasing number of people afflicted globally. Understanding the frequency of
these disorders, their risk factors, and the potential health repercussions is
critical for informing public health efforts, clinical management, and
individual lifestyle choices.
2) Understanding Food Allergies
Food allergies occur when the
immune system overreacts to a normally harmless chemical, resulting in an
allergic reaction. Peanuts, tree nuts, fish, shellfish, eggs, milk, wheat, and
soy are the most prevalent food allergies in the United States. Symptoms can
range from mild to severe, including a potentially fatal reaction known as
anaphylaxis, which can include difficulty breathing, disorientation, and
fainting.
a) Molecular Biology and
Immunology of Major Food Allergens
Certain proteins in food cause
food allergies. When a person with a food allergy consumes a food containing
these proteins, their immune system produces immunoglobulin E (IgE), which
neutralizes the allergen. The next time the person consumes even a small amount
of that food, the IgE antibodies cause the immune system to release chemicals
into the bloodstream, including histamine, resulting in allergic symptoms.
According to a study published in
the Journal of Allergy and Clinical Immunology, the allergenicity of foods may
be attributed in part to three-dimensional protein structures found in many
different plants that induce allergies. According to the study, 65% of 129
major plant food allergens belonged to just four structural families, implying
that specific protein structures contribute to a plant's allergenicity.
Some of these typical structures
may cause a protein to be extremely stable and hence difficult to digest. For
example, the cupin family, one of the four dominating families found in this
study, features barrel-shaped portions (the family takes its name from cupa, a
Latin word meaning "barrel"). Because of this structure, the proteins
are relatively stable, which may contribute to their allergenicity.
The researchers also looked at
surface features of cross-reactive proteins. One protein family, the Bet v 1
homologues, demonstrated exceptional surface shape conservation across plants.
The researchers researched the family thoroughly to learn more about it and how
it explains the allergic cross-reactivity between birch pollen and plant foods
like apples and celery.
Mills claims that the degree of
change on the surface of the allergenic protein appears to correlate with the
severity of allergic symptoms experienced by patients. Api g 1, a Bet v
1-related allergen, is present in celery, but its surface form differs more
from Bet v 1 than the apple allergen. Similarly, persons who are allergic to
birch pollen sometimes experience cross-reactions to celery, but not as
frequently as they do to apples.
b) Clinical Manifestations of
Food Allergies
meal allergy symptoms typically
appear between minutes to two hours of ingesting the offending meal. Food
allergies are most commonly manifested by stomach issues, rashes, or enlarged
airways. A food allergy can induce severe symptoms or even a life-threatening
reaction known as anaphylaxis in certain people.
c) Diagnosis and Management of
Food Allergies
A complete medical history and
physical examination are used to diagnose food allergies. If a food allergy
appears to be a possibility, a blood test or skin prick test may be
recommended. These tests evaluate serum IgE levels against particular allergenic
proteins found in foods, assisting in determining whether or not a person has a
food allergy.
A skin prick test (SPT) is a
standard method for detecting IgE antibodies in questionable foods. The
allergist will apply a drop of solution containing the food allergen to your
forearm or back during this test. The doctor delicately pricks or scratches the
skin with a little plastic probe or needle to allow a tiny amount of the
solution to enter just below the surface. The SPT is normally not unpleasant,
and no bleeding occurs. Results are usually available within 30 minutes. A
wheal is a raised white lump surrounded by a small circle of irritated red skin
that indicates a positive result.
A blood test can detect your
immune system's response to specific meals by measuring immunoglobulin E (IgE),
an allergy-related antibody. A blood sample is drawn and sent to a medical
laboratory, where various diets are analyzed.
Food allergies are primarily
managed by avoiding the allergic food. Food allergies can be managed by
carefully reading food labels, washing hands and surfaces to avoid accidental
contact, and carrying an epinephrine auto injector for severe reactions.
Always read labels to verify that
they do not include an ingredient to which you are allergic. Cook with caution
to avoid cross-contamination. Dine defensively by notifying the restaurant
staff about your allergies and inquiring about safe menu options. Create a plan
of action that includes guidelines for preventing, recognizing, and managing
food allergies. Wear a medical ID bracelet with information about your food
allergy on it. Carry your medication, ideally two doses, at all times in case
of a severe allergic response.
For effective food allergy
diagnosis and management, it is critical to consult with a healthcare expert.
They can advise you on the best course of action and assist you in developing a
customized plan to manage your individual allergies.
d) Allergen-Based Food Allergies
Food allergies induced by
allergens are triggered by a specific food protein (the allergen) that reacts
with the host's IgE. Allergic reactions can range from minor itchiness to
life-threatening anaphylactic shock. The only method to avoid potentially dangerous
allergy responses is to avoid allergenic foods completely.
e) Disease-Based Food Allergies
Food allergies that are caused by
a disease are referred to as disease-based food allergies. Asthma and food
allergies, for example, frequently coexist, and when they do, both food allergy
and asthma symptoms are more likely to be severe. Similarly, if you have other
allergic reactions, such as hay fever or eczema, your chances of developing a
food allergy are higher.
Food allergies are described as
an immunological response to proteins in food that might be IgE-mediated or
non-IgE-mediated. Allergic responses caused by food intake cause a variety of
symptoms affecting the skin, gastrointestinal tract, and respiratory tract.
Allergies can be caused by any food, however only a few foods account for the
great majority of allergies. Milk, eggs, peanuts, seafood, wheat, and nuts are
all examples.
Asthma and food allergies are
frequently found to coexist, especially because they share risk factors (family
history of allergy, atopic eczema, and asthma). Food allergies have been
demonstrated in studies to emerge in the first year of life, preceding the
development of asthma. There appears to be a link between asthma and
non-IgE-mediated food allergy, however it is less common than in IgE-mediated
allergy.
Pollen Food Allergy Syndrome
(PFAS), also known as oral allergy syndrome, is caused by allergens that react
with both pollen and raw fruits, vegetables, or some tree nuts. The immune
system detects pollen and related proteins in food and creates an allergic
response. Because the proteins are deformed during the heating process, and the
immune system no longer recognizes the food, people who are PFAS-affected can
normally eat the same fruits or vegetables in cooked form.
Food protein-induced
enterocolitis syndrome (FPIES) is another type of delayed food allergy reaction
that develops two to six hours after consuming milk, soy, some cereals, and
some other solid foods. It mostly affects young infants who are being weaned or
are being introduced to certain foods for the first time.
3) Understanding Food
Sensitivities
Food sensitivities are unpleasant
reactions to specific foods that are not as severe as food allergies. They are
frequently associated with elevated levels of certain IgG class antibodies that
react to diet. Food sensitivities, unlike actual food allergies, can cause
symptoms to appear several days after consuming the trigger meal. Many people
are unaware they have a food sensitivity because the symptoms are nonspecific
and mimic common diseases.
a) Signs and Symptoms of Food
Sensitivities
Food sensitivities, also known as
food intolerances, can cause a variety of symptoms that differ from person to
person. These symptoms are usually related to the digestive system, as the body
struggles to break down particular foods, causing discomfort and other
problems.
Food sensitivities are commonly
characterized by the following symptoms:
i) Bloating: A sense of fullness
or swelling in the belly that can be uncomfortable or even painful. It is
frequently caused by excessive gas production or disruptions in the movement of
the muscles in the digestive system.
ii) Migraines: A type of headache
marked by strong, throbbing pain on one side of the head. They can be caused by
certain foods in those who have food sensitivities.
iii) Diarrhea: This is
characterized by loose, watery stools and frequent bowel movements. It may
indicate that the body is having difficulty digesting particular foods.
iv) Brain fog: This refers to
emotions of bewilderment, forgetfulness, and a lack of attention or mental
clarity. It can be a less visible indication of food sensitivity.
v) Fatigue: This is a persistent
sense of exhaustion or weakness that might be induced by the body's inability
to digest certain foods.
vi) Flushed skin, itching, joint
or muscle pain: These are all symptoms of an immunological response to certain
foods. Certain types of antibodies to triggering chemicals may be produced by
the body, resulting in certain symptoms.
vii) Headaches or migraines,
sneezing, and a stuffy or runny nose: These symptoms can mimic minor allergy
reactions and are not necessarily immediate. In fact, it could take up to three
days for problems to develop.
Food sensitivities are not the
same as food allergies. While food allergies include an immunological response
and can produce severe symptoms practically immediately after eating the
trigger item, food sensitivities involve a slower, less severe reaction that
might take hours or even days to manifest.
b) Diagnosis of Food
Sensitivities
Food sensitivities are diagnosed
by a multi-step approach that includes a detailed medical history, symptom
tracking, and testing. The allergist begins by obtaining a thorough medical
history, including questions about the symptoms you have after eating certain
foods, the time it takes for these symptoms to appear after eating, the
frequency of the reaction, and whether it occurs with other meals.
Food sensitivities can be
diagnosed using a variety of assays. These include skin and blood testing to
determine IgG antibody levels. However, these tests are not conclusive and
cannot confirm whether someone has a food sensitivity with full confidence.
Skin or blood tests can detect a
food sensitivity, but they do not usually reveal a real allergy unless there
has been a previous reaction to the food. These tests can provide information
about the origins of symptoms, but they cannot definitively confirm whether
someone has a food allergy.
Blood tests detect the existence
of IgE antibodies to particular meals. However, the presence of IgE antibodies
for a certain item does not always predict how severe your reaction would be if
you consume that food.
An oral food challenge may be
utilized in some circumstances to confirm the meal that is causing the
condition. Under the close supervision of an allergist, the patient consumes
steadily increasing amounts of the suspected allergy-causing food. An oral food
challenge is a highly accurate food allergy diagnostic test. The allergist
feeds you the questionable food in measured doses during the food challenge. If
you have no major symptoms, your dose will be gradually increased. If you
exhibit evidence of a reaction, the food challenge will be terminated.
In addition to these testing,
symptom tracking can aid in the diagnosis of food sensitivities. Apps like
mySymptoms Food Diary can help you track your food and symptoms, revealing
potential triggers.
It's crucial to note that
diagnosing food sensitivities can be difficult and should only be done by a
qualified allergist. The allergist will assess the results of the tests and use
them to help make a diagnosis. Both types of testing can indicate a food
allergy, but neither is definite. A positive test result for a specific meal
does not always indicate that the patient will respond to it when it is
consumed. A negative test is more useful in excluding a food allergy.
c) Most Common Food Sensitivities
Food sensitivities differ from
person to person, however there are several common culprits that are frequently
connected with food intolerance. These are some examples:
i) Soy: A soy allergy can cause
symptoms such as stomach pain, coughing, and itching. Anaphylaxis may occur in
severe situations.
ii) Eggs: Egg allergies can range
from mild to severe, causing skin rashes, hives, nasal congestion, and stomach
issues.
iii) Dairy products and cow's
milk: Lactose intolerance is a frequent digestive problem that causes diarrhea,
bloating, and gas. Lactose intolerant people should avoid dairy products such
as milk and ice cream.
iv) Corn: Corn is a common food
sensitivity that can cause bloating, gas, and diarrhea in people who are unable
to absorb it effectively. v) Shellfish: Shellfish allergy can cause rashes,
difficulty breathing, and, in severe cases, anaphylaxis.
vi) Food additives and processed
foods: Food additives such as sulfites, artificial colors, and monosodium
glutamate (MSG) can induce headaches, rashes, and chest pain in some people.
vii) Foods containing gluten
(wheat, rye, barley): Bloating, gastrointestinal pain, diarrhea or
constipation, headaches, exhaustion, joint pain, skin rash, and depression are
all signs of non-celiac gluten sensitivity.
Certain types of meat (beef, hog,
and lamb): Some people may struggle to digest particular proteins contained in
meats such as beef, hog, and lamb, resulting in symptoms such as diarrhea and
abdominal pain.
To properly manage your symptoms,
you must first determine your individual dietary sensitivities. An elimination
diet, in which suspected foods are removed from your diet for a period of time
and then reintroduced one at a time while monitoring symptoms, can aid in the
identification of food sensitivities. If you feel you have a food intolerance,
consult a doctor immediately to receive correct advise and testing.
d) Food Elimination Diet for
Sensitivities
An elimination diet is a way for
identifying items that a person cannot tolerate. It entails eliminating
specific foods or food groupings from your diet because they may be triggering
your symptoms. Following a period of elimination, these items are reintroduced
one at a time while symptoms are monitored. This procedure aids in identifying
specific meals that trigger symptoms. However, it is critical to do so under
the guidance of a healthcare expert to ensure that the diet remains balanced
and nutritionally enough.
e) FODMAPs vs. Food Sensitivities
FODMAPs (Fermentable
Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) are carbohydrate
groups that are poorly absorbed in the small intestine and can induce digestive
irritation in sensitive people. These carbohydrates are fermentable and osmotic,
and they can cause gas production in the gut, leading in cramps, diarrhea,
constipation, stomach bloating, and flatulence.
Food sensitivities, on the other
hand, are negative reactions to certain foods that are not caused by the immune
system. They are triggered by dietary molecules, which can induce symptoms in
sensitive people by irritating nerve endings. Reactions to natural food
chemicals such as salicylates, amines, and glutamate, as well as reactions to
FODMAPs, can all cause food chemical sensitivity. Food sensitivities can cause
a variety of symptoms, including bloating, diarrhea, flatulence, stomach
discomfort, constipation, hives, migraines, sinus problems, mouth ulcers,
nausea, skin rashes, and mood disturbances.
A low FODMAP diet is a three-step
exclusion diet meant to help persons with IBS and/or SIBO identify which meals
are problematic and which foods alleviate symptoms. The diet entails removing
high FODMAP items over a short period of time before reintroducing them one at
a time to see which ones cause symptoms. Dried fruit, stone fruit, cherries,
apples, mango, papaya, sour cream, cottage cheese, yogurt, milk from cows,
sheep, or goats, beans, lentils, squash, garlic, mushrooms, cabbage, broccoli,
onions, coffee, high-fructose corn syrup, agave, artificial sweeteners, and
chocolate are examples of high FODMAP foods.
4) Comparing Food Allergies and Sensitivities
a) Differences and Similarities
between Food Allergies and Sensitivities
Food allergies and sensitivities,
often known as food intolerances, are both allergic or sensitive to specific
foods. Their underlying causes, the severity of their symptoms, and the
physical systems they affect varies.
Food allergies and sensitivities
can also induce unpleasant sensations after eating specific foods. Gas,
bloating, diarrhea, and abdominal pain are examples of gastrointestinal
symptoms. A food allergy causes an immune system reaction. When you have a food
allergy, your immune system recognizes a protein in the food as an invader and
produces antibodies to combat it. This immunological response can result in the
release of substances such as histamine, which causes food allergy symptoms. A
food sensitivity or intolerance, on the other hand, is caused by the digestive
system. It happens when your digestive tract is unable to break down and
process particular meals adequately. This could be caused to a lack of
digestive enzymes, hypersensitivity to dietary additives or preservatives, or
sensitivity to sugars naturally contained in specific meals.
Food allergies typically cause
more severe symptoms that can be fatal. They can include hives and swelling on
the skin, difficulty breathing, wheezing, disorientation, and, in severe cases,
anaphylaxis, a potentially fatal allergic reaction. Food sensitivities, on the
other hand, result in milder symptoms that are not life-threatening. Gas,
bloating, diarrhea, constipation, cramps, and nausea are the most common
digestive complaints.
If you have a food allergy, you
should keep an emergency epinephrine shot on hand in case of a severe allergic
reaction. You should also avoid the offending meal entirely, as even small
amounts can cause a reaction.
If you have a food intolerance,
your doctor may advise you to take actions to help digestion or to treat the
underlying disease that is causing your reaction. Small portions of the
offending food may be tolerated, and over-the-counter medications such as
antacids or antidiarrheals may help manage symptoms.
b) Symptoms Comparison: Food
Allergy vs. Food Sensitivity
Food allergies can cause hives,
swelling, itching, anaphylaxis (difficulty breathing, wheezing, disorientation,
and, in severe cases, death), as well as digestive problems such as vomiting
and diarrhea. Food allergies can induce severe, life-threatening reactions,
especially if the person suffers from anaphylaxis.
Food sensitivities, on the other
hand, can cause symptoms such as gas, bloating, diarrhea, constipation,
cramping, nausea, brain fog, exhaustion, flushed skin, itching, joint or muscle
discomfort, headaches or migraines, sneezing, and a stuffy or runny nose. These
symptoms are not always immediate and can occur up to three days later. Food
sensitivities are not fatal, but they can cause discomfort and reduce one's
quality of life.
5) Nutritional Aspects and Diets
in Food Allergy and Sensitivity
Food allergies and sensitivities
can have a big impact on a person's nutritional intake and general health.
Dietary intervention is an important part of food allergy therapy, although it
can have a negative impact on nutritional intake. Immune-mediated food
allergies and non-immune-mediated intolerances are examples of adverse food
reactions.
a) Nutritional Considerations for
Individuals with Food Allergies or Sensitivities
Individuals with food allergies
or sensitivities require special nutritional considerations to ensure that they
get the nutrients they need for good health. Essential fatty acids, zinc, and
vitamin D are thought to improve the anti-inflammatory and antioxidative
barrier, as well as boost immunologic tolerance.
Children with food
hypersensitivity, for example, have higher levels of mastocytes, eosinophils,
and neutrophils in their digestive system. Chronic allergen exposure can cause
chronic inflammatory changes in mucosal membranes as well as increased production
of reactive oxygen species (ROS). Excess ROS should be neutralized by
antioxidative barrier components.
A study of 134 children with food
allergies aged 1 to 36 months revealed that children with food allergies had
considerably lower zinc concentrations and thus a reduced antioxidative
barrier.
The most common allergies in
adults are shellfish, peanuts, and tree nuts. Tree nuts include pistachios,
pecans, Brazil nuts, cashews, hazelnuts, and walnuts, and persons who are
allergic to them frequently respond to multiple varieties due to substantial
cross-reactivity. Tree nuts are high in minerals, proteins, and unsaturated
fats, and also have documented health benefits, such as the
cholesterol-lowering characteristics of walnuts.
b) Diet Management for Food
Allergies and Sensitivities
An elimination diet, which is
regarded the gold standard for diagnosing food intolerances, sensitivities, and
allergies, is frequently used in the management of food allergies and
sensitivities. This diet entails eliminating foods from your diet that you
believe your body will not accept properly. The meals are then reintroduced one
at a time as you watch for indicators of a reaction.
However, if you have a known or
suspected food allergy, you should only attempt an elimination diet under the
direction of a medical practitioner. Reintroducing a food allergen may result
in a potentially fatal syndrome known as anaphylaxis.
Furthermore, the classic
avoidance diet has been entirely rethought in recent years. New research on the
protective benefit of increased food diversity offered in the first years of
life has resulted in a paradigm shift in the approach to preventing food
allergies.
Finally, nutritional damages
might be produced by incorrect diagnostic processes that result in unnecessary
dietary restrictions. In recent years, tests for the diagnosis of food allergy
and intolerance that have not been scientifically validated—or that have been
shown to have insufficient sensibility and specificity—have gained traction as
alternate techniques to determining the etiology of signs and symptoms
suggestive of food-related manifestations.
6) Public Policy and Educational Programs for Food Allergies and Food Sensitivities
Public policies and educational
initiatives are critical in the management of food allergies and sensitivities.
To safeguard persons with food allergies and other food hypersensitivities, the
Food and Drug Administration (FDA) enforces rules requiring corporations to
declare ingredients on packaged foods and drinks.
The FDA also advises the food
industry, consumers, and other stakeholders on the best methods for assessing
and managing allergy dangers in food.
In the educational sector,
initiatives such as the Be a PAL® program teach children and teenagers how to
save lives by being good friends to children with food allergies. The program
offers materials to assist teachers and other educators in creating and
maintaining a safe and healthy learning environment.
a) Food Allergy Labeling and
Detection of Allergens in Processed Foods
The Food allergy Labeling and
Consumer Protection Act of 2004 (FALCPA) and the Food Allergy Safety,
Treatment, Education, and Research Act of 2021 (FASTER) are two major pieces of
legislation in the United States that address allergy labeling and detection in
processed foods.
Milk, eggs, fish, crustacean
shellfish, tree nuts, peanuts, wheat, and soybeans were classified as
significant food allergies by the FALCPA. 90% of food allergies are caused by
these allergens. The rule mandates that all main food allergens used to create
the meal be identified on food labels. This criteria is satisfied if the common
or typical name of an ingredient, such as buttermilk, already specifies the
allergen's food source name.
The FASTER Act was passed into
law in 2021, making sesame the 9th significant food allergy identified in the
United States. This legislation became law on January 1, 2023, and requires
allergy labeling requirements to be revised to cover sesame seeds, sesame oil,
sesame paste, and any other sesame goods.
The FDA has developed a number of
ways for detecting allergens in foods. One such technology is the xMAP food
allergen detection test, which can detect 16 allergens, including sesame, in a
single examination. This test was created by combining 30 distinct antibodies
against 14 different dietary allergens as well as gluten. The xMAP FADA
additionally employs two distinct extraction techniques, allowing for several
confirmatory end-points.
Conventional methods for
detecting allergens in foodstuffs include the enzyme-linked immunosorbent test
(ELISA), protein biosensors, DNA-based approaches, and mass spectrometry.
ELISA, for example, is a popular quantitative approach for detecting food allergen
residues.
These legislation and testing
procedures are important for public health because they help food-allergic
people avoid items that might cause allergic responses. They also enforce rules
requiring food makers to prevent allergy cross-contact, defined as the
unintended inclusion of a significant food allergen into a meal.
b) Educational Programs for Food
Allergies and Sensitivities
Food allergy and sensitivity
education programs are aimed to provide a safe environment for kids with food
allergies. The Be a PAL: Protect A LifeTM From Food Allergies teaching program,
for example, teaches students how to be good friends to children with food
allergies.
Be a PAL is a program for
children and teenagers that provides tools for parents, school personnel,
educators, scout troop leaders, youth group leaders, and coaches to deliver to
students in grades K-12. The program provides a number of materials, such as
instructional manuals, posters, handouts, and presentations, all with the goal
of raising food allergy awareness. These materials are accessible in a variety
of languages, including English, Spanish, Arabic, Portuguese, Vietnamese, and
Chinese.
The initiative also includes an
interactive education for middle and high school students that puts them in the
shoes of a classmate with food allergies. This lesson teaches kids about the
seriousness of food allergies and how they can Be a PAL and Protect A Life for
friends who have food allergies.
Other tools are available to help
teachers and other educators build and maintain a safe and healthy classroom
environment, in addition to the Be a PAL program. The Toolkit for Food
Allergies in the Classroom, for example, includes materials like posters,
training programs, and advice for reducing the risk of accidental ingestion or
exposure to food allergens in the classroom.
There are also free online
courses available to teach school personnel and administrators to manage food
allergies properly and respond to food allergy crises. The FARE Food Allergy
Academy, for example, provides live and on-demand instructional content for the
food allergy community and the professional teams who assist them, such as
healthcare practitioners, registered dietitians, and educators.
Furthermore, Kids With Food
Allergies (KFA) provides a free online course called "Managing Your
Child's Food Allergies," which covers a wide range of food allergy topics,
such as the basics of food allergies and diagnosis, recognition and treatment
of severe allergic reactions, finding safe foods, and managing food allergies
outside the home.
7) Quality of Life and Food
Allergies/Sensitivities
Food allergies and sensitivities
can have a substantial influence on an individual's quality of life,
influencing social, nutritional, and psychological issues. The persistent
threat of allergic food exposure, the necessity for monitoring, and the anticipation
of result can all have a significant influence on quality of life.
Food allergies can cause emotions
of isolation and distinction, particularly at social activities involving food.
This is because eating is an essential element of daily living, and food
allergy limitations extend far beyond mealtimes. Individuals with food
allergies, for example, must be cautious while eating out, and a greater
frequency of checking information at various phases of eating out was
associated with a lower quality of life.
The intensity of responses is
also important in deciding quality of life. More severe responses are
associated with a worse health-related quality of life. Furthermore, persons
with food allergies frequently experience heightened psychosocial stress, which
can have a negative impact on health-related quality of life and coping.
Food allergies may have a huge
influence on the family, particularly on the parents. Parents of children with
food allergies frequently endure anxiety and may even experience panic attacks
as a result of the disease. Caring for children with food allergies is
extremely expensive, costing American families over $25 billion every year.
Food sensitivities, on the other
hand, frequently impact mainly the digestive tract and result in less severe
symptoms than food allergies. They can, however, create discomfort and need
dietary changes, which can have an influence on an individual's quality of
life.
Several factors can influence
food allergy patients' health-related quality of life, including perceived
illness severity, patient age, particular kind of allergy (such as peanut or
soy allergy), place of origin, and having allergies to two or more foods.
Several questionnaires have been
created to assess the quality of life in patients with food allergies. These
surveys take into account a variety of aspects, including allergen avoidance
and dietary limitations, emotional effect, risk of accidental exposure, and
food allergy-related health.
8) Prevention and Future
Directions of Food Allergies and Food Sensitivities
a) Prevention of Food
Allergies and Sensitivities
Preventing food allergies and
sensitivities is a difficult topic that involves many aspects, such as when to
introduce allergenic foods to newborns and how to maintain a healthy gut
microbiota.
Early introduction of allergenic
foods such as peanuts, eggs, and milk, according to research, may help minimize
the likelihood of developing food allergies in children, particularly those
regarded at high risk owing to the existence of existing food allergies or
severe eczema. The American Academy of Pediatrics (AAP) and other professional
organizations advocate starting allergenic foods about 6 months of age, but no
earlier than 4 months. This approach is based on the premise that early
exposure to allergenic foods during childhood might result in oral tolerance,
avoiding allergies from developing.
It is crucial to highlight,
however, that the efficacy of early introduction of allergenic foods for
avoiding food allergy in a general population with no underlying risk factors
for allergy is still being studied. As a result, because each child's condition
is unique, it's critical to check with a healthcare expert before introducing
allergic foods to newborns.
Maintaining a healthy gut flora
is another part of prevention. The gut microbiome is a colony of microorganisms
that live in our intestines. According to research, a diverse and healthy gut
microbiota may have a role in the prevention of food allergies and
sensitivities.
Epidemiologic research show links
between exposures known to alter the microbiota and the incidence of food
allergy. Direct microbiome profiling in human cohort studies has shown that
persons with food allergies have different gut microbiomes than healthy
controls, and dysbiosis (imbalance or maladaptation in the microbiome) precedes
the development of food allergy.
A diet high in fiber, fruits and
vegetables, and fermented foods can help maintain a healthy gut flora. These
foods are high in prebiotics, which are fibers that nourish the beneficial
bacteria in your stomach. This can assist your gut bacteria in producing
nutrients for your body, resulting in a healthy digestive system.
b) Future Directions in Food
Allergy and Sensitivity Research and Management
The development of novel
diagnostic methods, therapies, and preventative techniques are among the future
goals in food allergy and sensitivity research and management. Among the areas
of continuing study are:
i) Immunotherapy: Oral,
sublingual, and epicutaneous immunotherapy are being investigated as possible
treatments for food allergies. To assist the immune system acquire tolerance,
these treatments entail exposing the patient to small, progressively increasing
doses of the allergen.
ii) Microbiome research: Research
is being conducted to investigate the function of the gut microbiome in the
development and prevention of food allergies and sensitivities. This study
might result in novel ways for supporting a healthy gut flora and lowering the
likelihood of food allergies and sensitivities.
iii) Biologics and innovative
vaccinations: Researchers are looking into how biologic drugs and novel
vaccines may be used to treat food allergies. These medications may aid in
modulating the immune system's response to allergens and reducing the intensity
of allergic responses.
iv) Personalized nutrition:
Identifying individual genetic and environmental variables that contribute to
food allergies and sensitivities, for example, may aid in the development of
focused preventative and treatment measures.
Finally, new diagnostic methods,
therapies, and preventative techniques are being created in the field of food
allergy and sensitivity research. More effective and tailored ways to manage
food allergies and sensitivities may become accessible as our understanding of
the underlying processes and risk factors for these illnesses improves.
9) Real Life Testimonials and Stories of People Suffering with Food Allergies and Sensitivities
Cate is a young woman whose life
is complicated by life-threatening food allergies, which influence her everyday
decisions. She is affiliated with the University of Michigan's Mary H. Weiser
Food Allergy Center, a world-renowned center for food allergy research.
meal allergies are immune
responses that arise quickly after ingesting a specific meal. Even a tiny
amount of the allergenic food can induce symptoms such as stomach issues,
rashes, trouble breathing, or even a potentially fatal response called as
anaphylaxis. These allergies can be a continual cause of anxiety for people
like Cate, necessitating careful monitoring of food consumption and preparation
to eliminate potential allergens.
The Mary H. Weiser Food Allergy
Center (MHWFAC) at the University of Michigan is a research hub for food
allergies. The staff of the center comprises internationally recognized
immunology researchers as well as distinguished clinicians from the Michigan Medicine
Food Allergy Clinic. The center's mission is to improve the lives of people
with food allergies by undertaking thorough research that will dramatically
increase patient treatment, as well as to extend education, research, and
services.
There are currently no effective
treatments for food allergies. The only way for patients and their families to
control this condition is to avoid particular foods and carry an epinephrine
auto-injector in case of accidental allergy exposure. Taking lessons from other
diseases, the center's experts are creating ground-breaking ways to
understanding, treating, and preventing food allergies.
The center is also active in
clinical studies, which are critical in the advancement of medicines for
disorders such as food allergies. The MHWFAC's clinical researchers are now
developing immunotherapy studies for both children and adults that will include
oral immunotherapy, topical patch treatment, and sublingual therapy.
The activities of the center is
not confined to research and clinical trials. It also involves outreach and
advocacy initiatives, such as sharing personal experiences of people like Cate
in order to increase awareness about the realities of living with food
allergies. Mary H. Weiser, the center's namesake, is a Food Allergy Center
advocate and fundraising chair who has held a variety of roles in local and
federal politics.
Finally, Cate's collaboration
with the Mary H. Weiser Food Allergy Center at the University of Michigan is
part of a larger effort to better understand, treat, and eventually prevent
food allergies. The center is aiming to discover solutions for thousands of
families afflicted by food allergies via research, clinical trials, and
advocacy.
Paul's tale exemplifies the
difficulties and hazards that people with food allergies confront. Paola, his
mother, discovered his allergy when he was 2-1/2 years old, when he had a
violent reaction to a slice of peanut butter toast. For Paul and his family,
this episode marked the start of a lifelong path of vigilance and knowledge
regarding food allergies.
Food allergies are quite
prevalent, affecting around 6% of adults and 8% of children. They are caused by
the immune system incorrectly identifying certain proteins in food as
hazardous, resulting in a variety of preventive actions, including the production
of substances such as histamine, which promotes inflammation. Even extremely
little amounts of the problematic food might trigger an allergic response. In
Paul's instance, his response to the peanut butter was quick and severe,
resulting in swelling of his face and vomiting.
Food allergies can cause a wide
range of symptoms, from mild reactions such as itching or swelling of the
tongue, mouth, or face to severe cases that can result in anaphylaxis, a
potentially fatal condition characterized by symptoms such as an itchy rash,
swelling of the throat or tongue, shortness of breath, and low blood pressure.
Food sensitivities need continual
attention. This involves constantly checking food labels, exercising caution
when cooking to minimize cross-contamination, dining out defensively by telling
restaurant personnel about the allergy, and carrying emergency medicine at all
times. Paola has been vigilant in educating Paul about these measures, as well
as lobbying for food allergy awareness in his school and community. Paola's
efforts to educate others about food allergies are critical, because public
knowledge and accommodation may have a substantial influence on the safety and
quality of life of those with food allergies. This includes measures such as
nut-free schools and well-informed restaurant employees. Paola's activism also
includes raising funding for food allergy research, emphasizing the need of
understanding the causes of food allergies, developing effective therapies, and
educating the public about food allergy safety.
Finally, Paul's tale emphasizes
the need of food allergy awareness, education, and research. It emphasizes the
difficulties that people with food allergies and their families endure, as well
as the critical role that advocacy plays in improving safety and understanding.
Oliver's situation is one of food
intolerance, which developed when his mother, Heidi, began adding foods into
his diet. Food intolerance is not the same as food allergy. Food allergies
cause an immune system reaction that can range from unpleasant to life-threatening,
but food intolerance does not, though some of the same symptoms may be present.
meal intolerance can be caused by a lack of an enzyme required to digest a
certain meal or by inadequate enzymes to adequately digest a food. Bloating,
loose stools, and gas after eating a certain food are all symptoms of food
intolerance. Even while this reaction is not hazardous, it can be unpleasant.
In the case of food allergies, a
kid must have been exposed to the food at least once previously, and
sensitization through breast milk is also possible. The allergy symptoms appear
the second time your youngster consumes the meal. Histamines are created when
IgE antibodies react with food, which might cause your kid to have hives,
asthma, itching in the mouth, difficulty breathing, stomach cramps, vomiting,
and/or diarrhea.
The introduction of solids into a
child's diet at 7 months or later, as well as a maternal history of allergic
illness, were both risk factors related with an increased chance of food
allergy or intolerance. It is important to note, however, that the development
of food allergies cannot be prevented, but it can often be delayed in infants
by following certain recommendations such as breastfeeding for the first six
months, delaying solid foods until your child is 6 months old or older, and
avoiding cow's milk, wheat, eggs, peanuts, and fish during your child's first
year of life.
If your child develops an
allergic response to a meal, you should take him or her to the doctor. For the
appropriate tests, your doctor will recommend you to an allergist. If a severe
allergy is established, your doctor may give a drug (e.g., EpiPen or Allerject),
a needle that will immediately protect your kid if they are exposed to the
allergen.
Finally, food intolerance and
food allergies are two distinct illnesses that can arise in a kid when new
foods are introduced into their diet. It's critical to keep track of your
child's reactions to new meals and speak with a doctor if any unpleasant reactions
arise.
Lauren's encounter with walnut
bread, followed by a skin prick test that verified her severe sensitivity to
walnuts and pecans, is a frequent situation for many people who have food
allergies. Tree nut allergies, such as those to walnuts and pecans, are prevalent
and frequently severe, manifesting by the age of two. These allergies can
produce a variety of symptoms, including itchy mouth and hives, as well as
swelling of the lips, mouth, tongue, and throat, and even anaphylaxis, a
potentially fatal reaction that hampers breathing and can plunge the body into
shock.
Lauren's allergies were validated
using a skin prick test, which is a common approach for diagnosing allergic
diseases. This test looks for acute allergic responses to up to 50 distinct
chemicals at the same time. Lauren would have developed a raised, red, itchy
mark (wheal) that resembled a mosquito bite if she was allergic to one of the
compounds tested. The nurse would next measure the size of the bump and record
the results.
Lauren's allergy requires
numerous actions to be managed. To begin, it is critical to avoid
cross-contamination, which occurs when a little quantity of a food allergy
accidently enters another meal or comes into touch with utensils, surfaces, or
items. An allergen can elicit an allergic response even in trace amounts. Even
if the nuts are removed, nuts on top of a salad will cause cross-contamination
of other items in the salad. As a result, it's critical to thoroughly clean
cookware, plates, and utensils, as well as clean surfaces using soap and water,
commercial cleansers, or commercial wipes. It's also a good idea not to share
food, utensils, or beverages.
Another important aspect of
controlling Lauren's allergy is reading food labels. Food manufacturers
frequently include possible allergies on their goods, and it is critical to
carefully read these labels to avoid accidental allergy consumption. If you have
any concerns about a product, contact the manufacturer to explore if
cross-contamination is a possibility.
Finally, it is critical to have a
strategy in place in case of accidental allergy consumption. Carrying an
epinephrine auto-injector, understanding the indications of an allergic
response, and seeking prompt medical assistance if one happens are all examples
of precautions.
To summarize, treating a severe
food allergy like Lauren's entails avoiding the allergen as much as possible,
reading product labels carefully, and having a plan in place in case of
accidental ingestion. Lauren and her family may properly manage her allergy
with these safeguards in place.
10) Conclusion
To summarize, understanding the
distinctions between food allergies and sensitivities (or intolerances) is
critical for accurate diagnosis, management, and general well-being. Food
allergies affect the immune system and can result in severe or life-threatening
reactions, whereas food sensitivities or intolerances affect the digestive
system and often result in milder symptoms.
Food allergies can include
rashes, swelling, trouble breathing, and anaphylaxis, which needs rapid medical
intervention. Food sensitivities or intolerances, on the other hand, can induce
symptoms such as bloating, gas, diarrhea, and headaches. A healthcare expert
should be consulted for an accurate diagnosis and proper management options.
The most effective way to manage
food allergies is to avoid the allergen. Management of food sensitivities or
intolerances may include avoiding trigger foods, utilizing over-the-counter
drugs, or seeking medical guidance for underlying disorders.
In conclusion, recognizing the
distinctions between food allergies and sensitivities is critical for accurate
diagnosis and therapy. Individuals may take necessary efforts to preserve their
health and well-being if they are aware of the signs and causes.
FAQ’s
A food allergy is when the immune
system reacts to a food (allergen), which is usually harmless. The immune
system produces allergy antibodies called Immunoglobulin E (IgE) that can
result in symptoms
2) What is food sensitivity or
intolerance?
Food sensitivity or intolerance
is a chemical reaction that some people have after eating or drinking some
foods; it does not involve the immune system. Symptoms of food intolerance can
include nervousness, tremor, sweating, palpitations, rapid breathing, headache,
migraine, diarrhea, burning sensations on the skin, tightness across the face
and chest, breathing problems, and allergy-like reactions
3) What are the signs and
symptoms of allergic reactions to foods?
Signs and symptoms of mild to
moderate allergic reactions to foods include swelling of the face, lips, eyes,
hives or welts on the skin, and abdominal pain, vomiting. Severe allergic
reactions (anaphylaxis) to foods include one or more of the following: difficult
or noisy breathing, swelling of the tongue, swelling or tightness in the throat
4) Are all adverse reactions to
foods due to allergy?
No. The term food allergy is
often misused to describe any adverse reaction to foods. Adverse reactions to
foods that are not food allergy include food intolerances, toxic reactions,
food poisoning, enzyme deficiencies, food aversion, or irritation from skin
contact with certain foods
5) What is the difference between
food allergy and food intolerance?
A food allergy involves the
immune system and symptoms can be life-threatening. A food intolerance is the
inability to digest or absorb certain foods. For example, someone with lactose
intolerance doesn’t have enough of the enzyme lactase to break down the sugar
(lactose) in dairy products. The symptoms of food intolerance affect the
gastrointestinal tract and can cause discomfort but are generally not
life-threatening
6) What foods are most likely to
cause food allergy?
The most common food allergens
are cow's milk (dairy), egg, peanut, tree nuts, sesame, soy, fish, shellfish,
and wheat
7) What foods are most likely to
cause food intolerance?
The foods that tend to cause
intolerance reactions in sensitive people include dairy products, including
milk, cheese, and yogurt, chocolate, eggs, particularly egg white
8) Can someone outgrow a food
allergy?
Most children allergic to cow's
milk, soy, wheat, or egg will outgrow their food allergy. By contrast, allergic
reactions to peanut, tree nuts, sesame seeds, and seafood persist in
approximately 75% of children affected. When food allergy develops for the
first time in adults, it usually persists
9) Does cooking the food remove
the allergen?
Cooked or baked foods, such as
cow’s milk and/or egg in muffins, cakes, or biscuits, may be tolerated by some
people with allergy to cow’s milk and/or egg. Unless tolerance to cooked or
baked foods is confirmed, this should be discussed with your clinical
immunology/allergy specialist before introducing these foods
10) Are allergic reactions to
inhaled foods common?
People can have reactions when
they inhale food proteins to which they are allergic, such as in the steam
produced while cooking certain foods, like fish
11) Can someone have a reaction
without ingesting their allergen?
For most people, accidentally
eating a food containing their allergen poses the greatest risk. Allergic
reactions to foods are caused by specific food proteins. Since food odors do
not contain protein, they cannot cause reactions
Yes. People at risk need to tell
their friends and partners about their food allergies to avoid accidental
exposure, as small amounts of food can be transferred from one person to
another through kissing
13) How are allergic reactions
avoided?
Reading ingredient labels on
foods, taking special precautions in food preparation, and ensuring proper hand
washing and cleaning go a long way toward reducing the risk of an accidental
exposure
14) Why do so many people seem to
have food allergy these days?
There is no easy explanation to
explain the prevalence of food allergy. One theory, known as the “dual-allergen
exposure hypothesis” suggests that initial exposure to food allergens through
the skin, especially in babies with eczema, can lead to allergy while oral
exposure (eating the food) can lead to tolerance
15) Can food allergy be
prevented?
In 2019, the Canadian Paediatric
Society released updated recommendations on the specific timing of early
introduction of allergenic foods for high-risk infants. The new guidance is to
actively offer non-choking forms of foods containing common allergens (e.g.
peanut, egg) around 6 months of age, but not before 4 months, as this can be
effective in preventing food allergy in some high-risk infants
16) Is there a cure for food
allergy?
Currently, there is no cure for
food allergy, though there are newly emerging therapies that show promise. The
best studied treatments involve immunotherapy or desensitization to a food
allergen
17) How can people with food
allergy manage their condition?
People living with food allergy
can learn to manage their condition with the guidance of their clinical
immunology/allergy specialist. Strict avoidance of confirmed food allergens is
essential in the management of food allergy
18) What is the treatment for
food intolerance?
The easiest way to treat a food
allergy or intolerance is to eliminate the offending food/s from the diet.
Sometimes, the body can tolerate the food if it is avoided for a time, then
reintroduced in small doses, particularly for food intolerances
19) Can an antihistamine prevent
allergic reactions for food allergies?
For those with true allergy to a
food, taking an antihistamine during an allergic reaction may be helpful to
relieve the hives and itching. They have little role in relieving any type of
respiratory problem. If a child is having anaphylaxis or respiratory symptoms
(e.g. throat closing, coughing, wheezing), the only treatment that is effective
is injectable epinephrine (EpiPen or AuviQ)
20) What are the priority food
allergens in Canada?
Health Canada defines the
priority food allergens as: peanut, tree nuts, sesame, milk, egg, fish,
crustaceans (e.g., lobster, shrimp) and molluscs (e.g., scallops, clams), soy,
wheat and triticale, and mustard
Comments
Post a Comment