Food Allergies

1. Food Allergies Melissa Bess Nutrition and Health Education Specialist FNEP STAFF TRAINING ONLY, DO NOT USE WITH FNEP PARTICIPANTS 03/2007

2. Discussion Topics • What is a food allergy? • Who gets a food allergy? • Most common food allergies • Symptoms • How is it diagnosed? • How can you avoid food allergies? • Tips to prevent allergies • What to do if there is a reaction.

3. Discussion Topics • Children and allergies • New research • How a child might describe reaction • Food intolerance • Cross-reactions • Hidden allergens

4. What is a food allergy? • Immune system function • Super-sensitive • Allergens • Usually the protein part • Allergens react to antibodies • Release chemicals causing symptoms

5. Who gets a food allergy? • About 3 to 8 percent of children have reaction • Only 1 to 2 percent have true food allergies • Children usually grow out of sensitivity by age 4 (not peanuts, tree nuts, shellfish) • About 1 to 2 percent of adults

6. Most common food allergies • Children • Milk, egg, peanuts, wheat, soy, tree nuts • Most will outgrow eggs, milk, wheat, and soy • Adults • Peanuts, tree nuts (almonds, walnuts), fish, shellfish (shrimp, lobster, crab), mollusks (oysters, clams, scallops)

7. Most common food allergies • Peanuts and/or tree nuts = three million Americans (1.1% of population) • About 150 people in US die each year, 30,000 ER visits • About 4% believed to have food allergy, 2.3% to seafood • More than 160 foods associated with allergic reactions

8. Symptoms of food allergies • Reaction within minutes to two hours • How soon and how severe depend on sensitivity to food, how much was consumed, other foods consume, and preparation • May have minor symptoms at first

9. Digestive system Swelling, itching Tightness Hoarseness Nausea Cramping Pain Vomiting Diarrhea Body systems (skin, lungs, etc) Hives, skin swelling Anaphylaxis – BP falls, wheezing, breathing problems, nausea, rapid pulse, flushing, faintness, passing out Can lead to death Symptoms

11. Symptoms • Severe reactions more common in peanuts, tree nuts, shellfish, fish, and eggs • Also more common in those with asthma • Death usually seen in peanuts or tree nuts

12. How are food allergies diagnosed? • Physician • Medical history, physical exam • Skin test • Lab tests • Oral food challenge • Elimination diet • Double-blind food challenge

13. How can you avoid food allergies? • Identify those at risk • Consult a doctor • Consider breast feeding • Maternal diet avoiding eggs, cow milk, peanuts, fish

14. Tips to prevent allergies • Do not consume allergic foods • Read the ingredient list • New in 2006 – must clearly state food allergen (milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, or soybeans) • If traveling, bring special foods • When eating out, ask about foods

15. Tips to prevent allergies • Know which children have allergies and what those are • Know how to recognize symptoms • Have a plan in cause of allergic response • Wash hands with soap, surfaces with cleaners for peanut allergies

16. What to do if a child has a reaction • Take medication • Seek medical help • Keep injectable epinephrine • Wear Medic-Alert bracelet

17. Children and allergies • For babies, discuss formula options with doctor • Don’t introduce solid foods too early – wait about 6 months • Wait on foods with common allergens • Cow milk – age 1 • Eggs – age 2 • Peanuts, nuts or fish – age 3 or after • American Academy of Pediatricians

18. Children and allergies • Cow’s milk common – cause hives, asthma, colic, sleeplessness, blood in stool, poor growth • Immature immune systems • May change to soy or elemental formula • Drugs to severe cases • Breast milk helps

19. New research • Peanut allergies increasing • Peanut exposure, in peanut butter, reduces severe reaction • Peanut vaccine • Link in food allergies and asthma • Roasting peanuts may increase allergic properties • FDA proposing a gluten-free label

20. How child describes reaction • Put hands to mouth, pull or scratch tongues, voices may change • “Food is too spicy” • “My tongue is hot, something is poking it” • “My mouth is tingly, itches, or feels funny” • “My tongue feels full, my throat feels thick”

21. Food Intolerance • More common than allergies • Food poisoning • Histamine toxicity (cheese, wine, fish) • Lactose intolerance • Food additives (MSG) • Gluten intolerance (small intestine) • Corn products • True allergy – avoid food (immune system) • Intolerance – small amount is ok (digestive system)

22. Cross Reactions (food and non-food) • Ragweed- Watermelon, cantaloupe, honeydew, bananas • Birch pollen-carrots, apples, hazelnuts, potatoes • Banana – latex • * If allergic to one shellfish or legumes, likely allergic to all!

23. Hidden allergens • Eggs – baked goods, noodles • Milk – pies, cheese • Soy – baked goods, candy, tv dinners • Wheat – flours, soup mixes, snacks • Peanut – candy, baked goods, ice cream • Fish – seafood flavors • New food labels should help

24. Eating out with allergies • Chinese, Indonesian, Mexican, etc dishes usually made with peanuts • Cross-contamination of allergens • Not as easy to read ingredient list

25. Resources • Food Allergy and Anaphylaxis Network (FAAN) • American Academy of Allergy, Asthma, and Immunology • Food and Drug Administration • USDA – National Agriculture Library

26. Any Questions?