Food Allergy - A Common Health Problem

The leading cause of anaphylaxis in the USA is food allergy. Anaphylaxis is a severe allergic reaction, rapid in onset and sometimes lethal. Food allergies account for at least 30,000 emergency room visits each year. It is responsible for close to 200 deaths annually in this country. Some four percent of Americans, or almost 12 million of us, suffer from food allergies. Of these, close to 6.5 million adults are allergic to seafood and over three million are allergic to peanuts and tree nuts. The prevalence of food allergy in USA appears to be rising.

Food allergies develops when the body thinks a food ingredient, usually a protein, is harmful. It responds by generating specific disease-fighting antibodies (called immunoglobulin E or IgE). When the food is eaten again, the body releases large amounts of IgE antibodies and other chemicals, including histamine, in an effort to expel this protein "invader". These powerful chemicals unfortunately also affect the respiratory system, gastrointestinal tract, skin or cardiovascular system, resulting in the symptoms of anaphylaxis.

Food allergies are most common to peanuts, fish, shellfish, soy, wheat, eggs, cows milk, and tree nuts such as pistachios, walnuts and cashews. Most severe allergic reactions occur to peanuts. Peanuts are often the main ingredient in quick energy foods. Peanut or peanut butter is often present in candies, cookies, pastries and gravies. Chinese restaurants may use peanut butter to hold together edges of egg rolls. The same wok is often used to cook a variety of meals, and peanut allergens can get into unrelated food.

Anaphylaxis is a severe allergic reaction, rapid in onset and sometimes lethal. Besides food, anaphylaxis reactions often occur to hymenoptera stings (e.g. bee, wasp, "jumper ants") and medications. Uncommon triggers include latex, exercise, tick bites, transfusions, dialysis membranes and airborne allergens like domestic animals and pollen. Most allergies to household pets and ragweed or birch pollens are limited to itching, sneezing and watery eyes. These are rarely serious. Anaphylactic reactions can include hives, swelling of the lips, tongue and throat, nausea, difficulty breathing, wheezing, dizziness, diarrhea, confusion, drop in blood pressure, loss of consciousness and death. These reactions can happen within minutes of a person coming into contact with his or her specific allergic trigger. According to the AAAI, when a person develops an anaphylactic reaction, epinephrine should be injected, and 911 or emergency medical services should be called. Immediate action is needed, because it is difficult to predict whether the anaphylaxis episode will be mild, life-threatening, or fatal. They also recommend a close follow-up, because anaphylaxis can occur repeatedly. Risk-assessment should be performed, and the trigger has to be confirmed. Your physician will then implement a risk reduction strategy.

Severe food allergy differs from food intolerance. A food intolerance is defined as an adverse reaction to a particular food due to the body’s inability to properly break it down and digest it. It may manifest with headache, nausea, abdominal cramping, diarrhea or bloating. An allergy is however an immune system response. About 30 % of Americans have food intolerance and avoid certain foods. Lactose intolerance is the most common and affects about 10% of the Americans. The intolerance may be due to some chemical ingredients added to food to provide color, enhance taste, or to protect against the growth of bacteria. These ingredients include various dyes and monosodium glutamate (MSG), a flavor enhancer. Other culprits are sulfites, occurring naturally in red wine or salicylates, which are often present in many fruits, vegetables, nuts, coffee, juices, beer, and wine.

Food allergies affect children and adults of all races and ethnicity, and can develop at any age. Food allergies often run in families, suggesting that the condition can be inherited.

Dr. Shashi K. Agarwal is a Board Certified Internist and Cardiologist with a private practice in New York City and New Jersey. He is also a diplomat of the American Board of Holistic Medicine and the American Academy of Anti-Aging Medicine.