Food allergies statistics
Food allergies have increased in the last few years. This kind of allergy concerns particularly young children. The number of severe cases of allergies appears to be on the increase, however precisely how much is difficult to ascertain as anaphylactic reactions have been poorly recorded in the UK.
Why so many food allergies
Our eating habits have changed considerably in the last thirty years.
- New foods are consumed: exotic, Indian, African, Mexican...
- New proteins flavour enhancers are developed and used to modify the colour and consistency of food.
- New ways of preparing and storing food
- The success of `fast food' and the development of sesame allergy.
- Weaning babies too early.
Potentially severe allergic symptoms
- The symptoms caused by a food allergy are numerous and occur in general from a few seconds to a few hours after having eaten the concerned food.
- They can cause moderate symptoms, sometimes severe ones and in exceptional cases anaphylactic shock.
- Hives (urticaria) , and swelling localised around the mouth or generalised throughout the body, are one of the most frequent symptoms.
- Angio- oedema, and in exceptional cases, anaphylactic shock can also occur.
- The number of deaths caused by food allergies is also exceptional.
Symptoms caused by food allergies in babies
- swelling of the lips
- Abdominal pain
Any signs or symptoms observed in an infant or small child needs immediate attention and full investigation by an allergy specialist. Especially where there is an allergy (atopic) family background.
Rhinitis and asthma are also found in connection with food allergy
People having had symptoms of food allergy should wait 3 hours after a meal before doing any sports.
The main foods to be concerned about
More than 150 food products are listed today as potentially allergenic, and the list is growing:
Eggs, cow milk, peanut, shellfish, fish, corn, vegetables of the family of celery (fennel, parsley, coriander), soy, nuts (almond, hazel nut, cashew nut, pecan nut, Brazil nut, pistachio, macadamia nut and produces containing these fruits), mustard, sesame...
- For children under 15, 5 foods are responsible for 80% of allergic symptoms: eggs, peanut, cow milk, fish and mustard.
- Up to 3 years old: cow's milk and eggs are generally the culprits.
- Beyond 3 years old, it is peanut and fish.
Factors contributing to severe food allergy reactions
- Having asthma can predispose you to having food allergies.
- Taking aspirin or non-steroidal anti-inflammatory medication, beta-blockers or alcohol all of which can cause severe asthma attacks.
- Doing sports or exerting after a meal or taking these drugs.
Food allergy: medication, which worsens the symptoms
The consumption of certain medications associated with a food allergen can worsen allergic symptoms.
The 4 classes of medications
- Non-steroidal anti-inflammatory drugs prescribed for pain.
- Beta-blockers prescribed for cardiac problems.
- Angiotension Converting-enzyme inhibiters (ACE) prescribed for high blood pressure.
Alcohol and exercise
The association of alcohol and exercise with these foods can worsen allergic symptoms.
Prevention of severe reactions of food allergies
If you have a known food allergy;
- Do not to take aspirin or non-steroidal anti-inflammatory drugs, before meals
- Check with your doctor or allergy specialist if you are prescribed beta-blockers, or ACE inhibitors as these can worsen a food allergy.
Diagnosis of food allergies
- Consulting an allergy specialist is essential to determine a food allergy.
- A questionnaire, keeping a food diary, having skin prick and blood tests are enough in most cases to identify the food allergy.
- Other skin prick tests are sometimes carried out: tests with natural food, consisting in scratching the skin with a piece of natural food.
- It is sometimes necessary to take oral tests in hospital:
- An allergic person will consume a potentially allergic food under strict medical supervision, close to an intensive care unit.
- Periods of removal and reintroduction of a suspect food also makes it possible to confirm a diagnosis or to authorise the person to reintroduce certain types of food.
Treatment of food allergies
The best solution is obviously to avoid the food responsible for the allergic reaction.
This avoidance is relatively easy to implement when a product is easy to isolate and is used little in your daily diet. However difficulties arise when food is prepared by other means for example, factories and processing plants.
An allergy specialist, after having confirmed his diagnosis, can advise you on food avoidance and how to ensure you get a full balanced diet. A dietician may be helpful here..
An allergic person needs to know precisley all the products which contain the food to which he is allergic to.
The European directive of November 2005 specifies from now on the list of 12 foods must be labelled, even if they are present in trace quantities:
- Cereals containing gluten: corn, rye, kamut and products containing these cereals
- Shellfish and products containing shellfish
- Eggs and products containing egg
- Fish and products containing fish
- Peanut and products containing peanut
- Milk and product containing milk
- Soy and product containing soy
- Nuts: almond, hazel nut, cashew nut, pecan nut, Brazil nut, pistachio, macadamia nuts and products containing these fruits.
- Celery and products containing celery
- Mustard and products containing mustard
- Sesame seeds and products containing sesame
- Sulphur dioxide and sulphites in concentration of more than 10mg/kg or mg/l expressed in SO2.
- 2 products were added on this list at the end of 2006: lupin (lupin seeds and products made out of lupin) and molluscs (snails, clams, oysters, mussels, squid, abalone and octopus)
Allergy to cow's milk: one of most frequent infant allergy
The number of people affected by an allergy to cow's milk proteins
- It represents 13% of infant food allergies and affects 2 to 3% of infants under 2.
- More than 50% of the children presenting an allergy to food are allergic to several foods, like cow's milk, eggs, peanut.
Allergy to cow's milk appears generally from the very first time children are bottle-fed.
- It disappears in 90% of cases around the age of 3 at the condition of having removed from the child's diet cow's milk and all the products being able to contain allergenic proteins.
- Approximately 18% of children allergic to cow's milk are likely to develop other food allergies, approximately 40% asthma and 30% allergic rhinitis.
Where can cow's milk proteins be found?
Allergenic proteins are in
- Fresh milk or `long life' milk
- Concentrated powder milk
- Baby formula milk, even the "hypoallergenic" ones
- Milk/cream desserts
- Mash Potato
- Ready made meals NON EXHAUSTIVE LIST
The proteins of cow's milk are present in food in various forms: milk and powder, casein, caseinate, lactoglobine, lactalbumine, whey.... NON EXHAUSTIVE LIST
Symptoms of allergy to cow's milk proteins
Between 2 %and 7% of babies are allergic to cow's milk. Babies that suffer with eczema are more likely to suffer with it..
- Vomiting generally after the meal
- A chronic diarrhoea accompanied by semi-liquid stools and colic in younger children.
- abdominal pains in older children
- Eczema and or hives (urticaria) have also been observed.
- Asthma, angio-oedema, or very rarely anaphylactic shock.
These symptoms are not specific to food and cows milk allergy. They can be symptoms of other illnesses.
Advice if you are allergic to proteins in cow's milk
- Ensure your diagnosis is confirmed by your GP or allergy specialist. Tests may include: traditional skin prick tests (they highlight the immediate reactions to the allergen), a patch test (the Diallertest highlights delayed aspects of this kind of allergy, followed by a blood test and sometimes provocation tests. They should always be performed by a doctor that specialises in allergy.
- Be wary of soya milk, ewe and goats milk. There can be a cross allergy with cow's milk proteins: 30% of the children allergic to cow's milk are also to soy proteins and 70% of them are to goat's milk proteins.
- If you have any doubts about a food, better avoid consuming it. Contact the manufacturer's customer services to find out the exact composition of the product.
- Check that shampoos and creams which you use with a newborn baby do not contain cow's milk proteins.
- Seek advice from a dietician, because a diet without milk can cause protein and calcium deficiency
- Follow the advice of medical personnel and avoid criticism from family and friends, because what is appropriate for some babies is not necessarily appropriate for others.
A prescription of substitution products will be necessary. Hydrolysate proteins which are appropriate for 90% of the children, have been used for several years as substitutes to cow's milk.
- Sometimes these hydrolysates cause allergies. In this case, a formula containing amino-acids is safe, and ensures effective nutrition which provides the baby with all it's nutritional needs to grow.
Several formulas are available, get advice from your doctor.
Re-introduction of cow's milk
- In 90% of the cases, a child will tolerate cow's milk proteins from 18 months or at the latest aged 4.
- After an avoidance diet and an allergy re-evaluation (skin prick tests, blood tests) a first attempt of reintroduction of cow's milk is made towards the age of 10-12 months, and this preferably in hospital.
- In case of failure, new attempts of reintroduction should be made in succession with 6 months intervals .
- It is always difficult to predict at which age exactly a child will be able to consume milk without showing reactions.
Allergy to eggs
Symptoms caused by an allergy to eggs
- Allergy to eggs represents 30% of infant food allergies.
- It appears in general towards the age of 1 and disappears spontaneously around the age of 4 in more than 60% of the cases, on one essential condition, having strictly avoided eggs.
- The symptoms caused by an allergy to eggs can be, separately or associated, an atopic dermatitis, hives, conjunctivitis, a rhinitis, asthma, vomiting, stomach pains. Anaphylactic shock can happen in very exceptional cases.
Food containing egg proteins which should be avoided
- Egg in all its forms: hard, soft boiled, fried, omelette.
- Gratins, soufflé, quiche
- Butter, mayonnaise, sauces : Bearnaise,
- Some breads, egg-based pasta, ravioli, cannelloni, puff pastries, gnocchi, pizza, sandwiches and hamburgers
- Fruit or vegetables in the form of mousse containing eggs, fritters or gratins
- Pastries, cookies, brioche, ice-creams, some sweets ...
- Some potatoe dishes, especially in restaurants.
- Mixed salad with eggs
- Terrines, Pies, Rolls, stuffings, breaded preparations
- Quenelle (fish/potatoe/egg dish)
- Surimi (Japanese seafood dish - contains egg)
- Egg-based pasta
- Cheeses containing E1105
- Fritters, confectioner's custard, custards, ile flottante (a French egg desert)
- Pie pastry... NON EXHAUSTIVE LIST
- To make sure that: industrial products, prepared dishes, those consumed in restaurants or baby food do not contain traces of egg.
Egg proteins are hidden under other names that an allergic person to egg must know
- Lysosyme (E 115, additive which can be found in many preparations and some cheeses)
Some shampoos can contain egg proteins.
Yellow fever, influenza and tick encephalitis vaccines, contain egg proteins. Ask your GP or allergy specialist if you are allergic to egg proteins and you need to be vaccinated. These vaccines may be done in specialised centres according to protocols defined by an allergy specialist.
Vaccines against measles, mumps and rubella do not contain egg proteins.
Advice to be followed in case of an allergy to eggs
- Raw fruits and cooked fruit compotes are the recommended deserts for egg allergy sufferers.
- Use egg substitutes : in powder form, they are manufactured from corn starch and potato starch. Several companies sell desserts for allergic to egg sufferers.
Your dietician will advise you regarding any additional nutritional requirements caused by an egg-free diet
- Studies show that a child allergic to egg who regularly tolerates the absorption of cooked egg saw his allergy to eggs disappear more quickly than with a strict egg free diet.
- The decision to carry out a strict or a more flexible avoidance strategy can only be taken on the advice of an allergy specialist. they have the sufficient experience to be able advise allergic people.
Some skin prick tests and or blood tests can reveal a positive allergic reaction, however if the person has never reacted allergically to the food in question, avoidance of this food is not always necessary.
There is no standard way as regards to reintroducing food. Each situation and each child is different. The attitude depends on many factors, like the severity of the symptoms, the proportion of the specific antibodies, skin prick tests, provocation tests. The opinion of a professional is essential.
The number of people, children and adults, affected by nut allergy is constantly increasing.
The number of children with nut allergy has doubled in the last ten years. It is the most common allergy in a child over 3 years old.
- Nuts belong to the family of leguminous plants (garden peas, soy, broad beans, lupin, chick-pea.) with which it can present cross-reactive allergies.
- Nuts have great nutritional value, they are low cost and are increasingly added to many foods.
- In addition, nuts improve taste, the volume and the consistency of many foods.
Nut allergy does not tend to disappear and persists into adulthood. Only 10 to 15% of the children recover towards the age of 20.
Be AWARE of which foods contain nuts and therefore should be AVOIDED for a person with nut allergy
- Peanut oil
- Peanut butter
- Some salamis, pies, sausages.
- Mixed salads
- Dessert creams , cheeses with dried fruit, yoghurt with muesli, dairy products including cereals
- Sweets, chocolates, confectionary products. Check their labels as these preparations may also have peanut oils used during processing.
- Oils used for Crisps and chips
- Bread manufactured with flour of lupin and special bread with cereals
- Breakfast cereals ,biscuits, cookies, industrial pastries, canapes snacks,
- Cereal bars
- Pralines, filled chocolates, ice-creams, nougats, frangipane pie, wafers, chocolate bars with dried fruit.
- Ready made meals
- Ice decorations containing "hazel nut" powder
- Almonds and almond paste, certain flavourings...
- Dried fruit and potatoes because of a possible cross-reactive allergy with nuts: your specialist doctor will advise you if it is safe to eat these.
..............NON EXHAUSTIVE LIST
Avoid preparations mentioning "vegetal oil" without specifying if it is sunflower, olive or chestnut oil.
Many cosmetics, certain shampoos and certain medications contain peanuts. Food for fish and birds can also contain some.
At restaurants, do not hesitate to ask the chef which oil he uses, and ingredients for dishes and sauces. This is particularly important in exotic restaurants, as the majority of severe incidents occur in these places.
Cross-reactive allergies with peanuts
- Garden peas
- Soy beans
- Broad beans
Ask the baker if he uses lupin flour which improves the bread and brioches' suppleness.
Symptoms of a nut allergy
Nut allergy appears as a rhinitis, hives (sudden onset urticaria), atopic eczema, asthma, vomiting, abdominal pains , symptoms appearing on there own or together and they can be severe sometimes causing anaphylactic shock.
Nut allergy sufferers must always carry a card specifying their nut allergy.
It is vital allergic people should always have within reach an emergency kit containing a steroid drugs, a bronchodilatator inhaler (ventolin) and an self-injection epinepherine syringe.
Additives can cause food allergies
Additives include dyes, preservatives, flavour enhancers, antioxidants, texture enhancers, enzymes, sweetening substances and flavours.
Pseudo (false) allergies to food
Many people think they suffer from an allergy to food whereas they are victims of symptoms similar to those caused by allergies. These "pseudo allergies" or "false allergies" are not related to the production of specific antibodies.
These false food allergies are caused by food histamine releasers. They are rich in histamine or tyramine, a component causing an inflammatory reaction, close to a typical allergic reaction.
The observed symptoms are hives, eczema or angio-oedema. Asthma and rhinitis are seldom noted. Severe reactions such as anaphylactic shock are never observed.
Food rich in histamine
Strawberries, chocolate in all its forms, tuna, sardine, salmon, anchovies, herring, dried fish, smoked fish, beer, wines, cider, alcohol, dry sausage, ham, pig's liver and all cured meat, Emmental, Parmesan cheese, Roquefort, Gouda, Camembert, Cheddar, egg white, tomatoes, spinach, garden peas, sauerkraut, lentils, beans, broad beans, nuts, hazel nuts, peanuts, pineapple, orange, grapefruit, lemon, tangerine, Clementine, papaw, mango.
Food rich in tyramine
Cured meat, chocolate, red wine, white wine, beer, Gruyere, Brie, Roquefort, cabbages, spinaches, avocado, potato, herring, caviar , game,...
Food allergens can be found in some dishes without the consumers' knowledge.
- For example, on can find cow's milk proteins in some reconstituted salmon products, nut protein in pizza or chocolate bars, milk in raviolis rusks, apricot starch in brioches, mustard in small pots for babies, traces of egg protein in products containing surimi, of apricot stones used as almond substitutes....
People allergic to a food, especially those having had severe reactions, must read labels and know precisely the contents of dishes prepared by friends or at the restaurant.