February 14, 2011

Queenie Gene Gadong

Angeli Louise Cando
April Rose Dionson
FOOD ALLERGY

INTRODUCTION

Foods are composed of different nutrients and organic components. During its
consumption, these foods are being digested in our body by enzymes and nutrients are either
being absorbed or being broken down for our body to absorb and be used.
However, there are times when a certain food being consumed by our body reacts negatively
with our body which causes different reactions and effects to those who consumed it. Certain
reactions lead to rashes, skin itchiness and even death. These reactions, are what we call a food
allergy and/or food intolerance.

WHAT IS AN ALLERGY?

An allergy is a condition where the body overreacts following "contact" with an allergen
(dust, molds, pollen, flower, dander, fur, animal protein from hair, perfume, cosmetics,
medications---applied to skin or swallowed---food or drink, etc.).

Essentially, it is an immune reaction to a substance that is inhaled, injected, ingested, or

even just touched. The body's immune system responds to an allergen -- the substance causing
the reaction -- by releasing histamines and other chemicals that result in symptoms such as nasal
and respiratory congestion, an itchy or runny nose, a sore throat, diarrhea, itchy, watery eyes, and
itchy rashes. In some serious cases, it can lead to sudden inability to breathe, shock and death.

Allergic reaction is triggered, and symptoms develop, when the body's immune system
detects the presence of an allergen. This automatic protective response is aimed at warding off
any adverse effects of the "culprit substance" on the body by producing antibodies and

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mobilizing the "immune soldiers into the battlefield to fight the invading foreign" substance.
This is a natural part of the defense mechanism of our body.

According to studies on the incidence of food allergy attacks, about 10 percent of people
have some form of allergies or another. That is, almost 7 million Filipinos suffer from this
malady. Luckily, most of the allergies people have are mild. If repeated exposures to the same
allergen, at the same high dose, are allowed to occur, the symptoms could become more severe.

Also, medical reports have shown that about 2% (two out of a hundred) of adults and
about 8% of children have true food allergies. Food allergy is not the same as food intolerance
(like stomach aches following ingestion of milk for those with deficiency of lactase, the enzyme
that digests lactose--milk and milk products). Food intolerance is due to body metabolism and
does not involve the immune system. Some people are allergic to shellfish, peanuts, a few to
chicken. Cow's milk, soy, wheat and eggs are common cause of allergies in children. In some
cases, children outgrow their allergies, but early peanut allergy can be for life.

WHAT IS A FOOD INTOLERANCE?

Food intolerance unlike allergy is not an immune response rather it is a digestive system
response, a varied physiological response associated with a particular food, or compound found
in a range of foods. This may also be referred to as non-allergic food hypersensitivity.

SYMPTOMS:

The symptoms and signs by which food allergy and intolerance manifest its characteristic
effects vary. The most obvious symptoms for food allergy are flushed skin or rashes, the
swelling of the tongue, face and lips, and the itchy or tingly sensation in certain parts of the body
especially in the mouth. It also includes dizziness or lightheadedness, and in extreme cases it
includes, abdominal cramps, vomiting or diarrhea, swelling of the throat and vocal cords
resulting to coughing or wheezing and difficulty in breathing, and loss of consciousness. The
swelling is mostly due to the production of the histamine of the body as a reaction to the allergen
(see mechanism).

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 Symptoms of food allergies typically appear from within a few minutes to two hours after
a person has eaten the food to which he or she is allergic. In some allergic reactions the symptom
may appear well after many hours and even days after ingestion of the allergen. Because of this a
patient is not able to realize the connection of this/her allergy with a food product since the
reaction is greatly deferred.

Symptom of food intolerance, on the other hand, is commonly in manifested through the
patient’s gastro-intestinal tract. Food intolerance may also manifest in the respiratory system,
may also show up in the skin, produce chronic headache, muscle and bone disorders, and may
lead to infertility.

MECHANISM:

In general the mechanism reaction of food allergy involves the food protein reacting with
the body’s antibody which subsequently produces histamine triggering the symptoms and signs
of allergy. Specifically there are two types of allergic reactions, the immediate on-set reaction
and the delayed on-set reaction.

The immediate on-set reaction shows up immediately after the food ingestion through the
tingling or itchy sensation in the mouth. The reaction starts when the food allergic person eats a
certain allergic protein which is mistakenly recognized by the body as “hazardous”. The body
then produces the antibody immunoglobulin E (IgE) directed against the “hazardous” protein.
The second time the person eats that certain food protein the IgE the body was able to produce
will then react with each other and with the food protein triggering the release of histamine from
the basophil, a type of white blood cell. The release of histamine, which is an amine,
“immediately effects a dilation of the blood vessels. This dilation is accompanied by a lowering
of blood pressure and an increased permeability of the vessel walls, so that fluids escape into the
surrounding tissues.”1 The swelling of the body tissues during allergic reaction is caused by the
release of histamine.
1
"Histamine." Microsoft® Encarta® 2009 [DVD]. Redmond, WA: Microsoft Corporation, 2008.

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 HISTAMINE

Accordingly there is a protein that acts as a receptor for the IgE, enabling it to react in
food allergic reactions, the CD23, a protein normally expressed in a person's intestinal tract.

The second type of allergic reaction is the delayed on-set reaction. This type of reaction
shows up rather belatedly, appearing even after two (2) days from ingestion of the allergenic
foods. This kind of reaction shows up to people with a given predisposition for the delayed on-
set allergic reaction, who instead of creating the antibody IgE creates a T-cell. On the initial
ingestion of the “hazardous” food protein the body synthesizes the T-cell, a component of the
immune system, which is the one that attacks the part of the body about to suffer. The T-cell
release certain chemicals that lead to signs and symptoms associated with allergy.

The reason to the delayed allergic reaction is attributed to the processing and the
presentation and of the food protein to the T-cell, and the consequent “invasion” of the affected
area, which could generally take up to 24-48 hours.

Unfortunately search from published literatures on as to what specific food protein acts as
allergen was unproductive. It was said that complex mixtures of allergens seem to exist in
commonly allergenic foods, of which purification and characterization may be hard. To further
understand the chemistry of food allergens further research will be required.

Examples of Food Allergy:

Peanut Allergy

The most common food allergy problem in the United States and even here in the country
is the peanut allergy; furthermore it appears to be on the rise. A research study showed that there
is a doubling on the number of incidence of peanut allergy in children from 1997 to 2002. The

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severity of the allergy is dependent on the sensitivity of the person and on the quantity of the
peanut protein that person consumed. Other times the allergic reaction is caused by the unwary
ingestion of the person of products that are unexpected sources of peanut.

Some unexpected sources of peanuts are:

o Potato pancakes
o Asian and Mexican dishes
o Some vegetarian food products, especially those advertised as meat substitutes
o Foods that contain extruded, cold-pressed, or expelled peanut oil, which may
contain peanut protein
o Sauces such as chili sauce, hot sauce, pesto, gravy, mole  sauce, and salad
dressing
o Sweets such as pudding, cookies, and hot chocolate
o Egg rolls

Cow Milk Allergy

A study related that cow milk allergy affects some 2-3% of infants, who develop
symptoms within their first few months of life. This kind of allergy is due to a person’s hyper
sensitivity to cow milk. Again, in this case, the body falsely recognizes the milk protein as
“hazardous” thereby creating antibodies that will neutralize the foreign materials presence.

This risk can be overcome with an alternative hypoallergenic formula, such as amino-
acid based formulas (AAF) or extensively hydrolyzed formulas (eHF), which can provide rapid
relief of symptoms and enables optimal growth and development.

The recommended approach to common food allergies is avoidance. But sometimes this
method is very hard since products that contain these common food allergens are not properly
labeled on its package, because of these labeling rules and regulations are implemented in
respective countries, other times medications are employed to treat allergy symptoms.

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FOOD ALLERGENS and LABELLING STANDARDS

Labeling information standard has been set to help avoid the health risks posed by food
allergens, Congress passed the Food Allergen Labeling and consumer Protection Act of 2004
(FALCPA).
The law applies to all foods whose labeling is regulated by FDA, both domestic and
imported. (FDA regulates the labeling of all foods, except for poultry, most meats, certain egg
products, and most alcoholic beverages.)
Before FALCPA, the labels of foods made from two or more ingredients were required to
list all ingredients by their common or usual names. The names of some ingredients, however, do
not clearly identify their food source. But now, the law requires that labels must clearly identify
the food source names of all ingredients that are — or contain any protein derived from —the
eight most common food allergens, which FALCPA defines as “major food allergens.”

How Are Major Food Allergens Listed?

It could either be:

 The name of the food source of a major food allergen must appear:
In parenthesis following the name of the ingredient.

Examples: "lecithin (soy)," "flour (wheat)," and "whey (milk)"

– OR –

 Immediately after or next to the list of ingredients in a "contains" statement.

Example: "Contains Wheat, Milk, and Soy."

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 Example of proper labeling information.
TREATMENT

The best way to treat allergies is to prevent them from occurring in the first place. This is
accomplished through the avoidance of allergic triggers. However, avoidance is not always
possible, such as when a person is allergic to pollen in the air. Therefore, many people with
allergies require medications to treat their symptoms.

Medications

When avoidance doesn't work to treat allergy symptoms, most people turn to
medications. There are a wide variety of medications available to treat allergic diseases such as:
 hay fever pills
 asthma inhalers
 topical creams
 epinephrine injectors for severe allergic reactions

Immunotherapy

Immunotherapy offers the only form of allergic treatment that actually changes the way
the body deals with allergies. While medications only cover up symptoms, immunotherapy can
reduce the immune system's response to allergic triggers. Immunotherapy involves administering
what a person is allergic to in an injection (shot) form, or as drops under the tongue (sublingual
immunotherapy). As a result, the immune system reacts in a non-allergic way to allergic triggers,

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resulting in a decrease in allergic symptoms over time. Most people taking immunotherapy need
less medication to treat their allergies - some need none.

RECENT STUDIES

New research from the UK suggests an immune system malfunction could play a profound
role in the onset of food allergies. As the European food industry gets to grips with imminent
rules on the labeling of allergens, the UK findings will help industry and consumer alike.

Some recent research has also begun to show that some kinds of common parasites, such as
intestinal worms, secrete immunosuppressant chemicals into the gut wall and hence the
bloodstream which prevent the body from attacking the parasite. This gives rise to a new slant on
the hygiene hypothesis - which co-evolution of man and parasites has in the past led to an
immune system that only functions correctly in the presence of the parasites. Without them, the
immune system becomes unbalanced and oversensitive.

So far, there is only sporadic evidence to support this hypothesis - one scientist who
suffered from seasonal allergic rhinitis (hay fever) infected himself with gutworms and was
immediately 'cured' of his allergy with no other ill effects. Full clinical trials have yet to be
performed however. It may be that the term 'parasite' could turn out to be inappropriate, and in
fact a hitherto unsuspected symbiosis is at work.

The May 2009 "Journal of Allergy and Clinical Immunology" published a study that
suggests rising childhood obesity may be promoting the increased occurrence of food allergies
which rose by 18 percent from 1997-2007. Obesity was associated with a greater development of
atopic disease such as eczema and psoriasis, and a whopping 59 percent increase in food
sensitization. Researchers in this study noted, "The analysis of continuous Body Mass Index
(BMI) with total IgE levels supports the concept that increased weight is associated with
increased allergic predisposition.”. 

References

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 American Gastroenterological Association (2006, July 21). Researchers Demonstrate
Potential Mechanism Of Food Allergy.ScienceDaily. Retrieved January 30, 2011, from
http://www.sciencedaily.com/releases/2006/07/060721120023.htm

 http://www.fda.gov/Food/ResourcesForYou/Consumers/SelectedHealthTopics/ucm11907
5.html 3

 pressrelease@medicalnewstoday.com

 "Histamine." Microsoft® Encarta® 2009 [DVD]. Redmond, WA: Microsoft Corporation,

2008.
 "Food Allergy and Intolerance." Microsoft® Encarta® 2009 [DVD]. Redmond, WA:
Microsoft Corporation, 2008.
 http://www.babycenter.com.ph/baby/health/allergies/
 http://health.yahoo.net/channel/food-allergies.html
 http://www.mb.com.ph/articles/210702/milk-intolerance-among-adults