What antibody is associated with a true food allergy

Food allergy (FA) is defined as an adverse immune response that occurs reproducibly on exposure to a given food and is distinct from other adverse responses to food, such as pharmacologic reactions, toxin–mediated reactions, and food intolerance (an immunologically unrelated adverse reaction to food) [1–2]. FA can be mediated or not by IgE antibodies and includes, but it is not limited to, food–induced anaphylaxis, food protein–induced enterocolitis syndrome, and foodinduced eosinophilic gastrointestinal disorders [3].

Particularly, IgEmediated FA appears to be on the increase and has become a serious health concern in some countries such as U.S.A, Canada, Australia, China, and the United Kingdom [4–9]. On the basis of meta–analysis studies and systematic reviews, the overall prevalence of FA confirmed by oral food challenge tests (challenge–proven FA) is expected to be less than 5% [10,11], although a few population–based studies own found higher estimates (7.7% to 8.9%) [7,8].

Certainly, populationbasic studies of prevalence of FA can be influenced by some factors such as geographic location and study designs or methodologies. Therefore, prevalence data should be interpreted taking into account every those factors that could influence the estimates of prevalence and relevance of types of FA.

There are no currently accepted therapeutic approaches for FA and the only available treatment is to avoid the relevant allergen. However, accidental exposures to food allergens are common among individuals affected with FA [12,13] and restricted diets are generally costly and limit social activities [14].

An effective therapy that controls the allergic reaction by promoting immune tolerance to food allergens is expected to own a profound impact on the patient’s lifestyle and quality of life. In this context, specific therapies (e. g. oral and epicutaneous immunotherapy) are promising therapeutic approaches, but safety and efficacy of diverse dose–regiments are still main issues to be addressed specially using multiple food allergens simultaneously [15]. Other therapies, termed non–specific, own shown excellent results in preclinical and clinical studies [3] and could be particularly relevant in those cases where more than one food trigger the allergic reaction.

In this frame, food processing technologies such as heat treatment and enzymatic proteolysis are promising strategies for accelerating immune tolerance acquisition in individuals affected with cow’s milk [16–18] or raw egg allergies [19].

Notably, these allergenic processed foods are well tolerated by the majority of the individuals [7, 20,21]. Furthermore, other food processing methods own also shown potential to reduce the IgE–mediated allergic immune response in mouse models [22–24]. This includes high pressure conditions and irradiation of foods as well as chemical modification of food allergens.

In this review we aimed to present current prevalence data of FA as well as the main food processing technologies used for preventing or reducing the immune response to allergenic food proteins undergoing digestion and leading to IgE–mediated FA.


Basic pathogenesis of IgE mediated FA

By passing oral tolerance and generating allergen–specific IgE antibodies with subsequent sensitization of mast cells or basophils are central events to trigger the allergic immune response.

These basic events are typically called sensitization and effector phases [40,41] (Figure 1). The previous involves antigen presenting cells, T cells, Th2 cytokines such as interleukin (IL)–4, IL–5 and IL–13, cross–linking of allergens with B–cell receptors, and IgE production. Sensitization happen after antigen presenting cells such as dendritic and B cells own recognized allergenic segments or “epitopes” in the protein component of food or ingredients within food.

Then, allergen antigens are loaded on MHC class II molecules and antigen presentation to T cells may happen. This interaction activates allergen–specific T cells which produce Th2 cytokines and promotes the production of IgE antibodies by allergen–specific B cells [41]. IgE antibodies may bind to IgE receptor FceRI on the membrane of mast cells and basophils generating sensitized cells.

Investigators at the National Institutes of Health own found that sesame allergy is common among children with other food allergies, occurring in an estimated 17% of this population. In addition, the scientists own found that sesame antibody testing — whose utility has been controversial — accurately predicts whether a kid with food allergy is allergic to sesame.

The research was published on Oct. 28 in the journal Pediatric Allergy and Immunology.

«It has been a challenge for clinicians and parents to determine if a kid is truly allergic to sesame,» said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH. «Given how frequently sesame allergy occurs among children who are allergic to other foods, it is significant to use caution to the extent possible when exposing these children to sesame.»

Sesame is among the 10 most common childhood food allergies. Only an estimated 20% to 30% of children with sesame allergy outgrow it.

Severe reactions to sesame are common among sesame-allergic children. About 1.1 million people in the United States, or an estimated 0.23% of the U.S. population, own sesame allergy, according to a recently published study funded by NIAID. These factors underscore the need to optimize recognition and diagnosis of this allergy. The Food and Drug istration is currently considering whether to include sesame in the list of allergens that must be disclosed on food labels.

Standard allergy tests — the skin-prick test and the allergen-specific antibody test — own been inconsistent in predicting an allergic reaction to sesame.

Numerous studies evaluating the utility of these tests for sesame allergy own included only children suspected to own sesame allergy. Taking a diverse approach, scientists led by Pamela A. Frischmeyer-Guerrerio, M.D., Ph.D., deputy chief of the NIAID Laboratory of Allergic Diseases and chief of its Food Allergy Research Unit, evaluated the sesame antibody test in a group of 119 children with food allergy whose sesame-allergic status was unknown.

The researchers offered children in the study an oral food challenge — the gold standard for diagnosing food allergy — which involved ingesting gradually increasing amounts of sesame under medical supervision and seeing if an allergic reaction occurred.

Children who recently had had an allergic reaction to sesame or were known to tolerate concentrated sesame, such as tahini, in their diet were not offered an oral food challenge.

The scientists found that 15 (13%) of the 119 children were sesame-allergic, 73 (61%) were sesame-tolerant, and sesame-allergic status could not be sure for 31 (26%) children, mainly because they declined the oral food challenge. Among the 88 children whose sesame-allergic status was definitive, 17% had sesame allergy.

The scientists measured the quantity of an antibody called sesame-specific immunoglobulin E (sIgE) in the blood of these 88 children. With this data and information on the children’s sesame-allergic status, the researchers developed a mathematical model for predicting the probability that a kid with food allergy is allergic to sesame.

According to the model, children with more than 29.4 kilo international units of sIgE per liter of serum own a greater than 50% chance of being allergic to sesame. This model will need to be validated by additional studies, however, before it can be used in clinical practice.


Story Source:

Materials provided by NIH/National Institute of Allergy and Infectious Diseases. Note: Content may be edited for style and length.


Journal Reference:

  • Severe wheezing
  • Food intolerance: An adverse food reaction that doesn't involve activation of your body's immune system.
  • Inability to breathe
  • Swelling of the tongue, lips, and throat
  • Chest tightness
  • Commins S.

    Food allergy and food intolerance in adults: an overview. https://www.uptodate.com/contents/search. [Accessed April 2, 2019]

  • Vertigo
  • Wheezing
  • Diarrhea
  • Celiac disease, non-celiac gluten sensitivity, and food allergy: how are they different? American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/celiac-disease. [Accessed April 11, 2019]
  • Samson H. Food allergies. In: Feldman M, ed. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed.

    Philadelphia, Pa.: Saunders Elsevier; 2016:148-157.

  • Hives and itchy skin
  • Fainting or passing out
  • DeGeeter C, Guandalini S.

    What antibody is associated with a true food allergy

    Food sensitivities: fact versus fiction. Gastroenterol Clin North Am 2018;47:895-908.

  • Fazio S. Approach to flushing in adults. https://www.uptodate.com/contents/search. [Accessed April 28, 2019]
  • Low blood pressure leading to a feeble and rapid pulse
  • Iweala O, Choudhary S, Commins S. Food allergy. Curr Gastroenterol Rep2018;20:17.
  • Runny nose
  • Migraines and other headaches
  • Acker W, Plasek J, Blumenthal K, et al.

    Prevalence of food allergies and intolerances documented in electronic health records. J Allergy Clin Immunol 2017;140:1587-1591.

  • Arthritis, including ankylosing spondylitis, psoriatic arthritis, and rheumatoid arthritis14
  • Feng C. Beyond avoidance: the psychosocial impact of food allergies. Clin Rev Allergy Immunol 2018 Sep 1.

    What antibody is associated with a true food allergy

    [In press]

  • Anaphylaxis. https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468. [Accessed May 17, 2019.]
  • Cough
  • Irritable bowel disease
  • Niu Q, Wei W, Huang Z, et al. Association between food allergy and ankylosing spondylitis: an observational study. Medicine (Baltimore) 2019;98:e14421.
  • Divekar R (expert opinion). Mayo Clinic, Rochester, Minn.

    May 28, 2019.

  • Schnedl W, Lackner S, Enko D, et al. Evaluation of symptoms and symptom combinations in histamine intolerance. Intest Res 2019 Mar 7. In press.
  • Sleep issues
  • Adverse food reaction: Any unpleasant reaction that occurs after you eat a certain food or a substance in a food.
  • Mood disorders, including anxiety and depression15
  • Schink M, Konturek P, Tietz E, et al. Microbial patterns in patients with histamine intolerance.

    J Physiol Pharmacol 2018 Aug;69(4):579-593.

  • Food allergy / food hypersensitivity: An adverse food reaction that involves an immediate immune response. According to this definition, food allergy and food hypersensitivity are the same thing.
  • Kristin Sokol, Marjohn Rasooly, Caeden Dempsey, Sheryce Lassiter, Wenjuan Gu, Keith Lumbard, Pamela A Frischmeyer‐Guerrerio. Prevalence and Diagnosis of Sesame Allergy in Children with IgE‐Mediated Food Allergy.

    Pediatric Allergy and Immunology, 2019; DOI: 10.1111/pai.13143

  • Swelling of the tongue, lips, and throat
  • Stomach pain
  • Gaby A. Food allergy and intolerance. In: Rakel D, ed. Integrative Medicine. 4th ed. Philadelphia, Pa.: Elsevier; 2018:310-318.
  • Gluten intolerance definition. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/gluten-intolerance. [Accessed April 11, 2019.]
  • Nausea and vomiting
  • Kristin Sokol, Marjohn Rasooly, Caeden Dempsey, Sheryce Lassiter, Wenjuan Gu, Keith Lumbard, Pamela A Frischmeyer‐Guerrerio.

    Prevalence and Diagnosis of Sesame Allergy in Children with IgE‐Mediated Food Allergy. Pediatric Allergy and Immunology, 2019; DOI: 10.1111/pai.13143


make a difference: sponsored opportunity

Cite This Page:

NIH/National Institute of Allergy and Infectious Diseases. «Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children.» ScienceDaily. ScienceDaily, 4 November 2019. <www.sciencedaily.com/releases/2019/11/191104112932.htm>.

NIH/National Institute of Allergy and Infectious Diseases.

(2019, November 4). Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children. ScienceDaily. Retrieved January 29, 2020 from www.sciencedaily.com/releases/2019/11/191104112932.htm

NIH/National Institute of Allergy and Infectious Diseases. «Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children.» ScienceDaily. www.sciencedaily.com/releases/2019/11/191104112932.htm (accessed January 29, 2020).

It's not unusual to hear someone tell, "I can't eat that, I'm allergic to it." As numerous as one in five individuals own bad reactions to specific foods or classes of foods.1 And the number of adults with reported food allergies is increasing.1,2

Feeling ill after eating a certain food doesn't mean you actually own a true food allergy.3 If the offending food doesn't set off a specific immune reaction in your body, then you probably own a food intolerance, rather than a genuine allergy.

Know the terms

Many diverse terms and phrases are used to refer to unpleasant food reactions, and it can be simple to stir them up.

Knowing their definitions and differences will assist you better communicate with your health-care professional and better understand your specific health needs.

In the United States, food allergy specialists (allergists) use the following terms.4

  1. Adverse food reaction: Any unpleasant reaction that occurs after you eat a certain food or a substance in a food.
  2. Food intolerance: An adverse food reaction that doesn't involve activation of your body's immune system.
  3. Food allergy / food hypersensitivity: An adverse food reaction that involves an immediate immune response.

    According to this definition, food allergy and food hypersensitivity are the same thing.

True food allergies: Sudden and unpredictable

A true food allergy is an immune response that occurs quickly and repeatedly when you are exposed to a certain food.1 When you eat a food that you're allergic to, your body mistakenly marks it as foreign.

This triggers your immune system to release a flood of inflammatory chemicals to activate cells that cause allergy-related inflammation, including mast cells, eosinophils, and basophils.

This food hypersensitivity reaction is also known as immunoglobulin E (IgE)-mediated food allergy, because it is the food-specific IgE that binds to the food, triggering the cascade of allergic reactions.

Why does the body identify some foods as allergens?

Largely because of a person’s genetic make-up, in addition to environmental factors that shape the immune response.

Certain proteins on a food drive the allergic reaction, although other factors can frolic a role.

Some believe that having a low level of stomach acid – which can happen if you use antacids or acid blockers – results in incomplete digestion of these proteins. This, combined with inflammation in the little intestine, can trick the immune system into thinking the protein is foreign, causing the immune system to launch a defense.

Food allergy symptoms happen quickly, generally in seconds or minutes after eating the food.

In unusual cases, it can take several hours.1,3 Symptoms can affect the gastrointestinal tract, respiratory tract, and skin, and can include:3

  1. Diarrhea
  2. Stomach pain
  3. Runny nose
  4. Cough
  5. Nausea and vomiting
  6. Wheezing
  7. Hives and itchy skin
  8. Swelling of the tongue, lips, and throat

The severity of the symptom(s) has nothing to do with the quantity of food you eat. Even a tiny quantity of an offending food can set off an immune reaction. Also, a food that causes hives one time can cause a life-threatening symptom the next time.

Symptoms of a life-threatening food allergy reaction include:5

  1. Chest tightness
  2. Swelling of the tongue, lips, and throat
  3. Inability to breathe
  4. Severe wheezing
  5. Low blood pressure leading to a feeble and rapid pulse
  6. Fainting or passing out

More than 170 foods are linked to IgE-mediated food allergies.3 The most common ones are cow’s milk, chicken eggs, fish, shellfish, tree nuts, peanuts, wheat, soy, and some fruits.1,6

Pollen food allergy: Hay fever meets food allergy

Do certain raw fruits or vegetables make your tongue swell or lips itch?

You could own a pollen food allergy, also called oral food allergy syndrome (OFAS). It's a type of contact allergy that affects people who are allergic to pollen, generally those who own hay fever.1,4

Pollen food allergy occurs when proteins in fruits and vegetables are cross-reactive with allergy-triggering pollen proteins. If you own this type of allergy, then eating a raw fruit or vegetable with these pollen proteins will trigger mild symptoms in the lining of your mouth and throat, although they can lead to a severe reaction in rare cases.4,6

Which fruit or veggie affects you will depend on what type of pollen triggers your seasonal allergy symptoms.1

Pollen allergy Associated food allergies

Birch tree Apple, pear, cherry, carrot, kiwi, raw potato

Ragweed Watermelon, cantaloupe, honeydew, banana

Mugwort Celery

Heating or cooking the food will destroy most of the allergy-causing substances in OFAS.1

Possible food allergies

Food allergy science is constantly evolving and being studied.

One debated topic is whether immunoglobulin G (IgG) antibodies are to blame for hidden food allergies. The body can produce IgG antibodies to specific foods even under normal circumstances. Some individuals own noticed they are more sensitive to the inflammatory processes caused by these substances, although their role in food allergies is controversial.

Food intolerance: When digestion goes awry

A food intolerance is not the same thing as a food allergy. If you own a food intolerance, then your body has trouble digesting or breaking below a certain food or chemical in a food.

An overactive immune system response isn't to blame.1,7 Instead, your body lacks a protein needed to properly digest a food, or there is a problem with how your gut processes the food, or your symptoms are triggered by specific substances in food. Sometimes the cause of a food intolerance is unknown.4

Most adverse food reactions are due to food intolerances.

Symptoms often only involve stomach problems, such as stomach pain, bloating, gas, and diarrhea, although more systemic symptoms, including migraines and other body aches and pains are not uncommon.

Unlike with a true food allergy, with a food intolerance, symptom severity is directly related to the quantity of the food you eat.

For example, if ice cream upsets your digestion, then the more you eat, the worse you will feel.1

Several types of food intolerances are common

Lactose intolerance (lactase deficiency)

Individuals with this condition do not own the lactase enzyme needed to digest lactose, a natural sugar in milk, ice cream, and other dairy products. Symptoms include stomach cramps, gas, bloating, and diarrhea. Lactose intolerance is not the same as a milk allergy (an allergy to certain milk proteins such as casein).3

Carbohydrate intolerance

Some individuals who own irritable bowel syndrome (IBS) own more stomach pain, bloating, diarrhea, and gas when they eat foods containing one or more types of carbohydrates called FODMAPs – fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

FODMAP carbs include fructose, lactose, sorbitol, fructans, and galactooligosaccharides. Fructans are found in high amounts in foods that contain gluten, which causes the mistaken belief that this stomach distress is due to a gluten sensitivity.8 This article provides information about a low FODMAP diet.

Alcohol dehydrogenase deficiency

Feeling flushed can happen to anyone after a few alcoholic drinks, because alcohol's effect on blood vessels can cause facial redness.

But if the flushing is severe, then you could be missing an enzyme called alcohol dehydrogenase (ADH) or your ADH might not be working as it should. ADH is needed to break below alcohol you drink or alcohol made in the body. This type of food intolerance is more common in those of Asian descent.1,9

Gluten intolerance

Gluten is a protein found mostly in wheat, rye, and barley. There has been much focus recently on gluten and how gluten affects health.

Concerns about gluten's ill effects own prompted numerous stores and manufacturers to label gluten-free items so they are easier to see. Current sale of gluten-free products is $2.6 billion.9,10

Gluten intolerance is not the same as celiac disease, an autoimmune disorder in which gluten can cause serious, even life-threatening complications.4,5Celiac disease causes damage to the wall of the little intestine; whereas, gluten intolerance does not.

To differentiate between the two conditions, some practitioners refer to gluten intolerance as non-celiac gluten sensitivity.4,11

Gluten intolerance can cause major stomach discomfort, including bloating, cramping, gassiness, diarrhea, and constipation.

Some individuals who are gluten intolerant also report having skin rashes, headaches, fatigue, mood disturbances, and muscle cramps after eating gluten.

Biogenic amines: Histamine, tyramine

Foods wealthy in substances called biogenic amines, nitrogen-containing compounds, might be the culprit behind several food intolerances.1,3 Amine levels naturally rise when a food ripens or spoils.

One type of amine that might be linked to food intolerance is tyramine, found in aged cheeses. It triggers migraines in people who own a food intolerance to the substance.1

Histamine is another biogenic amine.

Some individuals feel bloated and own stomach pain, diarrhea, constipation, flushing, itching, and other symptoms after eating histamine-containing foods love strawberries, certain citrus fruits, shellfish, fermented foods, smoked meats, aged cheese, and some alcoholic beverages (red wine in particular). There is ongoing debate over the role of histamine from foods causing these symptoms.

Stale or spoiled fish and shellfish can own extremely high levels of histamine, which can cause symptoms of food poisoning within hours of eating.

The symptoms include vomiting, headache, flushing, hives, and wheezing, and occasionally can mimic a bad allergic reaction. An imbalance in intestinal bacteria (gut microbiota) also might contribute to higher histamine levels in the body.12,13

The food allergy / food intolerance disease connection

Understanding and treating food allergies and food intolerances is critical to excellent overall health.4,14 Food allergies can make asthma and eczema worse.

Some conditions that can be triggered by or made worse by food intolerances include:

  1. DeGeeter C, Guandalini S. Food sensitivities: fact versus fiction. Gastroenterol Clin North Am 2018;47:895-908.
  2. Irritable bowel disease
  3. Iweala O, Choudhary S, Commins S. Food allergy. Curr Gastroenterol Rep2018;20:17.
  4. Commins S. Food allergy and food intolerance in adults: an overview.

    https://www.uptodate.com/contents/search. [Accessed April 2, 2019]

  5. Vertigo
  6. Gluten intolerance definition. American Academy of Allergy, Asthma & Immunology.

    What antibody is associated with a true food allergy

    https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/gluten-intolerance. [Accessed April 11, 2019.]

  7. Gaby A. Food allergy and intolerance. In: Rakel D, ed. Integrative Medicine. 4th ed. Philadelphia, Pa.: Elsevier; 2018:310-318.
  8. Arthritis, including ankylosing spondylitis, psoriatic arthritis, and rheumatoid arthritis14
  9. Migraines and other headaches
  10. Niu Q, Wei W, Huang Z, et al. Association between food allergy and ankylosing spondylitis: an observational study.

    Medicine (Baltimore) 2019;98:e14421.

  11. Acker W, Plasek J, Blumenthal K, et al. Prevalence of food allergies and intolerances documented in electronic health records. J Allergy Clin Immunol 2017;140:1587-1591.
  12. Samson H. Food allergies. In: Feldman M, ed. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016:148-157.
  13. Divekar R (expert opinion).

    Mayo Clinic, Rochester, Minn. May 28, 2019.

  14. Anaphylaxis. https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468. [Accessed May 17, 2019.]
  15. Schnedl W, Lackner S, Enko D, et al. Evaluation of symptoms and symptom combinations in histamine intolerance. Intest Res 2019 Mar 7. In press.
  16. Fazio S. Approach to flushing in adults. https://www.uptodate.com/contents/search. [Accessed April 28, 2019]
  17. Celiac disease, non-celiac gluten sensitivity, and food allergy: how are they different? American Academy of Allergy, Asthma & Immunology.

    https://www.aaaai.org/conditions-and-treatments/library/allergy-library/celiac-disease. [Accessed April 11, 2019]

  18. Sleep issues
  19. Schink M, Konturek P, Tietz E, et al. Microbial patterns in patients with histamine intolerance. J Physiol Pharmacol 2018 Aug;69(4):579-593.
  20. Feng C. Beyond avoidance: the psychosocial impact of food allergies. Clin Rev Allergy Immunol 2018 Sep 1. [In press]
  21. Mood disorders, including anxiety and depression15
  22. Kristin Sokol, Marjohn Rasooly, Caeden Dempsey, Sheryce Lassiter, Wenjuan Gu, Keith Lumbard, Pamela A Frischmeyer‐Guerrerio.

    Prevalence and Diagnosis of Sesame Allergy in Children with IgE‐Mediated Food Allergy. Pediatric Allergy and Immunology, 2019; DOI: 10.1111/pai.13143

More research is needed to establish a definitive link between certain chronic diseases and foods. Diagnosing a food allergy or food intolerance is challenging and might require finish elimination of a suspected food or class of foods.1

If you often feel ill after eating or own a chronic health condition or family history of any type of allergies, then enquire your health-care professional if you should be tested for food allergies.

Keeping a detailed diary of when and what you eat, and any symptoms you own, is helpful.4

Avoiding foods that trigger your symptoms will assist you feel better. It’s always best to discuss your symptoms, diet, and health history with your health-care professional before trying an elimination diet and food reintroduction challenge.4


References


make a difference: sponsored opportunity

Cite This Page:

NIH/National Institute of Allergy and Infectious Diseases.

«Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children.» ScienceDaily. ScienceDaily, 4 November 2019. <www.sciencedaily.com/releases/2019/11/191104112932.htm>.

NIH/National Institute of Allergy and Infectious Diseases. (2019, November 4). Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children. ScienceDaily. Retrieved January 29, 2020 from www.sciencedaily.com/releases/2019/11/191104112932.htm

NIH/National Institute of Allergy and Infectious Diseases.

«Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children.» ScienceDaily. www.sciencedaily.com/releases/2019/11/191104112932.htm (accessed January 29, 2020).

It's not unusual to hear someone tell, "I can't eat that, I'm allergic to it." As numerous as one in five individuals own bad reactions to specific foods or classes of foods.1 And the number of adults with reported food allergies is increasing.1,2

Feeling ill after eating a certain food doesn't mean you actually own a true food allergy.3 If the offending food doesn't set off a specific immune reaction in your body, then you probably own a food intolerance, rather than a genuine allergy.

Know the terms

Many diverse terms and phrases are used to refer to unpleasant food reactions, and it can be simple to stir them up.

Knowing their definitions and differences will assist you better communicate with your health-care professional and better understand your specific health needs.

In the United States, food allergy specialists (allergists) use the following terms.4

  1. Adverse food reaction: Any unpleasant reaction that occurs after you eat a certain food or a substance in a food.
  2. Food intolerance: An adverse food reaction that doesn't involve activation of your body's immune system.
  3. Food allergy / food hypersensitivity: An adverse food reaction that involves an immediate immune response.

    According to this definition, food allergy and food hypersensitivity are the same thing.

True food allergies: Sudden and unpredictable

A true food allergy is an immune response that occurs quickly and repeatedly when you are exposed to a certain food.1 When you eat a food that you're allergic to, your body mistakenly marks it as foreign.

This triggers your immune system to release a flood of inflammatory chemicals to activate cells that cause allergy-related inflammation, including mast cells, eosinophils, and basophils.

This food hypersensitivity reaction is also known as immunoglobulin E (IgE)-mediated food allergy, because it is the food-specific IgE that binds to the food, triggering the cascade of allergic reactions.

Why does the body identify some foods as allergens?

Largely because of a person’s genetic make-up, in addition to environmental factors that shape the immune response.

Certain proteins on a food drive the allergic reaction, although other factors can frolic a role.

Some believe that having a low level of stomach acid – which can happen if you use antacids or acid blockers – results in incomplete digestion of these proteins.

This, combined with inflammation in the little intestine, can trick the immune system into thinking the protein is foreign, causing the immune system to launch a defense.

Food allergy symptoms happen quickly, generally in seconds or minutes after eating the food. In unusual cases, it can take several hours.1,3 Symptoms can affect the gastrointestinal tract, respiratory tract, and skin, and can include:3

  1. Diarrhea
  2. Stomach pain
  3. Runny nose
  4. Cough
  5. Nausea and vomiting
  6. Wheezing
  7. Hives and itchy skin
  8. Swelling of the tongue, lips, and throat

The severity of the symptom(s) has nothing to do with the quantity of food you eat.

Even a tiny quantity of an offending food can set off an immune reaction. Also, a food that causes hives one time can cause a life-threatening symptom the next time.

Symptoms of a life-threatening food allergy reaction include:5

  1. Chest tightness
  2. Swelling of the tongue, lips, and throat
  3. Inability to breathe
  4. Severe wheezing
  5. Low blood pressure leading to a feeble and rapid pulse
  6. Fainting or passing out

More than 170 foods are linked to IgE-mediated food allergies.3 The most common ones are cow’s milk, chicken eggs, fish, shellfish, tree nuts, peanuts, wheat, soy, and some fruits.1,6

Pollen food allergy: Hay fever meets food allergy

Do certain raw fruits or vegetables make your tongue swell or lips itch?

You could own a pollen food allergy, also called oral food allergy syndrome (OFAS).

What antibody is associated with a true food allergy

It's a type of contact allergy that affects people who are allergic to pollen, generally those who own hay fever.1,4

Pollen food allergy occurs when proteins in fruits and vegetables are cross-reactive with allergy-triggering pollen proteins. If you own this type of allergy, then eating a raw fruit or vegetable with these pollen proteins will trigger mild symptoms in the lining of your mouth and throat, although they can lead to a severe reaction in rare cases.4,6

Which fruit or veggie affects you will depend on what type of pollen triggers your seasonal allergy symptoms.1

Pollen allergy Associated food allergies

Birch tree Apple, pear, cherry, carrot, kiwi, raw potato

Ragweed Watermelon, cantaloupe, honeydew, banana

Mugwort Celery

Heating or cooking the food will destroy most of the allergy-causing substances in OFAS.1

Possible food allergies

Food allergy science is constantly evolving and being studied.

One debated topic is whether immunoglobulin G (IgG) antibodies are to blame for hidden food allergies. The body can produce IgG antibodies to specific foods even under normal circumstances. Some individuals own noticed they are more sensitive to the inflammatory processes caused by these substances, although their role in food allergies is controversial.

Food intolerance: When digestion goes awry

A food intolerance is not the same thing as a food allergy.

If you own a food intolerance, then your body has trouble digesting or breaking below a certain food or chemical in a food. An overactive immune system response isn't to blame.1,7 Instead, your body lacks a protein needed to properly digest a food, or there is a problem with how your gut processes the food, or your symptoms are triggered by specific substances in food. Sometimes the cause of a food intolerance is unknown.4

Most adverse food reactions are due to food intolerances.

Symptoms often only involve stomach problems, such as stomach pain, bloating, gas, and diarrhea, although more systemic symptoms, including migraines and other body aches and pains are not uncommon.

Unlike with a true food allergy, with a food intolerance, symptom severity is directly related to the quantity of the food you eat.

For example, if ice cream upsets your digestion, then the more you eat, the worse you will feel.1

Several types of food intolerances are common

Lactose intolerance (lactase deficiency)

Individuals with this condition do not own the lactase enzyme needed to digest lactose, a natural sugar in milk, ice cream, and other dairy products. Symptoms include stomach cramps, gas, bloating, and diarrhea.

Lactose intolerance is not the same as a milk allergy (an allergy to certain milk proteins such as casein).3

Carbohydrate intolerance

Some individuals who own irritable bowel syndrome (IBS) own more stomach pain, bloating, diarrhea, and gas when they eat foods containing one or more types of carbohydrates called FODMAPs – fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. FODMAP carbs include fructose, lactose, sorbitol, fructans, and galactooligosaccharides.

Fructans are found in high amounts in foods that contain gluten, which causes the mistaken belief that this stomach distress is due to a gluten sensitivity.8 This article provides information about a low FODMAP diet.

Alcohol dehydrogenase deficiency

Feeling flushed can happen to anyone after a few alcoholic drinks, because alcohol's effect on blood vessels can cause facial redness. But if the flushing is severe, then you could be missing an enzyme called alcohol dehydrogenase (ADH) or your ADH might not be working as it should.

ADH is needed to break below alcohol you drink or alcohol made in the body. This type of food intolerance is more common in those of Asian descent.1,9

Gluten intolerance

Gluten is a protein found mostly in wheat, rye, and barley. There has been much focus recently on gluten and how gluten affects health. Concerns about gluten's ill effects own prompted numerous stores and manufacturers to label gluten-free items so they are easier to see.

Current sale of gluten-free products is $2.6 billion.9,10

Gluten intolerance is not the same as celiac disease, an autoimmune disorder in which gluten can cause serious, even life-threatening complications.4,5Celiac disease causes damage to the wall of the little intestine; whereas, gluten intolerance does not.

To differentiate between the two conditions, some practitioners refer to gluten intolerance as non-celiac gluten sensitivity.4,11

Gluten intolerance can cause major stomach discomfort, including bloating, cramping, gassiness, diarrhea, and constipation.

Some individuals who are gluten intolerant also report having skin rashes, headaches, fatigue, mood disturbances, and muscle cramps after eating gluten.

Biogenic amines: Histamine, tyramine

Foods wealthy in substances called biogenic amines, nitrogen-containing compounds, might be the culprit behind several food intolerances.1,3 Amine levels naturally rise when a food ripens or spoils.

One type of amine that might be linked to food intolerance is tyramine, found in aged cheeses.

What antibody is associated with a true food allergy

It triggers migraines in people who own a food intolerance to the substance.1

Histamine is another biogenic amine. Some individuals feel bloated and own stomach pain, diarrhea, constipation, flushing, itching, and other symptoms after eating histamine-containing foods love strawberries, certain citrus fruits, shellfish, fermented foods, smoked meats, aged cheese, and some alcoholic beverages (red wine in particular). There is ongoing debate over the role of histamine from foods causing these symptoms.

Stale or spoiled fish and shellfish can own extremely high levels of histamine, which can cause symptoms of food poisoning within hours of eating.

The symptoms include vomiting, headache, flushing, hives, and wheezing, and occasionally can mimic a bad allergic reaction. An imbalance in intestinal bacteria (gut microbiota) also might contribute to higher histamine levels in the body.12,13

The food allergy / food intolerance disease connection

Understanding and treating food allergies and food intolerances is critical to excellent overall health.4,14 Food allergies can make asthma and eczema worse. Some conditions that can be triggered by or made worse by food intolerances include:

  1. DeGeeter C, Guandalini S. Food sensitivities: fact versus fiction.

    Gastroenterol Clin North Am 2018;47:895-908.

  2. Irritable bowel disease
  3. Iweala O, Choudhary S, Commins S. Food allergy. Curr Gastroenterol Rep2018;20:17.
  4. Commins S. Food allergy and food intolerance in adults: an overview. https://www.uptodate.com/contents/search. [Accessed April 2, 2019]
  5. Vertigo
  6. Gluten intolerance definition. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/gluten-intolerance. [Accessed April 11, 2019.]
  7. Gaby A.

    Food allergy and intolerance. In: Rakel D, ed. Integrative Medicine. 4th ed. Philadelphia, Pa.: Elsevier; 2018:310-318.

  8. Arthritis, including ankylosing spondylitis, psoriatic arthritis, and rheumatoid arthritis14
  9. Migraines and other headaches
  10. Niu Q, Wei W, Huang Z, et al. Association between food allergy and ankylosing spondylitis: an observational study. Medicine (Baltimore) 2019;98:e14421.
  11. Acker W, Plasek J, Blumenthal K, et al. Prevalence of food allergies and intolerances documented in electronic health records.

    J Allergy Clin Immunol 2017;140:1587-1591.

  12. Samson H. Food allergies. In: Feldman M, ed. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016:148-157.
  13. Divekar R (expert opinion). Mayo Clinic, Rochester, Minn. May 28, 2019.
  14. Anaphylaxis. https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468. [Accessed May 17, 2019.]
  15. Schnedl W, Lackner S, Enko D, et al. Evaluation of symptoms and symptom combinations in histamine intolerance. Intest Res 2019 Mar 7.

    In press.

  16. Fazio S. Approach to flushing in adults. https://www.uptodate.com/contents/search. [Accessed April 28, 2019]
  17. Celiac disease, non-celiac gluten sensitivity, and food allergy: how are they different? American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/celiac-disease. [Accessed April 11, 2019]
  18. Sleep issues
  19. Schink M, Konturek P, Tietz E, et al. Microbial patterns in patients with histamine intolerance. J Physiol Pharmacol 2018 Aug;69(4):579-593.
  20. Feng C. Beyond avoidance: the psychosocial impact of food allergies.

    Clin Rev Allergy Immunol 2018 Sep 1. [In press]

  21. Mood disorders, including anxiety and depression15
  22. Kristin Sokol, Marjohn Rasooly, Caeden Dempsey, Sheryce Lassiter, Wenjuan Gu, Keith Lumbard, Pamela A Frischmeyer‐Guerrerio. Prevalence and Diagnosis of Sesame Allergy in Children with IgE‐Mediated Food Allergy. Pediatric Allergy and Immunology, 2019; DOI: 10.1111/pai.13143

More research is needed to establish a definitive link between certain chronic diseases and foods. Diagnosing a food allergy or food intolerance is challenging and might require finish elimination of a suspected food or class of foods.1

If you often feel ill after eating or own a chronic health condition or family history of any type of allergies, then enquire your health-care professional if you should be tested for food allergies.

Keeping a detailed diary of when and what you eat, and any symptoms you own, is helpful.4

Avoiding foods that trigger your symptoms will assist you feel better. It’s always best to discuss your symptoms, diet, and health history with your health-care professional before trying an elimination diet and food reintroduction challenge.4


References

  • Divekar R (expert opinion). Mayo Clinic, Rochester, Minn.

    May 28, 2019.

  • Commins S. Food allergy and food intolerance in adults: an overview. https://www.uptodate.com/contents/search. [Accessed April 2, 2019]
  • Gluten intolerance definition. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/gluten-intolerance. [Accessed April 11, 2019.]
  • Anaphylaxis. https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468. [Accessed May 17, 2019.]
  • Samson H. Food allergies. In: Feldman M, ed. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed.

    Philadelphia, Pa.: Saunders Elsevier; 2016:148-157.

  • Celiac disease, non-celiac gluten sensitivity, and food allergy: how are they different? American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/celiac-disease. [Accessed April 11, 2019]
  • Acker W, Plasek J, Blumenthal K, et al. Prevalence of food allergies and intolerances documented in electronic health records. J Allergy Clin Immunol 2017;140:1587-1591.
  • DeGeeter C, Guandalini S. Food sensitivities: fact versus fiction. Gastroenterol Clin North Am 2018;47:895-908.
  • Iweala O, Choudhary S, Commins S.

    Food allergy. Curr Gastroenterol Rep2018;20:17.

  • Niu Q, Wei W, Huang Z, et al. Association between food allergy and ankylosing spondylitis: an observational study. Medicine (Baltimore) 2019;98:e14421.
  • Schink M, Konturek P, Tietz E, et al. Microbial patterns in patients with histamine intolerance. J Physiol Pharmacol 2018 Aug;69(4):579-593.
  • Gaby A. Food allergy and intolerance. In: Rakel D, ed. Integrative Medicine. 4th ed. Philadelphia, Pa.: Elsevier; 2018:310-318.
  • Fazio S.

    Approach to flushing in adults. https://www.uptodate.com/contents/search. [Accessed April 28, 2019]

  • Schnedl W, Lackner S, Enko D, et al. Evaluation of symptoms and symptom combinations in histamine intolerance. Intest Res 2019 Mar 7. In press.
  • Feng C. Beyond avoidance: the psychosocial impact of food allergies. Clin Rev Allergy Immunol 2018 Sep 1. [In press]

Basic pathogenesis of IgE mediated FA

By passing oral tolerance and generating allergen–specific IgE antibodies with subsequent sensitization of mast cells or basophils are central events to trigger the allergic immune response. These basic events are typically called sensitization and effector phases [40,41] (Figure 1).

The previous involves antigen presenting cells, T cells, Th2 cytokines such as interleukin (IL)–4, IL–5 and IL–13, cross–linking of allergens with B–cell receptors, and IgE production. Sensitization happen after antigen presenting cells such as dendritic and B cells own recognized allergenic segments or “epitopes” in the protein component of food or ingredients within food.

Then, allergen antigens are loaded on MHC class II molecules and antigen presentation to T cells may happen. This interaction activates allergen–specific T cells which produce Th2 cytokines and promotes the production of IgE antibodies by allergen–specific B cells [41]. IgE antibodies may bind to IgE receptor FceRI on the membrane of mast cells and basophils generating sensitized cells.

Investigators at the National Institutes of Health own found that sesame allergy is common among children with other food allergies, occurring in an estimated 17% of this population. In addition, the scientists own found that sesame antibody testing — whose utility has been controversial — accurately predicts whether a kid with food allergy is allergic to sesame.

The research was published on Oct. 28 in the journal Pediatric Allergy and Immunology.

«It has been a challenge for clinicians and parents to determine if a kid is truly allergic to sesame,» said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH. «Given how frequently sesame allergy occurs among children who are allergic to other foods, it is significant to use caution to the extent possible when exposing these children to sesame.»

Sesame is among the 10 most common childhood food allergies.

Only an estimated 20% to 30% of children with sesame allergy outgrow it. Severe reactions to sesame are common among sesame-allergic children. About 1.1 million people in the United States, or an estimated 0.23% of the U.S. population, own sesame allergy, according to a recently published study funded by NIAID. These factors underscore the need to optimize recognition and diagnosis of this allergy. The Food and Drug istration is currently considering whether to include sesame in the list of allergens that must be disclosed on food labels.

Standard allergy tests — the skin-prick test and the allergen-specific antibody test — own been inconsistent in predicting an allergic reaction to sesame.

Numerous studies evaluating the utility of these tests for sesame allergy own included only children suspected to own sesame allergy. Taking a diverse approach, scientists led by Pamela A. Frischmeyer-Guerrerio, M.D., Ph.D., deputy chief of the NIAID Laboratory of Allergic Diseases and chief of its Food Allergy Research Unit, evaluated the sesame antibody test in a group of 119 children with food allergy whose sesame-allergic status was unknown.

The researchers offered children in the study an oral food challenge — the gold standard for diagnosing food allergy — which involved ingesting gradually increasing amounts of sesame under medical supervision and seeing if an allergic reaction occurred.

Children who recently had had an allergic reaction to sesame or were known to tolerate concentrated sesame, such as tahini, in their diet were not offered an oral food challenge.

The scientists found that 15 (13%) of the 119 children were sesame-allergic, 73 (61%) were sesame-tolerant, and sesame-allergic status could not be sure for 31 (26%) children, mainly because they declined the oral food challenge. Among the 88 children whose sesame-allergic status was definitive, 17% had sesame allergy.

The scientists measured the quantity of an antibody called sesame-specific immunoglobulin E (sIgE) in the blood of these 88 children.

With this data and information on the children’s sesame-allergic status, the researchers developed a mathematical model for predicting the probability that a kid with food allergy is allergic to sesame. According to the model, children with more than 29.4 kilo international units of sIgE per liter of serum own a greater than 50% chance of being allergic to sesame. This model will need to be validated by additional studies, however, before it can be used in clinical practice.


Story Source:

Materials provided by NIH/National Institute of Allergy and Infectious Diseases.

Note: Content may be edited for style and length.


Journal Reference:

Basic pathogenesis of IgE mediated FA

By passing oral tolerance and generating allergen–specific IgE antibodies with subsequent sensitization of mast cells or basophils are central events to trigger the allergic immune response. These basic events are typically called sensitization and effector phases [40,41] (Figure 1). The previous involves antigen presenting cells, T cells, Th2 cytokines such as interleukin (IL)–4, IL–5 and IL–13, cross–linking of allergens with B–cell receptors, and IgE production.

Sensitization happen after antigen presenting cells such as dendritic and B cells own recognized allergenic segments or “epitopes” in the protein component of food or ingredients within food. Then, allergen antigens are loaded on MHC class II molecules and antigen presentation to T cells may happen. This interaction activates allergen–specific T cells which produce Th2 cytokines and promotes the production of IgE antibodies by allergen–specific B cells [41]. IgE antibodies may bind to IgE receptor FceRI on the membrane of mast cells and basophils generating sensitized cells.

Investigators at the National Institutes of Health own found that sesame allergy is common among children with other food allergies, occurring in an estimated 17% of this population.

In addition, the scientists own found that sesame antibody testing — whose utility has been controversial — accurately predicts whether a kid with food allergy is allergic to sesame. The research was published on Oct. 28 in the journal Pediatric Allergy and Immunology.

«It has been a challenge for clinicians and parents to determine if a kid is truly allergic to sesame,» said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH. «Given how frequently sesame allergy occurs among children who are allergic to other foods, it is significant to use caution to the extent possible when exposing these children to sesame.»

Sesame is among the 10 most common childhood food allergies.

Only an estimated 20% to 30% of children with sesame allergy outgrow it. Severe reactions to sesame are common among sesame-allergic children. About 1.1 million people in the United States, or an estimated 0.23% of the U.S. population, own sesame allergy, according to a recently published study funded by NIAID. These factors underscore the need to optimize recognition and diagnosis of this allergy. The Food and Drug istration is currently considering whether to include sesame in the list of allergens that must be disclosed on food labels.

Standard allergy tests — the skin-prick test and the allergen-specific antibody test — own been inconsistent in predicting an allergic reaction to sesame.

Numerous studies evaluating the utility of these tests for sesame allergy own included only children suspected to own sesame allergy. Taking a diverse approach, scientists led by Pamela A. Frischmeyer-Guerrerio, M.D., Ph.D., deputy chief of the NIAID Laboratory of Allergic Diseases and chief of its Food Allergy Research Unit, evaluated the sesame antibody test in a group of 119 children with food allergy whose sesame-allergic status was unknown.

The researchers offered children in the study an oral food challenge — the gold standard for diagnosing food allergy — which involved ingesting gradually increasing amounts of sesame under medical supervision and seeing if an allergic reaction occurred.

Children who recently had had an allergic reaction to sesame or were known to tolerate concentrated sesame, such as tahini, in their diet were not offered an oral food challenge.

The scientists found that 15 (13%) of the 119 children were sesame-allergic, 73 (61%) were sesame-tolerant, and sesame-allergic status could not be sure for 31 (26%) children, mainly because they declined the oral food challenge. Among the 88 children whose sesame-allergic status was definitive, 17% had sesame allergy.

The scientists measured the quantity of an antibody called sesame-specific immunoglobulin E (sIgE) in the blood of these 88 children.

With this data and information on the children’s sesame-allergic status, the researchers developed a mathematical model for predicting the probability that a kid with food allergy is allergic to sesame. According to the model, children with more than 29.4 kilo international units of sIgE per liter of serum own a greater than 50% chance of being allergic to sesame. This model will need to be validated by additional studies, however, before it can be used in clinical practice.


Story Source:

Materials provided by NIH/National Institute of Allergy and Infectious Diseases.

Note: Content may be edited for style and length.


Journal Reference:

  • Inability to breathe
  • Food intolerance: An adverse food reaction that doesn't involve activation of your body's immune system.
  • Severe wheezing
  • Swelling of the tongue, lips, and throat
  • Hives and itchy skin
  • Commins S. Food allergy and food intolerance in adults: an overview. https://www.uptodate.com/contents/search. [Accessed April 2, 2019]
  • Vertigo
  • Nausea and vomiting
  • Diarrhea
  • Mood disorders, including anxiety and depression15
  • Acker W, Plasek J, Blumenthal K, et al.

    Prevalence of food allergies and intolerances documented in electronic health records. J Allergy Clin Immunol 2017;140:1587-1591.

  • Wheezing
  • Low blood pressure leading to a feeble and rapid pulse
  • Fainting or passing out
  • Schink M, Konturek P, Tietz E, et al. Microbial patterns in patients with histamine intolerance. J Physiol Pharmacol 2018 Aug;69(4):579-593.
  • Swelling of the tongue, lips, and throat
  • DeGeeter C, Guandalini S. Food sensitivities: fact versus fiction.

    Gastroenterol Clin North Am 2018;47:895-908.

  • Stomach pain
  • Arthritis, including ankylosing spondylitis, psoriatic arthritis, and rheumatoid arthritis14
  • Samson H. Food allergies. In: Feldman M, ed. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016:148-157.
  • Gaby A. Food allergy and intolerance. In: Rakel D, ed. Integrative Medicine. 4th ed. Philadelphia, Pa.: Elsevier; 2018:310-318.
  • Niu Q, Wei W, Huang Z, et al. Association between food allergy and ankylosing spondylitis: an observational study.

    Medicine (Baltimore) 2019;98:e14421.

  • Divekar R (expert opinion). Mayo Clinic, Rochester, Minn. May 28, 2019.
  • Runny nose
  • Irritable bowel disease
  • Migraines and other headaches
  • Anaphylaxis. https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468. [Accessed May 17, 2019.]
  • Schnedl W, Lackner S, Enko D, et al. Evaluation of symptoms and symptom combinations in histamine intolerance.

    Intest Res 2019 Mar 7. In press.

  • Sleep issues
  • Adverse food reaction: Any unpleasant reaction that occurs after you eat a certain food or a substance in a food.
  • Celiac disease, non-celiac gluten sensitivity, and food allergy: how are they different? American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/celiac-disease. [Accessed April 11, 2019]
  • Fazio S. Approach to flushing in adults. https://www.uptodate.com/contents/search. [Accessed April 28, 2019]
  • Food allergy / food hypersensitivity: An adverse food reaction that involves an immediate immune response.

    According to this definition, food allergy and food hypersensitivity are the same thing.

  • Kristin Sokol, Marjohn Rasooly, Caeden Dempsey, Sheryce Lassiter, Wenjuan Gu, Keith Lumbard, Pamela A Frischmeyer‐Guerrerio. Prevalence and Diagnosis of Sesame Allergy in Children with IgE‐Mediated Food Allergy. Pediatric Allergy and Immunology, 2019; DOI: 10.1111/pai.13143
  • Chest tightness
  • Cough
  • Gluten intolerance definition. American Academy of Allergy, Asthma & Immunology.

    https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/gluten-intolerance. [Accessed April 11, 2019.]

  • Iweala O, Choudhary S, Commins S. Food allergy. Curr Gastroenterol Rep2018;20:17.
  • Feng C. Beyond avoidance: the psychosocial impact of food allergies. Clin Rev Allergy Immunol 2018 Sep 1. [In press]

make a difference: sponsored opportunity

Cite This Page:

NIH/National Institute of Allergy and Infectious Diseases. «Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children.» ScienceDaily.

ScienceDaily, 4 November 2019. <www.sciencedaily.com/releases/2019/11/191104112932.htm>.

NIH/National Institute of Allergy and Infectious Diseases. (2019, November 4). Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children. ScienceDaily. Retrieved January 29, 2020 from www.sciencedaily.com/releases/2019/11/191104112932.htm

NIH/National Institute of Allergy and Infectious Diseases.

«Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children.» ScienceDaily. www.sciencedaily.com/releases/2019/11/191104112932.htm (accessed January 29, 2020).

It's not unusual to hear someone tell, "I can't eat that, I'm allergic to it." As numerous as one in five individuals own bad reactions to specific foods or classes of foods.1 And the number of adults with reported food allergies is increasing.1,2

Feeling ill after eating a certain food doesn't mean you actually own a true food allergy.3 If the offending food doesn't set off a specific immune reaction in your body, then you probably own a food intolerance, rather than a genuine allergy.

Know the terms

Many diverse terms and phrases are used to refer to unpleasant food reactions, and it can be simple to stir them up.

Knowing their definitions and differences will assist you better communicate with your health-care professional and better understand your specific health needs.

In the United States, food allergy specialists (allergists) use the following terms.4

  1. Adverse food reaction: Any unpleasant reaction that occurs after you eat a certain food or a substance in a food.
  2. Food intolerance: An adverse food reaction that doesn't involve activation of your body's immune system.
  3. Food allergy / food hypersensitivity: An adverse food reaction that involves an immediate immune response.

    According to this definition, food allergy and food hypersensitivity are the same thing.

True food allergies: Sudden and unpredictable

A true food allergy is an immune response that occurs quickly and repeatedly when you are exposed to a certain food.1 When you eat a food that you're allergic to, your body mistakenly marks it as foreign.

This triggers your immune system to release a flood of inflammatory chemicals to activate cells that cause allergy-related inflammation, including mast cells, eosinophils, and basophils.

This food hypersensitivity reaction is also known as immunoglobulin E (IgE)-mediated food allergy, because it is the food-specific IgE that binds to the food, triggering the cascade of allergic reactions.

Why does the body identify some foods as allergens?

Largely because of a person’s genetic make-up, in addition to environmental factors that shape the immune response.

Certain proteins on a food drive the allergic reaction, although other factors can frolic a role.

Some believe that having a low level of stomach acid – which can happen if you use antacids or acid blockers – results in incomplete digestion of these proteins. This, combined with inflammation in the little intestine, can trick the immune system into thinking the protein is foreign, causing the immune system to launch a defense.

Food allergy symptoms happen quickly, generally in seconds or minutes after eating the food.

In unusual cases, it can take several hours.1,3 Symptoms can affect the gastrointestinal tract, respiratory tract, and skin, and can include:3

  1. Diarrhea
  2. Stomach pain
  3. Runny nose
  4. Cough
  5. Nausea and vomiting
  6. Wheezing
  7. Hives and itchy skin
  8. Swelling of the tongue, lips, and throat

The severity of the symptom(s) has nothing to do with the quantity of food you eat. Even a tiny quantity of an offending food can set off an immune reaction. Also, a food that causes hives one time can cause a life-threatening symptom the next time.

Symptoms of a life-threatening food allergy reaction include:5

  1. Chest tightness
  2. Swelling of the tongue, lips, and throat
  3. Inability to breathe
  4. Severe wheezing
  5. Low blood pressure leading to a feeble and rapid pulse
  6. Fainting or passing out

More than 170 foods are linked to IgE-mediated food allergies.3 The most common ones are cow’s milk, chicken eggs, fish, shellfish, tree nuts, peanuts, wheat, soy, and some fruits.1,6

Pollen food allergy: Hay fever meets food allergy

Do certain raw fruits or vegetables make your tongue swell or lips itch?

You could own a pollen food allergy, also called oral food allergy syndrome (OFAS). It's a type of contact allergy that affects people who are allergic to pollen, generally those who own hay fever.1,4

Pollen food allergy occurs when proteins in fruits and vegetables are cross-reactive with allergy-triggering pollen proteins. If you own this type of allergy, then eating a raw fruit or vegetable with these pollen proteins will trigger mild symptoms in the lining of your mouth and throat, although they can lead to a severe reaction in rare cases.4,6

Which fruit or veggie affects you will depend on what type of pollen triggers your seasonal allergy symptoms.1

Pollen allergy Associated food allergies

Birch tree Apple, pear, cherry, carrot, kiwi, raw potato

Ragweed Watermelon, cantaloupe, honeydew, banana

Mugwort Celery

Heating or cooking the food will destroy most of the allergy-causing substances in OFAS.1

Possible food allergies

Food allergy science is constantly evolving and being studied.

One debated topic is whether immunoglobulin G (IgG) antibodies are to blame for hidden food allergies. The body can produce IgG antibodies to specific foods even under normal circumstances. Some individuals own noticed they are more sensitive to the inflammatory processes caused by these substances, although their role in food allergies is controversial.

Food intolerance: When digestion goes awry

A food intolerance is not the same thing as a food allergy.

If you own a food intolerance, then your body has trouble digesting or breaking below a certain food or chemical in a food. An overactive immune system response isn't to blame.1,7 Instead, your body lacks a protein needed to properly digest a food, or there is a problem with how your gut processes the food, or your symptoms are triggered by specific substances in food. Sometimes the cause of a food intolerance is unknown.4

Most adverse food reactions are due to food intolerances.

Symptoms often only involve stomach problems, such as stomach pain, bloating, gas, and diarrhea, although more systemic symptoms, including migraines and other body aches and pains are not uncommon.

Unlike with a true food allergy, with a food intolerance, symptom severity is directly related to the quantity of the food you eat.

For example, if ice cream upsets your digestion, then the more you eat, the worse you will feel.1

Several types of food intolerances are common

Lactose intolerance (lactase deficiency)

Individuals with this condition do not own the lactase enzyme needed to digest lactose, a natural sugar in milk, ice cream, and other dairy products. Symptoms include stomach cramps, gas, bloating, and diarrhea. Lactose intolerance is not the same as a milk allergy (an allergy to certain milk proteins such as casein).3

Carbohydrate intolerance

Some individuals who own irritable bowel syndrome (IBS) own more stomach pain, bloating, diarrhea, and gas when they eat foods containing one or more types of carbohydrates called FODMAPs – fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

FODMAP carbs include fructose, lactose, sorbitol, fructans, and galactooligosaccharides. Fructans are found in high amounts in foods that contain gluten, which causes the mistaken belief that this stomach distress is due to a gluten sensitivity.8 This article provides information about a low FODMAP diet.

Alcohol dehydrogenase deficiency

Feeling flushed can happen to anyone after a few alcoholic drinks, because alcohol's effect on blood vessels can cause facial redness. But if the flushing is severe, then you could be missing an enzyme called alcohol dehydrogenase (ADH) or your ADH might not be working as it should.

ADH is needed to break below alcohol you drink or alcohol made in the body. This type of food intolerance is more common in those of Asian descent.1,9

Gluten intolerance

Gluten is a protein found mostly in wheat, rye, and barley. There has been much focus recently on gluten and how gluten affects health. Concerns about gluten's ill effects own prompted numerous stores and manufacturers to label gluten-free items so they are easier to see. Current sale of gluten-free products is $2.6 billion.9,10

Gluten intolerance is not the same as celiac disease, an autoimmune disorder in which gluten can cause serious, even life-threatening complications.4,5Celiac disease causes damage to the wall of the little intestine; whereas, gluten intolerance does not.

To differentiate between the two conditions, some practitioners refer to gluten intolerance as non-celiac gluten sensitivity.4,11

Gluten intolerance can cause major stomach discomfort, including bloating, cramping, gassiness, diarrhea, and constipation.

Some individuals who are gluten intolerant also report having skin rashes, headaches, fatigue, mood disturbances, and muscle cramps after eating gluten.

Biogenic amines: Histamine, tyramine

Foods wealthy in substances called biogenic amines, nitrogen-containing compounds, might be the culprit behind several food intolerances.1,3 Amine levels naturally rise when a food ripens or spoils.

One type of amine that might be linked to food intolerance is tyramine, found in aged cheeses. It triggers migraines in people who own a food intolerance to the substance.1

Histamine is another biogenic amine.

Some individuals feel bloated and own stomach pain, diarrhea, constipation, flushing, itching, and other symptoms after eating histamine-containing foods love strawberries, certain citrus fruits, shellfish, fermented foods, smoked meats, aged cheese, and some alcoholic beverages (red wine in particular). There is ongoing debate over the role of histamine from foods causing these symptoms.

Stale or spoiled fish and shellfish can own extremely high levels of histamine, which can cause symptoms of food poisoning within hours of eating. The symptoms include vomiting, headache, flushing, hives, and wheezing, and occasionally can mimic a bad allergic reaction. An imbalance in intestinal bacteria (gut microbiota) also might contribute to higher histamine levels in the body.12,13

The food allergy / food intolerance disease connection

Understanding and treating food allergies and food intolerances is critical to excellent overall health.4,14 Food allergies can make asthma and eczema worse.

Some conditions that can be triggered by or made worse by food intolerances include:

  1. Iweala O, Choudhary S, Commins S. Food allergy. Curr Gastroenterol Rep2018;20:17.
  2. Irritable bowel disease
  3. DeGeeter C, Guandalini S. Food sensitivities: fact versus fiction. Gastroenterol Clin North Am 2018;47:895-908.
  4. Commins S. Food allergy and food intolerance in adults: an overview. https://www.uptodate.com/contents/search. [Accessed April 2, 2019]
  5. Vertigo
  6. Gluten intolerance definition.

    American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/gluten-intolerance. [Accessed April 11, 2019.]

  7. Gaby A. Food allergy and intolerance. In: Rakel D, ed. Integrative Medicine. 4th ed. Philadelphia, Pa.: Elsevier; 2018:310-318.
  8. Arthritis, including ankylosing spondylitis, psoriatic arthritis, and rheumatoid arthritis14
  9. Migraines and other headaches
  10. Schnedl W, Lackner S, Enko D, et al. Evaluation of symptoms and symptom combinations in histamine intolerance. Intest Res 2019 Mar 7. In press.
  11. Acker W, Plasek J, Blumenthal K, et al.

    Prevalence of food allergies and intolerances documented in electronic health records. J Allergy Clin Immunol 2017;140:1587-1591.

  12. Samson H. Food allergies. In: Feldman M, ed. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016:148-157.
  13. Anaphylaxis. https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468. [Accessed May 17, 2019.]
  14. Divekar R (expert opinion).

    Mayo Clinic, Rochester, Minn. May 28, 2019.

  15. Schink M, Konturek P, Tietz E, et al. Microbial patterns in patients with histamine intolerance. J Physiol Pharmacol 2018 Aug;69(4):579-593.
  16. Mood disorders, including anxiety and depression15
  17. Fazio S. Approach to flushing in adults. https://www.uptodate.com/contents/search. [Accessed April 28, 2019]
  18. Sleep issues
  19. Niu Q, Wei W, Huang Z, et al. Association between food allergy and ankylosing spondylitis: an observational study.

    What antibody is associated with a true food allergy

    Medicine (Baltimore) 2019;98:e14421.

  20. Celiac disease, non-celiac gluten sensitivity, and food allergy: how are they different? American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/celiac-disease. [Accessed April 11, 2019]
  21. Feng C. Beyond avoidance: the psychosocial impact of food allergies. Clin Rev Allergy Immunol 2018 Sep 1. [In press]

More research is needed to establish a definitive link between certain chronic diseases and foods. Diagnosing a food allergy or food intolerance is challenging and might require finish elimination of a suspected food or class of foods.1

If you often feel ill after eating or own a chronic health condition or family history of any type of allergies, then enquire your health-care professional if you should be tested for food allergies.

Keeping a detailed diary of when and what you eat, and any symptoms you own, is helpful.4

Avoiding foods that trigger your symptoms will assist you feel better. It’s always best to discuss your symptoms, diet, and health history with your health-care professional before trying an elimination diet and food reintroduction challenge.4


References


make a difference: sponsored opportunity

Cite This Page:

NIH/National Institute of Allergy and Infectious Diseases.

«Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children.» ScienceDaily. ScienceDaily, 4 November 2019. <www.sciencedaily.com/releases/2019/11/191104112932.htm>.

NIH/National Institute of Allergy and Infectious Diseases. (2019, November 4). Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children. ScienceDaily. Retrieved January 29, 2020 from www.sciencedaily.com/releases/2019/11/191104112932.htm

NIH/National Institute of Allergy and Infectious Diseases.

«Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children.» ScienceDaily. www.sciencedaily.com/releases/2019/11/191104112932.htm (accessed January 29, 2020).

It's not unusual to hear someone tell, "I can't eat that, I'm allergic to it." As numerous as one in five individuals own bad reactions to specific foods or classes of foods.1 And the number of adults with reported food allergies is increasing.1,2

Feeling ill after eating a certain food doesn't mean you actually own a true food allergy.3 If the offending food doesn't set off a specific immune reaction in your body, then you probably own a food intolerance, rather than a genuine allergy.

Know the terms

Many diverse terms and phrases are used to refer to unpleasant food reactions, and it can be simple to stir them up.

Knowing their definitions and differences will assist you better communicate with your health-care professional and better understand your specific health needs.

In the United States, food allergy specialists (allergists) use the following terms.4

  1. Adverse food reaction: Any unpleasant reaction that occurs after you eat a certain food or a substance in a food.
  2. Food intolerance: An adverse food reaction that doesn't involve activation of your body's immune system.
  3. Food allergy / food hypersensitivity: An adverse food reaction that involves an immediate immune response.

    According to this definition, food allergy and food hypersensitivity are the same thing.

True food allergies: Sudden and unpredictable

A true food allergy is an immune response that occurs quickly and repeatedly when you are exposed to a certain food.1 When you eat a food that you're allergic to, your body mistakenly marks it as foreign.

This triggers your immune system to release a flood of inflammatory chemicals to activate cells that cause allergy-related inflammation, including mast cells, eosinophils, and basophils.

This food hypersensitivity reaction is also known as immunoglobulin E (IgE)-mediated food allergy, because it is the food-specific IgE that binds to the food, triggering the cascade of allergic reactions.

Why does the body identify some foods as allergens?

Largely because of a person’s genetic make-up, in addition to environmental factors that shape the immune response.

Certain proteins on a food drive the allergic reaction, although other factors can frolic a role.

Some believe that having a low level of stomach acid – which can happen if you use antacids or acid blockers – results in incomplete digestion of these proteins. This, combined with inflammation in the little intestine, can trick the immune system into thinking the protein is foreign, causing the immune system to launch a defense.

Food allergy symptoms happen quickly, generally in seconds or minutes after eating the food.

In unusual cases, it can take several hours.1,3 Symptoms can affect the gastrointestinal tract, respiratory tract, and skin, and can include:3

  1. Diarrhea
  2. Stomach pain
  3. Runny nose
  4. Cough
  5. Nausea and vomiting
  6. Wheezing
  7. Hives and itchy skin
  8. Swelling of the tongue, lips, and throat

The severity of the symptom(s) has nothing to do with the quantity of food you eat. Even a tiny quantity of an offending food can set off an immune reaction. Also, a food that causes hives one time can cause a life-threatening symptom the next time.

Symptoms of a life-threatening food allergy reaction include:5

  1. Chest tightness
  2. Swelling of the tongue, lips, and throat
  3. Inability to breathe
  4. Severe wheezing
  5. Low blood pressure leading to a feeble and rapid pulse
  6. Fainting or passing out

More than 170 foods are linked to IgE-mediated food allergies.3 The most common ones are cow’s milk, chicken eggs, fish, shellfish, tree nuts, peanuts, wheat, soy, and some fruits.1,6

Pollen food allergy: Hay fever meets food allergy

Do certain raw fruits or vegetables make your tongue swell or lips itch?

You could own a pollen food allergy, also called oral food allergy syndrome (OFAS). It's a type of contact allergy that affects people who are allergic to pollen, generally those who own hay fever.1,4

Pollen food allergy occurs when proteins in fruits and vegetables are cross-reactive with allergy-triggering pollen proteins. If you own this type of allergy, then eating a raw fruit or vegetable with these pollen proteins will trigger mild symptoms in the lining of your mouth and throat, although they can lead to a severe reaction in rare cases.4,6

Which fruit or veggie affects you will depend on what type of pollen triggers your seasonal allergy symptoms.1

Pollen allergy Associated food allergies

Birch tree Apple, pear, cherry, carrot, kiwi, raw potato

Ragweed Watermelon, cantaloupe, honeydew, banana

Mugwort Celery

Heating or cooking the food will destroy most of the allergy-causing substances in OFAS.1

Possible food allergies

Food allergy science is constantly evolving and being studied.

One debated topic is whether immunoglobulin G (IgG) antibodies are to blame for hidden food allergies. The body can produce IgG antibodies to specific foods even under normal circumstances. Some individuals own noticed they are more sensitive to the inflammatory processes caused by these substances, although their role in food allergies is controversial.

Food intolerance: When digestion goes awry

A food intolerance is not the same thing as a food allergy. If you own a food intolerance, then your body has trouble digesting or breaking below a certain food or chemical in a food.

An overactive immune system response isn't to blame.1,7 Instead, your body lacks a protein needed to properly digest a food, or there is a problem with how your gut processes the food, or your symptoms are triggered by specific substances in food. Sometimes the cause of a food intolerance is unknown.4

Most adverse food reactions are due to food intolerances.

Symptoms often only involve stomach problems, such as stomach pain, bloating, gas, and diarrhea, although more systemic symptoms, including migraines and other body aches and pains are not uncommon.

Unlike with a true food allergy, with a food intolerance, symptom severity is directly related to the quantity of the food you eat.

For example, if ice cream upsets your digestion, then the more you eat, the worse you will feel.1

Several types of food intolerances are common

Lactose intolerance (lactase deficiency)

Individuals with this condition do not own the lactase enzyme needed to digest lactose, a natural sugar in milk, ice cream, and other dairy products. Symptoms include stomach cramps, gas, bloating, and diarrhea. Lactose intolerance is not the same as a milk allergy (an allergy to certain milk proteins such as casein).3

Carbohydrate intolerance

Some individuals who own irritable bowel syndrome (IBS) own more stomach pain, bloating, diarrhea, and gas when they eat foods containing one or more types of carbohydrates called FODMAPs – fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

FODMAP carbs include fructose, lactose, sorbitol, fructans, and galactooligosaccharides. Fructans are found in high amounts in foods that contain gluten, which causes the mistaken belief that this stomach distress is due to a gluten sensitivity.8 This article provides information about a low FODMAP diet.

Alcohol dehydrogenase deficiency

Feeling flushed can happen to anyone after a few alcoholic drinks, because alcohol's effect on blood vessels can cause facial redness. But if the flushing is severe, then you could be missing an enzyme called alcohol dehydrogenase (ADH) or your ADH might not be working as it should.

ADH is needed to break below alcohol you drink or alcohol made in the body. This type of food intolerance is more common in those of Asian descent.1,9

Gluten intolerance

Gluten is a protein found mostly in wheat, rye, and barley. There has been much focus recently on gluten and how gluten affects health. Concerns about gluten's ill effects own prompted numerous stores and manufacturers to label gluten-free items so they are easier to see.

Current sale of gluten-free products is $2.6 billion.9,10

Gluten intolerance is not the same as celiac disease, an autoimmune disorder in which gluten can cause serious, even life-threatening complications.4,5Celiac disease causes damage to the wall of the little intestine; whereas, gluten intolerance does not.

To differentiate between the two conditions, some practitioners refer to gluten intolerance as non-celiac gluten sensitivity.4,11

Gluten intolerance can cause major stomach discomfort, including bloating, cramping, gassiness, diarrhea, and constipation.

Some individuals who are gluten intolerant also report having skin rashes, headaches, fatigue, mood disturbances, and muscle cramps after eating gluten.

Biogenic amines: Histamine, tyramine

Foods wealthy in substances called biogenic amines, nitrogen-containing compounds, might be the culprit behind several food intolerances.1,3 Amine levels naturally rise when a food ripens or spoils.

One type of amine that might be linked to food intolerance is tyramine, found in aged cheeses.

It triggers migraines in people who own a food intolerance to the substance.1

Histamine is another biogenic amine. Some individuals feel bloated and own stomach pain, diarrhea, constipation, flushing, itching, and other symptoms after eating histamine-containing foods love strawberries, certain citrus fruits, shellfish, fermented foods, smoked meats, aged cheese, and some alcoholic beverages (red wine in particular). There is ongoing debate over the role of histamine from foods causing these symptoms.

Stale or spoiled fish and shellfish can own extremely high levels of histamine, which can cause symptoms of food poisoning within hours of eating. The symptoms include vomiting, headache, flushing, hives, and wheezing, and occasionally can mimic a bad allergic reaction.

An imbalance in intestinal bacteria (gut microbiota) also might contribute to higher histamine levels in the body.12,13

The food allergy / food intolerance disease connection

Understanding and treating food allergies and food intolerances is critical to excellent overall health.4,14 Food allergies can make asthma and eczema worse. Some conditions that can be triggered by or made worse by food intolerances include:

  1. Iweala O, Choudhary S, Commins S. Food allergy.

    Curr Gastroenterol Rep2018;20:17.

  2. Irritable bowel disease
  3. DeGeeter C, Guandalini S. Food sensitivities: fact versus fiction. Gastroenterol Clin North Am 2018;47:895-908.
  4. Commins S. Food allergy and food intolerance in adults: an overview. https://www.uptodate.com/contents/search. [Accessed April 2, 2019]
  5. Vertigo
  6. Gluten intolerance definition. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/gluten-intolerance. [Accessed April 11, 2019.]
  7. Gaby A. Food allergy and intolerance.

    In: Rakel D, ed. Integrative Medicine. 4th ed. Philadelphia, Pa.: Elsevier; 2018:310-318.

  8. Arthritis, including ankylosing spondylitis, psoriatic arthritis, and rheumatoid arthritis14
  9. Migraines and other headaches
  10. Schnedl W, Lackner S, Enko D, et al. Evaluation of symptoms and symptom combinations in histamine intolerance. Intest Res 2019 Mar 7. In press.
  11. Acker W, Plasek J, Blumenthal K, et al. Prevalence of food allergies and intolerances documented in electronic health records. J Allergy Clin Immunol 2017;140:1587-1591.
  12. Samson H. Food allergies. In: Feldman M, ed. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed.

    Philadelphia, Pa.: Saunders Elsevier; 2016:148-157.

  13. Anaphylaxis. https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468. [Accessed May 17, 2019.]
  14. Divekar R (expert opinion). Mayo Clinic, Rochester, Minn. May 28, 2019.
  15. Schink M, Konturek P, Tietz E, et al. Microbial patterns in patients with histamine intolerance. J Physiol Pharmacol 2018 Aug;69(4):579-593.
  16. Mood disorders, including anxiety and depression15
  17. Fazio S.

    Approach to flushing in adults. https://www.uptodate.com/contents/search. [Accessed April 28, 2019]

  18. Sleep issues
  19. Niu Q, Wei W, Huang Z, et al. Association between food allergy and ankylosing spondylitis: an observational study. Medicine (Baltimore) 2019;98:e14421.
  20. Celiac disease, non-celiac gluten sensitivity, and food allergy: how are they different? American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/celiac-disease. [Accessed April 11, 2019]
  21. Feng C. Beyond avoidance: the psychosocial impact of food allergies.

    Clin Rev Allergy Immunol 2018 Sep 1. [In press]

More research is needed to establish a definitive link between certain chronic diseases and foods. Diagnosing a food allergy or food intolerance is challenging and might require finish elimination of a suspected food or class of foods.1

If you often feel ill after eating or own a chronic health condition or family history of any type of allergies, then enquire your health-care professional if you should be tested for food allergies.

Keeping a detailed diary of when and what you eat, and any symptoms you own, is helpful.4

Avoiding foods that trigger your symptoms will assist you feel better. It’s always best to discuss your symptoms, diet, and health history with your health-care professional before trying an elimination diet and food reintroduction challenge.4


References

  • Divekar R (expert opinion). Mayo Clinic, Rochester, Minn. May 28, 2019.
  • Commins S. Food allergy and food intolerance in adults: an overview.

    https://www.uptodate.com/contents/search. [Accessed April 2, 2019]

  • Gluten intolerance definition. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/gluten-intolerance. [Accessed April 11, 2019.]
  • Anaphylaxis. https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468. [Accessed May 17, 2019.]
  • Samson H. Food allergies.

    In: Feldman M, ed. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016:148-157.

  • Celiac disease, non-celiac gluten sensitivity, and food allergy: how are they different? American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/celiac-disease. [Accessed April 11, 2019]
  • Acker W, Plasek J, Blumenthal K, et al.

    Prevalence of food allergies and intolerances documented in electronic health records. J Allergy Clin Immunol 2017;140:1587-1591.

  • DeGeeter C, Guandalini S. Food sensitivities: fact versus fiction. Gastroenterol Clin North Am 2018;47:895-908.
  • Iweala O, Choudhary S, Commins S. Food allergy. Curr Gastroenterol Rep2018;20:17.
  • Niu Q, Wei W, Huang Z, et al. Association between food allergy and ankylosing spondylitis: an observational study. Medicine (Baltimore) 2019;98:e14421.
  • Schink M, Konturek P, Tietz E, et al. Microbial patterns in patients with histamine intolerance.

    J Physiol Pharmacol 2018 Aug;69(4):579-593.

  • Gaby A. Food allergy and intolerance. In: Rakel D, ed. Integrative Medicine. 4th ed. Philadelphia, Pa.: Elsevier; 2018:310-318.
  • Fazio S. Approach to flushing in adults. https://www.uptodate.com/contents/search. [Accessed April 28, 2019]
  • Schnedl W, Lackner S, Enko D, et al. Evaluation of symptoms and symptom combinations in histamine intolerance. Intest Res 2019 Mar 7. In press.
  • Feng C.

    Beyond avoidance: the psychosocial impact of food allergies. Clin Rev Allergy Immunol 2018 Sep 1. [In press]

Despre Căutare de cărţi

Privire generală | Istoric | Realitate şi ficţiune

Căutaţi textul integral al cărţilor
Găsiţi cartea perfectă ce serveşte scopurilor dvs. şi descoperiţi altele noi care vă interesează.

Căutare
Căutarea de cărţi funcţionează similar căutării pe Web.

Încercaţi o căutare pe Căutare de cărţi sau pe .ro. Când găsim o carte al cărei conţinut include o potrivire pentru termenii dvs. de căutare, vom face trimitere către aceasta din rezultatele dvs. de căutare.

Răsfoiţi cărţi online
În cazul în care cartea nu este protejată prin drepturi de autor sau avem permisiunea editorului, veţi putea să vedeţi o previzualizare a cărţii, iar în unele cazuri textul complet. Dacă aceasta aparţine domeniului public, puteţi să descărcaţi o copie PDF.

Aflaţi mai multe despre vizualizări diferite.

Aflaţi mai multe — rapid
Am creat pagini de referinţă corespunzătoare fiecărei cărţi, astfel încât să puteţi găsi rapid toate tipurile de informaţii relevante: recenzii, referinţe de pe pagini Web, hărţi şi altele. Iată un exemplu.
Cumpăraţi cartea … sau împrumutaţi-o de la bibliotecă
Dacă găsiţi o carte care vă put, faceţi clic pe link-urile „Achiziţionaţi această carte” şi „Împrumutaţi această carte” pentru a vedea de unde o puteţi cumpăra sau împrumuta.
De unde vin cărţile?
În prezent, realizăm legătura cititorilor cu cărţile în două moduri: prin Programul de parteneriat şi prin Proiectul Biblioteca.

Nou! Creaţi propria dvs. bibliotecă cu Căutare de cărţi. Aflaţi cum »

Sunteţi editor sau autor? Aflaţi cum vă puteţi promova gratuit cărţile pe .

Despre Căutare de cărţi

Privire generală | Istoric | Realitate şi ficţiune

Căutaţi textul integral al cărţilor
Găsiţi cartea perfectă ce serveşte scopurilor dvs. şi descoperiţi altele noi care vă interesează.

Căutare
Căutarea de cărţi funcţionează similar căutării pe Web. Încercaţi o căutare pe Căutare de cărţi sau pe .ro.

Când găsim o carte al cărei conţinut include o potrivire pentru termenii dvs. de căutare, vom face trimitere către aceasta din rezultatele dvs. de căutare.

Răsfoiţi cărţi online
În cazul în care cartea nu este protejată prin drepturi de autor sau avem permisiunea editorului, veţi putea să vedeţi o previzualizare a cărţii, iar în unele cazuri textul complet. Dacă aceasta aparţine domeniului public, puteţi să descărcaţi o copie PDF. Aflaţi mai multe despre vizualizări diferite.
Aflaţi mai multe — rapid
Am creat pagini de referinţă corespunzătoare fiecărei cărţi, astfel încât să puteţi găsi rapid toate tipurile de informaţii relevante: recenzii, referinţe de pe pagini Web, hărţi şi altele.

Iată un exemplu.

Cumpăraţi cartea … sau împrumutaţi-o de la bibliotecă
Dacă găsiţi o carte care vă put, faceţi clic pe link-urile „Achiziţionaţi această carte” şi „Împrumutaţi această carte” pentru a vedea de unde o puteţi cumpăra sau împrumuta.
De unde vin cărţile?
În prezent, realizăm legătura cititorilor cu cărţile în două moduri: prin Programul de parteneriat şi prin Proiectul Biblioteca.

Nou! Creaţi propria dvs. bibliotecă cu Căutare de cărţi. Aflaţi cum »

Sunteţi editor sau autor? Aflaţi cum vă puteţi promova gratuit cărţile pe .


Prevalence of food allergy

Except for those cases where the cause of a severe FA reaction can be clearly identified, FA diagnosis should be confirmed by food challenge tests, the “gold standard”, ideally performed as a doubleblind placebo–controlled food challenge test.

However, just a few studies own based their prevalence data on this laborious and time consuming clinical practice. As an alternative, other studies of prevalence of FA are based on questionnaires⁄interviews (self reported FA) or at less extend on allergen–specific IgE serology tests and⁄or skin prick test (where a tiny quantity of allergen is introduced into the skin and may elicit a localized allergic response) to estimate the prevalence of adverse reactions or sensitization to food.

Certainly, self–reported FA studies are influenced by other food related conditions leading to an overestimation of the prevalence of FA [25].

Although the assessment of “convincing” symptoms of immediate hypersensitivity (e.g., wheezing, trouble for breathing, skin with hives, vomiting, and diarrhea) could improve the performance of these studies [5, 26], the main worth of self–reported FA prevalence is thought to serve as groundwork for further investigations based on objective diagnostic criteria (e.g., allergen–specific IgE, skin prick test, and food challenge tests).

With regards to IgE levels in blood, clinical studies own proven that higher allergen–specific IgE levels indicate a greater probability of clinical FA [27,28] and this could be helpful to better estimate prevalence of FA [29].

A research study on FA funded by the European Commission (EuroPrevall program) carried out a meta–analysis that included 51 articles published in the period of January 1990 to December 2005 [11].

Under the basis of self–reported FA, combination of symptoms plus sensitization, and challenge–proven FA, the estimates of overall prevalence to specific foods were as follows, respectively: cow’s milk (3.5%, 0.6%, 0.9%), hen’s egg (1%, 0.9%, 0.3%), peanut (0.75%, 0.75%, not available), fish (0.6%, 0.2%, 0.3%), and Shellfish (1.1%, 0.6%, not available). Prevalence of self–reported FA to any food varied widely (from 3% to 35%) showing heterogeneity among studies. Additionally, the EuroPrevall working group also reported prevalence of plant food allergy in a systematic review that included 36 studies published in the time period of January 1990 to December 2006 [30].

Notably, 27 of the studies were originated from Europe. Overall estimates of prevalence of self–reported FA, skin prick test, and challenge–proven FA ranged as follows, respectively: fruits (0.03% to 11.5%, 0.03% to 4.2%, 0.1% to 4.3%), vegetables⁄legumes (0.01% to 13.7%, 0.01% to 2.7%, 0.1% to 1.4%), nuts (0% to 7.3%, 0.02% to 4.5%, 0.1% to 4.3%), wheat (0.2% to 1.3, 0.03% to 0.2%, 0% to 0.5%), soy (0.03% to 1.3%, 0.03% to 0.2%, 0% to 0.7%), and other food items (<1.3%, <1%, <0.1% one study only). Estimates of IgE sensitization to wheat and soy were <3.7% and <3% respectively.

A recent meta–analysis that included 30 studies published in the period of January 2000 to 30 September 2012 evaluated the prevalence of FA in Europe [10].

It was found a prevalence of perceived FA to any food of 6.8% in children and 5.0% in adults. The overall prevalence of sensitization was 10.1% and 2.7% on the basis of blood levels of allergen–specific IgE or skin prick tests respectively. When this analysis was performed including symptoms (clinical FA), the prevalence of sensitized FA was 2.7% (5 studies) and 1.5% (4 studies) respectively. With regards to challenge–proven FA (12 studies), its prevalence was 0.99% in children and 0.89% in adults.

In a systematic review published in 2010 the prevalence of FA was summarized as affecting more than 1% or 2% but less than 10%of the US population [2].

A recent study from the National Health and Nutrition Examination Survey reported that the prevalence of self–reported FA in U.S.A was 6.5% in children and 9.7% in adults[31].

What antibody is associated with a true food allergy

The main allergens reported in this study were milk, peanut and shellfish. Alternatively, based on the study by Liu et al., [29] the prevalence of sensitization to food or clinical FA (considering allergen–specific IgE levels and age–based criteria) was summarized as 16.8% and 2.5% respectively. In this US nationally representativecohort study, blood levels of allergen–specific IgE to peanut, cow’s milk, egg white, and shrimp were assessed.

Other recent studies own reported estimates of prevalence of FA in Canada, Australia, Asia, and Latina America. A nationwide telephone survey reported that the prevalence of self–reported FA in Canadian population was 7.1% in children and 8.3% in adults [32].

Milk, shellfish, fruits⁄vegetables, tree nut, and peanuts were the most reported allergens. In a challenge–proven FA study representative of the Melbourne (Australia) population, Osborne et al. [7] reported that the prevalence to peanut, raw egg, and sesame was 3%, 8.9%, and 0.8% respectively. In the same study, the estimates of sensitization to cow’s milk and shellfish assessed by skin prick test were of 5.6% and 0.9% respectively.

In Asia, some studies found that the prevalence of self–reported FA and challenge–proven FA ranged from 4.8% to 16.7% and 1.1% to 3.8% respectively [8,33–36].

Diverse from others geographic locations, fish seems to be the most reported allergen in Asian population and this has been attributed to the abundance of seafood in this region [37]. With regards to Latin America, Marrugo et al. [38] found an overall prevalence of self–reported FA of 14.9% in a cohort of 3099 individuals from Cartagena Colombia aged 1–83 years. Fruit⁄vegetables, seafood, and meats were the most reported allergens. In another self–reported FA study, Hoyos–Bachiloglu et al. [39] found an overall prevalence of 5.5% in a cohort of 455 Chilean school–aged children.

In this study, typical symptoms of immediate hypersensitivity allergic reactions were assessed in a second questionnaire. Therefore, walnut, peanut, egg, chocolate, avocado, and banana were the most reported allergens.

Taking into account the background presented above, we consider that estimates of prevalence of FA are influenced by several factors such as, dietary exposures, differences between populations (age, race⁄ ethnicity), study designs or methodologies, among others. This make challenging to determine the prevalence of FA with certainly. Also we believe that the prevalence data of FA are widely variable among populations and therefore an overall prevalence of challenge–proven FA of less than 5% could be considered an appropriated estimate.



Food Allergy: Know the Facts

Do you, or someone you know own a food allergy?

Food allergies can be extremely serious or even deadly for those that are highly sensitive. While most food allergies in adults are caused by a little group of foods or food products, adverse reactions in young children can be caused by a wider variety of food.

What is a Food Allergy?

A food allergy is a specific immune system reaction that happens after a person consumes what is normally considered a safe food. Food allergies happen more often in children than in adults. Approximately 5-8% of children (aged 4 or under) and about 2% of adults own food allergies.

Allergic reactions to food lead to over 30,000 emergency room visits and 2,000 hospitalizations per year. There are approximately 150 fatalities associated with food allergic reactions in the US annually.

90% of food allergies in the US are made with food allergens and products made with them.

  1. Shellfish (e.g., crab, lobster, shrimp, and crayfish)
  2. Peanuts
  3. Egg
  4. Tree nuts (walnuts, almonds, cashews, pistachios, pecans, and hazlenuts)
  5. Milk
  6. Wheat
  7. Soy

What Causes Food Allergies?

A true allergy is caused by a person’s immune system reacting to a protein(s) in a specific food.

The process begins when the food is first eaten; the body “remembers” the specific protein(s) in the food. When the same food is eaten again, the immune system overreacts in an excessive and potentially   True food allergies are caused by the rapid release of immunoglobin E antibodies after a person ingests the problematic food. This over-production of IgE is triggered by the food allergen and causes either a local or systemic effect, such as inflammation, sever swelling, or hypersensitivity reactions.

What Are Food Allergy Symptoms?

The reaction to an allergen is related to the overproduction of IgE after consuming the problematic food.

Symptoms can happen locally, in multiple locations, or can be spread over the entire body.

  1. Hoarseness and sensation of tightness in throat
  2. Abdominal pain or cramps
  3. Swelling of the lips or tongue
  4. Nausea and/or vomiting
  5. Itching/tingling of lips, palate, tongue, or throat
  6. Diarrhea

Who is at Risk?

People who had previous allergic reactions to food or non-food items such as insect bites and latex, or who own a family history of allergies, are most susceptible to developing allergies.

Generally, food allergies are developed at an early age, but some may appear at any time.

What is Anaphylaxis?

Anaphylaxis is a severe allergic reaction that rapidly affects the entire body and, if not treated, can be fatal. The symptoms are caused by the body’s tissue releasing histamines and other substances. This results in tightening of airways, which makes the reaction more severe than a normal allergic reaction. Severe reactions can also cause unconsciousness due to decreased blood flow.

Anaphylaxis is commonly seen in children and young adults, but can affect anyone.

Managing Food Allergies

If a person has an allergy to a specific food, any meal containing that food, even as flavoring, may cause an allergic response. It is significant to carefully read food labels and ingredient lists if a person has a known food allergy. Almost any food that contains protein has the potential to cause an allergy or hypersensitivity reaction in a susceptible person. Food allergies are only triggered by proteins. Sugars and fats do not cause food allergies.

How to Deal with a Severe Allergic Reaction

If a person has an allergy to a specific food, the only proven therapy is strict avoidance of the food or its products.

If a person has a minor allergic reaction to a food, oral antihistamines can be taken, but in the case of severe reactions, the medication of choice is an injection of epinephrine. A person suffering from anaphylaxis should be taken to a hospital immediately.

While there is no “cure” for food allergies, there are some promising studies of new treatments. Guidelines and regulations are updated as more research is conducted. With every new finding, the most precise information is passed on to the consumers, thus minimizing the risk of adverse allergic reactions.

If you would love to know more about food allergies, visit edis.ifas.ufl.edu or contact your local extension office.

Jana Hart-Extension Agent- FCS, 4-H

Category: Food Safety, Health & Nutrition, Relationships & Family, Work & Life

Tags: allergy, awareness, food, food allergy, health, nutrition, peanut allergy

Austin J Nutri Food Sci.

2014;2(5): 1029.

Ontiveros N4, Flores-Mendoza LK2, Canizalez-Román VA3 and Cabrera-Chavez F1*

1School of Nutrition Sciences. Autonomous University of Sinaloa, Mexico

2Mexican Social Security Institute (IMSS), CIBIOR, Immunology Department, Puebla, Mexico

4Regional Program for PhD in Biotechnology, FCQB, Autonomous University of Sinaloa, Mexico

*Corresponding author: :Cabrera-Chavez F, School of Nutrition Sciences.

Autonomous University of Sinaloa. Av. Cedros y Calle Sauces S/N, Fracc. Los Fresnos, 80019, Culiacán, Sinaloa, México

Received: February 20, 2014; Accepted: April 24, 2014; Published: April 29, 2014


Abstract

IgE–mediated food allergy (FA) is a reproducible adverse immune reaction to certain proteins in food matrices and the only available treatment is to avoid the allergen of interest. Establishing the precise prevalence of IgE–mediated FA is challenging as a number of factors affect the estimates and relevance of the type of FA.

Based on recent studies, clinical FA affects less than 5% of the population and has become a serious health concern. Thus, there is an increasing interest to discover strategies to give a solution for dietary restrictions which affect the patients’ quality of life. In this frame, some food technologies are proposed as excellent tools to reduce the allergenic or sensitizing potential of food proteins.

This review presents and discusses the current prevalence data of FA and addresses the main food technologies used to control IgE–mediated FA. Also, the implications of these food technologies on the functional properties of foods are discussed.

Keywords: Food allergy; Prevalence; Modification of allergens; Food processing


Abbreviation

FA: Food Allergy; IgE: Immunoglobulin E; IL–: Interleukin; IFN–γ: Interferon Gamma; Th1, Type 1 T Helper Cells; Th2: Type 2 T Helper Cells; FceRI: High–Affinity IgE Receptor; Mpa: Megapascal


RELATED VIDEO: