Food Allergies: Frequently Asked Questions
By now, most everyone knows my story and understands my passion for supporting people who manage food allergies. Whether you’re newly-diagnosed, an adult, child, or family dealing with food restrictions, integrative support is key. I find that, aside from needing acute support in meal planning with new restrictions, many of my clients have the same questions and concerns. The following questions originated when a dear friend’s daugther chose to interview me as part of a school project. She did such a wonderful job that I thought this would make an incredible FAQ on the topic!
Who are you and what do you do professionally?
My name is Emily and I am a board-certified clinical nutritionist licensed in the state of Maryland. I offer individualized nutrition counseling at Thrive Inside Nutrition LLC as treatment for a number of health conditions, but I specialize in supporting people with food allergies and sensitivities.
What are food allergies?
True food allergies, also known at type I hypersensitivities, occur when the body recognizes a food protein as an invader and launches an inflammatory defense against it. Since this type of reaction is protein-specific, the first exposure to a food will not cause a reaction. Instead, the body creates antibodies against a food protein the first time you try a food and those antibodies will be released in an inflammatory reaction the next time that food is ingested. This is called a hypersensitivity because the immune system determines that something harmless (like peanut or egg protein) is actually harmful and launches a full-scale attack against the food.
How can a food allergy affect someone in their daily life?
Currently there is no cure for food allergy, though researchers are working on immunotherapy in hopes of resolving this condition. For those managing severe allergies, even trace amounts of allergens can cause a serious reaction. Learning to read food labels and identify hidden ingredients is a vital but challenging part of dealing with food allergies. Cross-contact is another worry for those with allergies; an apple cut with a knife that was just used to cut cheese could provoke a reaction in someone who is allergic to dairy foods. Our holiday celebrations and social gatherings are also very food-centric, making it difficult for people with food allergies to feel safe and included. Often those with allergies end up eating before such gatherings, or bringing safe food for themselves. As you can see, this condition can feel like a very steep learning curve for someone who is newly-diagnosed. Having support is critical!
Why did you choose your profession?
My son was diagnosed with multiple, severe food allergies at the age of 6. After having a scary reaction at school, we brought him for allergy testing and learned that he was severely allergic to more than 20 foods. We were sent away from the allergist’s office with epinephrine and a long list of foods to avoid, but no advice on how to deal with this new way of living. It was a life-altering experience for our whole family as we learned just how complicated the management of allergies can be. I became interested in not only managing the condition, but in healing his digestion while supporting his growth and development so I pursued an advanced degree in Nutrition and Integrative Health. My goal is to offer hope and guidance to those with allergies – especially for those who have been newly diagnosed – so that they don’t have to go through the stages of helplessness, fear and transition that we did after diagnosis. Food allergies can feel like a very lonely condition.
In what ways does your job help people?
My specific approach to nutrition looks at healing the root cause of disease by identifying what nutrients and lifestyle changes the body needs to heal itself. With regard to allergy, I can help a family develop a meal plan to fit their specific needs and ensure that they’re still achieving proper nutrition even though there are foods they must avoid. I can also walk them through a healing protocol to reduce allergy symptoms and eventually aim for the reintroduction of foods (in some cases) in conjuction with board-certified allergists. A big part of my job is counseling, so while we focus on managing allergy symptoms and healing digestion, I also offer support for the family or individual that is struggling to deal with the diagnosis as part of their new lifestyle.
What is the most common found allergy?
The top 8 allergens (eggs, milk, peanuts, tree nuts, soy, shellfish, fish, and wheat) cause 90% of the food allergy reactions nationwide. The most common allergens for children are milk, eggs and peanuts and the most common allergens for adults are fruit & vegetable pollens (known as oral allergy syndrome), peanuts and tree nuts, and fish and shellfish. Worldwide, cow’s milk is the #1 food allergy.
How can someone raise awareness for food allergies?
Education is the key to raising awareness. Teaching about the severity of food allergies, the administration of epinephrine, and how washing hands is important (hand sanitizer does not remove food proteins) are all important steps in helping others to understand this condition. Recognizing a severe reaction, what to do if a friend has a reaction, and the serious dangers of food allergy bullying are all things that can also raise awareness in the community.
Food Allergy Research and Education is a non-profit organization dedicated to education and awareness with excellent ideas for taking action in your community or school. Also, every May is Food Allergy Awareness Month and many mayors and governors issue proclamations acknowledging this within their jurisdictions. It’s an opportunity to deliver a short speech on the importance of awareness to local or state officials.
What are the different effects a severe allergy can cause vs a minor one?
Food allergies typically cause a range of symptoms, including hives, itching, swelling, vomiting, shortness of breath and sudden changes in blood pressure. These are immediate reactions, occurring upon immediate ingestion to about an hour after eating.
Food sensitivities are often confused with allergy, but these reactions are delayed (anywhere from hours to days after ingestion) and involve more digestive symptoms such as cramping, diarrhea and bloating. Celiac Disease is an example of a food sensitivity; it will not cause anaphylaxis, but it still requires patients to avoid certain foods.
Finally, food intolerance is common but also not life threatening like food allergies can be. Intolerance happens when the body cannot digest certain components of food – lactose intolerance, for example, occurs when a person cannot break down the milk sugar lactose. It’s really important to understand that a food allergy that provokes a minor response (like hives) is always capable of creating a severe response with future exposures. Again, avoidance is imperative when it comes to food allergies.
Do you agree or disagree that food allergies are a big problem in schools? Why or why not?
Yes, I agree that food allergies are on the rise so it is wise for schools to implement awareness programs to help students with allergies feel included and safe within the school environment. I see education as the key to awareness so I’d like to see more school-wide curriculum aimed at this problem. For younger populations, programs may foster a community of caring and diversity within a school. For older kids, awareness becomes vital as a guard against food allergy bullying.
Life threatening food allergy qualifies as a disability in the school setting, so parents can request 504 plans for children who require special accommodations. Self-carrying epinephrine, an allergy-free zone in the cafeteria, no food in the classroom and asking students to wash hands after lunch are all examples of accomodations. Federal law requires schools to comply with 504 plans, ensuring student safety and inclusion just as they must offer ramps to students in wheelchairs.
Are there ways a food allergy can be helped or made better? If so, how?
This is a big topic and one that not all healthcare providers agree on. There is no cure for food allergy, so avoidance is important. Food allergy is really a heightened immune response to a food protein that has found it’s way into the bloodstream. Typically, food proteins are broken down and remain in our gastrointestinal tract, not in our bloodstream, so many of the protocols for healing food allergies focus on healing the lining of our intestines. Also, healing is centered on ensuring that food is being properly broken down during the digestive process. If a protein is properly broken down, it will not be able to trigger an immune response in a healthy digestive tract. Finally, a patient with food allergies needs immune support to help balance their hypersensitive immune system.
As you can see, treatment aimed at healing is multifold and differs for each individual. Nutritionally, I use a multi-tiered approach involving healing foods, supplements and some lifestyle interventions to help clients progress along the path to healing. Most importantly, if someone is having a hard time healing and continues to test positive for their food allergies, we must find ways to ensure that they’re getting all the nutrients the body requires. This can be very challenging in the case of multiple, severe allergies where there are many restrictions.
How does a food allergy affect the people around the person with the allergy?
Friends of individuals who have food allergies should be aware of the foods that can trigger a reaction and what they can do to help if their friend accidentally ingests something they shouldn’t. Boyfriends or girlfriends need to understand that food proteins can be transmitted through kissing, so its important to be cognizant of when they’ve last eaten something their partner is allergic to. A study done in 2006 showed that peanut residue can stay in the mouth for hours after ingestion, so many partners skip eating trigger foods on the days when they’ll be hanging out with their loved one – or they give up the food altogether. This is a concern for family as well, with many reports of children having severe reactions after being kissed by Grandma!
For families, food allergies can affect the way the entire family approaches food. Some families keep allergens completely out of the house, while others do not. This decision widely varies based on a family’s response to the diagnosis and the severity of reaction. The biggest quality of life changes are noted in families who are balancing multiple allergies, which often require them to prepare and cook every meal without the luxury of dining out.
Why should people be aware of food allergies?
Food allergy reactions can be deadly and quick. Knowing how to react in the face of a reaction could save someone’s life. Knowing how to help keep a person with food allergies safe is a great way to show support as a friend, family member, classmate or citizen. As the incidence of food allergy rises, awareness will be the key to helping people manage this disease.