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Food Allergies Melissa Bess Nutrition and Health Education Specialist FNEP STAFF TRAINING ONLY, DO NOT USE WITH FNEP PARTICIPANTS 03/2007 Discussion Topics What is a food allergy? Who gets a food allergy? Most common food allergies Symptoms How is it diagnosed?

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Food allergies l.jpg

Food Allergies

Melissa Bess

Nutrition and Health Education Specialist



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Discussion Topics

  • What is a food allergy?

  • Who gets a food allergy?

  • Most common food allergies

  • Symptoms

  • How is it diagnosed?

  • How can you avoid food allergies?

  • Tips to prevent allergies

  • What to do if there is a reaction.

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Discussion Topics

  • Children and allergies

  • New research

  • How a child might describe reaction

  • Food intolerance

  • Cross-reactions

  • Hidden allergens

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What is a food allergy?

  • Immune system function

  • Super-sensitive

  • Allergens

  • Usually the protein part

  • Allergens react to antibodies

  • Release chemicals causing symptoms

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Who gets a food allergy?

  • About 3 to 8 percent of children have reaction

  • Only 1 to 2 percent have true food allergies

  • Children usually grow out of sensitivity by age 4 (not peanuts, tree nuts, shellfish)

  • About 1 to 2 percent of adults

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Most common food allergies

  • Children

    • Milk, egg, peanuts, wheat, soy, tree nuts

    • Most will outgrow eggs, milk, wheat, and soy

  • Adults

    • Peanuts, tree nuts (almonds, walnuts), fish, shellfish (shrimp, lobster, crab), mollusks (oysters, clams, scallops)

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Most common food allergies

  • Peanuts and/or tree nuts = three million Americans (1.1% of population)

  • About 150 people in US die each year, 30,000 ER visits

  • About 4% believed to have food allergy, 2.3% to seafood

  • More than 160 foods associated with allergic reactions

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Symptoms of food allergies

  • Reaction within minutes to two hours

  • How soon and how severe depend on sensitivity to food, how much was consumed, other foods consume, and preparation

  • May have minor symptoms at first

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Digestive system

Swelling, itching








Body systems (skin, lungs, etc)

Hives, skin swelling

Anaphylaxis – BP falls, wheezing, breathing problems, nausea, rapid pulse, flushing, faintness, passing out

Can lead to death


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  • Severe reactions more common in peanuts, tree nuts, shellfish, fish, and eggs

  • Also more common in those with asthma

  • Death usually seen in peanuts or tree nuts

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How are food allergies diagnosed?

  • Physician

  • Medical history, physical exam

  • Skin test

  • Lab tests

  • Oral food challenge

  • Elimination diet

  • Double-blind food challenge

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How can you avoid food allergies?

  • Identify those at risk

  • Consult a doctor

  • Consider breast feeding

  • Maternal diet avoiding eggs, cow milk, peanuts, fish

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Tips to prevent allergies

  • Do not consume allergic foods

  • Read the ingredient list

    • New in 2006 – must clearly state food allergen (milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, or soybeans)

  • If traveling, bring special foods

  • When eating out, ask about foods

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Tips to prevent allergies

  • Know which children have allergies and what those are

  • Know how to recognize symptoms

  • Have a plan in cause of allergic response

  • Wash hands with soap, surfaces with cleaners for peanut allergies

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What to do if a child has a reaction

  • Take medication

  • Seek medical help

  • Keep injectable epinephrine

  • Wear Medic-Alert bracelet

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Children and allergies

  • For babies, discuss formula options with doctor

  • Don’t introduce solid foods too early – wait about 6 months

  • Wait on foods with common allergens

    • Cow milk – age 1

    • Eggs – age 2

    • Peanuts, nuts or fish – age 3 or after

    • American Academy of Pediatricians

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Children and allergies

  • Cow’s milk common – cause hives, asthma, colic, sleeplessness, blood in stool, poor growth

  • Immature immune systems

  • May change to soy or elemental formula

  • Drugs to severe cases

  • Breast milk helps

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New research

  • Peanut allergies increasing

  • Peanut exposure, in peanut butter, reduces severe reaction

  • Peanut vaccine

  • Link in food allergies and asthma

  • Roasting peanuts may increase allergic properties

  • FDA proposing a gluten-free label

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How child describes reaction

  • Put hands to mouth, pull or scratch tongues, voices may change

  • “Food is too spicy”

  • “My tongue is hot, something is poking it”

  • “My mouth is tingly, itches, or feels funny”

  • “My tongue feels full, my throat feels thick”

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Food Intolerance

  • More common than allergies

  • Food poisoning

  • Histamine toxicity (cheese, wine, fish)

  • Lactose intolerance

  • Food additives (MSG)

  • Gluten intolerance (small intestine)

  • Corn products

  • True allergy – avoid food (immune system)

  • Intolerance – small amount is ok (digestive system)

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Cross Reactions (food and non-food)

  • Ragweed- Watermelon, cantaloupe, honeydew, bananas

  • Birch pollen-carrots, apples, hazelnuts, potatoes

  • Banana – latex

  • * If allergic to one shellfish or legumes, likely allergic to all!

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Hidden allergens

  • Eggs – baked goods, noodles

  • Milk – pies, cheese

  • Soy – baked goods, candy, tv dinners

  • Wheat – flours, soup mixes, snacks

  • Peanut – candy, baked goods, ice cream

  • Fish – seafood flavors

  • New food labels should help

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Eating out with allergies

  • Chinese, Indonesian, Mexican, etc dishes usually made with peanuts

  • Cross-contamination of allergens

  • Not as easy to read ingredient list

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  • Food Allergy and Anaphylaxis Network (FAAN)

  • American Academy of Allergy, Asthma, and Immunology

  • Food and Drug Administration

  • USDA – National Agriculture Library