Food Allergy Comorbidities Medical Health
Allergies and intolerances
1. Introduction
Most people can eat a wide variety of foods without any problem. For a small percentage of individuals, however, certain foods or food components can cause negative reactions, by a light rash to an allergic response to be severe.
Negative reactions to food can be caused by food allergy or food intolerance. Although about one in three people considered to be "allergic" to certain foods, food allergy has a real effect at around 2% of the adult population. In children, the figure rises to 3-7%, although, in most cases, the allergy is exceeded with the school age.
2. What is the difference between allergies and food intolerances?
The negative reaction to food is often incorrectly defined food allergy. In many cases, it is caused by other causes such as food poisoning-type microbial, psychological aversion to food or intolerance to a particular ingredient in a food.
Food allergy is a specific form of intolerance to foods or food components that activate the immune system. An allergen (a protein in the food at risk in most people is quite harmless) triggers a chain reaction of the immune system including the production of antibodies. The antibodies cause the release of organic chemicals such as histamine, which cause various symptoms: itchy, runny nose, coughing or wheezing. Allergies to food or food components are often hereditary and is usually diagnosed early in life.
Food intolerance involves the metabolism but not the immune system. A typical example is lactose intolerance: the people who are affected to have a deficiency of lactase, the digestive enzyme that breaks down milk sugar.
3. Food Allergy
3.1. What happens in an allergic reaction?
Generally, the immune system protects the body from harmful foreign proteins triggering a reaction to eliminate them. Allergy is essentially "immune alteration" in which a normally harmless substance is "perceived" as a threat - an allergen - and attacked by the immune defenses. In a true allergic reaction, the body produces antibodies (proteins that bind specifically to other proteins called antigens - allergens in this case - to disable and eliminate from the body). The class of antibodies that takes the name of immunoglobulin E (IgE) reacts with the allergen triggering a further reaction within the mast cells (tissue cells) and basophils (a type of blood cell). Mast cells in the skin on the ground and the nose, respiratory tract, eyes and intestines are found muginallina membranes for example, as shown in the table below as leukotrienes and prostaglandins that cause allergic reactions that release histamine or other substances in the material. In general, there will be immediate and negative responses. Some allergic reactions after exposure to a foreign protein for several hours or days to be manifestthe "delayed hypersensitivity reactions." It referred to as.
Fortunately, most of the allergic response to food is relatively slight, but in a limited number of people, there is a violent reaction that can be lethal, and that takes the name of anaphylaxis. Sometimes the anaphylactic reaction may occur within a few minutes of exposure and requires immediate medical attention. Peanuts are well known for causing "anaphylactic shock," a serious condition in which blood pressure falls and the person may die of cardiac arrest, unless he is quickly administered epinephrine to open the airway.
SYMPTOMS OF ALLERGIC REACTIONS TO FOODS
Respirators
Runny nose or nasal congestion
Sneezing
Asthma (difficulty breathing)
Cough
Wheezing-whistling
Skin
Swelling of lips, mouth, tongue, face and / or throat (angioedema)
Urticaria
Skin rash or redness
Itch
Eczema
Gastrointestinal
Abdominal cramps
Diarrhea
Nausea
Vomit
Colic
Swelling
Systemic
Anaphylactic shock (severe shock, generalized)
3.2. What are the subjects at risk for food allergy?
allergy two suffer allergies if increases times. compared suffer
3.3. What is the incidence of food allergies?
The estimated effect on the incidence of food allergies are far below the perception of people. Although about one in three people believe they suffer, in fact, food allergies are barely mentioned. The true incidence is indicated by only a few studies, with confirmation of the allergic reaction through a double-blind clinical trial (eating food or a placebo, in a non-recognizable, and neither the patient nor the doctor know the sequence of administration).
Based on these studies, it was estimated that food allergies occur in 1-2% of the adult population. The incidence is highest among young children, with an estimated between 3 and 7%. Fortunately, the 80-90% of these subjects exceeds the sensitivity to reach the third year of age. While childhood allergies to egg and cow's milk may disappear, allergies to nuts, legumes, fish and shellfish tend to persist throughout life.
3.4. What foods are the most common cause of food allergies?
Although allergic reactions can occur with any food or food component in some allergies are likely to cause higher. Among the most common food, allergens are cowed's milk, eggs, soy, wheat, shellfish, fruit, peanuts and various types of nuts.
3.4.1. Allergy to cow's milk protein
Allergy to cow's milk protein is found most commonly in infants and children, especially those who have a family history of allergic predisposition. It occurs in a number of infants between 0.5 and 4%, but the incidence decreases with age. The most common symptoms are vomiting and diarrhea, although the range of negative responses varies from person to person. Fortunately, reactions to cow's milk proteins are generally of short duration and incidence in older children, and adults is much lower.
The allergenicity of cow's milk may be reduced by some dairy processes for example, the high-temperature treatment that modifies the structure of some of the milk proteins. For this reason, some individuals are sensitive to this food can tolerate the products based on milk or sterilized evaporated but not pasteurized milk. There are also other dairy processes, such as the enzymatic transformation of proteins into peptides, which can reduce the allergenic potential of the proteins of whey. In fermented products, such as yogurt, and cheeses, milk proteins retain largely unchanged their structure and therefore their allergenicity.
Having received confirmation of the diagnosis of allergy to milk protein, it is important to follow a balanced, healthy diet, especially during growth and development of the child. The dietary advice of a professional dietician is necessary to ensure optimal intake of essential nutrients such as calcium, magnesium, vitamins A, D, B2 and B12. The consumption of sardines and salmon with bones (canned) and cooked green vegetables, e.g. broccoli, helps to provide the right amount of milk protein calcio. To have-been confirmed, it is important to ensure that a healthy balanced diet is maintained, Especially During a child's growth and development. Dietary advice from a registered dietician is needed to Ensure optimal intakes of essential nutrients. Such as calcium, magnesium, vitamins A, D and B2 and B12. The consumption of salmon and sardines with bones (canned) cooked and dark-green vegetables like broccoli, will help to Maintain calcium intakes.
3.4.2. Allergy to various types of nuts
The nut allergy is a disease of any severity because it starts at an early age, lasts throughout life and can be fatal. Peanuts, also known as peanuts, and various types of nuts that grow on trees, like walnuts themselves, almonds, brazil nuts and hazelnuts can cause symptoms even with minimal contact with skin or inhalation. In its mildest form, the nut allergy may simply cause rashes, nausea and headaches and sometimes swelling of the tongue and lips, while in its most severe form can cause anaphylactic shock. For the potential severity of symptoms, nut allergy sufferers absolutely must avoid contact with these foods, and always carry adrenaline (to counteract the severe allergic reaction).
3.4.3. Other common food allergens
Other foods that are more likely to be associated with allergic reactions include fruits, legumes (including soybeans), eggs, crustaceans (crabs, crayfish and seafood, lobster), fish, vegetables, sesame seeds, sunflower seeds, cotton seeds, poppy seeds and mustard seeds. The allergenic potential of some food allergens can be eliminated (although not always) by cooking or industrial processing, through which the proteins are denatured. The latest techniques, such as the high-pressure treatment, the fermentation and treatment with enzymes, may help to reduce the allergenicity of certain food proteins. In the case of oils, it is also possible to eliminate allergens by refining. One of the problems remained unresolved in the field of food allergies, both for industrial products than for those consumed outside the home, could be the presence of slight traces that can cause allergic reaction.
4. Food intolerance
Food intolerance can cause allergy-like symptoms (including nausea, diarrhea and stomach cramps), but the reaction does not involve the same way the immune system. Food intolerance occurs when the body fails to proper digest a food or food component. While individuals are truly allergic in general eliminate the offending food, the people who have an intolerance can often tolerate small amounts of the food or component in question without developing symptoms. Exceptions are individuals sensitive to gluten and sulphate.
4.1. What are the most common causes of food intolerance?
The two most common charge of food intolerance are lactose and gluten.
4.1.1. Lactose intolerance
Lactose is the sugar found in milk. Normally, the enzyme called lactase, present in the small intestine, breaks down lactose into simpler sugars (glucose and galactose) and then enters the bloodstream. When enzyme activity is reduced, the lactose is not split, and is transported in the large intestine where it is fermented by bacteria present in that part of the body. This can cause symptoms such as flatulence, abdominal pain and diarrhea.
Even though most of the people of northern European strain produce sufficient lactase throughout their lives, among non-white races and peoples of the Middle East, India and parts of Africa, including their descendants, the lactase deficiency is a widespread phenomenon. In fact, approximately 70% of the adult population does not produce enough lactase, and therefore, has some degree of lactose intolerance. In Europe, lactase deficiency occurs in about 5% of the white population, with marked variations from country to country, and in a proportion much higher (50-80%) in ethnic minorities.
The amount of milk and dairy products that caused symptoms of intolerance is very variable. Low intestinal lactase activity with a drink of milk can be made by many people, no problem. Similarly, low lactose, and milk products like yogurt and hard cheese which are hidden, was generally well tolerated by. The lactase deficiency is more prevalent in regions of the world for the products of large consumption of milk and yogurt cultures. Additions in the case of lactose in the meal - the food, the constant introduction of mutation causes a progressive decrease in the amount of lactoses and consumed the same meal to improve the tolerance of sensitive individuals.
4.1.2. Gluten Intolerance
Gluten intolerance (the last effective role in determining the subject of much controversy and research; however, the protein found in wheat, oats, barley, and rye), an intestinal disorder that caused the body cannot tolerate gluten. Commonly known as celiac disease or gluten intolerance disease, estimated to be less than the spread. If there are no serological tests for the European population of 100 individuals (by region) will be diagnosed until the disease was detected in 1.
Screening for celiac disease at any age, can be called permanent, and work. If the effect of the food consumed by people with gum, and damage to the walls of the small intestine, fat, proteins, carbohydrates, minerals and vitamins that are less able to absorb essential nutrients by the coating process. Symptoms of diarrhea, irritability, weakness, abdominal cramps and weight loss are included. Characteristics of child malnutrition, for example, a failure to occur. At present, the stomach can only help the patients of the food is gluten free. For information about celiac disease, gluten-free food available at food centers and institutions to make lists. Except for food for this object, the bowel symptoms gradually disappear; the repairs have been made.
Research is ongoing to identify the exact nature and sequence of amino acids that determine the gluten and celiac disease; this knowledge in future constitute the basis for the application of biotechnology to the development of cereals that do not cause intolerance.
5. Food additives and adverse reactions
If the majority of people on food additives are not a problem, some people who suffer from specific allergies may be sensitive to certain additives such as sulfites and certain colors.
Since all food additives must be clearly indicated on the label, those who have a specific sensitivity or believe it can easily avoid any additive that builds a potential problem.
6. How do you diagnose allergies and food intolerance?
A correct diagnosis of allergies and intolerances can be done by scientific tests. If a person believed to suffer from allergic reactions to certain food substances, the first thing to do is consult your doctor to check that the symptoms are not caused by another disease and possibly be referred to a dietician or an allergist.
The first step of a reliable diagnosis is a detailed history of the patient and his family. You should pay particular attention to the type and frequency of symptoms, as well as the precise moment at which they occur in relation to consumption of certain foods. The patient must also undergo a complete physical examination then, using the following methods of assessment.
6.1. Skin tests
Diet based on history, foods suspected of causing allergic reactions are included in the series used for skin tests. The value of this type of test is very controversial, and the results are not one hundred percent reliable. The tests involve the subcutaneous insertion of extracts of a particular food, by injection or rubbing, to verify the possible occurrence of a reaction of itching or swelling.
6.2. Exclusion diets
The principle of the exclusion diet is based on the elimination of a food or a combination of suspected food for a period of about two weeks before performing a test. If during this period the symptoms disappear, the suspect foods are reintroduced into the diet, one at a time, in small amounts and gradually increase until it reaches the normal dose. After checking all suspect foods, you can avoid those that cause problems.
6.3. RAST test (radioallergosorbent)
In this type of tests are mixed in a test tube small samples of blood of the patient with extracts of food. In a true allergy, blood produces antibodies to fight the foreign protein which can thus be detected. The test can only be used as an indicator of an allergy, but does not determine the extent of sensitivity to the food organism.
6.4. Test double-blind, placebo-controlled (DBPCF)
The allergy testing, a suspected allergen (e.g., fish, milk, soy) should be inserted into or near a patient under medical supervision in the management of food to hide. These tests are the most common food allergy and food items were identified to cause adverse effects.
Other types of tests for diagnosing allergies have not been scientifically avvallati and could be worthless.
7. What can you do to prevent allergies and food intolerance?
After making a thorough examination to identify accurately harmful foods or food components, the only way to prevent the allergic reaction in susceptible individuals is to eliminate these foods from the diet or environment, or components. In the case of food intolerance, the mere fact of reducing the portions may be sufficient to avoid symptoms. The best method of defense is to careful read the information concerning the ingredients listed on product labels and know what are the foods that trigger allergies, or asthma.
The professional support of a dietitian cannot exclude any nutrients from the diet and food changes when inserting in its stead. When eating away from home, you must learn about the ingredients and cooking methods to avoid known food problems and explain the situation and the special requirements to their host or caterer if necessary, you can ask to speak to the chef or manager of the bar or restaurant.
If in doubt, better to play it safe and stick to simple foods, such as grilled meats, or bring food prepared at home. You should always provide an emergency plan and, in case of severe food allergic reaction or through others, immediately call a doctor or ambulance.
8. What are the responsibilities of food manufacturers and retailers?
That allergy is now recognized as a major problem for the safety of food and the food industry must engage with the utmost care to help those who suffer from allergies to confidently choose a proper diet. Producers must take very great care in evaluating the use as ingredients, the most common allergens that might give serious reactions, warning of actual or potential presence of such allergens in products and preventing inadvertent cross-contamination with allergens present in other industrial products.
That allergy is now recognized as a major problem in the safety of food and the food industry must engage with the utmost care to help those who suffer from allergies to confidently choose a proper diet. Producers must take very great care in evaluating the use as ingredients, the most common allergens that might give serious reactions, warning of actual or potential presence of such allergens in products and preventing inadvertent cross-contamination with allergens present in other industrial products.
An answer to these problems is the adoption of Good Manufacturing Practices (or GMP, Good Manufacturing Practices English), including the adoption of the system of Hazard Analysis and Critical Control Points (HACCP, Hazard Analysis Critical English Control Points), which involve close collaboration with suppliers of raw materials and other links in the food chain. The correct preparation of the recipes and controls ensures that the food contain only the ingredients specified on the label. We are also taken precautions to prevent cross-contamination during storage of raw materials, handling and processing of foods, especially when the same systems are used for different foods.
9. What are the developments in the labeling of potential allergens in food?
The EU is considering the most correct way to indicate the allergens on the label and, at the same time, several national organizations have developed guidelines that encourage the spread of the Good Manufacturing Practices and Consumer information.
The Codex Alimentarius Commission, the European Commission and other international organizations are developing the scientific criteria for the selection of allergenic foods to be indicated on labels. The main identified allergens are: peanuts, various nuts, shellfish, fish, soybeans, milk, eggs, wheat and sesame (EU Commission).
Although, according to European legislation, no regulation's specific dietary requirement for the label to indicate the potential allergens, the inclusive rule requires that all ingredients add to food must be indicated in the list of ingredients stated on the product. Currently, there are some exceptions to this general rule:
ingredients that fall under the "rule of 25%" this is the case of compound ingredients (an ingredient known as a common name but composed of different ingredients), which constitute less than 25% of the final product;
ingredients "transferred," which some additives that do not have any technological function in the finished product, but are channeled through one of its ingredients in the food;
some foods (eg. some cheese or most alcoholic beverages).
On their own initiative, some manufacturers and retailers already say in the ingredients list allergens riskier even when present in very small quantities. It Furthermore, contains phrases such as "may contain" about products that may be accidentally current evidence of a potential allergen. However, in response to repeated requests from consumers for better information about the food they buy, the Commission issued a proposal to amend Directive 2000/13/EC on the labeling of foods. The proposal will abolish the "25% rule," which means that all ingredients intentionally added will have to be labeled. The proposal will impose the obligation to label those ingredients recognized by the scientific literature as responsible for allergies. The amendment aims to ensure better information on the composition of food to enable consumers with allergies to identify the harmful ingredients that may be present in the product.
Some manufacturers and retailers provide lists of consumer products for which no specific allergens through flyers, Internet communication and information services and assistance.
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