Unwanted food reactions

In recent years, the share of sensitivity to food in inducing many ailments not only of the digestive tract, but also the respiratory system, skin and other organs has been increasing. This particularly affects the population of development age and is a reflection of the general increase in allergies in the world.

Abnormal reactions following the consumption of food has been known since ancient times:
“What is food to one man may be fierce poison to others”
Lucretius (100 BC)

Medicover has prepared another informational meeting within the cycle concerning pediatric allergies. The topics of the current lecture will be food allergy and intolerance as well as atopical inflammation of the skin. The meeting will be held 26.04.2003 at ul. Grzybowskiej 77, in the conference hall of Dom Wydawniczy “Bellona.” The lecture will begin at 11.00 A.M and be conducted in the Polish language.

How often is an abnormal reaction to food encountered?

The frequency of unwanted reactions to food is estimated at approximately 20% of the population, with allergic reactions occurring in approximately 5-7% of children and 1.4% of adults (occurring 3 times more frequently in women than in men). Abnormal reactions to food have a complex character and are connected with various mechanisms.

The most important are milk and eggs.

Among the most frequently occurring food allergies / intolerances are a hypersensitivity to milk, chicken eggs (mainly protein), fish, wheat, Soya, fruit (strawberries, tomatoes, citrus, melons), vegetables (celery, legumes), meat (with children, most frequently – beef, veal, chicken, with adults – pork), nuts (particularly peanuts), and cocoa. Numerous substances (approximately 1500) used by the modern foodstuff industry, which are added to products in order to improve their color, consistency, smell or to increase the intensity of taste, are increasingly more frequently the reason for a hypersensitivity to food. 

What are the most common symptoms and illnesses caused by consuming allergenic foods?

Symptoms of milk allergies
 

• Abnormal reactions to milk occur in almost 20% of infants. Allergy to cow milk protein is an illness occurring almost exclusively during infancy and early childhood, and rarely occurring in adulthood. Symptoms occur in more than 90% of children above the age of 3. Cross reactions occur between proteins of cow, goat and sheep milk. Therefore, it is recommended that children sensitive to cow milk avoid milk of other animals.
• Digestive tract: abdominal colic of breastfed infants is frequently caused by an allergy to the milk consumed by the mother. Following the introduction of milk formulas, spitting up, lack of appetite, diarrhea, watery stools often mixed with mucus or blood, which can lead to dehydration or ischemia, can occur. In older children, milk can be the cause of so-called sensitive intestine syndrome, in which diarrhea and constipation occurs alternatively.
• Symptoms of respiratory system: occur in 25% of children allergic to cow milk, which can include wheezing, stuffy nose, fits of sneezing, rhinitis, nasal polyps, sinus inflammation, exudative inflammation of the ear (common), swelling of the tonsils, chronic coughing, recurring chronic inflammation of the bronchial tubes and lungs, bronchial asthma.
• Skin changes: the following occur in the case of the youngest infants: rough skin, reddening of the cheeks, cradle cap, itching papular changes with an erythematous character, located on the extremities, buttocks, in the are of the genitourinary system, while in severe cases the entire skin is inflamed. The child suffers from persistent itching, skin changes have a tendency to ooze (particularly with young infants) and become superinfected by bacteria. The typical locations of skin changes in older children are the inside of the elbow and knee as well as ear lobes.
• Nervous system: anxiety, irritability, tearfulness, trouble with concentration, hyperactivity and sleep disorders.

Other allergens:

• Chicken eggs

Chicken eggs are common allergens in children. The yolk has significantly weaker allergenic properties than the white of the egg. Due to nutritional value, it is recommended that infants eat egg yolks beginning at the age of 6 months. The yolk contains iron, phosphorous, calcium and magnesium as well as the vitamins A, B2, B6, D. Supplementing an infant’s diet with egg yolks prevents anemia and rickets. Therefore, it is recommended not to eliminate egg yolks from the diet even if allergy to eggs is suspected. However, they should be introduced very cautiously. Together with age, a tolerance to egg whites increases (50% to the age of 5), however this allergy continues for a longer time than an allergy to milk protein and occurs more frequently in adults than an allergy to milk.
 

• Fish
  Fish contain very strong allergens. Cases of shock, posing a threat to life, are known caused by introducing fish allergens into the skin during tests. An allergy to fish is common in both children and adults. Fish allergens are thermostable and the allergic reaction occurs both to raw and cooked fish. Angio-kinetic swelling, hives, symptoms of gastrointestinal pains, asthma attacks and anaphylactic reaction (shock) can occur within several minutes after eating fish. In the case of hypersensitive people, touching or even inhaling the smell of cooked fish as well as even kissing someone who just consumed fish can cause an attack of asthma or result in other types of allergic reactions.
   
• Grains (wheat, rye and barley) These three grains belong to the same family and show clear cross reactivity. Wheat protein can cause three types of ailments: gluten-dependent enteropathy, inhalatory allergy (baker’s asthma) and food allergy.
  A sensitivity to corn occurs rarely but is difficult to treat as corn-base products as used in many foods (meat products, jellies, peanut butter, cheese, cookies)
  An allergy to rice is also rare.
  
  Legumes (Soya, peas, beans, lentils)
  Among this group, the strongest allergen is Soya. Soya-based products are used increasingly more frequently in the foodstuff industry (hamburgers, processed meats)
   
• Nuts
  Sensitivity to hazelnuts and walnuts is common among people with an allergy to birch pollen. The main symptom is an itch of the mouth and throat. Shock reactions following the consumption of peanuts have been recorded.
   
• Fruit and vegetables
  The majority of these allergens is not thermostable, which means cooking, freezing or conserving significantly weakens their allergenic properties.
  Symptoms of an allergy to fruit and vegetables are usually limited to the mouth and throat. “Fruit and vegetable” syndrome, also known as oral allergy syndrome occurs frequently in people allergic to pollen due to the similarity of the pollen and food allergens. People with an allergy to birch pollen are usually hypersensitive to raw apples, peaches, carrots, pears, and peeling young potatoes can cause sneezing. An allergy to mugwort is frequently associated with sensitivity to celery, and bananas frequently show a cross reaction with latex and kiwis. 
   

What is food intolerance? 

Food intolerance is an ailment for which non-immunological mechanisms are responsible.
An example of food intolerance is intolerance to carbohydrates, which is most frequently connected with a deficiency of lactase, an enzyme responsible for digesting lactose (a sugar found in milk). Temporary intolerance to lactose is frequently observed following acute diarrhea. Passing loose stools for more than 5-7 days following acute diarrhea is an indication that a lactose-free diet should be followed. Congenital allergies lasting an entire lifetime are rare.
Symptoms of intolerance to carbohydrates (other than diarrhea) include vomiting, flatulence and stomach pain, rumbling of the bowels, feeling full, gassiness, growth impairment and an aversion to carbohydrates. 

How to diagnose food allergy / intolerance?

Due to the limited usefulness of laboratory tests (the presence of IgE antibodies is confirmed in only 48% of cases), meticulous observation of the patient in order to determine a correlation between the food consumed and the occurrence of clinical symptoms as well as an improvement following the implementation of a diet devoid of the allergenic food play a key role in diagnosing hypersensitive.

Dr Barbara Sieradzka, Dr Marcin Patrzałek