1. Food Allergies Melissa Bess Nutrition and Health Education Specialist FNEP STAFF TRAINING ONLY, DO NOT USE WITH FNEP PARTICIPANTS 03/2007

2. 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.

3. Discussion Topics Children and allergies New research How a child might describe reaction Food intolerance Cross-reactions Hidden allergens

4. What is a food allergy? Immune system function Super-sensitive Allergens Usually the protein part Allergens react to antibodies Release chemicals causing symptoms

5. 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

6. 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)

7. 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

8. 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

9. Symptoms Digestive system Swelling, itching Tightness Hoarseness Nausea Cramping Pain Vomiting Diarrhea 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

11. Symptoms 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

12. How are food allergies diagnosed? Physician Medical history, physical exam Skin test Lab tests Oral food challenge Elimination diet Double-blind food challenge

13. How can you avoid food allergies? Identify those at risk Consult a doctor Consider breast feeding Maternal diet avoiding eggs, cow milk, peanuts, fish

14. 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

15. 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

16. What to do if a child has a reaction Take medication Seek medical help Keep injectable epinephrine Wear Medic-Alert bracelet

17. 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

18. 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

19. 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

20. 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”

21. 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)

22. 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!

23. 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

24. Eating out with allergies Chinese, Indonesian, Mexican, etc dishes usually made with peanuts Cross-contamination of allergens Not as easy to read ingredient list

25. Resources Food Allergy and Anaphylaxis Network (FAAN) American Academy of Allergy, Asthma, and Immunology Food and Drug Administration USDA – National Agriculture Library