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By Virginia Lester,
RN, MSN, ARNP

People believe (often incorrectly) that a bad reaction to food is an allergy. Actually, bad or adverse reactions can be divided into two groups: True allergies that call the immune system into action (immunologically mediated) and non-allergic reactions that do not cause an immune response (non-immunologic). Bad reactions to food are common and quite often are assumed by people to be from an allergic cause. Between 20-30 percent of people report food allergies in themselves or their children, although true food allergies are present in only six to eight percent of children under the age of five and only three to four percent of adults.

The non-allergic (non-immunologic) reactions to food are more common and include: 1) gastrointestinal disorders such as structural abnormalities, carbohydrate malabsorption, gastroesophageal reflux, ulcer diseases, gallbladder diseases and cystic fibrosis; 2) toxic reactions from seafood or spoiled or contaminated food; 3) food intolerances such as caffeine, wine/alcohol, tomato, chocolate and flavorings; 4) psychological reactions such as food phobias and food aversions and 5) accidental contaminations such as pesticides and antibiotics.

Adverse reactions to food additives are believed to be rare. Migraine headaches are often triggered by certain foods; however the link between the headache and allergy has not been established.

True food allergy or hypersensitivity to food proteins are immune responses in the body. These responses can produce symptoms that cause discomfort such as a mild itchy rash to a life threatening reaction that requires immediate medical intervention. There are many types of food allergies, each with a distinct clinical and physical feature, often requiring several types of tests to accurately identify them. True food allergies can affect every body organ depending on the causative agent.
Allergic reaction from food ranges from very rapid to two hours. The most common reaction is acute hives and swelling of the mucus membrane of the mouth, eyes, nose and throat. However, chronic hives lasting for six weeks or longer does not appear to be an allergic reaction, although 50 percent of adults with chronic hives perceived food to be the cause. One study found that 10 percent of patients with chronic hives displayed allergic type signs and symptoms when given a placebo food.

Several common myths and facts about food allergies:
Myth: Most people with food allergies are allergic to strawberries and tomatoes. Fact: People can be allergic to any kind of food but the most common food allergies are nuts, cow’s milk, eggs, soy, fish and shellfish. Myth: Some people are allergic to sugar. Fact: Food allergy is caused by the immune system fighting against a food protein, not sugar and fats. Myth: Milk allergy is very common in adults. Fact: Milk allergy is more common in children and it is usually outgrown by the age of six. Adults who have difficulty digesting the sugar in milk may have a condition known as lactose intolerance, not allergy. Myth: People with food allergies are allergic to many foods. Fact: Most people are allergic to fewer than four foods. Myth: Food allergy is not dangerous. Fact: It can be fatal if it is severe, called anaphylaxis. Myth: If a true food allergy is diagnosed, absolutely avoid the food at all times. Fact: It is true that children often outgrow allergies to milk, eggs, soybean products and wheat. However, people usually do not outgrow allergy to nuts, fish and shellfish. Read labels and have your health practitioner provide information on emergency treatment. Also, if you have identified a food intolerance, it is wise to avoid this food as well.
Please note: I will be away from the clinic some days during the month of May. The clinic will be covered by one of the other ICHC clinicians. Please call before coming to the clinic to be sure a clinician is available to provide your care. Thank you for your patience.