To live, people have to eat. Yet for those with food allergies – in America, that’s one out of every 25 people – mealtime can be dangerous. Every year, food allergies cause 30,000 cases of anaphylaxis, 2,000 hospitalizations and 150 deaths.

What is a food allergy?

Top Allergy Causing Foods

  • Milk
  • Eggs
  • Fish, including anchovies, salmon, tuna
  • Shellfish, including crab, lobster and shrimp
  • Tree nuts, including almonds, pecans and walnuts
  • Wheat
  • Peanuts
  • Soybeans

Like allergies to dust, grass or the household cat, a food allergy occurs when the body’s immune system reacts to a harmless exposure as if it were a threat. Eating, touching or simply breathing near the item causes responses ranging from mild itching to life-threatening anaphylaxis. Difficulty breathing, swallowing, slurred speech, confusion and dizziness can occur within minutes. Other times, it may be hours before these symptoms appear.

Anyone can develop a food allergy, but the problem is most prevalent during childhood. That is when milk allergy usually appears. Shellfish allergies, on the other hand, often do not show up until adulthood. Some allergies – milk, egg and soy for example – are typically outgrown, while peanut allergy tends to be permanent. People who develop food allergies as adults usually have them for life.

Food Intolerance is not Food Allergy

Signs and symptoms are sometimes similar, but food allergy and food intolerance, which causes most food reactions, are not the same. Food allergy is an immune system reaction that affects the entire body. Food intolerance is a digestive system response to a food ingredient that either irritates the digestive system or cannot be broken down because the digestive system lacks the necessary enzyme. Intolerance to lactose, found in milk and other dairy products, is the most common food intolerance. Unlike food allergy, where you must avoid the offending food entirely, a food intolerance can sometimes be circumvented with medication, which makes it possible for you to digest the offending food. For example, lactase enzyme pills may resolve lactose intolerance. You can also drink lactose-free milk.

Allergy shots (immunotherapy) are not effective against food allergies. The only way to prevent serious health consequences is to avoid the allergy-causing foods. This may be easier said than done. Many allergens turn up in unexpected places, like peanuts in candy, eggs in pasta and anchovies in Worcestershire sauce.

Reading ingredient labels is key to avoiding a food allergy reaction. So is speaking up. When dining in a restaurant, school or someone’s home, explain that you or your child has a food allergy and ask what went into making the meal. Remember that cross-contamination from use of the same manufacturing equipment, utensils or cutting board can make all food dangerous. If you have doubts about ingredients or preparation, don’t eat it.

Unintentional exposures

Even with the best precautions, unintentional exposures sometimes happen. Be prepared:

  • Develop a plan with your health care provider
  • Alert your place of business or your child’s school or day care
  • Wear a medical alert bracelet or necklace
  • Always have an accessible auto-injector device containing epinephrine (adrenaline)
  • Seek medical help immediately if you are exposed

Food allergies can be managed. Vigilance about what and where you are eating and how food is prepared will allow you to go about life’s daily business without putting life on the line.

[Janet Lubman Rathner]