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Food Allergy Research

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Airborne Food Allergens—What’s the Risk?

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When we hear stories of serious allergic reactions to food, they often involve someone unknowingly ingesting a food that contains their allergen. Gut-wrenching stories like the grilled cheese that killed a NYC preschooler, the Indian takeout food fatality in England, the woman left paralyzed after ingesting peanuts while traveling in Budapest, and the sesame-related death of a teenage girl after eating a Prèt A Manger baguette at an airport. 

For many of us, these stories hit a bit too close to home.

In these cases, the food was ingested—but what happens when the allergen goes airborne?  

In January, a story about an 11-year-old New Jersey boy rocked headlines after he died from what authorities believe was an allergic reaction from breathing in the steam from fish cooking in the kitchen. 

While rare, allergic reactions to aerosolized allergens do occur. 

According to Dr. John Lee, Clinical Director of the Boston Children’s Food Allergy Program, most airborne reactions probably occur due to particles of protein that rise into the air when food is actively cooked, and then they’re inhaled. “I’ve had patients describe their throat itching while around peanuts, or reported mild reactions on airplanes, but most airborne reactions typically result from particles of protein rising off heated foods.” For example, he offers someone with a shellfish allergy walking into a seafood restaurant, or a wheat-allergic patient standing near boiling pasta.

According to the American Academy of Allergy, Asthma and Immunology, exposure to airborne food allergens does not typically result in anaphylaxis; however, these airborne particulates can cause symptoms such as itchy eyes, a runny nose, a cough, congestion, and difficulty breathing.

Airborne food particulates can also trigger two forms of occupational asthma: 1) baker’s asthma, following exposure to powdered allergen substances such as dried egg powder, soy flour, or wheat flour during baking; and 2) crab asthma, which is caused by dust and fume exposure from steaming, cooking, or scrubbing crab in processing plants. Both forms of asthma are considered allergic diseases because of the role allergenic proteins play in the respiratory response.

Notably, airborne allergic reactions aren’t limited to food. In at least one case, a chemical fragrance was the culprit. After a teenager named Brandon started developing headaches and hives at school, he connected his symptoms to Axe Body Spray. His allergy to the spray worsened, eventually leading to anaphylactic shock. Laws protecting manufacturers like Axe barred disclosure of the spray’s full ingredients list, preventing his family from discovering the allergenic trigger. Brandon had to leave school because of the exposure risks. 

Suffice it to say, airborne allergenic reactions extend beyond food. 

Most reported airborne reactions, however, continue to stem from common allergenic foods. Since peanut is the number one trigger of food-related anaphylaxis, the extent to which peanut particulates pose a risk is a common question in the food allergy community. 

In a 2003 study of 30 children with severe peanut allergies, researchers examined the extent to which inhalation and skin exposure elicited a reaction. For the skin test, one third of children experienced reddening or skin flares after peanut butter was pressed to their skin for one minute. Conversely, no child experienced respiratory symptoms after sitting in close proximity to three ounces of peanut butter for ten minutes.

The topic of aerosolized allergenic reactions has stirred enough controversy among food-allergic travelers that Southwest Airlines stopped serving peanuts on all flights starting in August 2018, and JetBlue does not serve peanuts on its aircrafts.

Food for thought? We think so. Have you experienced an airborne allergen causing an allergic reaction? Please share your experience if so! 

- Meg and the Allergy Amulet Team 

This piece was written by the Allergy Amulet team and reviewed by Allergy Amulet advisors Dr. John Lee and Dr. Jordan Scott. 

Dr. John Lee is the Clinical Director of the Food Allergy Program at Boston Children’s Hospital. Dr. Lee is widely recognized for his work in food allergy, and his commitment to patient health. 

Dr. Scott is an allergist/immunologist and operates several private allergy clinics throughout the Boston area. He is on the board of overseers at Boston Children’s Hospital, and the past President of the Massachusetts Allergy and Asthma Society. 

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Humans Are Pooping Plastic

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Got your attention? Thought so. 😉

If you’re thinking, What does poop have to do with food allergies? First, food allergies affect our health and diet, which implicates our digestive tract. Number two, research is increasingly looking to the gut for answers around the rise in food allergies. For these reasons, we thought the topic was a-poo-priate. 💩

This past summer, Austrian researchers reported that the deluge of plastic entering our environment is now entering our stool. That’s right—plastic has been discovered in 114 aquatic species90% of seabirds, and now, evidently, in us. 

As part of this first-of-its-kind study, researchers followed eight volunteers from a handful of European countries, tracked their consumption habits, and then sampled their stool. Small fibers of plastic—known as microplastics—were found in all participants’ feces to varying degrees, amounting to the first documentation of plastic in human feces to date. The findings confirmed what many scientists have long suspected: we’re eating plastic.

Scientists are now grappling with the health implications, which are largely unknown. Microplastics are capable of damaging the reproductive and gastrointestinal systems in sea life, but little is known about their impact on humans.

On average, 13 billion microplastic particles enter US waterways every day through the municipal water supply. An estimated 8 million tons of plastic enter the oceans each year. The latter bulk of plastic gets broken down into smaller bits, which are eaten by smaller organisms, and make their way up the food chain.

How does this relate to the food allergy and intolerance community? 

First, we know that immune health is closely tied to food allergies and intolerances. Experts have found that plastic in the gut can suppress the immune system and increase the likelihood of gastrointestinal diseases like inflammatory bowel disease. Second, research has shown that exposure to phthalates, which are found in many plastics, can increase childhood risk of allergies. According to the lead researcher of the study, Dr. Philipp Schwabi: “[my] primary concern is the human impact… especially [on] patients with gastrointestinal diseases.” He notes that “the smallest particles are capable of entering the bloodstream, the lymphatic system and may even reach the liver.”

While research on the human impact of plastic is still early, one thing is clear: plastic may be harming our immune systems, which could potentially implicate our body’s ability to tolerate and digest certain foods.

We’re eating our waste—that much is clear. Now the question is, what are we going to do about it? 

-      Abi and the Allergy Amulet Team 

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More Adults Have Food Allergies Than Previously Believed

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Last month, we shared the latest research on food allergy trends among children. The study found that approximately 7.6%—or 6 million—kids in the U.S. have a food allergy. Now we have more breaking food allergy news to share—this time concerning adults.

In early January, The Journal of the American Medical Association (JAMA) published a study on the prevalence of food allergies among U.S. adults. What did they discover? Approximately 1 in 10 American adults (~26 million) have a food allergy. 

This brings the total number of Americans with a food allergy to approximately 32 million, more than doubling the food allergy population! Previous estimates had the population at roughly 15 million Americans.

Below are a few more key findings:

  • Adult onset of food allergies is becoming more common; nearly half of food-allergic adults have at least one food allergy that began in adulthood.

  • The most common allergies among adults are shellfish (7.2 million), milk (4.7 million), peanuts (4.5 million), tree nuts (3 million), and fin fish (2.2 million).

  • Food allergies occur more often in non-white adults than in white adults.

  • Nearly 40% of adults with a food allergy reported at least one food allergy-related ER visit in their lifetime.

  • Adults ages 30-39 had higher rates of food allergy than younger adults. Adults over 60 had lower rates than other adult age groups.

Dr. Ruchi Gupta and her team at Northwestern University conducted both the adult and pediatric studies. Consistent with their research on children, Dr. Gupta’s team applied a stringent symptom methodology, which looked at the frequency, type, and severity of allergy symptoms as part of diagnosis to filter out those who more likely had a food intolerance. 

One thing is clear: food allergies are on the rise, and we need greater education, awareness, and research on this troubling health trend. 

A big thanks to Dr. Gupta and her team for their ongoing efforts to shine a light on the rising food allergy epidemic in our country.

- Susannah and the Allergy Amulet Team

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Emerging Epidemic: Latest Research on Childhood Food Allergies Shows Troubling Trend

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We like to follow research in the food allergy world closely—after all, many of our team members are as personally vested as we are professionally in the advancement of food allergy research! Several of our senior team members either have food allergies or have children with food allergies. 

Last month at FABlogCon, we learned that Dr. Ruchi Gupta and her team at Northwestern University were soon releasing a new study in PediatricsThe Public Health Impact of Parent-Reported Childhood Food Allergies in the United States.

The study was published this month, and we wanted to share some key findings with you: 

  • Food allergies continue to affect a significant number of children in the United States—7.6 percent, or nearly 6 million kids, have a food allergy. Of those, 40 percent report having multiple food allergies.

  • Food allergies have a meaningful impact on families—42 percent reported a severe allergic reaction to their food allergen, and nearly 1 in 5 reported that their child had visited the emergency department for a food-allergic reaction in the past year!

  • Not everyone has emergency medicines at the ready—less than half of parents reported that their child has a current prescription for an epinephrine auto-injector, the only treatment for anaphylaxis. 

This study is a continuation of the work carried out by Dr. Gupta and her team in 2011. Their objective was to better assess the public health impact on childhood food allergies. They surveyed over 40,000 households using advanced statistical modeling to ensure they captured a representative sample of children in the United States. 

One noteworthy feature of this study was a “stringent symptom” methodology, which looked at the frequency, type, and severity of allergy symptoms as part of a diagnosis. This approach helped filter out those who did not likely have a food allergy, as several parents reported a food allergy when the symptoms were more characteristic of a food intolerance or oral allergy syndrome (OAS).

Even after applying the stricter criteria, food allergies are still a significant problem for American children. Today, 1 in 13 kids has a food allergy, which translates to 2 in every classroom. Peanut (2.2%) and milk (1.9%) are the most commonly reported food allergies, affecting 1.6 million and 1.4 million children, respectively. African American children are also more likely to have a food allergy than non-Hispanic white children and are more likely than other children to have multiple food allergies. 

Dr. Gupta (second from the left on the bottom row) and her SOAAR research team (Science and Outcomes of Allergy and Asthma Research) at Northwestern University.

Dr. Gupta (second from the left on the bottom row) and her SOAAR research team (Science and Outcomes of Allergy and Asthma Research) at Northwestern University.

We appreciate the work of Dr. Gupta and her team to increase awareness of the public health implications of food allergies. To quote from the study: “With the growing epidemic and life-threatening nature of food allergies, developing treatments and prevention strategies are critical.” 

We couldn’t agree more!

- Susannah & the Allergy Amulet Team 


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