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food allergy diagnosis

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Scientists Find Link Between Antacid & Antibiotic Exposure and Food Allergies & Asthma

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As someone who remembers (with disgust) that pink goo as a child (also known as the antibiotic amoxicillin), I read this headline in shock. Did that chalky bubble gum syrup make me more susceptible to developing food allergies and asthma?

Here’s what the scientists found. 

In a recent study published in JAMA Pediatrics, researchers looked at approximately 800,000 infants that had ingested antibiotics or antacids in their first six months of life. They found that those exposed were more likely to develop food allergies or asthma. 

Babies are routinely prescribed antacids for regurgitating food or experiencing acid reflux after a feeding. This is very common in infants, so you can appreciate why this study is sending shockwaves throughout the parenting community!

The research hones in on how antacids and antibiotics affect an infant’s microbiome—that place where trillions of bacteria help aid in digestion, fight infection, and regulate the immune system. We know that antibiotics kill the bad bacteria that make us sick, but they also wipe out the good stuff that keeps us healthy. Antacids similarly can help ease digestion, but a less acidic stomach can alter the bacterial composition of the intestine and reduce protein digestion

The microbiome has been a hotbed of research lately—especially in the food allergy field. As we’ve discussed in a previous post, one of the leading theories behind the rise in food allergies is the impact that chemicals and medications are having on our microbiome and gut health—especially at a young age. We’ve also previously written on gut health and the important role the microbiome plays in healthy immune function.  

“This does not mean that infants should never get antacids or antibiotics,” Dr. Claire McCarthy notes in response to the study. “Antibiotics can be lifesaving for infants with bacterial infections, and there are situations when antacids can be extremely useful.” She adds though that both medications are often overprescribed and encourages doctors to “ask if it is truly necessary [to prescribe these medications]—and whether there are any alternative treatments that might be tried.” The lead author of the study, Dr. Edward Mitre, also recommended in light of the findings that “antibiotics and acid-suppressive medications should only be used in situations of clear clinical benefit.”

The recent surge in research surrounding gut health and the microbiome is a welcome trend, and one that will hopefully lead us to more concrete answers surrounding the origin of food allergies and how to mitigate or eliminate them altogether. 

- Abi and the Allergy Amulet Team

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The Nutty Nature of Nuts

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For years, patients diagnosed with a tree nut or peanut allergy have been told to avoid all nuts. But what if I told you that being allergic to one nut doesn’t necessarily mean you’re allergic to another? What if I also told you that avoiding nuts altogether could result in a higher risk of BECOMING allergic to nuts?

Nuts, right?

To make things even more confusing, it’s possible to be allergic to some tree nuts and not others (e.g., a patient could be allergic to all tree nuts except hazelnut and almond). Walnuts and pecans are almost 100% cross-reactive, so if you’re allergic to one, you’re almost certainly allergic to the other. The same is true of cashews and pistachios. But that’s pretty much where the similarities end. 

Often, if a patient has an allergic reaction to a peanut or a tree nut, their allergist will advise the patient to avoid all nuts. Why? The rationale is three-fold: 1) some tree nuts are cross-reactive with others; 2) nuts are often packaged and handled in a shared facility, making cross-contact more likely; and 3) it is often easier for a doctor to advise patients to avoid all nuts (including peanuts, which are technically a legume). 

Doctors have also generally recommended strict avoidance of all nuts after a peanut or tree nut allergy diagnosis because of the challenges in distinguishing between nuts. Otherwise, the patient would be expected to know the difference between all of the different types of nuts: almonds, brazil nuts, cashews, hazelnuts, macadamia nuts, pecans, pine nuts, pistachios, and walnuts—both shelled and unshelled. Studies have also shown that allergy patients are only slightly worse at identifying tree nuts than their allergists. 

Patients would also have to trust that kitchen and waitstaff at restaurants could distinguish between the nuts (spoiler alert: many can’t). Additionally, it’s hard to find bags of tree nuts that don’t list warnings of possible cross-contact with other tree nuts or peanuts due to manufacturing practices. In order to determine which nuts a patient is allergic to and which ones are safe, one or more oral food challenges may be necessary. 

Because of this, recommending that a patient avoid all nuts has historically been deemed the more practical—and safer—approach to food allergy management. 

Then came the LEAP (Learning Early About Peanut) study.

The LEAP study suggested that kids who were at risk for developing a peanut allergy were significantly less likely to become allergic if they ate peanuts early and often. The study also showed that if a patient was unnecessarily avoiding peanuts they were more likely to become allergic to peanuts over time. This suggested that unnecessarily eliminating certain allergenic foods could increase a child’s risk of becoming allergic.

This study led to a seismic shift in the food allergy community’s understanding of food allergies and allergy management practices. Suddenly, blanket avoidance of all tree nuts and peanuts came with the potential risk of increasing an at-risk child’s chances of developing a food allergy. For this reason, it is important that allergists talk with their patients and/or the patient’s families after a peanut or tree nut diagnosis about the different approaches to managing food allergies and decide together what is in their best interest. 

The first option is the oldest approach: strict avoidance of all peanuts and tree nuts. Many patients and families feel safe with this approach. Total avoidance may lessen the fear of a reaction due to cross-contact. Accordingly, for many patients and/or families, avoidance is the right choice. Another option is to have the patient continue to avoid the foods they are allergic to (in this example certain tree nuts) and teach families how to safely eat the foods they are not allergic to. This process may involve a food challenge. Deciding to eat certain nuts when allergic to others does involve learning how to read labels to check for potential cross-contact, learning what the different nuts look like shelled and unshelled, and understanding that eating those nuts is something that should be done at home and not in restaurants. 

We still have a lot to learn about food allergies, but hopefully in time we’ll get better at managing, diagnosing, and treating them. In the meantime, for newly diagnosed food allergy patients, candid conversations are a good start. 

 

Brian Schroer, MD is on staff at Cleveland Clinic Children’s Hospital where he sees patients of all ages with allergic and food-related diseases. 

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Spokin’s Susie Hultquist: A Fearless Food Allergy Mama!

Susie and her food-allergic daughter, Natalie.

Susie and her food-allergic daughter, Natalie.

If you’ve followed Allergy Amulet for a while, you know our team was founded by a female and that we love to support female entrepreneurs!

Unsurprisingly, we’re big fans of Susie Hultquist and the team she’s assembled at Spokin. This Chi-town team has built an app to help make managing food allergies easier! We recently sat down with Susie and asked her a few questions.

1. We understand you left your financial career on Wall Street to start Spokin. When did the “light bulb” moment happen?

It happened when my co-worker was selling girl scout cookies. I wanted to buy some, but in order to do that, I had to get ahold of a package to check the label and ensure they were safe for my family. I then went to their website to make sure the cookies were also available in our area. It took me 15 minutes to track down all the information I needed! That’s when I realized I was probably not the only person managing food allergies searching for this same information, and that there was a clear need to streamline and consolidate food safety information for the food allergy community.

At the time I was managing my company’s consumer internet portfolio and saw how different businesses were managing pain points. No one was solving this one, and I felt I was uniquely positioned to do so.

2. How long did it take to launch the app? 

It was two years in the making. I started by meeting with a lot of people who have food allergies. From there, we developed a content strategy and hired a graphic designer to work on app designs. We just celebrated the app’s first birthday!

3. What is your “why”?

My daughter Natalie. She’s allergic to peanuts and several tree nuts. I am determined to make her life easier and to help her live the fullest life possible. That’s what gets me up every day. 

A food allergy diagnosis often comes with a lot of no’s when it comes to food, and I want to be able to say yes as often as I can!

4. Spokin has a lot of new features and capabilities on the app. What are you most excited about?

Far and away is the map functionality! If you’re in the app and search within the “eateries” category you can choose any city in the US and see in seconds all the restaurants, bakeries, and ice cream shops others in the Spokin community have recommended. We now have 2.7 million reviews on the app and reviews span across 18 countries! 

To find in seconds all these yes’s after so many no’s is amazing. And it’s built by the food allergy community! This community is so generous. 

5. What does Spokin mean?

It’s a play on the word spoken. I had so many amazing interactions with people in the food allergy community that gave me advice verbally (where to eat in London, what chocolate chips to bake with, what to take with us on an airplane, etc.) but once spoken, that advice then vanished into thin air. All of this knowledge needed to be captured and shared with everyone. The idea was that if we built this platform, we could harness and share all of this great food wisdom with the food allergy community at large. 

6. When do you plan to release the Android version of the app?

We have started an Android waiting list and it’s on our product roadmap. We’re currently assessing demand, so please add your email to the Android list on our website, if interested! 

7. When you’re not focused on helping the food allergy community, what do you enjoy doing?

Spending time with my girls and my husband! We love to cook together, run together, and travel when we can. My girls all have very different interests so it’s fun to watch them pursue their passions. 

8. Since Spokin is based in Chicago, we have to know: do you cheer for the White Sox or the Cubs?

I love the Cubs, but I applaud the White Sox for offering peanut-free ballgames!

9. What’s your long-term vision for Spokin?

If everyone in the US with food allergies shared five recommendations we could build a database of 75 million data points that everyone can access! We’ve estimated that if it takes you 15 minutes a day to manage food allergies, then you can save a year of your life by having all of this information accessible to you. 

If you haven’t downloaded the Spokin app we recommend you check it out ASAP! Both Susie (Susie in the Spokin app) and Allergy Amulet’s founder, Abi Barnes, (allergy_amulet_abi in the Spokin app) have provided lots of recommendations!

-      Meg and the Allergy Amulet Team

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Food Allergies Today: An Expert Q & A

There are many unknowns in the food allergy world today. Why are food allergies on the rise? What can I do to prevent my child from developing a food allergy? How do I find out if I have a food allergy or intolerance, or if my child has one? With the help of two of our medical advisors, Dr. Jordan Scott and Dr. John Lee, we have answered some of these common food allergy questions to help you dine with confidence! Let’s get started.

1) What is a food allergy and how does it differ from a food intolerance?

A food allergy is an immune system reaction. Your immune system is comprised of five different types of immunoglobulins/antibodies (IgA, IgD, IgE, IgG, and IgM). If you have a food allergy, IgE is the responsive antibody. When exposed to a food allergen, IgE attaches to the allergen, mistaking it as a foreign intruder. This IgE-allergen compound then binds to immune cells, triggering a release of histamine and other chemicals that produce an allergic reaction. Symptoms can affect the central nervous, respiratory, and gastrointestinal systems, and produce epidermal symptoms such as hives, rashes, or eczema. In the most extreme cases, a food-allergic reaction produces anaphylaxis, a life-threatening response that requires immediate medical treatment.

Food intolerances often affect gastrointestinal function, but they can also impact the central nervous system, respiratory health, and skin. The main difference between a food allergy and intolerance is that, although intolerance symptoms can be severe, they are not life threatening and will not produce anaphylaxis.

2) What are the leading theories for the significant increase in food allergies? 

Between 1997 and 2011, food allergies among children increased approximately 50 percent, according to the CDC. Unfortunately, there is no clear answer as to why. Below are some of the leading theories, in no particular order.

Theory One: Changes in our food system

Over the past few decades, our agricultural system has undergone a considerable transformation, including the introduction of GMOs (genetically modified organisms), increased pesticide application, and the addition of numerous chemicals to our foods. This theory suggests that these chemicals and modified foods are affecting our bodies and immune systems, particularly our gut health, thereby increasing our susceptibility to food allergies and intolerances.

Theory Two: Hygiene hypothesis

The second theory is the “hygiene hypothesis,” suggesting that our modern world is too clean, and our reduced exposure to bacteria is weakening our immune systems. Some research also suggests that the overuse of antibiotics in animals and the rise of prescription medication is killing the good bacteria in our gut alongside the bad.

Theory Three: Epigenetics

Some research indicates epigenetics are responsible for the rapid increase in food allergies—heritable changes in gene expression that don’t change the underlying DNA sequence. Epigenetic changes can be the product of environmental or other external factors, like diet or smoking, or the result of natural occurrence. Research is continuing to uncover the role of epigenetics in a variety of human disorders and fatal diseases.

Theory Four: Delayed allergen exposure

In the past few years, a growing body of research is suggesting that we may not be introducing children early enough to common allergens. In February 2015, the LEAP Study results came out, debunking the previously accepted practice of discouraging exposure to peanut among high-risk infants. This misguided approach may have contributed to the rise of peanut allergies and other food allergies.

3) What are the current methods for diagnosing a food allergy? How have they changed in the past several years? 

To diagnose a food allergy, an allergist performs one of two tests (or both): a blood test (such as an ImmunoCAP test) and/or a skin prick test. The blood test measures the level of allergen-specific IgE antibodies present in the blood. Skin prick tests are exactly as they sound: the allergists pricks the patient’s arm or back with a sterile small probe containing a tiny amount of the food allergen. A food allergy diagnosis is confirmed if a wheal (a raised white bump surrounded by a small circle of red irritated skin) develops around the contact area.

In some cases, an allergist may suggest a food elimination diet to pinpoint the offending food. They may also recommend an oral food challenge.

In an oral food challenge, an allergist administers tiny amounts of the potential allergen in gradually increasing doses over a set period of time (usually 1-3 hours). The patient is closely monitored in the event the food produces an allergic reaction, and epinephrine is always on hand in case of a reaction.

To date, oral food challenges are considered the gold standard for food allergy diagnosis. Skin prick and blood tests aid in diagnosis, but they are prone to error—false positives are not uncommon. For this reason, many allergists avoid blanket food allergy screening, and carefully choose which foods to test. Skin prick tests and blood tests have been standard practice for aiding in allergy diagnosis for the past two decades.

4) What are some common allergic reaction symptoms?

It’s first important to note that no two allergic reactions are the same, and just because you have a mild reaction to a small bit of sesame one day, doesn’t mean symptoms will present in the same way the next time you ingest that same small amount. Below are the most common symptoms to an allergic reaction.  

Mild symptoms include: itchy or runny nose, sneezing, itchy mouth, a few hives or mild itch, and mild nausea or discomfort.

Severe symptoms include: shortness of breath, wheezing, repetitive cough, pale or bluish skin, faintness, weak pulse, dizziness, tight or hoarse throat, trouble breathing or swallowing, significant swelling of the tongue or lips, hives or widespread redness, repetitive vomiting or severe diarrhea, anxiety or confusion, or some combination thereof.

It’s important that food-allergic individuals also be aware of biphasic anaphylaxis. A biphasic allergic reaction is a second episode of anaphylaxes that typically occurs within the first several hours after the initial anaphylactic event. The symptoms of biphasic anaphylaxis can be more severe than the initial reaction. Due to the risk of biphasic anaphylaxis, a doctor may require that you remain in the hospital for several hours after an anaphylactic event for monitoring.

5) What are the most common misconceptions about food allergies? 

There are several misconceptions about food allergies. Below are a few that we hear most frequently:

Food allergies aren’t real—False. Food allergies are real. They are a response to the body’s immune system upon exposure to an allergen. The immune system misinterprets the food as a harmful invader and releases histamine and other chemicals to protect the body from perceived harm.

Food allergies aren’t life threatening—False. If an allergic reaction becomes severe, it can lead to anaphylaxis—a potentially fatal allergic reaction that involves the rapid onset of swelling which can obstruct air passageways. Symptoms of an allergic reaction may be isolated to one major system in the body (e.g., wheezing or difficulty breathing), or can involve multiple systems (e.g., lungs, heart, throat, mouth, skin, or gut), and typically present within minutes after a person ingests the offending food.

Each allergic reaction becomes increasingly worse—Not necessarily. Allergic reactions can be unpredictable. The severity of a reaction is based on a number of factors, including: the amount of the allergenic food ingested, the person’s degree of sensitivity to that food, if exercise is involved, if they are sick, if alcohol is present in their body, and if certain medications are being used (for example, NSAIDS may increase the severity of a reaction). A person with food allergies might not always experience the same symptoms each time.

A food can be made less allergenic by cooking it—Partially true. Because a food allergy is an immune system response to a protein in a food, the protein remains in the food during heating, so it cannot be cooked out. The exception to this rule is sometimes seen in highly processed foods, and with milk and egg allergies—some people are able to consume these foods after heating, such as baked goods. Ask your allergist before trying this at home.

Adults don’t develop food allergies—False. Though most food allergies start in childhood, they can develop at any age.

Peanuts are the only food that cause severe reactions—False. While peanuts are the leading trigger of food-related anaphylaxis, any food can elicit a severe reaction—other common foods include seafood, milk, wheat, eggs, and sesame seeds.

One small bite is ok—If someone has a severe food allergy, and is highly sensitive to small amounts, even a tiny bite can trigger anaphylaxis. It is well documented that allergic individuals can experience severe reactions to trace amounts of an allergen in their food.

6) What are the three most important things a food-allergic individual can communicate to their friends, family, and co-workers?

First, alert your “tribe” (friends, family, work colleagues, caregivers) of your food allergies and their accompanying health risk. Also note the various ways you can be exposed (e.g., ingestion, touch, and inhalation).

Second, let them know what symptoms to watch for in case of a reaction.

Finally, tell them where you keep your emergency medications and teach them how to use an epinephrine auto-injector. Share your doctor-provided food allergy action plan, if you have one. Often parents with food-allergic children have one to serve as a guide for caregivers. The American Academy of Pediatrics recently published a customizable Allergy and Anaphylaxis Emergency Plan.

7) What role do you see technology playing in the lives of individuals with food allergies and how they manage them now, and in future? 

Food allergies have increased at an alarming rate over the past two decades. The silver lining is that we’re putting more research dollars and efforts into allergy education, management, and prevention. Numerous start-ups are spearheading this effort with cutting-edge technologies and innovation. This Spokin article published in January highlights several. Until we find a cure, technology is going to become a necessary part of how we manage food allergies.

8) What will be important for future food allergy diagnoses and treatment?

With food allergy diagnoses at an all-time high, it will become increasingly important to have improved diagnostic tools available to better understand who is at risk for severe reactions. New therapies to help people better manage their allergies are being developed every day. One example is oral immunotherapy, or OIT. OIT is a method of food desensitization that involves re-introducing the immune system to the allergenic food via oral ingestion in gradually increasing amounts over time, with the goal of eventual tolerance. Another example is the Viaskin® patch, otherwise known as the peanut patch. This approach uses epicutaneous immunotherapy. After applying the patch to your skin, the allergen is concentrated in the top layers of the skin, where it activates the immune system by targeting antigen-presenting cells without passage of the antigen into the bloodstream. The peanut patch recently entered Phase III clinical trials. Products are also currently being developed for milk and egg.

Is desensitization the future of food allergies? Or is a cure on the horizon? Only time will tell. Until then, innovation, research, heightened awareness, and education are paving the way for a brighter food allergy future.

If you have additional questions you’d like our experts to answer, please send them to Meg at mnohe@allergyamulet.com. We’d love to hear from you!

- The Allergy Amulet Team

 

These questions, and their corresponding responses, were written by the Allergy Amulet team and reviewed by Allergy Amulet advisors, Dr. Jordan Scott and Dr. John Lee.

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. Dr. Scott is an allergy/immunology instructor at the University of Massachusetts.

Dr. 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.

 

 

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May Contain Nuts: A Crash Course on FDA Food Allergy Labeling Laws

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Fact, Fad, or Fiction? A Brief History of Early Allergy Science

This guest post was written by Theresa MacPhail—assistant professor in the Science, Technology, and Society Program at Stevens Institute of Technology. 

“Many physicians think that idiosyncrasies to foods are imaginary.” – Albert Rowe, MD (1951)

Two years ago, my 63-year-old aunt developed hives. Large red wheals covered her entire body, and the slightest pressure to her skin—including wearing clothes—caused her pain. Over the course of her life, she had coped with eczema and the occasional rash, but this was new. This was different.

Her doctor sent her to a dermatologist, who—dumbfounded—sent her back to her doctor. After many medical appointments, blood tests, and rounds of steroids, an allergy specialist asked her to undertake an elimination diet, cutting out several foods. My aunt’s hives immediately cleared, and it was only after she introduced wheat back into her diet that the hives resurfaced. Her diagnosis: a wheat allergy.

My aunt’s experience is an all-too-common tale of food allergy classification: routine misdiagnosis, common misconception, and a general lack of understanding within the broader medical community. What is it about food allergies that make this story so familiar? Why are food allergies and intolerances so difficult to diagnose and treat? It turns out that our troubles with allergy diagnosis have a long and complicated history.

Rose Colds & Sea Anemones: Early Allergy Science

We begin in 1819, when the physician John Bostock presented the first clinical description of hay fever—or summer catarrh—to the medical community. By the mid-1800s, doctors had begun diagnosing patients with “summer” or “rose” colds (which we now call hay fever or seasonal allergies). In 1905, immunologists discovered they could produce an anaphylactic response in animals (injecting toxin from sea anemones into dogs) and began experimenting with allergic reactions in the laboratory. These anaphylactic responses to sea anemones were not considered allergic reactions or “allergies.” That link would be discovered later.

Hay fever and seasonal allergies were relatively easy for clinicians to diagnose with skin tests and desensitization techniques. Desensitization—or allergen immunotherapy—in its early form involved allergens converted into a serum or vaccine and injected into a patient. Leonard Noon and John Freeman discovered allergen immunotherapy in 1911, and this technique is still used for treating seasonal allergies today.

Until the early 20th century, food allergy remained somewhat of a nebulous concept. It was widely recognized, but hadn’t yet been proven. In 1912, Oscar Menderson Schloss breathed legitimacy into food allergy diagnosis and proved its existence. An American pediatrician, Schloss developed a skin scratch test with which he correctly diagnosed egg sensitivity. While this was seen as a breakthrough in allergy detection, skin scratch tests did not produce consistent results, as many patients with obvious clinical allergies didn’t react to these tests.

A leading difficulty with allergy diagnosis (food and seasonal)—both past and present—has been distinguishing allergy symptoms from the bevy of other ailments they mimic. Food allergy reactions are also highly idiosyncratic—meaning that no two patients with an egg or wheat sensitivity will necessarily react to the same degree or in the same fashion. Famed allergy specialist Warren T. Vaughan argued that the greatest difficulty in understanding and studying food allergy is the inconsistency of responses to different exposure levels among individuals. By 1931, after years of practice, Vaughan still couldn’t find logical patterns in the allergy symptoms of his patients. He had no explanation for why two patients reacted differently to equal doses of an allergen, concluding that “allergy to food is always an individual affair.”

By the late 1930s, physicians began realizing that chronic food allergies were far more prevalent among the general population than previously imagined. In some cases, food allergies were considered responsible for patient migraines, hives, intestinal troubles, bladder pain, and asthma. Guy Laroche and Charles Richet—two prominent French allergists at the time—argued that older physicians had failed to properly label food allergies as “alimentary anaphylaxis,” instead classifying these events as medical anomalies. For Laroche and Richet, the vigorous tracking of patient diet and symptoms proved their hypothesis: physicians were failing to recognize anaphylactic episodes to food as the result of an allergic response. This was a breakthrough.

A Fad is Born & Modern Trends

Because allergy diagnosis relied heavily on patient input, and were poorly understood, many doctors dismissed allergies as a response to emotional stress or neurosis. Doctors believed that these patients—the majority of whom were women—overplayed symptoms to garner attention or sympathy. It became a “grab bag” diagnosis, especially in the hands of general practitioners. As diagnoses surged, Samuel Fineberg warned that the glut of allergy research—only a few decades old—had led clinicians to dismiss allergies as just a trend. One prominent allergist observed that older generations regarded food allergy “as a passing fad.” Many today still view food allergies and intolerances as fads, although this is changing.

And while perceptions are evolving, allergy treatments have mostly remained stagnant. Between confirmation of the first food allergy in 1912 and the late 1960s, avoidance was the only prescription for food allergy patients. In 1935, food allergy specialist Dr. Albert Rowe argued that mild allergies couldn’t be diagnosed with skin tests alone, and insisted that elimination diets were a superior remedy to skin testing. He created a guide for physicians and patients, which became widely used among allergists from the late 1930s to as late as the 1980s. Rowe counseled that food allergy should not be dismissed as “mere fancy” but taken as medical fact, and helped shift the perception of food allergies in the medical community.

As evidenced in this history, food allergy treatments haven’t changed much. Desensitization for seasonal allergies has been around since the early 1900s, food allergy desensitization (oral immunotherapy), while relatively more recent, still builds off of the same concept of desensitization. With oral immunotherapy, the patient ingests small amounts of the allergic food in gradually increasing amounts. It’s not widely practiced at present, and is only offered by select allergists nationwide.

We can still see the echoes of this history when we look at current debates over food allergy versus food sensitivity designations. Take gluten, for example. While wheat allergy and the autoimmune disorder Celiac Disease are accepted medical conditions, gluten sensitivity is still debated by researchers and the public alike.

There is still much we don’t understand about food allergies and intolerances, but increasing research in this space holds promise for solving these medical mysteries. Fact, fad, or fiction? As history has shown, only through scientific advancements and research will facts eclipse fad and fiction.   

Part Two: Food Allergies Today

Stay tuned for part two of this story as we discuss the modern world of food allergy—epinephrine auto-injectors entering the market, the staggering increase in food allergy diagnosis, the LEAP study, and oral immunotherapy.

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Talking to Kids About Their Food Allergies

Many parents find themselves in a state of panic after their child is diagnosed with a food allergy. Suddenly the parent is tasked with learning all about food allergies, educating others, implementing allergy protocols, filling prescriptions, and often ridding their home of certain foods.

While all of these things are important, perhaps the most important action a parent can take is talking to their child about their allergy. After all, the child has a steeper learning curve to climb, and eventually must become their own advocate. 

If you are one of these parents, here are a few strategies to get you started:

Start simple.

Explain the allergy in age-appropriate terms. Discuss the difference between safe foods and non-safe foods. Take them to the grocery store and point out their allergen. Tell them why we read labels before we eat anything and why we don’t share food with friends. Information is education!  

Calmly explain a food allergy.

Though they may be little, it’s helpful to calmly discuss what an allergic reaction might look like and how it can make them feel. Most importantly, teach them that if they start to feel any of these symptoms to alert an adult right away.

Involve them in the process.

Take your child with you to train their teachers and caregivers. Create a routine around grocery shopping and checking labels.  Let them put their art supplies to work and create a reminder to place on your door to always pack emergency meds (epinephrine and anti-histamines) when leaving the house. Involving your child provides another layer of education. It’s also important to ensure that your child experiences as much “normalcy” as possible, as this can help them avoid feeling fearful.

Make it a part of your everyday conversation.

Food allergies affect the whole family, not just the child. Talk to them about their experiences. Help them to understand that a food allergy is a unique part of who they are. Role-play scenarios. Cook allergy-friendly recipes together. Don’t be afraid to have an open dialogue with your child! Remember, knowledge is power. An open dialogue will better prepare your food-allergic child to navigate the road ahead.

Support tools are key.

There are many tools and resources out there for newly diagnosed families. A great way to start is with a book. There are a great many allergy-themed children’s books out there, including Food Allergies and Me, Nutley the Nut Free Squirrel, and Blue: The Monkey who was Allergic to Bananas. You can also get them a medical ID bracelet—many brands now carry fashionable and fun medical jewelry. Or learn about allergies on TV! The beloved PBS Kids show Daniel Tiger's Neighborhood recently aired a great episode about food allergies.

Connect with others.

It’s helpful if you don’t try to go this alone—and you don’t have to: 1 in 13 children in the U.S. has a food allergy. There are numerous groups and support networks for families managing a food allergy. Many of these groups host allergy-friendly playgroups, share tips and recipes, and inform members of events for food allergy families.

Regardless of which approach you take, remember to strike a healthy balance between managing your child’s food allergy and ensuring that your little one takes advantage of all that childhood has to offer.

As a food allergy mom and Certified AllerCoach, I love talking with families about this topic. Feel free to reach out to me at mnohe@allergyamulet.com if you’d like to chat further!

- Meg and the Allergy Amulet Team

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