8.7: Food allergies and intolerance

It is important to consider that certain foods or food groups can cause particular issues.

Allergies

A food allergy occurs when the body has a specific and reproducible immune response to certain foods. The body’s immune response can be severe and life threatening, such as anaphylaxis. Although the immune system normally protects people from germs, in people with food allergies, the immune system mistakenly responds to food as if it were harmful.

Eight foods or food groups account for 90% of serious allergic reactions in the United States: milk, eggs, fish, crustacean shellfish, wheat, soy, peanuts, and tree nuts.

The symptoms and severity of allergic reactions to food can be different between individuals, and can also be different for one person over time. Anaphylaxis is a sudden and severe allergic reaction that may cause death.⁴ Not all allergic reactions will develop into anaphylaxis. The following statistics are remarkable -

• Children with food allergies are two to four times more likely to have asthma or other allergic conditions than those without food allergies.
• The prevalence of food allergies among children increased 18% during 1997-2007, and allergic reactions to foods have become the most common cause of anaphylaxis in community health settings.
• Although difficult to measure, research suggests that approximately 4% of children and adolescents are affected by food allergies. Food intolerance and food allergies are also an issue for some school-aged children. Recent studies show that three million children under age eighteen are allergic to at least one type of food.

The CDC recommends that as part of maintaining a healthy and safe environment for children, caregivers should:

• Be aware of any food allergies.
• Educate other children and all adults that care for a child with food allergies.
• Ensure the daily management of food allergies.
• Prepare for food allergy emergencies,[1] by knowing how to use, and having an epipen.

An allergy occurs when a protein in food triggers an immune response, which results in the release of antibodies, histamine, and other defenders that attack foreign bodies. Possible symptoms include itchy skin, hives, abdominal pain, vomiting, diarrhea, and nausea. Symptoms usually develop within minutes to hours after consuming a food allergen. Children can outgrow a food allergy, especially allergies to wheat, milk, eggs, or soy.[2]

Anaphylaxis is a life-threatening reaction that results in difficulty breathing, swelling in the mouth and throat, decreased blood pressure, shock, or even death. Milk, eggs, wheat, soybeans, fish, shellfish, peanuts, and tree nuts are the most likely to trigger this type of response. A dose of the drug epinephrine is often administered via a “pen” to treat a person who goes into anaphylactic shock.[3]

Figure \(\PageIndex{1}\): An EpiPen used as first aid to anaphylactic shock of allergy.[4]

Intolerance

Some children experience a food intolerance, which does not involve an immune response. A food intolerance is marked by unpleasant symptoms that occur after consuming certain foods. An intolerance is best managed by making dietary changes and avoiding any foods that trigger the reaction.[5]

Lactose intolerance, though rare in very young children, is one example. Children who suffer from this condition experience an adverse reaction to the lactose in milk products. It is a result of the small intestine’s inability to produce enough of the enzyme lactase. Symptoms of lactose intolerance usually affect the gastro-intestinal tract and can include bloating, abdominal pain, gas, nausea, and diarrhea. It is interesting to note that as a child grows from infancy into early and middle childhood, the amount of lactase (the enzyme used to digest lactose in milk) produced by the body decreases. As the child is weaned from breastfeeding, tolerance to dairy decreases. A majority of the world's adults are lactose intolerant. However there are some genetic mutations (Handwerk, 2022) and cultural differences that might cause differences between different nationalities.

References:

Handwerk, B. (July, 2022). Why Did Europeans Evolve Into Becoming Lactose Tolerant? Smithsonian Magazine.

Attributions:

Child Growth and Development by Jennifer Paris, Antoinette Ricardo, and Dawn Rymond, 2019, is licensed under CC BY 4.0

[1] Food Allergies in Schools by the CDC is in the public domain

[2] Childhood University of Hawai’i at Mānoa Food Science and Human Nutrition Program by is licensed under CC BY-NC-SA 4.0

[3] Food Allergy Quick Facts. National Institutes of Health, US Department of Health and Human Services. Updated March 27, 2017. Accessed December 10, 2017.

Childhood University of Hawai’i at Mānoa Food Science and Human Nutrition Program by is licensed under CC BY-NC-SA 4.0

[4] Image by Sean William is licensed under CC BY-SA 3.0

[5] Lactose Intolerance. National Institute of Diabetes and Digestive and Kidney Diseases. Updated June 2014. Accessed December 4, 2017.; Childhood University of Hawai’i at Mānoa Food Science and Human Nutrition Program by is licensed under CC BY-NC-SA 4.0