Understanding Common Food Allergies What Makes Your Tummy Ache – And Why

That bite of ice cream is dreamy, but will you pay for it later with a headache, stomachache, itchy skin or constricted airways? You’re probably one of a growing number of Americans with common food allergies or intolerances. To mark Food Allergy Awareness Week, learn how to sort out your symptoms and their causes... More than 12 million Americans have food allergies; millions more have food intolerances. What’s the difference? In short, allergies can be deadly; intolerance often is a digestive problem, more annoying than serious. But how do you know which you have, and what can you do about it? Here’s an exclusive Lifescript guide: Allergies A true food allergy is the body’s “mistaken notion that a food is an invader or an attacker,” says Clifford Bassett, M.D., medical director of Allergy and Asthma Care of New York. The immune system snaps into fighting mode. It produces a protein called IgE (immunoglobulin E) that attaches to blood and other cells and sends out histamine and other chemicals in a futile attempt to protect the body. The chemicals cause itchiness, hives, breathing difficulties, tightness in the throat and swelling of the tongue and face. In extreme cases, a reaction causes death. The incidence of food allergies has doubled in the U.S. in the last 10 years. The reason, experts say, may be our successful war against germs. “Early exposure to germs and multiple pets are actually thought to benefit and strengthen the immune system,” Bassett says. So what can you do? Learn the foods that might harm you and avoid them, Bassett says. If you slip up, a doctor can prescribe a fast-acting antihistamine and an epinephrine auto-injector to carry with you in case of accidental exposure. Epinephrine treats the rare but dangerous drop in blood pressure and breathing problems. So you know what to do if you have a severe reaction, but how can you tell what you’re allergic to? That’s not easy. Patty Meyerson, a fourth-grade teacher in Newport News, Va., discovered her daughter Melissa’s allergy by accident. Grabbing at the cup, the 5-month-old spilled formula on herself, and a rash formed instantly. More sips of formula triggered more rashes and vomiting. The diagnosis? A milk allergy that may last a lifetime. Children often outgrow allergies, but adults rarely do. Even at age 15, Melissa still has to avoid all milk-containing products. Any food can cause an allergy. But eight – milk, eggs, peanuts, tree nuts (such as almonds, hazelnuts and walnuts), fish, shellfish (such as shrimp, lobster and crab), soy and wheat – cause 90% of all food-related allergic reactions. Sesame seed allergies are also increasing, Bassett says, especially in Asia and the Middle East. Peanut and tree nut allergies are the most likely to be life-threatening. As Meyerson knows, allergies can be inherited. She’s allergic to peanuts. Her siblings and parents have food allergies too. “It makes family gatherings a challenge,” she says. “We’re all allergic to something different.” If you have one parent with an allergy, you have a 25% chance of developing any food allergy, not just the one your parent has. If two parents have allergies, at least half their children will develop them. So how can you tell what’s causing your allergy? Get ready to play detective, because allergens are sneaky. When Melissa was a toddler, Meyerson gave her a bite of a chocolate bar. Melissa immediately started rubbing her eyes, a classic sign of an allergic reaction. The culprit? Milk in the chocolate. Another time she reacted to canned tuna. It was the family’s usual brand, but this can contained casein, a milk protein. The sources can hide even deeper. Bassett discovered that a patient’s morning coffee was worsening his seasonal allergies. “He was drinking a lot of hazelnut-flavored coffee, and hazelnut cross-reacts with birch or tree pollen,” Bassett says. A cross-reaction occurs when the body’s immune system mistakes a certain food protein for a pollen protein. In this case, hazelnut proteins were mistaken for tree pollen, which the patient was allergic to. One-third of patients with seasonal allergies have oral allergy syndrome: They react to fresh fruits, vegetables and nuts because an airborne allergen-like tree pollen cross-reacts with protein in food. The upshot? A tingling mouth and lips and an itchy tongue and throat. Even a kiss can set off a reaction, as Meyerson learned firsthand. After a smooch with her husband triggered itchiness on her lips and face, she found out he had eaten peanuts earlier in the evening. The solution? Delay displays of affection for at least four hours after eating a food your sweetheart is allergic to, advises the Food Allergy and Anaphylaxis Network. Allergens have non-food sources too. Lotions and other beauty products might contain milk, soy or nut compounds. One of Bassett’s young patients who is allergic to peanuts had a bad reaction each time she came near her dad. They blamed peanut compounds in his shaving cream. Where else can allergens hide? Milk: In deli meats, nondairy whipped topping, grilled restaurant steaks Eggs: In pasta Peanuts: In Asian food, ice cream, baked goods Tree nuts: In BBQ sauce, cereals, crackers Fish/shellfish: In salad dressings, steak sauce Soy: In sauces, soups, peanut butter, cereal Wheat: In hot dogs, imitation hot dogs, ice cream Food Intolerances Unlike allergies, food intolerances are not life-threatening. Symptoms often occur long after you’ve eaten – even the next day. And they’re vague, ranging from bloating and diarrhea to headaches and lethargy. Although the immune system is sometimes involved, the protein IgE is not. Any food can cause intolerance and it can start at any age. But with intolerance, you may be able to eat small amounts of the offending food, like a scoop of ice cream, without a reaction. Lactose intolerance – the inability to digest milk sugar – is common, affecting as many as 50 million Americans. If your body doesn’t make enough of the enzyme that breaks down lactose, this milk sugar lingers in your gut, causing uncomfortable gas, stomach rumbling and frequent sprints to the bathroom. Here are common intolerances that may trigger reactions: Lactose intolerance Reactions: Gas, bloating, abdominal discomfort, diarrhea Sources: Milk, yogurt, ice cream, sour cream and other dairy foods MSG (monosodium glutamate) intolerance Reactions: Headache, flushing, chest discomfort Sources: Canned soups, processed meats, Asian restaurants, frozen meals, packaged flavor enhancers Sulfite intolerance Reactions: Severe constriction of the airways in people with asthma Sources: Red wines, dried fruits and packaged foods (added to prevent browning or mold growth) Histamine intolerance Reactions: Headache, flushing, runny nose, diarrhea Sources: Some wines, cheese, tuna, mackerel Gluten intolerance Reactions: Gas, bloating, abdominal discomfort, diarrhea Sources: Wheat, rye, and barley, beer, salad dressings, cold cuts, hot cocoa mixes and canned soups Whichever you have - allergy or intolerance - work with your doctor to identify the foods that trigger a reaction, learn where they lurk and avoid them as you would a patch of poison ivy. The following chart will help you sort out your symptoms and their causes: What's the difference? Food Allergy Food Intolerance Symptoms Frequently causes a rash or hives to develop quickly. Includes swelling of the lips, tongue and face. Respiratory symptoms include runny nose, scratchy throat, coush, shortness of breath, and/or asthma. Gastrointestinal problems include vomiting, abdominal cramps, and diarrhea. People sometimes feel dizzy and a sense of impending doom. Headache, stomachache, bloating, vomiting, diarrhea. Timing of symptoms Begin within minutes to several hours after ingestion. Begin an hour up to a day afterward. Amount of food eaten Any amount causes symptoms; symptoms occur consistently. May be able to tolerate small amounts; sometimes no symptoms. Treatment Avoidance. Medications for accidental exposure. See an allergist and a registered dietitian. Limit amount consumed. See a gastroenterologist and a registered dietitian.