As the year-end holidays approach, food is on everyone's mind. Some will wonder if this dish or that dish will make them gain weight or increase their cholesterol level. These are relatively trivial concerns, though, for those with a food allergy who must remain vigilant that the next bite might cause them to stop breathing.
People with food allergies are often portrayed on television and the movies as the ultimate party-poopers, sniveling twits ruining dinner parties and cocktail hours with their petty concerns about shellfish. These are the losers who made airplanes get rid of peanuts, right?
Why couldn't they be allergic to those rock-hard airplane dinner rolls or parents with screaming infants? I wouldn't mind that kind of ban.
Yet food allergies and food intolerances are remarkably widespread and are now seen as the underlying cause of a variety of ills, from hives and coughing to less obvious symptoms such as nausea, headaches and sluggishness, which can go misdiagnosed for years.
Like allergy sufferers themselves, the field of allergy research was long marginalized until only recently, as described in a new book by Dr. Scott Sicherer called "Understanding and Managing Your Child's Food Allergies." There was an acknowledgement that food could cause violent reactions, Sicherer said, but little scientific evidence was available linking a patient's symptoms to food. A headache, for example, can be triggered by many causes.
This changed in the 1980s when rigorous scientific studies were performed to identify cause and effect. Today, the Jaffe Food Allergy Institute at Mt. Sinai Hospital in New York, where Sicherer works, estimates that more than 11 million Americans have food allergies and many more have severe intolerances to dairy products, certain proteins and food additives.
As research continues, the next step for folks like Sicherer is to gain respect for allergy sufferers, who as children are bullied and teased, and who as adults are accused of being weak, finicky or just simply imagining their symptoms.
The main offenders
The most common foods triggering allergic reactions are nuts, legumes (such as peanuts and soybean), egg, milk, wheat and shellfish. The primary cause for the allergy is a trigger-happy immune system trying to do its best to protect the body against harmful substances.
One way the immune system works is by producing proteins, called immunoglobulin antibodies, that recognize foreign invaders amidst all the food we digest, and attack and destroy them. For reasons still unknown, one type of antibody, called IgE, can be hypersensitive to certain foods and attack them as if they were harmful.
IgE activity makes up the bulk of allergic reactions, although there are other pathways.
Children with allergies are more easily diagnosed than adults are. Partly this is because there are few other ways to explain the common symptoms such as rashes, lip swelling, vomiting, diarrhea, abdominal pain or breathing problems. Pediatricians these days are educated about allergies.
Not so with adults. A doctor might more readily attribute such symptoms to stress, poor diet, poor lifestyle or something that's just in the patient's head. This is particularly true with Celiac disease, an intolerance to gluten, a protein found in wheat, and similar proteins in rye, barley and other grains. Most people with this disease—estimated to affect 1 in 100 persons—live for years not knowing what is making them so sick, be it irritability or painful abdominal cramps.
Admittedly this is a tough diagnosis for both doctors and patients unfamiliar with the ubiquity and seriousness of food allergies. It's tough to avoid gluten; this is an underlying component in the American diet. So a sufferer will try numerous fixes, shunning dairy products or popping antacid tablets, for example, before finally stumbling upon an educated doctor who can administer a simple Celiac disease test.
Allergies on the rise
The prevalence of food allergies appears to be on the rise, according to Jaffe Institute research. Greater awareness means more diagnosis. Yet something about the modern food production system—perhaps more processed foods or an overabundance of certain proteins like gluten that tax the immune system—is causing more and more children and adults to suffer from allergies.
As doctors become more educated about this emerging problem, misdiagnoses will hopefully go down. Similarly, it is not ludicrous to investigate whether your own health problems, such as migraines or persistent coughing, might be related to otherwise healthy food.
Meanwhile, allergy sufferers would like it to be known that they can take care of themselves at a party and know what to avoid to stay healthy. All the more shrimp for me, as far as I'm concerned.
Christopher Wanjek is the author of the books “Bad Medicine” and “Food At Work.” Got a question about Bad Medicine? Email Wanjek. If it’s really bad, he just might answer it in a future column. Bad Medicine appears each Tuesday on LIveScience.
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Christopher Wanjek is a Live Science contributor and a health and science writer. He is the author of three science books: Spacefarers (2020), Food at Work (2005) and Bad Medicine (2003). His "Food at Work" book and project, concerning workers' health, safety and productivity, was commissioned by the U.N.'s International Labor Organization. For Live Science, Christopher covers public health, nutrition and biology, and he has written extensively for The Washington Post and Sky & Telescope among others, as well as for the NASA Goddard Space Flight Center, where he was a senior writer. Christopher holds a Master of Health degree from Harvard School of Public Health and a degree in journalism from Temple University.