What’s the big deal about food allergies? The simple answer: life or death.
Updated: May 25, 2022
In Australia and New Zealand, the occurrence of food allergy is at its highest peak, with allergies now estimated to effect around 1 in 5 people: including 10% of infants (1 in 10), 4-8% of children (1 in 20) and 2% of adults (2 in 100). Reactions to allergens can vary from mild to severe (life-threatening anaphylaxis) which is why everyone, whether they have allergies or not, should be aware of food allergy management to ensure everyone around them can eat safely and enjoy their food.
Allergy and Anaphylaxis Australia have developed the Food Allergy Awareness Week initiative to get the conversation started and invite Australians to learn and connect through food, education and advocacy for our fellow Aussie’s living with allergies. So, let’s start talking!
Here is all you need to know about food allergies, intolerances and some helpful nutrition tips for those living with food allergies.
What are allergies?
An allergy occurs when the body’s immune system overreacts to a normally harmless substance, known as an allergen. Allergens can be found everywhere – they may be hidden in medications, naturally occurring in the environment (e.g. grass, animals, dust and mould) in chemical or cosmetic products or in the everyday foods we eat. When the body is triggered by an allergen, antibodies called Immunoglobulin E (IgE) are produced and histamine is released. This can lead to symptoms known as allergic inflammation, characterised by itching, swelling, watery eyes/nose, hives and breathing difficulties.
Signs and symptoms of food allergies:
The immune response that triggers an allergic reaction can show various symptoms and complications, ranging from mild reactions to severe, life-threatening conditions (anaphylaxis). Symptoms can range depending on where the allergen enters the body (e.g. when you are exposed to pollen in the air (hay fever) will often result in itchy/watery eyes, nose and throat). Food allergy reactions are often more prominent and can affect all areas of the body as the allergen is ingested.
Signs to look out for include:
Swelling often seen in the lips, face and eyes as well as the tongue. People can report a swelling or tightness of their throat
Skin hives, excessive itching, or welts
Digestive vomiting or abdominal pain. Reflux or diarrhoea are less common but can occur.
Respiratory changes to voice, difficulty breathing, cough or wheezing
Physical and neurological in children particularly, floppiness or pale pallor can occur, people can become dizzy or collapse
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What are the most common food allergies?
Food Standards Australia & New Zealand (FSANZ) have declared the 10 most common allergies impacting our nation to be:
Tree Nuts (e.g. cashew)
As a part of food labelling law in Australia, all packaged foods must declare these allergens if they are present in the ingredients, as well as any traces or risk of contamination in the additives or manufacturing process.
Reactions can be heightened if a large amount of the allergen is eaten, if it is eaten solely, in a liquid form (quicker digestion and absorption) or is eaten around the same time as exercise.
What about intolerances? Are they the same as allergies?
Food allergy and intolerance are not the same. Food allergy is an immune response and can be life threatening, compared to food intolerance which is a chemical response that some people have after consuming certain foods. Symptoms of food intolerance usually occur hours after ingestion of a trigger food, compared to food allergy which can be seen within minutes. Intolerance occurs when a certain substance in a food irritates the digestive system, or can also come about when these compounds are unable to be digested and absorbed properly (e.g. lactose intolerance due to a lack of lactase enzyme in the digestive tract). Although intolerances are not allergies, they can cause discomfort and effect overall health and wellbeing.
The most common foods/fluids that are linked to food intolerance include:
Lactose found in cow’s milk and dairy foods
Fructose found naturally in fruits and some vegetables
Polyols natural sugars in some fruit/vegetables and artificial sweeteners
Caffeine found in coffee, tea, dark chocolate and cola drinks
Artificial preservatives (e.g. sulphites often used in dried fruit and benzoates (used in soft drinks)
Symptoms to look out for include:
Digestive abdominal pain, cramping, gas, reflux/indigestion, bloating, diarrhoea and/or constipation, vomiting, nausea
Skin hives, rashes or excessive itching
Neurological headaches or brain fog, irritability, nervousness
To add to the confusion, there are also many other reactions to foods that are not classified as an allergy or an intolerance. An example of this is coeliac disease which is an auto-immune response to gluten. Coeliac disease does not lead to anaphylaxis and therefore, is not classed as an allergy; however, it does still involve an immune response. (click here read more about Coeliac disease: The gluten-free lifestyle).
How can a dietitian help?
The treatment of food allergies is often put simply in the medical world – cut it out and avoid it! However, eliminating foods (particularly in people with multiple allergies or intolerances) can be daunting, difficult to navigate, create fear and confusion and impact overall nutritional adequacy of one’s diet.
When people (particularly children) are allergic to foods such as eggs, milk, wheat and/or soy, it can prevent them from meeting their nutrient targets (e.g. calcium), create food aversions (from food avoidance), limit variety and reduce food enjoyment.
Seeking dietary advice from an Accredited Practising Dietitian (APD) is recommended to ensure a nutritionally balanced and pleasurable diet can be achieved and maintained in the long-term. Your dietitian will be able to provide information and resources to help you navigate food labels, offer suitable food/fluid alternatives to increase variety in your diet, prevent nutrient deficiencies from food avoidance and promote adequate growth and development (in children).
Tips and tricks to managing your food allergies!
1. Read labels
FSANZ have made allergy labelling easy in Australia and New Zealand, with all the 10 common food allergens labelled in the ingredients list (usually bolded) AND in the allergen statement on the packet. Depending on the severity of your allergy, the “may contain” * statement may also help you decide whether the risk of cross contamination is suitable for you or not. Claims on food packets (e.g., nut free, dairy free, gluten free etc.) are also useful and food manufacturing companies follow rigorous laws and procedures to ensure allergen statements are correct so you can have peace of mind knowing the food is safe for you to consume.
It is important to note to always read food labels every time you purchase a product. Even if you think you know that food is safe, check the label as ingredients and manufacturing processes can change.
*note: may contain statements are not required by law.
2. If in doubt, throw it out!
Eating out, edible gifts, social gatherings, buffets and homemade treats are all fun, sociable events that are part of life – but can be extremely daunting for people with food allergies. Always quiz your waiter, family, friends, chefs or people who have supplied the food about its ingredients and the manufacturing process and if they are unable to put your suspicions at ease, steer clear.
Call ahead at restaurants and takeaway venues and remember to always disclose your allergy to the staff when arriving and when your meal is placed in front of you. Viewing the menu online to see how they label their dishes with allergen statements is also helpful.
3. Educate and collaborate
Make sure your family, friends, caregivers, work colleagues and health care providers are all aware of your food allergy(s). Provide allergy action plans and/or first aid plans (where required) to ensure everyone around you is up to speed with the treatment plan if you were to be exposed to an allergen in their company/care. The Australian Society of Clinical Immunology and Allergy (ASCIA) have a multitude of resources and action plans available to you.
Connecting with others via support groups (online and in-person) and membership of governing organisations (e.g. Coeliac Australia) can give you a forum and opportunity to discuss and share information with others in the same boat as you.
For food service staff within aged care and child care centres, OSCAR Care Group have a Food Allergy Awareness training session coming up in June 2022. With a food safety focus, this training sessions will be ideal for one preparing food for someone with an allergy.
The severity and anxiety surrounding food allergies can be daunting for allergy sufferers and their family/friends; however, it is important to know there is an abundance of support and help to assist you in managing it. Speak with your Accredited Practising Dietitian, GP and immunologist for more information and don’t forget…if you have to cut the soy there’s still plenty to enjoy! 😊
By Lauren Goffredo, Accredited Practising Dietitian for OSCAR Care Group