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Vital Signs

Summer 2010

Think You Have a Food Allergy? Maybe Not.


VS-Summer10-Food AllergiesAllergic reactions to foods — most often milk, eggs, soy and wheat, peanuts and tree nuts, fish and shellfish — account for some 30,000 emergency room visits and more than 200 deaths each year in the United States. Exposure to these foods may cause adverse reactions in the digestive or respiratory systems, on the skin or, in the most severe cases, anaphylactic shock or death. While some people are genetically predisposed to develop food allergies, environmental factors such as exposure to certain foods or medications in the perinatal period, as well as the composition of intestinal flora early in life, may also contribute to the condition, says pediatric allergist Maria Garcia-Lloret, M.D., co-director of UCLA’s Food Allergy Clinic.

But food allergies are not as common as most people think, according to Marc Riedl, M.D., who also serves as co-director of UCLA’s Food Allergy Clinic. “When asked, as many as 30 percent of people will say they have a food allergy, but we suspect the vast majority of these people don’t have a true, life-threatening food allergy,” Dr. Riedl explains. The National Institute of Allergy and Infectious Diseases estimates that food allergies occur in 6 to 8 percent of children 4 years of age or younger, and less than 4 percent of adults.

“There is tremendous stress and anxiety associated with perceived food allergies, and often these concerns are unnecessary and unfounded,” Dr. Riedl says. “It’s very uncommon, particularly in adults, to have long lists of true food allergies.”

Misdiagnoses often occur when people receive blood allergy tests for multiple foods, Dr. Garcia-Lloret says. In some cases, she explains, these tests may overestimate the body’s immune response to the antigen that causes a reaction. This may prompt some people to restrict their diets unnecessarily, which can increase financial burdens for families who believe they need to purchase expensive, specialized foods to avoid allergic reactions, and may also lead to nutritional deficiencies in children.

Dr. Garcia-Lloret recommends that people concerned about food allergies consult with an experienced allergist or immunologist, working in collaboration with a gastroenterologist and a dietician, to ensure accurate diagnosis and to receive advice regarding appropriate dietary modifications. She also encourages frequent retesting because children often outgrow allergies, particularly to milk, eggs, soy and wheat.

According to Dr. Garcia-Lloret, findings from preliminary clinical studies have also shown that food tolerance may be induced by progressively introducing small amounts of the problem foods, but currently the only proven treatment for a food allergy is to avoid the food. In case of accidental exposure, anyone diagnosed with a food allergy should carry and inject epinephrine (a small dose of adrenaline) and then seek emergency medical treatment.

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