Last fall, I came down with a severe case of hives that lasted for three weeks followed by a persistent upper respiratory infection that hung around until spring break. As a healthy, active 35-year-old, I couldn’t figure out why I wasn’t getting better. After a trip to the doctor, I discovered my diet was to blame. My doctor explained that no matter how closely you monitor your diet, count calories, and avoid processed foods, if you eat foods you are sensitive to, those foods can make you sick.
Results from a blood test indicated my body reacted negatively to bananas, peanuts, yeast (including the kind used to make beer), cocoa beans, coffee, almonds, all cows’ milk products, and egg whites. For sixty days I excised those items from my diet. After two weeks I slept better, awoke rested, and felt more energetic. After two months, I was thinking more clearly, my skin looked healthier, and my stomach was flatter. One by one I re-introduced these foods to gauge their effects and, happily, can still enjoy some of my favorites in moderation.
Food allergies are on the rise, impacting one percent of adults and seven percent of children, according to the Cleveland Clinic. Food intolerance is far more widespread. How can you tell if the foods you eat regularly are disrupting your sleep, affecting your fertility, weakening your bones? Read on to find out what may be causing your health problems and how food allergies inspired two Tidewater women to launch local businesses.
Jennifer Elizondo noticed that her 18-month-old son, Vaughn, had a patch of dry, irritated skin on his face that never went away. After learning that this could be a symptom of food allergies, Jennifer had Vaughn tested. He was diagnosed with soy and wheat allergies. When Vaughn was two, the Elizondos exposed him carefully to peanuts, another common allergen.
“When he first put the nuts in his mouth, he started pointing to his tongue,” Jennifer recalled. At age two, Vaughn could not articulate the tingling sensation on his tongue that is common for children with food allergies when they put an allergen in their mouths. According to Dr. Gary B. Moss of Allergy and Asthma Specialists, Ltd., “Toddlers will spit out food they don’t like and food they’re allergic to. It can be hard to tell the difference.”
Food allergies present in various forms. They can affect the skin, gastrointestinal tract, respiratory tract, and the cardiovascular system. Reactions range from mild to severe and include life-threatening anaphylaxis. Mild reactions consist of hives, eczema, redness of skin around the eyes, an itchy mouth or ear canal, nausea/vomiting, upper respiratory symptoms, and uterine cramping.
Symptoms of a severe reaction include significant swelling of the lips, tongue, and throat, difficulty breathing, shortness of breath, turning blue, loss of consciousness, chest pain, slowed pulse, and a sense of panic. In an anaphylactic reaction, allergic symptoms can affect multiple parts of the body and can impair breathing and blood circulation. Food allergies can arise within seconds of ingestion or up to two hours later.
The Elizondos turned to an allergist, and after more testing, they learned that in addition to soy, wheat, and peanuts, Vaughn was allergic to eggs and coconuts. After Vaughn’s diagnosis, life in the Elizondo home changed significantly. Ever since his diagnosis, they haven’t been able to go out for ice cream because of cross-contamination possibilities. When they dine at family or friends’ homes, Jennifer re-washes utensils to be on the safe side. When they eat at a restaurant, Jennifer brings Vaughn’s laminated food allergy card.
Jennifer struggled to prepare foods for her family that were safe for Vaughn. Allergen-friendly foods were not commonly stocked in grocery stores. As a result she started Navan Foods in 2007—now an online retail business that sells safe foods for those with allergies. Jennifer also blogs about parenting children with food allergies.
Both food and seasonal allergies are more prevalent today than a generation ago and continue to rise, says Dr. Moss. One possible reason is what he calls the “hygiene hypothesis,” which postulates that living in an extremely clean environment can make us more susceptible to allergies. Another theory is that the widespread use of BPA, a compound found in plastic, may contribute to the increase in food and seasonal allergies, says Dr. Moss.
TRIAL AND ERROR
Food allergy and food sensitivity/intolerance are vastly different. Food allergies directly impact the immune system. Nuts and shellfish (and wheat, dairy, eggs, soy, and more) can result in a trip to the emergency room or an outcome even worse. When the body’s immune system recognizes a food protein, an allergen, as a threat and attacks it like a bacteria or virus, serious reactions can occur. While almost any food can trigger an allergic reaction, eight foods are the culprits behind 90 percent of allergic reactions in the U.S.: peanuts, tree nuts, milk, eggs, wheat, soy, fish, and shellfish. According to Food Allergy Research and Education, food allergies result in an emergency room visit every three minutes.
Food allergies can be tested in three ways: skin test, blood test, and by food testing. However, skin and blood tests have limitations. Their results may indicate that a patient is allergic to a certain food, but they cannot demonstrate any threshold or level of reactivity. Only food testing can.
Food sensitivity/intolerance reactions occur in the digestive tract. The reactions are rarely immediate and occur after significant consumption of problem foods, not trace amounts like those that can trigger allergies. Symptoms of food sensitivity are: nausea, stomach pain, gas, cramps, bloating, vomiting, heartburn, diarrhea, headaches, fatigue, and irritability or nervousness. The identification of food sensitivity is often trial and error. If you suspect a food intolerance, start a food diary or log and note symptoms. If you are symptomatic only after eating dairy, for example, dairy may be a problem food. Blood tests are also available.
Treatment of food insensitivity involves restriction or elimination of trigger foods from your diet. Paying attention in the grocery store or while dining out is also required. Milk, for example, hides behind approximately twenty aliases including ammonium caseinate, casein, lactalbumin, lactate, lactoferrin, lactoglobulin, whey, and rennet. When it comes to food allergies and intolerances, common sense also plays a role. Said Dr. Moss, “If you feel worse when you eat a certain food, don’t eat it.”
Celiac disease, a food-intolerance disorder, is on the rise. According to the Mayo Clinic, celiac disease is four times more common now than 60 years ago and affects about one in 100 people. Celiac disease is an immune reaction to eating the protein gluten, and its cause is unknown.
When someone with celiac disease ingests gluten (a protein found in wheat, rye, and barley), her body launches an immune response that attacks the small intestine and damages the villi, the lining of the small intestine responsible for nutrient absorption.
Symptoms in adults include unexplained anemia, fatigue, bone or joint pain, arthritis, osteoporosis, depression or anxiety, tingling numbness in hands and feet, migraines, missed menstrual periods, infertility, canker sores inside the mouth, and itchy skin rash. Children with celiac disease are more likely to present digestive symptoms, as well as irritability and behavior issues and dental enamel damage to permanent teeth. A celiac disease diagnosis is two-part: a screening followed by an endoscopic biopsy. The only treatment for celiac disease is adherence to a gluten-free diet.
Concerns about ingredient safety and sources inspired another local business, Dr. Lucy’s, a bakery in Norfolk specializing in vegan-, gluten-, dairy-, peanut- and tree nut-free baked goods. Lucy Gibney, M.D., board-certified in emergency medicine, founded Dr. Lucy’s after her son was diagnosed with severe food allergies. She had “a deep concern” about food safety, including the ingredients that go into a product. Dr. Gibney opened a dedicated bakery that purchases ingredients only from known sources and then tests each ingredient for even trace amounts of gluten, eggs, milk, peanuts, and tree nuts.
During her shifts in the emergency room, Dr. Gibney treated plenty of children suffering from severe allergic reactions. “It’s a part of emergency medicine,” she said. “I’m sure I’d be seeing more now than I did then.” She advises anyone with food allergies or intolerance to focus on being prepared for an emergency, finding safe foods, and learning how to manage food allergies in social situations.
Making informed choices about food and safety for yourself or your child can be daunting. Talking with others who are dealing with food allergies can help. That’s why Dr. Gibney, together with Angela Hogan, M.D. started the Food Allergy Support Group of Tidewater (FASGOT) in 2007. It’s grown into an important resource for local parents and families coping with food allergies. At meetings you can learn about the latest research on food allergies and hear from experts about the social and emotional aspects of dealing with a food allergy in a family setting.
Teaching educators about food allergies has emerged as a primary focus for FASGOT. Before legislative requirements and resources became available for public schools, FASGOT’s founders worked with local public schools on best practices for handling food allergies. Now they are working with private schools and preschools.
Allergy therapy can provide hope for people with food allergies. While allergies to milk, egg whites, wheat, soy, and peanuts almost always occur in childhood, allergic reactions to tree nuts, shellfish, and fish can occur any time in life. Childhood-onset allergies are often outgrown, according to Dr. Moss, and allergy therapy can accelerate the process.
Often patients who are allergic to milk and egg whites can tolerate extensively heated milk and eggs in baked goods used in allergy therapy. “This treatment broadens [the patient’s] diet immediately,” Dr. Moss explained. “They can eat birthday cake, and if they incorporate those foods a couple of times a week, it will speed up their outgrowing it.” Most allergy sufferers have a threshold of tolerance before they experience an allergic reaction. Food testing and allergy challenging can increase those thresholds. As a result, someone who once had a reaction after a trace exposure will probably never be able to eat her own peanut butter sandwich, but may not be sickened by proximity.
While a diagnosis of a food allergy or sensitivity can be overwhelming for any individual or family, Dr. Gibney said, “You can do this.”
For more information on living with food allergies:
• Allergic Girl: Allergicgirl.com
• Kids with Food Allergies: kidswithfoodallergies.org
• Food Allergy Research and Education (FARE): Foodallergy.org
• Food Allergies Support Group of Tidewater (FASGOT): fasgot.com
• Dr. Lucy’s: drlucys.com
• Navan Foods: navanfoods.com
Kelly Sokol Avery, MFA, has been published in Connotation Press, The Quotable, and The Pitkin Review. She teaches creative writing at The Muse Writers Center in Norfolk.