Food Allergy Living Blog Tagged Results


allergy

Which came first: atopic dermatitis or food allergy?

Posted 3.17.11 | Rob McCandlish, RDN

In food allergy circles, we usually think of symptoms and side effects as results of food allergies, not the other way around. In most cases that’s true. Science has shown a strong link between food allergy and atopic dermatitis, a form of eczema. Last month Dr. Jon Hanifin, a respected dermatologist, gave a talk to colleagues discussing the link between atopic dermatitis and food allergies. The research he presented suggests that for some patients it may actually be atopic dermatitis that comes first and acts as a precursor to food allergies.

Atopic dermatitis is often one of the first signs that a parent or caregiver notices in their child which helps lead to the diagnosis of food allergy. As Dr. Hanifin explained, about 6-10% of children are diagnosed with atopic dermatitis, and of those about a third will be diagnosed with a food allergy. Which begs the question: If parents notice signs of atopic dermatitis first, and an allergy diagnosis comes later, couldn’t atopic dermatitis be causing some instances of food allergy?

What We Know:

-In cases of food allergy, offending foods cause reactions in the body which involve the immune system

-Immunoglobulin E antibodies (IgE) are immune substances which are normally in our bodies at low levels, but are higher with food allergy

-Allergy symptoms often involve the skin (including our digestive tract, which is like an inside skin), an important barrier that keeps most outside “things” from getting inside

-One factor of atopic dermatitis is “holes” in the barrier our skin provides

What Dr. Hanifin Proposed:

In the past it was assumed that food allergies came first, causing both high IgE levels and atopic dermatitis. Dr. Hanifin suggested that in some patients atopic dermatitis is caused by “gaps” in the skin (likely due to genetics), which means that foreign substances can enter the skin and cause adverse reactions. He thinks it may be proteins that get through these gaps which allows the body to become sensitive to certain foods, leading to a food allergy.

What does all of this mean? The biggest message here is that patients with atopic dermatitis, especially those under five years, should be tested for food allergies. While avoiding food allergens may not help improve atopic dermatitis, it could certainly prevent or improve other serious side effects of allergies. The second message is that more research needs to be done into the causes of atopic dermatitis and its relationship to food allergies. Any research that leads to better health, through reducing instances of atopic dermatitis and/or food allergies, is good research! Tell us about your experience: Was atopic dermatitis the first sign that you saw of your child’s food allergy?

- Rob


AAAAI Annual Meeting

Posted 3.15.11 | Sarah O'Brien

This weekend, March 18 – 22, we will be joining the best and brightest allergy and immunology experts at the American Academy of Allergy Asthma & Immunology (AAAAI) annual meeting in San Francisco, California.

AAAAI was established in 1943 and is the largest professional allergy and immunology medical organization in the United States. With nearly 6,500 members, AAAAI is made up of asthma specialists, clinical immunologists, allied health professionals and many others, all of who have a special interest in researching and treating allergic diseases.

Presenting new advancements and findings for allergy, asthma and immunology patients is the main goal of AAAAI and the annual meeting and we are looking forward to learning from the presentations at the conference. Some of the food allergy-related topics this year include:

  • The Food Allergy Guidelines: From Controversy to Consensus
  • What is New in Pediatric Allergy
  • Activation of the Innate Immune System by Allergens: How Allergic Reactions get Started
  • Living with Risk: Quality of Life for Families with Food Allergies

We’ll be sure to keep you posted on all of the fun and exciting things we hope to learn this weekend!

- Sarah


Allergies and Asthma: What’s the Link?

Posted 6.3.10 | Mallory West

You may have noticed that allergies and asthma often go hand in hand. Roughly, 70% of children with asthma have some type of allergy[1]. So do allergies cause asthma? Or does asthma cause allergies? The answer to both questions is no; one does not cause the other but the two conditions do have a strong connection.

Inflammation & Your Immune System

Allergies and asthma are both inflammatory conditions caused by dysfunction of the immune system. Sometimes they are referred to as “atopic diseases”. The immune system is the body’s defense to foreign invaders, such as bacteria, viruses, pathogens, fungi, etc. When the immune system detects these foreign invaders, it releases cells that seek out and destroy them. Inflammation is one of the first responses of the immune system to infection. Usually, the immune system keeps us healthy; however, a malfunctioning immune system can lead to illness. This is what happens with allergies and asthma.

Asthma vs. Allergies

With allergies, the immune system is hyperactive and produces an unnecessary inflammatory response to a traditionally harmless substance (such as a food protein). Asthma is a chronic lung disease characterized by episodes of inflammation and narrowing of the airway in response to certain "triggers." These triggers vary from patient to patient and may include infectious agents, exercise, stress, pollutants such as cigarette smoke, and common allergens such as cat dander, dust mites, and pollen.

Is there a link?

There are approximately 9 million kids in the US who have asthma[2]. Of this 9 million, about ¾ have asthma that is triggered by allergies. Remember, we talked about different triggers for asthma symptoms (exercise, pollen, allergens, etc.). Patients whose asthma is triggered by allergens are often said to have “allergic asthma”. [3] According to the Asthma and Allergy Foundation of America, allergic asthma is the most common type of asthma, affecting around half of asthma patients.

Does Genetics Play a Role?

Atopy refers to the genetic tendency to develop allergic diseases, such as eczema, allergies and asthma[4]. Someone with “atopy” produces certain antibodies associated with allergic disease. Genetics and environmental factors both contribute to whether a patient does or doesn’t develop atopic diseases. Not all people with atopy (that genetic predisposition) go on to develop allergic diseases because environmental factors play a role too; However, they are significantly more likely to. Likewise, not all people with atopic disease have atopy (but most do).

Genetics obviously plays a big role in the development of allergic diseases. If one parent has an atopic condition, their child has a 1 in 4 chance of having some form of atopic disease (not necessarily the same one as the parent)[5]. If both parents have an atopic condition, the child is more than 50% likely to develop an atopic disease.

Hopefully, this information gives you a better understanding of why asthma and allergies are so often seen together. While neither one causes the other, some people have a genetic predisposition which puts them at a greater risk for developing all forms of allergic disease (such as allergy, eczema and asthma). So if you have one allergic disease, you have a higher risk for developing other types of allergic conditions in comparison to the general population.

Have you found this to be true with your little ones? Be sure to share your experiences with us in the comments!

- Mallory


[1] World Health Organization. Global surveillance, prevention and control of chronic respiratory disease: a comprehensive approach, 2007.
[2]
The Nemours Foundation/KidsHealth®© 1995- 2010. http://kidshealth.org/.
[3]
American Academy of Allergy Asthma & Immunology.
[4]
Atopic Diseases in Childhood. Gold MS and Kemp AS. MJA 2005; 182 (6):298-304. [5] The National Eczema Association. http://www.nationaleczema.org/.


Recommended Reading: Coping with Allergies & Asthma

Posted 4.23.09 | Nutrition Specialist

I’ve been reading Coping with Allergies & Asthma, a magazine designed to aid allergy and asthma sufferers in taking a proactive approach to improving their quality of life. It’s a great way to get a quick update on what’s going on in the allergy community.

While the magazine has a lot of great content, one article in particular stuck out to me in the March/April issue that I wanted to share with you. The article, “Don’t Let Your Child’s Asthma or Allergic Illness Define the Family,” has a great message for all allergy parents — the emotional symptoms that come along with the physical symptoms of a food allergy can be just as hard, if not harder, to deal with.

The article offers the following tips to keep family allergy anxieties in check:

  • Focus on the normal elements of childhood;
  • Beware of transmitting anxiety to your children;
  • Have one medical hour a week to focus on the allergy; and
  • Reserve time for the allergy-free siblings.

Unfortunately, the articles aren’t available on the magazine’s Web site, but a table of contents is. You can see what else was in this issue of Coping with Allergies & Asthma by clicking here.

And to subscribe to the magazine, click here.

-Nita


The News Is Still Nuts About Allergies

Posted 1.8.09 | Nutrition Specialist

It’s a new year and it seems not much has changed in the news department — it’s still all about allergies! I just came across an article in Time magazine on allergies and Americans.

The article, called “Have Americans Gone Nuts Over Nut Allergies?” is very similar to the article from the US News & World Report that I blogged about a few weeks ago. This article is a bit different, however, because it covers both sides of the allergy argument: doctors that feel people are too worried about allergies and parents who feel there is never enough attention paid to allergies.

To read the entire article, click here. T

he way I look at it is the more articles that are written about allergies, the more people that are aware of them. And that is always a good thing!

Have you read any interesting allergy news articles lately?

- Nita


Water + Fruits + Vegetables = Allergies?

Posted 1.10.13 | Rob McCandlish, RDN


Most Neocate families pose the same question: Why is my child allergic to foods? Or another question common in food allergy circles: Why are more and more people being diagnosed with food allergies? There are many factors that contribute to food allergies, and no single cause can be identified that applies to everyone. But some new research has addressed one of these factors in detail, and it points to several sources, one of which may come as a surprise: tap water.


Microbes, Pesticides, and Allergies

If you’ve taken your child to see an allergist, you may have heard several theories about allergies. The simple version of one theory is that children today spend less time in the dirt, so get less exposure to the environment, and therefore are more likely they are to develop allergies. Or at least that’s the general idea! Past research has also linked pesticides with allergies, but it wasn’t always clear whether it was the presence of pesticides or the absence of bugs (or both) that contributed to allergies.
 

New Research

Dr. Elina Jerschow is both a professor and a practicing physician in New York. She and several of her colleagues recently published new research into the association between certain chemicals and food allergies. These particular chemicals, termed dichlorophenols, are commonly used in pesticides and weed killers. They may also be present in tap water, either coming from the environment or as byproducts of chlorine compounds. Adding chlorine is one of the most effective ways to ensure that tap water does not contain harmful bacteria.

Dr. Jerschow and her colleagues pulled data on over 2,000 Americans from an ongoing, national collection of health and nutrition data. They specifically looked at levels of dichlorophenols in urine, and compared this to whether or not participants had allergies. The results showed that individuals with the highest urine dichlorophenol levels were almost twice as likely to have at least one food allergy. You can find a summary of the article by CBS here. The research was published in the Annals of Allergy, Asthma and Immunology in December and both a free summary and a link to the full research article, available for purchase, can be found here.
 

Implications

Sometimes we draw incorrect conclusions from research. In this case, we see that people with higher levels of dichlorophenols in their urine are more likely to have food allergies. This doesn’t prove that dichlorophenols cause food allergies, but it does suggest that people with higher exposure to these chemicals are more likely to have food allergies. It could be that dichlorophenols reduce numbers of bacteria in our gut, which may raise the risk of developing food allergies. No association was found between dichlorophenol exposure and environmental allergies.

Avoiding dichlorophenols may not prevent food allergies. However, some people may prefer to try to avoid exposing themselves to high levels of dichlorophenols and pesticides in general. To do so, key steps you can take would be to avoid fruits and vegetables treated with pesticides and to limit consumption of tap water, either straight from the tap or from bottled water that originated from a municipal water supply. If your family drinks tap water, you can let the water sit out, preferably refrigerated in a clean container, for several hours. This gives much of the chlorine in the water time to evaporate, though it may not reduce any dichlorophenols present. You can also use a filter that removes chlorine, but again, we don’t know if household water filters remove dichlorophenols.
 

Do you think that you or any members of your family may change your food or water habits because of this research?

- Rob


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Will My Child Outgrow Their Cow Milk Allergy?

Posted 5.24.17 | Christine Graham-Garo


When children are diagnosed with milk allergies, parents might wonder, “Will my baby grow out of it?” As much as your new hypoallergenic formula and allergen-friendly diet is helping, you can’t help but wonder when you can feed your child without anxiety. Keep in mind, it’s normal to wonder!

Good news – Many children do outgrow their allergies; however, it may depend on what the child is allergic to and the type of allergy they have. Most importantly, keep in mind that all children are different!

Children with cow milk allergy (CMA) may be more likely to outgrow their allergies than their peanut or tree nut allergy buddies. One research study showed that 80% of kids diagnosed with a CMA will outgrow their allergy by 16 years of age[1]. More specifically, other research studies have found that about 45-50% of children outgrow CMA at one year, 60-75% at two years and 85-90% at three years.[2],[3]

Fortunately, the general consensus is that around 80% of children with cow milk allergy will outgrow it by 3-5 years of age[5]. Regular follow up by your medical specialist is important to re-test tolerance of cow milk protein.[6]

Now, compare that to the studies which show that about 20% and 10%, respectively, of young patients may outgrow peanut and tree nut allergies and approximately 8% of patients who outgrow a peanut allergy will later relapse, meaning the allergy comes back. Additionally, nut-related allergies are typically more severe and more likely to be fatal, which is quite scary![3]

For example, if your little one has multiple food allergies, such as both CMA and tree nut allergies, he or she may outgrow the CMA while the tree nut allergy could still persist. Still, outgrowing an allergy to cow milk will expand their diet and improve the quality of life and available foods for your little one.

Now this may be “good news/bad news” for some families. The good news is that the chance of the cow milk allergy being outgrown is very good, even if the child has the allergy into their teenage years, they are still likely to outgrow it. The bad news is that some infants with CMA may have it into their early teenage years, and a handful may never outgrow it.

The other factor that may influence your little one’s chances of outgrowing a food allergy is the levels of allergen-specific IgE detected in their blood. This means, the lower the allergen-specific IgE detected, the greater the chance of outgrowing the allergy. Your doctor can monitor this - make sure to ask them to explain the results, show you have the level has changed over time, and explain what the possible implications are.

As mentioned before, all children are different. Your little one may have all the right “ingredients” to overcome their cow milk allergy, but there is no way to know exactly when he or she will outgrow it. Your doctor may decide to attempt a food trial by introducing some foods that your child is allergic to, in order to see if the allergy still persists. Be patient, sometimes food trials can be taxing.

Our advice to allergy parents is not to worry, there is usually a light at the end of the tunnel! It’s wonderful if a child can outgrow their cow milk allergy, but if not, they can still thrive and lead happy, healthy lives.

To the more experienced food allergy parents, can you shed any advice on food trials and outgrowing allergies? Comment below or share your thoughts with us on our Facebook page!


[1] Skripack et al, J Allergy Clin Immunol. 2007

[2] de Boissieu D, Dupont C. Time course of allergy to extensively hydrolyzed cow's milk proteins in infants. J Pediatr 2000;136:119-20.

[3] de Boissieu D, Dupont C. Allergy to extensively hydrolyzed cow's milk proteins in infants: safety and duration of amino acid-based formula. : J Pediatr. 2002;141:271-3.

[4] The natural history of peanut and tree nut allergy. Fleischer DM. Curr Allergy Asthma Rep. 2007 Jun;7(3):175-81. Review.

[5] March 2016.  Cow’s milk (dairy) allergy, Australasian Society of Clinical Immunology and Allergy, [http://www.allergy.org.au/patients/food-allergy/cows-milk-dairy-allergy] Viewed 6 May 2016

[6] Motala & Fiocchi, 2012, Cow’s milk allergy in children, World Allergy Organisation, [http://www.worldallergy.org/professional/allergic_diseases_center/cows_milk_allergy_in_children/] Viewed 15 May 2016



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Food Allergy Living is a resource for parents of children with food allergies, brought to you by Nutricia, the makers of Neocate. For more in-depth information about our purpose & authors, see our About Food Allergy Living page.