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What are Food Allergens?
An allergen is a substance that triggers an allergic reaction. They are normally benign substances present in the environment, food, or medication that the body wrongly identifies as dangerous.
This allergic reaction can be life-threatening, a condition known as anaphylaxis, and requires immediate medical attention.
In the case of food allergens, the substances that the body reacts to are food particles, usually the proteins found within the food. This is why the majority of food allergens contain high amounts of proteins, such as nuts, crustaceans/mollusks, fish, and eggs.
People who react to food allergens are considered to have food allergies.
Mechanism of action
The allergic reaction is caused by a hypersensitive immune system that sees benign food allergens as a threat to the body (Dougherty et al., 2023). Once such an allergen comes into contact with the body, it triggers a cascade of biological immune responses similar to those found in bacterial and viral infections.
This cascade happens as follows:
- The body comes into contact with a food allergen. This exposure can happen by touching and/or eating it. If an individual is highly sensitive to an allergen, then inhaling the food allergen may be enough to cause a life-threatening allergic reaction. The first exposure may not cause an allergic reaction but rather prime the body to react to the next exposure.
- This allergen binds to antigens on specific white blood cells, the B cell lymphocytes, and T helper cells, which results in the formation of allergen-specific immunoglobulin E (IgE) antibodies.
- IgE attaches itself to the surface of basophils and eosinophils, white blood cells, and mast cells, in tissues. If this is the first exposure to the allergen, these IgE prime the body to have an allergic reaction on the second exposure. This initial exposure can be done through direct contact or through breast milk in young children.
- When an allergic reaction is initiated, the allergens activate the allergen-specific IgE and cause the granulation, or destruction of the cellular membrane, of the affected cells.
- Histamine, the main chemical responsible for an allergic reaction, is released as a result of the granulation along with other biochemicals and hormones involved in inflammation, vasodilation (widening of blood vessels), and bronchoconstriction (constriction of the airways).
- The flood of biochemicals and hormones leads to the typical symptoms of an allergic reaction. It may affect several areas of the body, including the eyes, nose, mouth, and lungs.
Symptoms
The symptoms associated with being exposed to a food allergen usually manifest within a few minutes but can take up to two hours.
In rare cases, the reaction is delayed for several hours after the exposure. This delayed reaction can be dangerous in children and/or toddlers, as they might be asleep when the symptoms first manifest.
The symptoms associated with food allergies are:
- Tingling/itching of the mouth/throat
- Difficulty breathing: shortness of breath, wheezing, chest/nasal congestion
- Blue lips and/or fingernails
- Swelling of the lips, tongue, face, throat, and/or exposed parts of the body
- Hives, rash, or eczema where the skin was exposed to the food allergen
- Gastrointestinal pain/discomfort
Please be aware that in children, toddlers, and newborns, these symptoms may not be easy to spot and may be accompanied by:
- Crying
- Increased irritability
- Reduced sleep
- Trouble focusing
- Repetitive rubbing around the nose and eyes
- Ear pressure/pain/infections
- Upset stomach/Gastrointestinal issues
- Nausea/vomiting
If you have any or a combination of the following symptoms, please call 911 or have someone bring you to the nearest emergency department:
- Shortness of breath/difficulty breathing
- Excessive swelling of the lips, mouth, nose, or eyes
- Sudden difficulty swallowing/talking clearly
- Blue lips and/or fingernails
- Feeling faint or exhausted
- Sudden redness/heat over your arms, face, and legs
- Nausea/vomiting
- Dizzy/vertigo spell with no known cause
- Hearing your pulse in your ears
- Rapid and weak heart rate/pulse
- Pins & needles/tingling sensation in your hands, feet, or scalp
These are signs of a dangerous allergic reaction that require immediate medical care. If you have a prescribed emergency medication, take it immediately as you wait for the ambulance or to be driven to the emergency clinic.
Common Food Allergic Triggers
The Canadian Food Agency requires that the following allergens, which cause about 90% of all food allergy reactions, be clearly indicated on food labels and menus (Priority Food Allergens – Food Allergy Canada, 2020).
- Nuts, including all products derived from them.
- Fish
- Crustaceans/mollusks: also known as shellfish, these are water creatures that have a shell of some kind.
- Eggs and egg-derived products. Some vaccine manufacturing processes involve exposure to eggs; as such, if an individual reacts to egg allergens, they are advised to discuss the vaccine with their medical team before receiving one.
As of 2010, research has shown that most vaccines are safe for individuals with egg allergies (Chung et al., 2010). Health Canada agrees with the current research on the safety of vaccines (Health Canada, 2016). - Milk
- Mustard and mustard-derived products
- Sesame and sesame-derived products
- Soy and soy-derived products
- Wheat and wheat-derived products
- Triticale: This is a hybrid grain resulting from wheat and rye.
- Sulphites: a substance that can be naturally found in foods but is most often used as a preservation agent. It might be labeled as something other than “sulphite”. For a full list of alternate names, please consult this list.
Coping with Food Allergies
Having a food allergy can make daily life hard, especially when a person is first diagnosed (Harvard Health, 2013; Day-to-day Management – Food Allergy Canada, 2019). Here are some tips on how to cope:
Always read the label: Health Canada has very strict regulations on labeling and declaring the presence of the most common food allergens, called “priority allergens”. This means that they must include priority allergens in their labels in plain language. However, companies are not required to indicate if their food could contain allergens due to cross-contamination. While many companies do so, it is important to be careful when eating food that comes from a company that also creates food with your allergen.
If you aren’t sure whether a product has an allergen or might be cross-contaminated, do not eat it. Many companies will gladly answer a call or email on this issue.
Keep in mind that recipes may change without warning as companies replace ingredients within their factories. As such, always read the label every time you buy a food product.
Food labeling requirements do not extend to non-food products such as beauty products, vitamins, or pet food. As such, these products may contain food allergens not marked on the label. Contacting the company will allow you to determine if the product contains a food allergen.
Do not buy from bulk bins: Bulk bins can be easily cross-contaminated by staff or clients. As such, never buy from bulk bins, no matter how they may be labeled.
Be clear about your allergy requirements when eating out: Restaurant kitchens and/or bars are places where cross-contamination may easily occur.
Furthermore, not all restaurant staff may be aware of the ingredients used in a dish. As such, always be clear and firm about your allergies and ensure that the kitchen/bar staff sanitize all utensils and cooking areas when preparing your food.
Practice good kitchen hygiene: When cooking for yourself or someone who has an allergy, always cook the allergen-free food first to prevent any allergens from transferring to their meal.
Clean your utensils and cooking surfaces regularly. This should be done immediately before and after cooking. You may need to do it more often depending on which food allergies are present in your family/friends. It is also recommended to have two separate sets of utensils when possible. One for regular meal preparation and one exclusively for allergen-free food preparations. This includes kitchen towels.
Keep food allergens, or products that may contain them, away from allergen-free foods.
Be prepared for an emergency: Create an emergency plan in advance. This will allow you and/or your family members/friends to know what to do if there is food allergen exposure. Always carry any prescribed emergency medication and teach those around you how to use it safely.
As climate change has increased the risks of wildfires, floods, and other natural disasters, it is important that information on allergies as well as emergency medications be included in any emergency bags.
Consider having a medical alert bracelet: Medical alert bracelets are an easy way for people to identify if you have an allergy and to what. These bracelets are available in most pharmacies.
Anxiety and therapy: As with most chronic health conditions, it is normal to develop anxiety or have any pre-existing anxiety increase when you have a severe allergy. Food allergies are fairly common and can be safely managed in most cases. If you are dealing with anxiety, consider finding a local support group and going to therapy with a trained professional. Your medical team may be able to provide you with additional resources to help you manage your mental health.
Here is a list of organizations that can provide you with additional information and resources on food allergies and how to manage them.
Wilderman Medical Clinic
The Wilderman Medical Clinic has an on-site allergy clinic that can provide you with testing for your environmental allergies.
Reference
Chung, E. Y., Huang, L. Q., & Schneider, L. C. (2010). Safety of Influenza Vaccine Administration in Egg-Allergic Patients. Pediatrics, 125(5), e1024–e1030. https://doi.org/10.1542/peds.2009-2512
Day-to-day management – Food Allergy Canada. (2019, March 20). Food Allergy Canada. https://foodallergycanada.ca/living-with-allergies/day-to-day-management/
Dougherty, J. M., Alsayouri, K., & Sadowski, A. (2023, February 8). Allergy. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK545237/
Harvard Health. (2013, April 6). 6 tips for managing food allergies. https://www.health.harvard.edu/healthbeat/6-tips-for-managing-food-allergies
Health Canada. (2016, August 31). Eggs – A priority food allergen. Canada.ca. https://www.canada.ca/en/health-canada/services/food-nutrition/reports-publications/food-safety/eggs-priority-food-allergen.html
Priority food allergens – Food Allergy Canada. (2020, July 17). Food Allergy Canada. https://foodallergycanada.ca/food-allergy-basics/food-allergies-101/what-are-food-allergies/priority-food-allergens/
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