Food allergy…what to eat?

So what if you are allergic to some foods? You can still get adequate nutrition.

It is common to find people who are allergic to certain foods. The most common allergic reactions in adults are to shellfish such as crabs, lobsters and prawns; nuts such as walnuts, almonds, pistachios and peanuts; and fish such as salmon. Children are mostly allergic to eggs, wheat, milk, soy [common allergen in infants], and nuts.

Those who are allergic or intolerant to certain foods need to be careful when making food choices and read food labels to ensure they don't consume elements they are allergic to.

Wheat allergy and gluten intolerance

Wheat allergy is caused by an abnormal reaction to one of the proteins [either albumin or globulin] present in the actual wheat grain or those found in wheat products. For people with wheat allergy, wheat and wheat products are to be avoided. Non-wheat and gluten-containing products, such as those containing barley malt syrup, are usually safe.

Gluten intolerance is the body's abnormal reaction to gluten, a protein found in wheat, barley and rye. People with gluten intolerance need to monitor their intake of B vitamins and minerals such as potassium, magnesium, iron, and phosphorus.

Avoid

  • Foods that contain: wheat and barley based syrups, whole wheat, spelt, triticale, bulgar, semolina, frumento, durum, graham, farina, seitan, wheat bran, wheat germ, starch and cake flour.

Consume

  • Calcium: Milk, yoghurt, cheese, ice-cream, sardines, salmon, broccoli, spinach, almonds and figs.
  • Iron: Meat, fish, poultry, nuts, seeds, legumes, dried fruit, eggs and amaranth.
  • Folate: Broccoli, asparagus, orange juice, liver, legumes, bean flour, peanuts, walnuts, sesame and sunflower seeds.
  • Vitamin B12: Eggs, milk, meat, poultry, and seafood.

Taking a multivitamin supplement may help fill some of the nutritional gaps.

Peanut allergy

This allergy is found more in children than in adults. Kids with allergy to peanuts can be sensitive to foods containing even small amounts of it.

Avoid

  • Groundnuts, monkey nuts, beer nuts and peanut butter
  • Peanut oil – cold pressed, expelled, expressed
  • Cakes, buns, biscuits, soups, salad dressing, kebabs, Thai food, breakfast cereals, chocolates, ice-cream and health bars as they may contain peanuts.

Consume

  • Water chestnut and nutmeg.

Milk allergy and lactose intolerance

Casein and whey protein in milk is what causes allergies. When cow's milk is introduced as weaning food in infants, the immune system doesn't recognise it as a friendly substance causing an abnormal reaction.

Lactose is sugar found in milk and milk products. Our body digests lactose with the help of an enzyme called lactase. In some people, this enzyme is missing, which makes them intolerant to lactose. Their body breaks down lactose with the help of bacteria present in the gut, which results in production of gas. This causes abdominal pain, diarrhoea and bloating. As we grow older, our lactase levels decline, which is why this condition is rarely seen in children below five years of age.

People with milk allergy and lactose intolerance lack minerals such as calcium and phosphorus.

Avoid

  • Butter, casein, caseinate, cheese, cream, curds, lactose, lactalbumin, milk/milk solids, non-fat dry milk and whey items.

Consume

  • Calcium: Yoghurt, buttermilk, calcium fortified soy milk, goat milk
  • Natural-source lactase supplement to replace the missing enzyme
  • Vitamin D: Egg, oily fish. Increase your exposure to early-morning sunlight
  • Phosphorus: Poultry, fish, eggs, and whole-grain foods
  • Fibre: Rice, oats
  • Omega-3 and antioxidants: Soy, almonds and hazelnuts
  • Dairy-free cheese or yoghurt.

Egg allergy

Allergens in eggs are proteins like ovomucoid and ovalbumin, which constitute 10 – 50 per cent of egg white protein. Boiling the eggs such that the egg white coagulates or solidifies completely reduces the allergenic activity. Children usually outgrow this allergy by the time they are three years old.

Avoid

  • Foods prepared with eggs, which include: French toast cake, cookies, pancakes, eggnog and puddings.
  • Foods that contain albumin, egg substitutes, globulin, livetin, lysozyme, ovalbumin, ovomucin, ovomucoid, ovotransferrin and silico-albuminate.

Like milk, egg white allergy fades with time.

Soy allergy

Allergic reaction to soy starts one or two weeks following the consumption of soy-based food. The allergens in soybean are conglycinin, glycinin proteins and trypsin inhibitor.

Avoid

  • Vegetable oil as it may contain soy oil
  • Natural mixed tocopherol [E306], tocopherol acetate and succinate
  • Hydrolysed soy protein [HVP]
  • Textured vegetable protein [TVP]
  • Lecithin
  • Soy protein [concentrate, isolate].

Exclude food containing miso, tofu, okara [soy pulp], soy sauce, soy milk, soy chunks and soybeans.

Fish allergy

Those who are allergic to all kinds of fish suffer reactions due to parvalbumin, a fish protein, present in all species of fish, whereas those who are allergic to shell fish suffer because of tropomyosin, a muscle protein present in shell fish like shrimps, lobsters and crabs. Cooking does not reduce the allergenic activity in fish.

Avoid

  • Foods that contain anchovies, and gelatin derived from fish or shellfish bones
  • Fish oil supplements, which may be contaminated with fish protein.

Tree nuts allergy

Tree nuts such as almonds, walnuts, hazelnuts, pistachios and cashews contain an allergen which is similar to that in peanuts. This may explain why almost half of children who are allergic to peanuts are also allergic to tree nuts. Avoid foods containing nuts.

Allergies have a strong heredity component in them with sometimes all members of the family having it. However, they may not be allergic
to the same foods. It's the tendency that they inherit, which may manifest differently. For instance, if the mother is allergic to eggs, her child may be allergic to some other food. Also, sometimes, you may simply develop an allergy, which may disappear on its own without medical intervention.

Still, it's always better to first consult a professional if you have an abnormal reaction to any food.

Symptoms of food allergies and intolerances

  • Skin: swelling, rashes
  • Nose: nasal congestion, asthma, sneezing, runny nose
  • Mouth: swelling of lips and tongue
  • Throat: difficulty in swallowing, itching
  • Chest: pain, difficulty in breathing, cough
  • Heart: drop in blood pressure, weak pulse, shock
  • Nervous system: dizziness or fainting
  • GI tract: diarrhoea, flatulence, vomiting, cramps.

Difference between food allergy and food intolerance

Food allergy is an abnormal reaction of the body's immune system to a protein molecule in a particular food ingredient. Body mistakes that protein in the food as a dangerous invader and fights it by producing antibodies [immunoglobulin E] to neutralise the allergen.

Food intolerance is an abnormal reaction by the body's digestive system to an ingredient in the food that may irritate the digestive system causing a reaction. It could also happen if the person is unable to digest a particular food completely or there is a deficiency of an enzyme in the body, which causes a reaction.

An individual may outgrow a food allergy but food intolerance is a lifelong condition.

The time factor

Allergic reactions are of two types: immediate and delayed.

Immediate reaction happens within minutes of consuming the food. Foods that cause an immediate reaction include sea food, fish and nuts. The allergen is a whole protein.

A delayed reaction is seen a few hours or days after consuming the food. Cereal, milk, egg, legumes, beef and orange juice cause a delayed reaction. Here, the allergen is a product formed due to the breakdown of protein during digestion.

The response to an allergen is influenced by:

  • The amount of food eaten at one time
  • The form of food—whether it is raw or cooked
  • The physiologic state—infants with eczema have hypersensitivity to food.

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