There is an enormous amount of information being passed around about food allergies and food intolerance these days but not all of the information is actually fact based, in fact the majority of is not based off validated medical results at all. I've interviewed a host of "experts" on food allergies to provide all of us with a better understanding. I've also taken the liberty of sharing a little glimpse of my own personal story and background of life with diagnosed food allergies.
While most information is simply theory, opinion, misinformation and invalidated results, today's interview is with Dr. Russ Leftwich who practiced internal medicine, allergy and immunology for 22 years. He is now in the clinical informatics field working across the entire spectrum of healthcare and involved in national and international efforts, developing clinical data standards and interoperability for care coordination, consumer engagement, and quality improvement.
Dr. Leftwich is the subject matter expert for one of the projects in the international clinical data standards development organization called Health Level Seven (hl7.org <hl7.org> ) which is developing a standard way to represent the information on the "Allergy List" in a medical record, the list of medications, foods and other substances that an individual is allergic to.
Some of our information is based on true life experience of dealing with medically diagnosed food allergic reactions but each person has a different experience and while some may be similar, no one knows your body like you do, so it's critical that we pay attention but don't go overboard and claim things we don't know the medical knowledge and facts to back up.
There is not much training about allergies in medical school or residencies and certainly not in the food industry. Only in an allergy/immunology fellowship is there extensive training provided in allergy (IgE type) and other immune problems.
The result: most physicians don' know much about food allergy or any other type of allergy and certainly the food industry knows even less.
Board certified allergists have to do a fellowship and pass an exam but they don't have to get a prefect score so no one knows everything, therefore all the things doctors say, may not be TRUE.
First of all we need to really look at the definition of ‘Food Allergy’ and call it what it is, basically it is food poisoning to those who have developed an autoimmune disorder to certain food proteins. There are different causes of food poisoning.
Every year 1 in 6 Americans get sick from food poisoning. Some reasons for food poisoning are bacteria, viruses, parasites, molds, toxins, contaminants and allergens. Most recover without any long term effects from their illness, however, the effects can be devastating and even deadly for others.
Serious long-term effects associated with several common types of food poisoning include:
• Kidney failure
• Chronic arthritis
• Brain and nerve damage
Allergists use the term ‘Food Allergy’ to mean a reaction caused by production of an antibody, Immunoglobulin E, which "recognizes" what we are allergic to.
Immunoglobulin E is not abnormal, it is part of our immune system that helps protect us from parasites. Since we don't have parasites, that part of our immune system is you might say twiddling its thumbs and accidentally starts "recognizing" something that vaguely resembles parasites (by a chemical feature on the surface of that substance that is almost always a protein). Allergen molecules tend to be in a certain size range.
Poison ivy allergy is common, but is caused by a completely different part of the immune system and the types of "allergens" that cause this type of allergy are oily, rather than proteins that cause allergies in food. This type of allergy to foods is very unusual.
Certain foods are more prone to be the cause of food allergies. They tend to be high in protein and on a molecular level we now know have certain chemical characteristics that make them more likely to "fool" the immune system and cause an allergy.
Foods from genetically modified plants would not have any reason to be more or less allergenic, but that doesn’t mean that they have not changed the molecular structure of our food supply and left no impact on our bodies.
WHAT a person becomes allergic to is determined in part by their genetic inheritance, what food they are exposed to, and when in their life they are exposed to it.
Before we are 18 months old, our intestines are not mature and we absorb larger molecules from digested food that are more likely to cause us to become allergic.
I can share my personal story with you because I have 10 food allergies all diagnosed as an adult.
My mother, god rest her beautiful soul, stopped breast feeding when I was very young. I was her only child. My family has been in farming for many generations. While some of them went on to have other jobs in life, farming and food has stayed in my family in some capacity for at least 6 generations.
I was taught to try every food. I honestly love food, even as a child I loved every food I was given from fresh picked okra to beautifully displayed sushi to fried chicken and my favorite queen anne cherries. I was a consummate snacker which included nuts, fruits and veggies. I have never been overweight, even though my first words included 'french fries.'
I have given birth to two children, neither have been diagnosed with food allergies and to my knowledge no one in my family has ever been diagnosed with food allergies or chronic kidney disease. I breastfed both my children for 6 months. I lost a kidney at age 11 for no apparent reason and was fine for 10 years, until the other kidney began to fail and shortly after that my first food allergies were diagnosed.
Now that I have been diagnosed with 10 food allergens, mostly I feel much better and am able to live a healthy normal life as long as I avoid those foods. I no longer wake up every morning and vomit or get nauseous, my skin isn't constantly red and irritated, I generally don't feel the need to scratch my blood because it itches.
The severity of my allergies has increased with my age and there have been times I've stood in a kitchen full of oranges (one of my food allergies) and felt like I couldn't breath because someone was standing on my chest. I hate having food allergies, it feels like I am cursed because I am a huge foodie and I love to cook and create. My favorite place to be is in the kitchen when I am home or in a restaurant. I feel most comfortable with food from picking it (which I did as a kid) to cooking it to talking to others about it. I love to feed people- in fact whenever possible, that's usually what I am doing. When food is what you know best and suddenly you can't have many of the things you knew best, it does change your life. I am not a picky eater and I hate being classified as such. I additionally hate being classified as someone who does this to lose weight, even the mention of it makes chills run down my spine and the hair on my neck raise up.
The foods I am allergic to have been deemed as "healthy" by all standards except in the case of those diagnosed with food allergies, in which case eating these "healthy" things will KILL me in some cases, not to mention make me very, very sick for weeks after and shut down my autoimmune system all together. - Oranges, cranberry, ginger, fish, sesame seeds, walnuts, almonds (tree nuts), peanuts, milk are all "good for you," beautiful things. I would rather be allergic to processed junk that I can't grow than the foods I have hand picked or caught and created awesome meals with.
There is probably a complicated combination of reasons people become allergic to foods, but we still have no specific medical facts to prove why certain people have food allergies and why others with the same genetic makeup have none.
While there may be differences in the most common food allergens from country to country there are not specific reasons as to why. Certainly what different countries decide to list is not based on any careful scientific formula.
Studies of food allergies usually involve only a few dozen or at most a few hundred persons, not the 10's of thousands of persons that would be necessary to answer many questions we have surrounding this issue.
There are no scientific studies showing that you lose a food allergy by being gradually reintroduced to it. That, like many food allergy tales, is an urban legend. While children can outgrow some food allergies, like milk (which is more common to outgrow) peanuts are much less likely to be outgrown.
Skin tests and blood tests are not very reliable for finding an unknown food allergy. There are many false negatives and false positives. A true food challenge is the only gold standard, but can be dangerous.
“We are making progress in the field of informatics and some day we may be able to answer those questions based on 10s of thousands of individuals with food allergy. Maybe one day will even make progress teaching medical students about allergies,” states Dr. Leftwich.