Food allergy and intolerance
Having a food intolerance can have a severe impact on people's lives that can be avoided by proper diagnosis and diet management. With as many as one in five people in Britain reporting symptoms of food intolerance Sainsbury's has developed the first specially produced supermarket range of gluten-, wheat- or dairy-free products. Not that long ago many food intolerance and allergy sufferers have had to completely eliminate most of their favourite foods from their diet, and subsequently found it almost impossible to follow every day, as the only suitable foods available were dull and tasteless.
This Freefrom range consists of 60 tempting sweet and savoury products which have been rigorously taste tested and competitively priced, and is endorsed by Allergy UK Britain's leading charity for allergy sufferers. Pinpointing any genuine links with food requires considerable skill and is not something which should be attempted without expert help from a specialist via a GP. Charities such as Allergy UK, The Anaphylaxis Campaign and Coeliac UK also offer help and support to people who have (or think they have) a food intolerance or allergy.
Background on food allergy and food intolerance:
Food allergy
A food allergy is where the body identifies food as a foreign substance and triggers an abnormal reaction in the immune system, the body's natural defence against infection.
Food allergies result in symptoms, which may include vomiting, diarrhoea, skin rashes, oral and facial swelling, and breathing difficulties. The reaction may be so severe as to cause a life-threatening response, e.g. anaphylactic shock from peanuts which requires urgent medical help. True food allergy is rare. It is estimated that only 1-2% of the UK population suffers from a food allergy. However, 20% of the adult population believe themselves to be allergic to a food, although tests fail to confirm that this is the case. Typical symptoms of food allergy are itching and swelling of the lips and mouth, streaming eyes and nose, throat swelling and asthma, abdominal pain, colic, vomiting and diarrhoea, eczema and hives, but most seriously anaphylaxis - a potentially life-threatening condition.
Peanut Allergy
The most commonly known food allergy is to peanuts. Peanut allergy starts in childhood and is usually a life-long problem. It can cause the most severe type of allergic reaction anaphylaxis. Peanut allergy is easily diagnosed and sufferers are instructed to carry adrenaline injections at all times. Food allergies are more common in children than adults and as well as peanuts, are usually caused by cows' milk, hens' eggs, fish, shellfish, soya and wheat. Fortunately, about half of all children outgrow their allergy by adulthood. The remission rate is less for peanuts, milk and eggs. Allergic reactions in adults are likely to begin at the age of 20 years and persist for 10 years or more. Characteristically, allergic symptoms develop within one hour after the food is eaten.
.
How is a food allergy recognised?
Food allergies are not difficult to diagnose as testing can be done by a simple skin prick test or by food challenges. It is important if a person thinks they have an allergy they should see their GP and get referred to a specialist who will perform these tests.
Food intolerance
Food intolerance is an unpleasant reaction to a food or food ingredient, but unlike food allergies, the immune system is not involved. It may be caused by the lack of a required substance for digestion, e.g. the enzyme lactase which is needed to digest milk, or a sensitivity of the individual to certain foods. Food intolerance is more likely to result in symptoms such as bloating, indigestion, migraines, fatigue or poor growth in children.
How is food intolerance recognised?
There are a few reliable tests to diagnose food intolerance. For example there are simple tests available for Coeliac Disease, Lactose Intolerance, PKU and Galactosaemia. Sometimes the dietary culprit is obvious, but more often it is not. Attempts to diagnose possible problems by self-imposed exclusion diets - suggested perhaps in books, magazines or by alternative practitioners - rarely succeed and are likely to cause other problems as a result of consuming a restricted and unbalanced diet.
Pinpointing any genuine links with food requires considerable skill and is not something which should be attempted without expert help from a specialist via a GP. Charities such as Allergy UK, The Anaphylaxis Campaign and Coeliac UK also offer help and support to people who have (or think they have) a food intolerance or allergy.
What do you do once you have been diagnosed?
Once you have been diagnosed, it is important that not only eating habits are changed but also food buying habits. The easiest way to minimise risk is to be extra vigilant; always read on pack labels, checking not just for the ingredient you are allergic/ intolerant to but also any byproducts e.g. caseinates for dairy allergic/intolerant people.
To make it easier for customers to quickly and easily spot allergens in ingredient lists retailers like Sainsbury's have an additional box highlighting the presence of any major allergens. Here is an example.
The information is under the heading Allergy Advice and has a pink background and lists CONTAINS followed by whichever of the following are present: NUTS, SESAME, SHELLFISH, FISH, EGG, MILK, SOYA, WHEAT, GLUTEN.
Why do people get adverse reactions to foods?
It is still largely unknown why some people have a food allergy or food intolerance and others don’t. However it is more likely that someone will develop a food allergy if they have a parent, brother or sister with an allergy of any type. Children under 3 years old are more likely to develop allergies. However food allergies / intolerance that begin in childhood often disappear, as the child gets older
A handful of foods are to blame for over 90% of allergic reactions to food. These foods (allergens) are:
- Milk and foods made from milk Wheat and items containing it
- Gluten from wheat, rye and barley
- Eggs and foods containing them
- Peanuts (groundnuts)
- Nuts from trees (including hazelnuts, almonds and brazil nuts)
- Fish Shellfish
- Soya Sesame including oils and seeds
Foods in the Freefrom range are free from gluten, wheat or dairy.
Gluten intolerance
Gluten is the protein found in wheat, rye, barley and oats. People with coeliac disease are intolerant to gluten and have to follow a strict gluten-free diet for life. In a person with coeliac disease, gluten damages the gut lining which greatly reduces its ability to absorb adequate nutrients from food, such as calcium and iron. In severe cases wasting can occur, leading to severe illness resembling malnutrition. Approximately 1 in 100 people in the UK (reference Coeliac UK) are unable to tolerate gluten.
People with the Coeliac Condition have to avoid all gluten-containing food, which includes wheat, rye, barley, and oats. This is difficult because gluten is present in many foods and drinks including bread, biscuits, cakes, pastries, breakfast cereals, pasta, beer and many soups, sauces and puddings. Cereals that are naturally gluten-free include rice, millet, maize and sorghum. Other gluten-free flour products are made from buckwheat, gram, soya and potato. Products made from these flours do not rise, so while they are acceptable for making biscuits, they are less successful when making bread. Foods can be made gluten-free by the removal of gluten from the wheat and some of these products are available on prescription for those with a definite diagnosis of gluten sensitivity. The UK Coeliac Society publishes a list of gluten-free foods, which is annually updated.
Wheat intolerance
A growing number of people in the UK suffer an intolerance to wheat, but can tolerate rye, oats and barley. Many people who suffer from symptoms such as bloating, indigestion, lethargy and skin disorders such as eczema say their symptoms improve when a wheat-free diet is followed.
Wheat is a widespread and nutritious staple in the UK diet, to the extent that following a wheat-free diet is a difficult task. Apart from the obvious sources such as bread, cakes, pasta and breakfast cereals, there are the less obvious sources where wheat is used either as a thickener in a wide range of foods such as sausages, soups and sauces.
Dairy allergy/intolerance
Dairy allergy can be mild, resulting in such common symptoms including skin rashes and hives, bloating, abdominal pains etc. However, in severe cases anaphylaxis can occur.
Some people have an intolerance to milk and products made from the milk of cows, goats, sheep and buffalo, and therefore have to follow a dairy-free diet. Lactose intolerance is the most common form of milk intolerance, and is the result of the body producing insufficient amounts of the lactase enzyme needed to digest lactose, the sugar in milk. Common symptoms for dairy intolerance include bloating, abdominal pain, diarrhoea or constipation, which will vary according to the individual. Avoidance of milk products can lead to a low calcium intake, and therefore it is important to look for good non-dairy sources.
Lactose intolerance occurs in individuals who lack or have low levels of the enzyme lactase, which is needed to digest the sugar lactose (found in milk) to its constituent sugars (glucose and galactose) in readiness for absorption in the small intestine. In the absence of lactase, undigested lactose passes into the large intestine causing the characteristic symptoms of diarrhoea, wind and general discomfort.
In about 70% of the world's population, a reduction in lactase production after early childhood is usual. When milk is consumed, symptoms are typically experienced to varying degrees in people of Asian, African, Jewish and Hispanic descent. Nevertheless, the majority of affected individuals can still tolerate moderate amounts of dairy products (e.g. a glass of milk), particularly if these are consumed as part of a meal. People of Northern European descent on the other hand, i.e. the majority of the British population, usually retain the ability to produce lactase throughout their life, presumably as a result of genetic inheritance. As a direct result, the prevalence of lactose intolerance in the UK is relatively very low, affecting an estimated 2% of older children and adults to varying extents.
There are also other allergies and intolerance to food including:
Nut allergy
One area where a greater awareness has been achieved is nut allergy. This is because peanut allergy and nut allergy are frequently severe and can cause anaphylactic shock. The symptoms for this range from hives and generalised flushing of skin, abdominal pain, nausea and vomiting through to a feeling of weakness and then collapse and unconsciousness.
Egg allergy
Egg allergy - common among children – can be mild, resulting in such common symptoms including skin rashes and hives, bloating, abdominal pains etc. However, in severe cases, anaphylaxis can occur. Some egg-allergic children can eat well-cooked egg, for example in a cake, without any ill effects; however, they cannot eat raw or lightly cooked egg. Others are allergic even to egg which has been well cooked. People who are fine with cooked egg are more likely to grow out of egg allergy.
Importance of Food Labeling
Clearly labeled food products are of great importance, particularly when they contain ingredients which can cause problems for some people.
As required by law, all Sainsbury's products carry a list of the ingredients they contain. In addition, Sainsbury's products have an 'Allergy advice' panel, highlighting the main ingredients which may cause problems for some people. Nuts (which includes peanuts), sesame, shellfish, egg, milk, soya and wheat are shown in the 'Allergy advice' panel.
Some products also have a 'gluten free' symbol - used on foods that do not contain wheat, rye, barley or oats, to help those who may be intolerant to gluten select suitable foods. This symbol is not used on foods that obviously do not contain gluten, e.g. fruit, vegetables, fresh meat, milk and bottled water.
The Freefrom range also includes a range of icons on the front of the pack to inform the customer whether the product is gluten, wheat or dairy free (some products are free from 2 or 3 of these ingredients). In addition, the range is endorsed by Allergy UK, a leading UK charity providing help and support for people with allergies.
© Active Kids Get Cooking November 2006