BY SUSAN BELKNAPP / CONTRIBUTING WRITER
Shelby Barone’s oldest child, Andrew, began having life-threatening reactions to food when he was very young.
“He had his first anaphylactic reaction to beans when we were dining at a Mexican restaurant when he was 2,” the Aliso Viejo mom said. “We didn’t know what was happening, but within seconds his lips were getting huge, his face looked like it was deforming and he was turning blue.”
They called 911, but her son had to be resuscitated by the time the medics arrived. At the hospital, he was given epinephrine and, later, lots of tests.
After this first allergic reaction, Andrew, who had been previously healthy and able to eat a variety of foods – he’d even had beans before – was suddenly reacting to almost anything he ate. The doctors explained that his immune system had been compromised by the first incident, but nothing they tried helped.
After several difficult considerations, Barone finally decided to take matters into her own hands and prepare only organic foods – many of which she grew in her backyard. “It took three full months, but once I started him on organic foods and being extremely careful about any common allergens, his health began improving. He could tolerate foods and his eczema went away. Over the next six to nine months, he stopped being so reactive to everything.”
The Barone family has followed a “diligent-but-accepting” regimen since then. Andrew is now a very healthy 13-year-old and comfortable advocating for himself. The Barones and their doctors have identified what he can and cannot eat. Andrew always carries an epinephrine injection system (EpiPen and Auvi-Q are two common brands) and can recognize his symptoms immediately and handle them accordingly.
In fact, he hadn’t had a reaction in four or five years until recently when he ate a school lunch (mac and cheese) that had somehow been cross-contaminated with the other lunch choice: bean burritos.
He’d stopped carrying his EpiPen and didn’t get to it before having an anaphylactic reaction. By the time Barone arrived, the medics were working to revive her son. He’s now doing well, but his mother has decided he needs to keep the EpiPen on him at all times.
Researchers estimate that 15 million people suffer from food allergies in the United States. One in 13 children younger than 18 has a food allergy, which breaks down to about two kids in every classroom. And that number is on the rise.
A 2013 study released by the Centers for Disease Control and Prevention revealed that food allergies in children increased by about 50 percent from 1997 to 2011.
What’s the difference between an actual allergy and a sensitivity or intolerance, and what’s being done to help stem the tide of sufferers?
Some allergy basics
The American College of Allergy, Asthma and Immunology (acaai.org) states: “A food allergy reaction occurs when your immune system overreacts to a food or a substance in a food, identifying it as a danger and triggering a protective response.”
The symptoms of food allergies are most common in babies and children, but they can appear at any time. People can develop allergies to foods they have eaten their entire lives without incident.
Although almost any food can cause a reaction, nearly 90 percent of all reactions can be narrowed down to eight food types: eggs, milk, peanuts (peanuts are legumes and not nuts), tree nuts (walnuts, almonds, etc.), fish, shellfish, wheat and soy.
Seeds, such as sesame and mustard, can be allergy triggers, too, and are considered major allergens in some countries.
An allergic reaction can manifest in a variety of places, including the skin, the gastrointestinal tract and the cardiovascular and respiratory systems. Common symptoms include vomiting and/or stomach cramps; hives; shortness of breath; wheezing; repetitive cough; shock or circulatory collapse; a tight, hoarse throat; trouble swallowing; swelling of the tongue, affecting the ability to talk or breathe; a weak pulse; pale or blue coloring of skin; dizziness or feeling faint; and anaphylaxis – a potentially life-threatening reaction that can impede breathing and send the victim into shock.
“It’s important to understand the difference between an allergy and a food intolerance,” said Dr. Steven Weinstein of Allergy and Asthma Specialists Medical Group (ocallergy.com), which has offices in Huntington Beach, Newport Beach and Irvine. “Allergies are rooted in the immune system, whereas food intolerance is more likely gastrointestinal. The problem arises when the term ‘allergy’ is used as a catch-all phrase; and it is often expensive and difficult to pinpoint what the exact issue is, so people just say, ‘It must be allergy.’ And they then avoid those foods, even if it’s not truly necessary.”
To test for actual allergies, blood and skin tests are done. It’s important to be diagnosed in a clinical setting because you may not be reacting to the actual food, but to an additive or component in that food.
Gluten allergies have flooded into the mainstream in the past few years. The problem is that many people are self-diagnosing an allergy when they may actually only have an intolerance or isolated reaction.
Celiac disease is a digestive and autoimmune disorder that results in damage to the lining of the small intestine when foods with gluten are eaten, and “ is detectable with a blood test that is about 97 percent accurate,” said Dr. Donald Levy, clinical professor of medicine in the division of immunology at UC Irvine and in private practice at Allergy and Immunology in Orange (drdonaldlevy.com).
“However, there is a very small percentage of people with celiac disease who have a negative blood test. I recommend that people who think that they have celiac disease, despite a negative blood test, avoid gluten for a month or so, and see if their symptoms resolve.”
A turning tide?
In February, an editorial published in the New England Journal of Medicine caused an avalanche of international headlines and it may end up revolutionizing how certain allergies are combated.
In the study conducted in London, 640 infants ages 4 months to 11 months old who were deemed high risk for developing a peanut allergy were randomly assigned either to be regularly fed food that contained peanuts or to have peanuts withheld completely (nejm.org). High-risk infants were defined as those with severe eczema or an egg allergy. The feeding patterns continued until the children were 5 years old.
The results showed that of the 530 who initially had negative skin-prick tests, 13.7 percent of those in the avoidance group had developed an allergy, while only 1.9 percent of those who ate peanuts did.
Weinstein explains that the study was inspired by observations that Jewish children in Israel have profoundly fewer incidents of peanut allergy than Jewish children living in the United Kingdom. This was discovered when Dr. Gideon Lack, professor of pediatric allergy at King’s College in London, was speaking to a group of doctors in Tel Aviv 15 years ago. When he asked how many of them had patients with peanut allergies, only three hands went up.
“If this had been in London, every hand in the room would have gone up,” Lack said. And so began his quest to determine if the Western directives that were created in 2000 – and later revised in 2007-’08 – advising parents not to introduce peanuts to children until age 3 or 4 were contributing to the rise in peanut allergies.
Levy finds the study interesting but does caution parents not to make any quick decisions, especially if their child is at high risk. Having one or both parents with food allergies puts a child in the high-risk category.
Weinstein is inclined to agree with the study’s results.
“For my patients, I’d probably encourage early introduction,” he said. “But that’s me.”
Another small but promising study was conducted by the Murdoch Childrens Research Institute in Australia. Thirty children with peanut allergies were given a daily mix of peanut protein and a probiotic in increasing amounts over an 18-month period.
Another group of 30 kids with peanut allergies received a placebo. Of the first group, 80 percent had no allergic reaction to peanuts after the study period ended. A follow-up study will test whether the results are long-lasting.
While this progress provides hope for the future, millions of kids like Andrew Barone still have to worry about every bite they take.