Understanding Food Allergies

Allergies are becoming more and more common in Australia, with approximately one in three Australians developing an allergy at some point in their lives. Although allergies can be dangerous for some people, they can be easily managed if the right steps are taken. Being aware of your allergies and taking on the right management strategies is important for living with an allergy. 

A food allergy is when someone’s immune system reacts to the protein in the food, thinking that it is dangerous. They occur in around 5-10% of children and 2-4% of adults in Australia and New Zealand.

Food allergies most commonly develop before the age of five, but can develop at any age. Children will commonly outgrow allergies, but allergies to peanuts, tree nuts, sesame and seafood will continue lifelong for approximately ~ 75% of affected children. When a food allergy develops for the first time in adults, it usually continues lifelong. 

The most common food allergies in Australia are peanuts, tree nuts (includes most other nuts such as macadamia, hazelnuts, almonds etc), egg, cow's milk, seafood, fish, sesame, soy and wheat. However, almost any food, including fruits, can cause an allergic reaction.

Allergic reactions to foods range from mild to severe

Mild to moderate symptoms of food allergy include:

• swelling of face, lips and/or eyes
• hives or welts on the skin, stomach (abdominal) pain 
• vomiting

Severe allergic reactions (anaphylaxis) affect breathing and the heart, and can be life threatening. Symptoms  may include any of the following

• difficult/noisy breathing
• swelling of the throat/tongue
• difficulty talking
• wheezing or coughing
• dizziness 
• becoming pale and floppy in young children
• The most common foods that cause anaphylaxis are peanuts, tree nuts, shellfish, milk and egg.
• Most deaths due to anaphylaxis can be prevented by careful food allergen avoidance measures and immediate administration of an adrenaline autoinjector (EpiPen).

How are food allergies developed?

Recent studies have shown that delayed introduction of solid foods to babies (after 12 months of age) can increase the chance of developing food allergies.  It is therefore now recommended that solid foods are introduced to babies around 6 months, but not before 4 months, to help prevent food allergies developing.

If possible, breastfeed your baby while you are giving them solid foods. This advice is for all babies, even if they have severe eczema and/or food allergy, or if a parent or sibling has allergies.

What is the difference between an allergy and an intollerance to food?

Not all adverse reactions to foods are allergies. The word ‘allergy’ is often incorrectly used to describe other reactions to foods that are annoying but not harmful, including some skin reactions, diarrhoea or constipation. This can include food intolerances, enzyme deficiencies, or skin reactions to physical contact with foods. 

Food intolerance is a reaction which does not involve the immune system.  It can be in response to some of the naturally occurring chemicals in food and to common food additives including preservatives, artificial colours and flavourings. People can react differently to different amounts and  different types of chemicals. 

It is important to differentiate between these reactions and true food allergies, as the ways to manage food allergies is different and much stricter than for these other reactions. 
Diagnosis of food allergies should always be medically confirmed and dietary avoidance for food allergy should only be undertaken under medical and dietitian supervision. There is currently no cure for food allergies so strict avoidance of that particular allergen is critical for the management of food allergies. 

To prevent malnutrition and other complications such as food aversion, foods should not be cut out of your diet unless an allergy has been diagnosed.

Important general steps for living with a food allergy are: 

1. Know what foods contain your allergen and what foods are considered high risk for cross contamination. 
2. Know how to read food labels and identify if a food contains any traces of your allergen.
3. It is best not to keep the allergic food in your house to avoid accidental eating it.
4. When dining out or at a friend’s house - be assertive and ask questions about ingredients, food preparation and storage. Always inform restaurant managers about your allergies.
5. Be aware of the early signs and symptoms of an allergic reaction and know what to do in an emergency 
6. Carry your Epi-Pen (if prescribed) and know how to use it.
7. Have an Action Plan for managing your anaphylaxis - The Australasian Society of Clinical Immunology and Allergy (ASCIA) Action Plans are specifically designed to help those who suffer from severe allergic reactions including anaphylaxis.
8. Most importantly – When in doubt, leave it out! 

For more information visit: 

• The Australasian Society of Clinical Immunology and Allergy 
• FSANZ (Food Standards Australia and New Zealand)
• Dietitians Association of Australia