Selena Gardner

KNH 420G

Food Allergies in Children

Miami University

August 1, 2018
Con

Do you, or someone you know, have an allergy to a certain food? Food allergies

approximately affect four to six percent of children and four percent of adults in the U.S.

(American College of Allergy, Asthma, & Immunology, 2016). The eight most common foods

that cause food allergies, that account for 90% of all food allergies, are: tree nuts, peanuts, soy,

wheat, crustacean shellfish, fish, eggs, and milk (CDC, 2018). Less common food allergies

include spices (garlic, mustard), seeds (sesame, poppy), meat, gelatin, and corn. Recent studies

have shown how food allergies are more prevalent in children than in adults. Upon the discovery

of food allergies, food allergies affect the development of children and are becoming more

common in the U.S. over time.

The term food allergy refers to an immune response that occurs when exposed to a food

(Venter et al., 2018). The reaction is usually a response to the protein antigen in the food. The

purpose of the immune system is to protects the body from infectious bacteria and kill any

harmful microorganisms that come in contact with the body. When a person with a food allergy

ingests the food they are allergic to, their immune system responds to the food as dangerous. The

allergic reaction is the body’s triggered response to the allergen. Immediate reactions to food

allergies are called immunoglobulin E (IgE), which are type 1 hypersensitivity. Some can be cell-

mediated or a combination of both. It is common for IgE-mediated allergies to cow’s milk,

wheat, egg and soy to be outgrown and for allergies to peanuts, tree nuts, fish and shellfish to

prolong into adulthood (Yu et al., 2016).

The body’s immune response to a food allergy can range from mild symptoms to

severe and life-threatening. Symptoms can involve the gastrointestinal tract, skin, the

respiratory tract and the cardiovascular system. Symptoms vary between children and adults.
Con

Mild symptoms can include irritated eyes, congestion, skin rash (eczema, hives), and upset

stomach (Robinson,
Background

2016). Peanuts, nuts, fish, and shellfish are known to cause severe reactions such as

troubled breathing/swallowing, swollen lips, tongue or throat, and dizziness (Robinson, 2016).

Anaphylaxis is the most severe allergic reaction because it is life-threatening (American College

of Allergy, Asthma, & Immunology, 2016). Anaphylaxis can develop within minutes of exposure

to an allergen. Symptoms include troubled breathing, a significant decrease in blood pressure,

swelling of the mouth, and heart failure.

Food intolerance refers to a non-immune reaction where the food is difficult to digest.

Most people mistake food intolerance to be a non-IgE mediated food allergy, however, food

intolerance is not cell-mediated (Devdas et al., 2018). Food intolerances can develop if a person

lacks an enzyme to digest a specific food, irritable bowel syndrome, celiac disease, or

psychological stress. Common intolerances are gluten intolerance and lactose intolerance. Most

people can avoid food intolerance by eliminating the allergen in the diet, eating small portions of

the allergen, or ingest enzyme pills to aid in digestion. Six million children in the United States

have some sort of food allergy. Children with food allergies are two to four times more likely to

develop asthma or other allergy conditions than children without food allergies (Branum &

Lukacs, 2008). A lactating woman’s diet can affect the infant’s allergies (Branum & Lukacs,

2008). Common allergies in children are mostly peanuts and milk.

Researchers from the European Academy of Allergy and Clinical Immunology (EAACI)

conducted a cross-sectional study. Nutritional assessments were evaluated for a 3-day diet record

of two groups. The experimental group followed an elimination diet and included 96 children

with food allergies, ages 5-10. The control group of 95 children, ages 5-10, had no food allergies.

Results showed that the protein, calcium, and energy intake was similar for both groups
Conclusion

(Flammarion et al., 2011). After evaluation of weight-for-age and height-for-age scores,

the study concluded that children with food allergies were smaller than children without food

allergies (Flammarion et al., 2011). Children with food allergies develop at a smaller rate than

children without food allergies.

Allergies are common in infants and children (American College of Allergy, Asthma, &

Immunology, 2014). Because of this, it is important for parents to become aware of allergy signs

and symptoms. However, it can be difficult to diagnose an allergy because symptoms may reflect

other conditions similar to allergies. A child should take an allergy test if they have conditions

such as rhinitis, asthma, skin rashes (eczema, contact dermatitis), or reactions to food, insects

and medications (American College of Allergy, Asthma, & Immunology, 2014). Some of these

conditions may be food related. An allergist should be seen to help diagnose any conditions.

Allergists first evaluate a patient for diagnosis by examining medical history of the

patient and family, conducting a physical exam, and allergy sensitivity testing (American College

of Allergy, Asthma, & Immunology, 2014). Allergists use skin tests, blood tests, and elimination

tests to identify allergens (American College of Allergy, Asthma, & Immunology, 2014).

Percutaneous and intradermal immediate-type skin tests. Percutaneous tests are conducted by

placing a diluted allergen to a prick at the top layer of skin (American College of Allergy,

Asthma, & Immunology, 2014). Intradermal tests have the diluted allergen injected into the skin,

which is sensitive and can cause an anaphylaxis reaction.

Children taking medications such as antihistamines and antidepressants may not have

accurate results on allergy tests. Blood tests such as the radioallergosorbent (RAST) test or

ImmunoCAP are less sensitive than skin tests. Although blood tests suggest for children to stop

ingest medication when being tested. An allergist may suggest for a child to participate in a
Conclusion

weeklong supervised elimination diet (American College of Allergy, Asthma, &

Immunology, 2014). Mild cases of allergic reactions are normally treated with an antihistamine.

Anaphylaxis can come on within minutes of exposure to the trigger food. It can be fatal and must

be treated promptly with an injection of epinephrine (adrenaline) (American College of Allergy,

Asthma, & Immunology, 2016).

Four out of every 100 children have a food allergy (Branum & Lukacs, 2008). In 2007, 3

million children were reported to have a food or digestive allergy in the past year (Branum &

Lukacs, 2008). With that said, children under age five have higher rates of recorded food

allergies in comparison to children ages 5-17 years. However, both female and male children

have the same food allergy rates. Approximately 9,500 hospital discharges linked to food

allergies in children under 18 were reported from 2004-2006 (Branum & Lukacs, 2008).

Food allergies are becoming more common in the U.S. Between 1996 and 2006, there

was a significant increase in food allergy rates among children and adolescents (Branum &

Lukacs, 2008). In 2007, 29% of children with food allergies had reported having asthma

compared to the 12% of children without food allergies (Branum & Lukacs, 2008).

Approximately 27% of children with food allergies reported a skin allergy compared to 8% of

children without a food allergy (Branum & Lukacs, 2008). A little over 30% of children with

food allergies reported a respiratory allergy compared to 9% of children without a food allergy

(Branum & Lukacs, 2008).

In conclusion, children have an increased risk of having food allergies compared to

adults. While some allergies can be outgrown, food allergies in general but children at risk for

other conditions such as asthma, skin allergies, and respiratory allergies. Food allergies become

more common in the U.S. as we progress into each year and it is important for parents and
schools to be aware of what’s in their food and how to manage a food allergy. Continued

research and advanced food science is the answer in helping our nation treat and manage food

allergies.
Works Cited:

American College of Allergy, Asthma, & Immunology. (2016). Food allergy. Allergist. Retrieved
from https://acaai.org/allergies/types/food-allergy.

Center for Disease Control & Prevention (CDC). (2018). Food allergies in schools. Retrieved
from https://www.cdc.gov/healthyschools/foodallergies/index.htm.

Venter, C., Groetch, M. Netting, M., & Meyer, R. (2018). A patient specific approach to develop
an exclusion diet to manage food allergy in infants and children. Clinical & Experimental Allergy,
48(2), 121-137. doi:10.1111/CEA.13087.

Yu, W., Freeland, D. M. H., & Nadeau, K. C. (2016). Food allergy: immune mechanisms,
diagnosis and immunotherapy. Nature Reviews. Immunology, 16(12), 751-765.
http://doi.org/10.1038/nri.2016.111.

Robinson, J. (2016). Common food allergy triggers. WebMD. Retrieved from

https://www.webmd.com/allergies/food-triggers#1.

Devdas, J. M., Mckie, C., Fox, A. T., & Ratageri, V. H. (2018). Food Allergy in Children: An
Overview. The Indian Journal of Pediatrics, 85(5), 369-374. doi:10.1007/S12098-017-2535-6

Flammarion S, Santos C, Guimber D, Jouannic L, Thumerelle C, Gottrand F, Deschildre A.

(2011). Diet and nutritional status of children with food allergies. Pediatr Allergy Immunol. 22:
161–165.

Branum, A. M., Lukacs, S. L. (2008). Food allergy among U.S. children: trends in prevalence
and hospitalizations. CDC Stacks Public Health Publications. NCHS data brief; no. 10; DHHS
publication. Retrieved from https://stacks.cdc.gov/view/cdc/42453.

American College of Allergy, Asthma, & Immunology. (2014). Allergy testing in children and
infants. Allergist. Retrieved from https://acaai.org/allergies/allergy-treatment/allergy-
testing/allergy-testing-children-and-infants.