Post on 14-Dec-2015
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Food Allergies in the United States
Module 1
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Module Content
Definitions Types and prevalence of food allergies in the United
States Types and prevalence of food allergies in foreign
countries Impact of food allergies
+Definitions
Food “any substance—whether processed, semi-processed,
or raw—that is intended for human consumption and includes drinks, chewing gum, food additives, and dietary supplements”
“substances used only as drugs, tobacco products, and cosmetics (such as lip-care products) that may be ingested are not included” (Boyce et al., 2010, p. S8).
+Definitions
Food allergy “an abnormal response to a food, triggered
by the body’s immune system” “an adverse health effect arising from a
specific immune response that occurs reproducibly on exposure to a given food”(Boyce et al., 2010, p. S8).
+Definitions
Food allergens
“those specific components of food or ingredients within food (typically proteins but sometimes also chemicals) that are recognized by allergen-specific immune cells and elicit specific immunologic reactions, resulting in characteristic symptoms” (Boyce et al., 2010, p. S8).
+Definitions
Allergic response “a reproducible adverse reaction to a substance
mediated by an immunological response. The substances provoking the reaction may have been ingested, injected, inhaled, or merely have come into contact with the skin or mucous membranes” (David, 2000, p. 34).
+Definitions
Food intolerances non-immunologic adverse reactions Intolerance symptoms are usually caused by
an inability to digest or metabolize a food, resulting in gas production, cramping, or diarrhea.
Lactose intolerance (inability to digest milk sugar) is the most common type of food intolerance”(Boyce et al., 2010, p. S9).
+Definitions
IgE (Immunoglobulin E) a unique class of immunoglobulin that
mediates an immediate allergic reaction (Boyce et al., 2010).
IgE is released from plasma cells in the mucosa of the GI (gastrointestinal) tract, respiratory tract, and tonsils when the immune system overreacts to an allergen, triggering the release of histamine, inflammation, and an allergic responses (Marieb & Hoehn, 2010).
+Types of adverse reaction to food
Adverse Food Reaction
Immune- Mediated
IgE- Mediate
d
Non-IgE Mediate
d
Mixed IgE & Non-IgE- Mediated
Cell Mediated
Non-Immune- Mediated
Metabolic Pharmacologic Toxic
Other/Idiopathic/Undefined
e.g., Food
Allergy
e.g., Celiac Disease
e.g., Lactose
Intolerance
(Boyce et al., 2010)
+Food Allergy Organizations
Food Allergy Research & Education [FARE] is: a newly formed organization which
combined two other groups, FAAN and FAI. FARE is “dedicated to food allergy research
and education with the mission of ensuring the safety and inclusion of individuals with food allergies while relentlessly seeking a cure” (FARE, 2014).
+Big 8 Food Allergens in the United States
In the U.S., 90% of food allergies are caused by eggs, milk, shellfish, wheat, peanut, fish, soy, and tree nuts (e.g., walnuts, cashews, almonds, pecans, pistachios, hazelnuts, macadamia nuts) (Sicherer, 2010).
The estimated prevalence of allergies among the U.S. population (Boyce et al., 2010): Peanut: 0.6%-1.3% Tree nuts: 0.4%-0.6% Fish: 0.4% Crustacean shellfish (crab, crayfish, lobster, shrimp): 1.2% All seafood: 0.6% in children and 2.8% in adults Milk and egg: 1%-2% for young children and 0.2%-0.4% in the
general population
+Big 8 Food Allergens in the United States
Eggs Albumin Eggnog Lysozyme Mayonnaise Meringue Ovalbumin Surimi
+Big 8 Food Allergens in the United States
Milk Butter Cream Cheese Lactose Pudding Yogurt Margarine Casein Whey
+Big 8 Food Allergens in the United States
Shellfish Barnacle Crab Crawfish Krill Lobster Prawns Shrimp
+Big 8 Food Allergens in the United States
Wheat Bread crumbs Flour Pasta Wheat germ oil
+Big 8 Food Allergens in the United States
Peanut Peanut oil Peanut butter Peanut flour
+Big 8 Food Allergens in the United States
Fish Anchovies Bass Catfish Cod Salmon
+Big 8 Food Allergens in the United States
Soy Edamame Miso Soya Soybean Soy sauce Tofu
+Big 8 Food Allergens in the United States
Treenut Almond Cashew Chestnut Coconut Pesto Walnut
+Food allergies among children
In 2007 about three million children under the age of 18 (3.9%) were reported to have a food allergy (Branum, 2008).
Reports of food allergies increased by 18% from 1997 to 2007 among children 18 years of age and younger (Branum, 2008).
From 2004 to 2006, children 18 years of age and younger represented approximately 9,500 hospital discharges per year after a diagnosis related to a food allergy (Branum, 2008).
It is more common for female than male adults to have food allergies, while male children typically have more food allergies than female children (Ben-Shoshan, Turnbull, & Clarke, 2012).
+Ethnic groups and children in the U.S.
Less
than
5 y
ears
5-17
yea
rsMal
e
Fem
ale
Non-H
ispa
nic whi
te
Non-H
ispa
nic bl
ack
Hispa
nic
Tota
l0
1
2
3
4
54.7
3.7 3.84.1 4.1 4.0
3.1
3.9
Percentage of children under 18 years who has a re-ported food or digestive allergy in the past 12 months
+Emerging and less prevalent allergens
The majority of studies have focused on the most common food allergens, even though more than 170 foods have been reported to cause IgE-mediated reactions (Boyce et al., 2010).
+Emerging and less prevalent allergens
Examples of uncommon allergens (FARE, 2014): Corn: raw and cooked Meat: beef, mutton, chicken, and pork (heating
and cooking meat may reduce the allergenicity) Gelatin: a protein formed when connective tissue
or skin is boiled Seeds: sesame, poppy, or sunflower Spices: coriander, mustard, and garlic
+Types and prevalence of food allergies in foreign countries Common allergens in other countries and regions
(Baumert, 2012) Canada: sesame, mollusks, mustard, sulfites, and gluten Europe: sesame, mollusks, sulfites, gluten, mustard,
celery, and lupin (a type of legume used in flour form) Codex (South Africa): gluten and sulfites Hong Kong: sulfites and gluten Japan: milk, egg, peanuts, and wheat Australia/New Zealand: sesame, mollusks, sulfites, and
gluten
+Impact of food allergies
Hospitalization related to food allergies
1998-2000 2001-2003 2004-20060
2,000
4,000
6,000
8,000
10,000
2,6154,135
9,537
Years
Avera
ge n
um
ber
of
dis
ch
arg
es p
er
year
+SUMMARY
Food allergy is “an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food” (Boyce et al., 2010, p. S8).
Food allergies are common in U.S. and increased by 18% from 1997 to 2007 among children 18 years of age and younger (Branum, 2008).
In the U.S., 90% of food allergies are caused by big 8 food allergens: eggs, milk, shellfish, wheat, peanuts, fish, soy, and tree nuts (Sicherer, 2010).