Dr. Pedro Morais Silva

Allergist-Immunologist

soualergico.com
Additional safety for allergic patients when shopping for food

HPA Magazine 14

Alterations of our eating habits in the Modern Era, with the introduction of new ingredients and the increasing use of processed food, has significantly increased the frequency of associated unwanted reactions. Now, a new online tool can help identify where the most dangerous ones can be found.
There are two types of adverse reactions due to food: allergic (Food Allergies) and non-allergic (usually known as Food Intolerance).

Allergies are an exaggerated and inadequate response of the immune system against harmless substances in the environment. In a normal situation, the body fights agents that can cause diseases, such as bacteria or parasites and beneficial substances such as food is "tolerated". In Western countries, food allergies affect approximately 5% of children and 3-4% of adults. There is usually a familial tendency, that is, a genetic predisposition for allergies. Frequency seems to be increasing and reactions are becoming more serious, although there is still no explanation for this increase.
Food intolerance is not related to the immune system - it results from incorrect food digestion. Food intolerances, is not related to a single disease, but to a set of different problems that result in unpleasant symptoms due to specific food. Symptoms usually do not occur every time the particular food is ingested and usually reasonable amounts of the particular food are required to cause symptoms. Although they are less severe than food allergic reactions, they can also greatly affect quality of life.
The most common cause of Food Intolerance is the absence of an enzyme necessary for the digestion of an ingredient present in the food or part thereof. A typical example is lactose intolerance, which is due to the lack of the lactase enzyme, a molecule responsible for the digestion of a sugar substance present in milk, known as lactose.
Food intolerance can also result from the chemical composition of the food itself - some food is very rich in amines (canned food, some fish, strawberries or citrus fruit), caffeine (tea, coffee or cocoa) or salicylates (tomatoes, citrus fruits, berries or tea ) which can cause symptoms in those that are more sensitive, even if eaten in small quantities.

When to suspect a food allergy?
A Food Allergy can cause many different symptoms. However, these symptoms are reproducible, that is, they appear whenever the food (or at least food from the same family) is eaten. Reaction is often immediate, and can occur after minutes to a maximum of 2 hours after ingestion. In some situations, contact or inhalation of cooking vapors of the particular food can also cause symptoms.
These symptoms often affect the skin and may appear as red blotches or boils, may cause itching (hives) or swelling, usually on the lips or eyes. They can also cause severe mouth itching, vomiting or abdominal cramp, sneezing, itchy or watery eyes, cough, wheezing, or difficulty breathing. In some situations, a severe allergic reaction (anaphylaxis) may occur involving several organs simultaneously, such as the skin, the respiratory, digestive and / or cardiovascular systems. In such cases, a sudden drop in blood pressure, sweating, pallor or loss of consciousness may occur. These reactions are life-threatening.
Food Intolerance can cause many different symptoms, as it is not one single disease. Symptoms are usually not reproducible or immediate, the most frequent being poor digestion, overeating, bloated stomach, flatulence, heartburn, poor appetite, hair loss, dark circles under the eyes, headaches, among others.

What type of food causes allergies?
Although any type of food can cause an allergic reaction, the food that causes the most allergic reactions is:

• in children – milk protein, eggs, fish, nuts, peanuts, soybean and wheat flour.
• in adults – seafood, fish, nuts/seeds, peanuts and fresh fruits.

At what age do allergies appear?
Food allergy can appear for the first time at any age, although it is more common in infants and children. Unfortunately, someone who previously tolerated a certain type of food can at any time in life become allergic.
In general, when food allergies appear in childhood, they tend to disappear, especially allergies to milk and eggs. On the contrary, a food allergy in adulthood tends to persist for life.

How is it diagnosed?
Food Allergies are diagnosed by an Immunoallergologist, based on a combination of medical history, skin tests, blood tests and oral tolerance tests.

How to live with a food allergy?
The only way to prevent an allergic reaction is to avoid the specific food or substance. This means reading labels carefully, being aware of meals in restaurants or food prepared by others, taking special care when preparing meals due to the possibility of reactions through contact or inhalation of cooking vapors or using poorly washed kitchen tools. 
However, sometimes reactions occur unexpectedly. It is therefore important to have a written emergency plan indicating the medication to be taken in case of an allergic reaction.
There is no homemade or natural remedy that can speed up or solve the symptoms of an allergic reaction. Patients should also not self-medicate at risk of aggravating the clinical condition and putting a life at risk.

The micro-site soualergico.com
The only way to prevent allergic reactions is to avoid the specific food. However, it is sometimes complicated to exclude certain substances when they are not always visible or correctly marked on packages. This creates anxiety in both patients and their families, due to the fear of accidental exposure, contributing a negative impact of this disease on quality of life. 
Together with two Medical Students from the University of the Algarve, we have recently developed a simple micro-site that quickly identifies the presence of food allergens in packed or frozen food, sold in the main supermarkets. 
The soualergico.com micro-site is available online and is totally cost free. It allows the patient to create a shopping list with allergen-free products in different food categories and also provides additional information on food allergies and intolerance.