Transcript Food Allergy Education Modules

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Food Allergies in the United States
Module 1
Module Content
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Definitions
Types and prevalence of food allergies in the United States
Types and prevalence of food allergies in foreign countries
Impact of food allergies
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Definitions
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Food
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“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).
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Definitions
 Food
 “an
allergy
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).
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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).
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Definitions
 Allergic
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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).
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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).
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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
NonImmuneMediated
ImmuneMediated
IgEMediated
e.g., Food
Allergy
Non-IgE
Mediated
e.g., Celiac
Disease
Mixed IgE &
Non-IgEMediated
Cell
Mediated
Metabolic
Pharmacologic
Toxic
Other/Idiopathic/
Undefined
e.g., Lactose
Intolerance
(Boyce et al., 2010)
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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).
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Big 8 Food Allergens in the United States
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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).
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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
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Big 8 Food Allergens in the United States
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Eggs
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Albumin
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Eggnog
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Lysozyme
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Mayonnaise
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Meringue
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Ovalbumin
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Surimi
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Big 8 Food Allergens in the United States
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Milk
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Butter
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Cream
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Cheese
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Lactose
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Pudding
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Yogurt
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Margarine
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Casein
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Whey
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Big 8 Food Allergens in the United States
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Shellfish
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Barnacle
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Crab
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Crawfish
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Krill
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Lobster
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Prawns
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Shrimp
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Big 8 Food Allergens in the United States
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Wheat
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Bread crumbs
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Flour
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Pasta
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Wheat germ oil
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Big 8 Food Allergens in the United States
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Peanut
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Peanut oil
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Peanut butter
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Peanut flour
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Big 8 Food Allergens in the United States
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Fish
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Anchovies
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Bass
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Catfish
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Cod
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Salmon
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Big 8 Food Allergens in the United States
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Soy
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Edamame
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Miso
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Soya
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Soybean
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Soy sauce
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Tofu
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Big 8 Food Allergens in the United States
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Treenut
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Almond
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Cashew
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Chestnut
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Coconut
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Pesto
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Walnut
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Food allergies among children
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In 2007 about three million children under the age of 18 (3.9%) were
reported to have a food allergy (Branum, 2008).
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Reports of food allergies increased by 18% from 1997 to 2007 among
children 18 years of age and younger (Branum, 2008).
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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).
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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.
Percentage of children under 18 years who has a reported food
or digestive allergy in the past 12 months
5
4.5
4
3.5
3
2.5
2
1.5
1
0.5
0
4.7
3.7
3.8
4.1
4.1
4.0
3.9
3.1
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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 IgEmediated reactions (Boyce et al., 2010).
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Emerging and less prevalent allergens
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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
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Types and prevalence of food allergies
in foreign countries
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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
Average number of discharges
per year
Hospitalization related to food allergies
10,000
8,000
6,000
9,537
4,000
2,000
2,615
4,135
0
1998-2000
2001-2003
Years
2004-2006
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Video Case Study
Peanut Allergy Causes Parental Outrage
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SUMMARY
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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).
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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).
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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).