Chapter 34: MNT for Adverse Reactions to Food: Food Allergies and Intolerances Flashcards
ARF meaning
adverse reaction to food
cover both food allergies and intolerances which can result to distressing symptoms and affecting a person’s quality of life
adverse reactions to food
an adverse immune-mediated reaction to a food, usually a chon, glycoprotein, or hapten that the person has been sensitized to, when eaten, causes the release of inflammatory mediators or chemicals that act on body tissues and result in symptoms
food allergy
an adverse reaction to a food or food additive that does not involve the immune system and results from the body’s inability to digest, absorb, or metabolize a food or component of the food
food intolerances
a small molecule which, when combined with a larger carrier such as a protein, can elicit the production of antibodies which bind specifically to it (in the free or combined state)
hapten
are caused by non-immunologic mechanisms including toxic, pharmacologic, gastrointestinal, genetic, metabolic, psychogenic, or idiosyncratic reactions
food intolerances
is any molecule that will elicit an immune response in the body
antigen
when an antigen elicits a hypersensitivity reaction, as in allergy, is called
allergen
used when it is unclear whether the reaction is immunologically-related or due to a biochemical or physiologic defect
food sensitivity
one etiology of adverse reactions to food is from cesarean delivery and lack of breastfeeding (T/F)
T
symptoms of food allergy (4)
dermatologic, gastrointestinal, systemic and nervous system, neurologic system
food allergies - symptoms
location: skin. mucus membrane and eyes, ears, nose and throat
symptoms:
-itching
-hives
-atopic dermatitis
-skin swelling and redness
-itchy, watery, and reddened eyes
dermatologic
food allergies - symptoms
symptoms:
-abdominal pain
-bloating and distention
-nausea and vomiting
-indigestion and belching
-diarrhea and constipation
-oral and pharyngeal itching
-gi bleeding
gastrointestinal
food allergies - symptoms
symptoms:
-migraine
-listlessness
-hyperactivity
-irritability
-chilliness
-dizziness
-anaphylaxis
-hypotension
-dysrhythmia
systemic and nervous system
food intolerances - causes and examples
ARFs resulting in clinical symptoms that are not immunologic in nature
food intolerances
food intolerances - causes and examples
includes enzyme deficiencies and malabsorptive disorder (lactose intolerance and g6pd)
diseases of the involving digestive system (cystic fibrosis, gallbladder and pancreatic disease), inflammatory bowel diseases
gastrointestinal disorders
food intolerances - causes and examples
ex: phenylketonuria/PKU and galactosemia
inborn errors of metabolism
psychologic or neurologic reactions
adverse reactions to the followiing:
phenylethylamine, tyramine, and histamine
reactions to pharmacologic agents in food
psychologic or neurologic reactions
adverse reactions to:
chocolates, aged cheese, and wines
phenylethylamine
psychologic or neurologic reactions
adverse reactions to:
aged cheeses, brewer’s yeast, canned fish, chicken liver, bananas, eggplant, tomatoes, raspberries
tyramine
psychologic or neurologic reactions
adverse reactions to:
aged cheese, fermented foods, shellfishes, egg whites, chocolates, alcohol, peanuts, etc.
histamine and histamine-containing foods
psychologic or neurologic reactions
adverse reactions to: artificial coloring agents (tartrazine and azo dyes), benzoates, butylated hydroxyanisol, (BHA), burylated hydroxytuluene (BHT), monosodium glutamate (MSG), nitrates and nitrites, salicylates
reactions to food additives
psychologic or neurologic reactions
adverse reactions to: shrimps, avocado, instant potatoes, dried fruits, and vegetables
sulfites
psychologic or neurologic reactions
adverse reactions to: proteus, klebsiella, or e.coli bacteria can cause histidine to breakdown a histamine
reactions to microbial contamination or toxins in food
more common than food allergies
food intolerances
can cause anaphylactic reactions
immune-mediated food allergy
do not cause anaphylactic reactions
food intolerances
food intolerances - clinical symptoms
-bloating and flatulence
-diarrhea and abdominal pain
-anemia
-malabsorption
-anorexia
-nausea
-elevated levels of phenylalanine
-mental retardation
-migraine
-hives, itching, eczema
food intolerance
adverse food reaction - assessment
includes skin tests and blood tests for serum antibody and other tests which measure cytokines released by the body’s immune system in response to food antigen exposure
immunologic testing
3 tests used in food challenge protocols
-double-blind, placebo-controlled food challenge
-single-blind food challenge
-open food challenge
3 tests used in food challenge protocols
neither the patient nor the physician knows the identity of the test food component
usually disguised as a powder in a food known to be tolerated (such as apple sauce) or in a gelatin capsule
patient’s reaction is compared to his or her reaction to the placebo, and the patient is monitored in a clinical setting
double-blind, placebo-controlled food
3 tests used in food challenge protocols
a food challenge in which the patient is blinded to the challenge food’s identity, but the clinician is not
the food or a powder of it is disguised in another food and reaction are observed and recorded
single-blind food challenge
3 tests used in food challenge protocols
the patient in knowingly given a serving of the suspect food and observed for several hourd for a reaction
open food challenge
adverse food reactions - management
include prescription of anti-histamine and anti-inflammatory medications with the purpose of alleviating the symptoms of allergic reaction
medical
adverse food reactions - management
involves a thorough recording of food and symptoms experienced over a period of 7-14 days to carefully analyze the culprit of allergic reaction
once a food is suspected to cause clinical symptoms, it will be eliminated in the diet for 4-12 weeks (food elimination)
dietary
reintroducing the food in minute amounts
desensitization
diet mgmt- bases
if the nutrients present in the food is vital to the individual’s health
essentiality of nutrients
diet mgmt- bases
as a rule, if the symptoms are serious, food item is completely eliminated
fatality of symptoms
big 8 allergens
milk, eggs, fish, Crustacean shellfish, tree nuts, peanuts, wheat, and soybeans
a general term for an adverse reaction to an
ingested food or food additive both immunological and non-immunological.
food sensitivity
proteins in the bloodstream or other body fluids that are produced in response to foreign materials that enter the body.
antibodies
immediate reaction
within 2 hours
delayed reaction
within 48 hrs
An abnormal immunologic response to a harmless food
proteins, include (2)
IgE(immunoglobulin E) – mediated and non-IgE -mediated allergic response.
have a slow onset and usually involve the GIT
Non-IgE mediated allergies
characterized by an immediate onset of symptoms.
IgE-mediated food allergies
an immunological hypersensitivity or truly allergic reaction resulting from the ingestion of food or food additive
food hypersensitivity
a general term for an adverse reaction after ingestion of a food or food additive as a result of a direct non-immune reaction
food toxicity
a quantitively abnormal response to a food or food additive. Such response differs from its physiologic or
pharmacologic effect and resembles a hypersensitivity reaction, but there is no immune mechanism involved.
food idiosyncrasy
RAST meaning (food allergy diagnosis)
radioallergosorbent extract test
ELISA meaning (food allergy diagnosis)
enzyme-linked immunosorbent
assay
A diagnostic test diet and the usual offending food such as protein rich food are eliminated one after the other, until the exact food causing the allergy is noted.
elimination diet
An adequate diet which excludes the food causing allergic reactions. Examples: milk-free diet, egg-free diet, wheat-free diet, etc.
avoidance diet
The food causing the allergy is given gradually in increasing amounts over a period of ten to twelve months. If the allergy is noted again after twelve months, the person is given the avoidance diet until the allergies has disappeared and desensitized once more.
desensitization diet
