FOOD ALLERGIES

Question 1

2 classifications of food reactions

Answer 1

1. immune mediated (food allergy)
2. NOT immune mediated (food intolerance)

Question 2

what type of food reaction is IgE?

Answer 2

immune mediated (immediate reaction)

Question 3

describe the two processes of IgE-mediated allergies

Answer 3

1. sensitization:
   - kid exposed to peanut - B-cells make a specific anti-body called IgE against the peanut
   - IgE binds to th emast cell which are allergy cells and then sit there bound
   - nothing happens the first time
   *first sensitization can happen through the skin
2. allergic reaction
   - have the mast cell with IgE primes
   - exposed to allergen, allergen binds to the mast cell rapidly cross linked the mast cells degranulate, release histamine and this is what causes the allergic reaction

Question 4

list the top 9 allergy foods for kids

Answer 4

1. Cow’s milk
2. Egg
3. Peanut
4. Tree nut
5. Fish
6. Shellfish
7. Wheat
8. soy
9. Sesame

Question 5

describe some clinical presentations of an allergic reaction

Answer 5

Skin: hives, swelling, flushing
Lungs: cough, wheeze, sneezing
GI: vomiting, abdominal pain, diarrhea
CVS: drop in blood pressure

Question 6

what is anaphylaxis

Answer 6

severe, immediate, potentially life-threatening reaction

2 body systems involved

Question 7

what is the treatment for anaphylaxis

Answer 7

epinephrine (anti-histamines are not enough)

Question 8

what are three ways to diagnose food allergies

Answer 8

1. skin prick testing
2. blood test
3. gold standard: oral food challenge
   - bring then into clinic and give them food in tiny bites
   - helpful if possibly outgrowing their allergy

Question 9

what is IgG testing

Answer 9

often used by Naturopaths
- only tells us about food intolerances, not food allergy (IgE)

Question 10

how does heating/processing affect food allergies

Answer 10

most allergens are heat stable - patient would still react to the heated/processed version of the food

• exception: cow’s milk and egg (80% would tolerate heavily cooked forms of the food)

Question 11

what is oral immunotherapy

Answer 11

new treatment option
- give incremental doses of an allergen to help outgrow the allergy
- mostly done in preschoolers
- immune system is still flexible when they are young

Question 12

for high risk infants, when should you consider introducing common allergenic solid foods?

Answer 12

• common allergenic solids at around 6 months of age, but not before 4 months
• allergenic foods should be introduced one at a time

Question 13

what is lactose intolerance

Answer 13

• lack of activity of the small intestinal enzyme - LACTASE
• lactase is used to digest lactose –> glucose and galactose

Question 14

what nutrients are most important for vegetarians?

Answer 14

• B12
• vitamin D
• calcium
• zinc