MNT for Adverse Reactions to Food Flashcards
Food allergies elicit reactions to food, certain reactions affect the digestive system due to ____ in the food.
Proteins
GI disorders such as celiac’s disease, include an _____ response.
Immune
T/F: Food intolerance also elicits an immune response
False
T/F: Food intolerance is the bodies inability to digest, absorb or metabolize food or a component in food
True
T/F: A food sensitivity is when it is unclear whether the reaction is immunologically related or due to a biochemical/physiological defect
True
Adverse food reactions encompass both food _____ and intolerances, both can adversely affect health
Allergies
Atopy is a genetic _______ to produce excessive IgE antibodies in response to an allergen, resulting in the development of symptoms like eczema, asthma etc.
Predisposition
T/F: A food allergy is an adverse immune reaction to a food, usually a food protein, or glycoprotein, causing the result of inflammatory mediators. The reaction can either be IgE or non IgE mediated upon the exposure to food.
True
T/F: Oral intolerance allows an individual to eat foods that are foreign, without any ill effects or reactions to it.
True
T/F: A food allergy is always involves an immune response, usually due to a protein in the food.
True
T/F: A food intolerance is when the body is unable to process the food or a component in the food.
True
A food intolerance ____ involves the immune system.
Never
T/F: Unlike food allergies, food intolerances are not usually caused by a protein in the food, rather, a carb, additive or some other compound in the food
True
If its not a food allergy or intolerance, it is usually categorized as a food _______.
Sensitivity
T/F: Some food sensitivities are immune mediated.
True
Ex. Someone with a milk allergy, is most likely having an immune reaction to the ____ or _____, the proteins in milk.
Whey, caesin
Ex. Someone with a lactose intolerance is unable to digest lactose, the _________ in milk.
Carbohydrate
IgE stands for immunoglobulin E, the same thing as an _______.
Antibody
T/F: Non IgE mediated allergies are still immune modulated.
True
Food borne illnesses are a form of food _______.
intolerance
Pharmacological food intolerance are usually caused by ____ in the food.
Additives like sulfites, caffeine, histamine, tyramine, MSG
GI food intolerances, such as IBS, are usually caused by _______.
FODMAPS
Part of the allergic response is your body producing ______ which causes symptoms such as hives, itching and swelling.
Histamine
T/F: IgE mediated food allergies are usually the most common.
True
Atopy is a risk factor for food allergies because it is a genetic predisposition that produces an ________ amount IgE antibodies in response to allergies
Excessive
The risk factors for food allergies include: heredity, atopy, __________________________, environmental factors, food processing, and hygiene hypothesis.
Amount and timing of antigen exposure
Increased permeability (loose junctions) and altered gut microflora can create higher risks for food allergies as the _______ is where majority of our immune system is stored.
GALT: gut associated lymphoid tissue
Characteristics of IgE-mediated allergic reactions include:
Rapid onset of symptoms (15-30 mins)
Exposure through inhalation, skin contact, or ingestion
Reactions to the 9 common allergens
9 foods that account for the majority of allergic reactions in the US:
wheat
dairy
peanuts
tree nuts
seasame (new)
eggs
soy
shellfish
fish
Food-induced anaphylaxis
It can be fatal, common with nuts
____ allergy syndrome is caused because certain fruits and vegetables contain antigens similar to certain pollens. If someone is allergic to the pollen, they will most likely be allergic to the food.
Oral allergy syndrome
Symptoms are confined to the oral cavity
Itchy mouth and throat
It is not very severe, mild
Cooked fruits and vegetables can be tolerated because they alter the protein.
Latex-fruit syndrome or latex-food syndrome: Some people with latex allergies have IgE antibodies that cross-react with antigens from foods such as avocado, _______, chesnut, kiwi, and mango.
Banana
Food-dependent, exercise-induced anaphylaxis
Not very common
Occurs when exercising within 2-4 hrs after consuming antigen
Allergen + exercise must be present for reaction to occur
T/F: If someone with food-dependent, exercise-induced anaphylaxis eats the food without exercising, they will NOT have an allergic reaction.
True
T/F: If someone with food-dependent, exercise-induced anaphylaxis eats the food and exercises, they will have an allergic reaction 6-8 hrs after consumption.
F, 2-4 hrs
For food-dependent, exercise-induced anaphylaxis, the food and _____ must be present for the allergy to occur.
Exercise
EGE and GEG (eosinophilic esophagitis and gastroenteritis) are ______ IgE-mediated responses, both having inflammation in response to certain foods, infiltrating WBC which damages the GI tract.
Non, resulting in a tricky diagnosis since blood tests cant determine
T/F: With cow milk protein allergy, the mother can still consume lactose-free milk
F, the mother must avoid all dairy if breastfeeding
The ___________ elimination diet is used to treat EGE and GEG (eosinophilic esophagitis and gastroenteritis). It begins with the removal of ______ and _____ for six weeks to see if symptoms resolve. If symptoms persist, remove _____ and ____ for six weeks. If symptoms persist, remove _____, _______, _______ and ________.
Step-up 2-4-6
Dairy and wheat
Eggs and soy
Nuts, tree nuts, fish and shellfish.
With cow milk protein allergy, if a mother is not breastfeeding, the baby must be given a _______ or elemental formula.
Hydrolyzed
Hydrolyzed formula breaks down protein into smaller _______, while in an elemental formula, the protein is broken down completely into individual _______ _______. Hydrolyzed formula is most preferred if tolerated.
Peptides, amino acids
____ formula is not recommended before 6 months of age, due to being a common food allergy.
Soy
T/F: CMPA is not as severe as food protein-induced enterocolitis syndrome (FPIES) because although it causes GI upset, it does not cause malnutrition.
True
Food protein-induced enterocolitis syndrome (FPIES)
Non-IgE mediated
Could be related to dairy or soy
Common in formula-fed infants
Main symptom- projectile vomiting
Inflammation of the intestines and colon
CMPA is _____ non-IgE and IgE mediated.
mixed
Food protein-induced enterocolitis syndrome (FPIES) requires mom to be ____ and _____ free if breastfeeding and formula-fed babies to have dairy-free/soy-free formula or _______ casein formula.
Milk, soy
Hydrolyzed
Milk soy protein intolerance (not an allergy)
Blood or mucus in infants’ stool - main symptoms
Mom must avoid dairy and soy if breastfeeding
Hydrolyzed or elemental on formula
Early onset and is usually outgrown
T/F: Usually, IgE-mediated allergies can be outgrown.
True
Carbohydrate intolerance includes being intolerant to _______ and FODMAPs. This is due to individuals lacking the _____ to break down the carbohydrate.
Lactose, enzyme
In food allergies, the intact protein may be absorbed through a permeable GI tract, eliciting an immune response. However, with food intolerances, the carbohydrate does not get ______ and travels to the intestine to be fermented, causing GI symptoms.
Absorbed
Carbohydrate intolerances can be diagnosed with ____ tests.
Breath
Food additives people could be intolerant to include: artifical food dyes, MSG, and _____.
Sulfites
_______ are a food additive, used in dried fruit and wine.
Sulfites
_____ is a food additive used in bouillon, canned and frozen foods and condiments.
MSG
T/F: A gluten intolerance/sensitivity, is NOT an autoimmune reaction, although it may involve an immune component.
True
T/F: Gluten intolerance/sensitivity is different than a wheat allergy. Because gluten is in rye, barley, and oats, people with a wheat allergy can still consume those items.
True
T/F: Unlike celiacs, there is no definitive test to diagnose gluten intolerance/sensitivity.
True
To diagnose gluten intolerance/sensitivity:
- Rule out wheat allergy and celiac disease
- Elimination diet: remove gluten for 4-6 weeks
- Follow up with food challenge: reintroduce gluten foods every 3 days to see which foods cause symptoms
T/F: The main difference between gluten intolerance/sensitivity and celiac disease is that you do not have malnutrition, inflammation, or damage to the intestinal wall.
True
T/F: Gluten intolerance/sensitivity has varying degrees of tolerance, whereas celiac patients can not consume any gluten.
True
Food additives that trigger migraines include: MSG, sulfites, artificial sweeteners, and ______.
Tyramine, is present in aged cheeses, cured meats, fermented beverages, pickled foods
Prevention of migraines may be associated with these supplements: Mg citrate, CoQ10, riboflavin, turmeric, and _____.
Zinc
_____ is a food shown to reduce migraines.
Ginger
Diagnosis of food allergies includes: clinical history, diet history, physical exam, biological tests (blood), non-immunological tests (stool), and __________ tests.
Immunological tests, including, skin-prick tests, serum IgE tests, and non-IgE tests (not very accurate).
Food allergy treatment includes: food avoidance, rescue treatments (antihistamines, EpiPen), _________, and a re-test to see if allergies were outgrown
immunotherapy
Types of allergen immunotherapy
Oral: mouth
Epicutaneous: through skin
Sublingual: under the tongue
Iclicker: A major difference between food intolerance and food allergy is that food allergies are…
Mediated by IgE
- The immune system mediates all allergy reactions, most are mediated by IgE but can be mixed or non IgE. Intolerances are not mediated by the immune system or release immungolobins.
Which of the following is NOT one of the allergens required to be listed on the food label?
a. Coconut
b. Soybeans
c. Shellfish
d. Wheat
a. Coconut
Ideally, infants at high risk for food allergies should be fed…
breastmilk with the introduction of complementary foods at 4-6 months
IgE-mediated reactions include (6)
Food induced anaphylaxis
Oral allergy syndrome
Latex fruit syndrome/Latex food syndrome
Food dependent exercise induced anaphylaxis
Atopic eczema
Asthma
Non IgE mediated allergies include (3)
Eosinophilic esophagitis and gastroenteritis
Food protein induced enterocolitis syndrome
Celiacs disease
Mixed IgE and Non IgE mediated include:
Cows milk protein allergy
T/F: Eosinophilic esophagitis and gastroenteritis are easy to diagnose
False, hard to diagnose since it is non IgE mediated and requires the elimination diet
T/F: Milk Soy protein intolerance is an allergy
False, an intolerance to milk and soy
T/F: Both CMPA and Milk Soy Protein Intolerance have early onset but can usually be outgrown. You should also reintroduce milk and soy at least at 1 year of age.
True
T/F: Foods that trigger EOE and EGE should be reintroduced in the diet
False, unless you’re sure they don’t cause problems
T/F: There are tests to diagnose wheat allergies
True
Immunological tests for food allergies include
- Measuring IgE antibodies via:
Serum prick test
Serum IgE test
Non IgE test
Nonimmunological tests for food allergies include
Stool
Urine
Sweat
Breath hydrogen
Genetic
Biochemical tests for food allergies include
Blood tests
Allergen immunotherapy for food allergies include:
Oral exposure
Epicutaneous/Skin exposure
Sublingual exposure
Types of immune mediated food allergies: (3)
IgE mediated
Non IgE mediated
Mixed IgE and non IgE mediated
Non immune mediated food intolerances (6)
Microbial
Pharmacological
Gastrointestinal
Physiological
Metabolic
Other/Idiopathic
Pharmacological food intolerances include:
Histamine
Tyramine
caffeine
Food additives
Tartrazine - Yellow 5
Benzoates
Sulfites
MSG
Metabolic food intolerances include:
PKU
MSUD
Symptoms of gluten intolerance/sensitivity
GI Symptoms
Eczema
Rash
Foggy mind
Headache
Fatigue
if someone tests negative for a skin-prick test of serum IgE test, we can rule out _____.
Allergies
Important nutrients for preventing food allergies (4):
Probiotics/Prebiotics
Human milk oligosaccharides
Vitamin D
Omega 3 fatty acids
Non–IgE-mediated reactions are present in delayed or ______ reactions to food allergen ingestion.
Chronic
