TAKE FOOD ALLERGIES SERIOUSLY; THE WRONG BITE MAY BE LIFE THREATENING.

Byline: Linda Shrieves Orlando Sentinel

Don't think food allergies are risky business?

Two years ago, an 8-year-old Michigan girl who was allergic to beans died after visiting a playmate's house. The girl hadn't eaten any beans; a pot of beans was on the stove and the fumes from the kitchen sent the girl into anaphylactic shock. She died before rescuers could treat her.

Food allergies are serious, but they don't get the attention that many allergists - and allergy sufferers - would like.

"People just don't take food allergies seriously," said Anne Munoz-Furlong, president of the Food Allergy Network, a nonprofit group that helps allergy sufferers and educates the public.

"When a person with a food allergy turns down a particular food, people say, 'Oh, one little bite won't hurt.' For some people, one little bite can be the last bite they take," Munoz-Furlong said. "It's very frustrating to people with allergies."

For people with food allergies - not to be confused with food intolerance, an annoying, but not life-threatening reaction - even 1/5,000th of a teaspoon of an offending food can send them into anaphylaxis, a sudden, severe allergic reaction.

Anaphylaxis occurs when the body's immune system attacks what it perceives as an invader. The person breaks out in hives, the lips and face swell, sometimes even closing the throat. Other symptoms include asthmatic reactions, vomiting, diarrhea, cramping, a dip in blood pressure and unconsciousness. To shut down the reaction, most patients must be treated quickly with liquid antihistamines and epinephrine.

Unfortunately, the public misconceptions about food allergies stem from the millions of Americans who go around pronouncing themselves "allergic" to particular foods. More than likely, most of them probably have a food intolerance - only 1 percent to 2 percent of the American public have true food allergies.

Food intolerance is also an adverse reaction to food, but, unlike food allergy, it doesn't involve the immune system. But the reactions may look the same. The symptoms include nausea, vomiting or diarrhea.

Food intolerances sometimes are caused by the body's lack of a digestive enzyme. Many people, for instance, lack the enzyme needed to process lactose in milk.

If you have a food intolerance, you usually can eat a small amount of the offending food without a reaction. With an allergy, the tiniest amount will cause a reaction.

Doctors aren't certain how food allergies develop, but they think that tendencies toward allergies - whether it's hay fever or food allergies - may be inherited.

But it is repeated exposure to foods that triggers the allergy itself. Eat a lot of peanut butter or peanut products as a kid and, if your body is predisposed to allergies, you may wind up allergic to peanuts.

"The way you develop any allergy is through repeated, intimate exposures, whether it's pollen, animal dander or food," said Dr. Eugene Schwartz, an allergist in Altamonte Springs, Fla.

That's why food allergies differ depending on culture, said Dr. Santiago Martinez, a Winter Park, Fla., allergist. In the United States, we eat a diet heavy on wheat. So, wheat allergies are very common, as are allergies to peanuts, milk, eggs, fish and shellfish. In Italy, however, where tomatoes constitute a major part of the everyday diet, tomato allergies are common, Martinez said.

If you're over age 20 and haven't developed a food allergy yet, chances are that you won't. Most food allergies appear in the first 20 years of life, Schwartz said.

Infants, on the other hand, can develop food allergies even before they are born. Allergies can develop in the womb because the baby is exposed to every food that the mother eats.

Infants also can develop food allergies if solid foods are introduced before their guts have matured. That's why pediatricians often recommend waiting to introduce solid food until babies are 4 months old.

If you suspect that you or your child has a food allergy, see an allergist. The doctor will want to know the symptoms that you've experienced. In particular, watch for hives or swelling of the lips after eating a food. Although reactions to food may be delayed, most patients experience a reaction between 15 minutes and an hour after eating the food.

Don't dismiss an allergic reaction that seems mild. Allergic responses can build, so the next time you eat the same food, you may experience a more severe reaction.

Once you've been diagnosed with a food allergy, though, the tough part begins. Now you must learn to live with a food allergy.

And it's not easy.

People with food allergies - particularly adults - often get depressed shortly after they've been diagnosed. The reason? Suddenly, a world of food possibilities seems very narrow.

And no wonder. Some allergists advise their patients that they should eat only food that they prepare themselves. That means no restaurants, no parties.

Some doctors aren't quite so strict, but they stress that patients should view every food with suspicion.

"What I say to patients is this: You have to be extremely careful. You have to carry some emergency medication with you everywhere," Schwartz said. "Go to restaurants that you've been to before and order dishes that they've had before. But to be absolutely certain, they can't eat out."

And some cuisines are out of the question. People allergic to peanuts, for instance, should never eat Chinese food. That's because Chinese cuisine uses peanuts so much that the oil and the woks are contaminated unless they are scrubbed after preparing each dish.

To make matters worse, the most common allergies are to common ingredients. If you're allergic to wheat, everything from pasta to crackers to bread may now be forbidden. People allergic to milk or other dairy products find themselves unable to eat what the rest of the world takes for granted.

And if you have food allergies, you will have to spend the rest of your life reading food labels. Any slip and you might land in the hospital.

That's why many allergists send patients to see a registered dietitian who has experience with food allergies. A dietitian can teach patients how to read food labels and help them rework their diets.

But there are some bright notes for people with food allergies.

In the past decade, food manufacturers and the health-food industry have introduced more alternative foods available for allergy sufferers.

"People usually are hungry and frustrated when they come in here," said Joan Carroll, a licensed nutrition counselor at Chamberlin's Markets, a chain of Central Florida health-food stores "If I have time, I'll walk through the store and show them all the alternatives that are available to them. And they usually leave feeling relieved and much happier."

People allergic to wheat, for instance, can buy breads made with other grains; they can eat rice pasta or corn pasta instead of traditional pasta. People allergic to dairy products can try soy milk or rice milk and substitute soy cheese for dairy cheese. All of these products are commonly available at health-food stores.

In addition, there's help from the Food Allergy Network. This Fairfax, Va., organization publishes a bimonthly newsletter that teaches allergy-sufferers how to read food labels, and notifies members when a product has been mislabeled.

"We encourage people to live a normal life," said Munoz-Furlong, who founded the group 11 years ago when her infant daughter was diagnosed with allergies to eggs and milk. "Believe it or not, it is possible."

For more information, the Food Allergy Network will send a free sample of its bimonthly newsletter ($24 per year) to you. Just send a self-addressed stamped envelope to: FAN, 10400 Eaton Place, Fairfax, Va. 22030.

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Photo (Color) Shellfish and fish allergies are common. Food allergies are serious, but they don't get the attention that many allergists and allergy researchers would like. Barbara V. Perez/Orlando Sentinel