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Could it be something you've eaten? Almost one in three of us believes we react badly to certain foods, so in Allergy Allergy Awareness Week, dietitian Juliette Kellow separates fact from fiction.

Byline: Kellow separates

EVEN if you're not a sufferer yourself, the chances are you know someone who avoids certain foods because they believe they're allergic or intolerant to them.

Increasingly, research is showing they may be right. Figures from Allergy UK suggest allergies are a major health problem.

Around 21 million adults in this country suffer from at least one allergy, ranging from hay fever, eczema and asthma to insect stings, pets and food.

Every year, the number of sufferers increases by 5% and research confirms that in recent years, there's been a particularly dramatic rise in food allergies, especially among children.

According to Allergy UK, cases of food allergies have doubled in the past decade and the number of hospital admissions caused by severe allergic reactions has increased sevenfold.

But how can we tell if we really are allergic to a food - and which are the most likely culprits?

Allergy or intolerance?

"A food allergy is a reaction produced by the body's immune system," explains Laura Forwood, dietitian for healthcare company Abbott.

"With an immediate allergic reaction to a food, your skin can be itchy or swell, you may feel sick or vomit, and experience stomach pains and diarrhoea.

"Although rare, some people can experience severe, sometimes life-threatening symptoms, which require immediate medical attention.

"This is known as anaphylaxis, and symptoms can include swollen eyes, face or lips, feeling light-headed or faint, or loss of consciousness."

If someone is suffering this badly, dial 999 and request an ambulance.

In contrast, a food intolerance doesn't involve the immune system.

Laura explains: "Symptoms tend to vary more, and because people sometimes react hours or days later, it can be difficult to identify the exact food that's caused the reaction.

"Intolerances primarily affect the gut, such as stomach pain or bloating, but eczema or itching are also common."

According to the British Society for Allergy & Clinical Immunology (BSACI), 6-8% of children and up to 4% of adults have a true food allergy.

And one in five people alters their diet because they believe they have a food intolerance, although experts believe the true incidence is much lower than this.

The main offenders

The British Dietetic Association says that around 90% of food allergies in children are caused by just eight foods - wheat, cow's milk, eggs, fish, shellfish, soy, peanuts and tree nuts, such as almonds.

Nevertheless, any food can cause an allergic reaction - and sesame, citrus fruits and kiwi seem to be becoming more common culprits.

Meanwhile, in adults, allergies to fish, shellfish, peanuts and tree nuts are often seen.

Surprisingly, another common food allergy is to raw fruits and vegetables, especially in hay fever sufferers. This is because the proteins in pollen from trees, grasses and weeds, and those in fruit, veg and nuts, have a similar structure.

In hay fever sufferers, the immune system recognises the proteins in fruit and veg as if they were pollen and responds by triggering an allergic reaction to them.

Symptoms include itching to lips, mouth and ears. The good news is that heat deactivates the protein responsible, so most people can eat the offending fruit or veg when it's cooked or processed.

Getting tested

If you think you have a food allergy, it's vital to get a proper diagnosis from a medical specialist. "Your doctor can refer you to a specialist for allergy testing," says Laura.

On the other hand, unless lactose intolerance is suspected, there's no reliable test to diagnose food intolerances so this is usually done through eliminating the suspected food, monitoring symptoms, then reintroducing it.

Dr Paul Seddon, Consultant Paediatric Allergist, believes high street or online allergy tests and kits are worthless.

"Invalid tests come with a high risk that you will be recommended inappropriate or potentially harmful treatments," he says. "I commonly see children who've been put on to unnecessarily restricted diets because their parents assume, in good faith, that they have allergies to multiple foods on the basis of allergy tests, which have no scientific basis."

Dangers of DIY diagnosis

Eliminating foods based on the results of unreliable tests or through selfdiagnosis can mean you become obsessed with what you eat and develop nutrient deficiencies - and resulting health problems.

For example, ditching dairy can mean poor calcium intakes, leading to osteoporosis in the long term And without a proper diagnosis, you could be avoiding the wrong food - yet still include the problematic one.

For more advice, visit Allergy UK (allergyuk.org), British Society for Allergy and Clinical Immunology (bsaci.org), Anaphylaxis Campaign (anaphylaxis.org. uk), NHS Choices (nhs.uk/conditions/ food-allergy).

Allergy alert - symptom checker

The symptoms of a food allergy usually develop very quickly after eating the offending food.

Common symptoms include:

Tingling or itchy mouth and throat

Itchy, often raised, red rash or hives on the skin

Swollen eyes, lips, tongue and roof of the mouth

Difficulty swallowing

Wheezing or shortness of breath

Dizziness or feeling light-headed

Feeling or being sick, stomach pains and diarrhoea

Anaphylaxis - this includes the symptoms above and can lead to increased breathing difficulties, rapid heartbeat, drop in blood pressure and unconsciousness

Avoiding diet deficiencies

Once a medical specialist has diagnosed a food allergy, the next step is to get advice from a qualified dietitian to ensure that removing offending foods doesn't leave you short on protein, vitamins or minerals. This is especially important if you need to avoid lots of foods or a whole food group, such as dairy. Here's how to make up nutrient shortfalls

DAIRY

Milk, yoghurt and cheese are the main providers of bonestrengthening calcium and, in the long-term, poor intakes can affect bone health.

"Suitable dairy alternatives include soya milk and yoghurts, or alternative milks like oat, rice or hemp," says Laura. Choose those with added calcium and avoid sweetened varieties. You'll also need to avoid anything containing butter, cream, milk powder or milk protein. Lactose-free milks are suitable for an intolerance to lactose.

"These aren't suitable for an allergy to milk protein though," adds Laura.

Non-dairy foods that boost calcium include tinned fish, such as salmon and sardines where the small bones can be eaten, green leafy veg such as kale, nuts, seeds and dried fruit.

PEANUTS, TREE NUTS AND SEEDS

These provide protein, heart-healthy monounsaturated fats, iron, calcium, zinc and vitamin E. Many people can eat some varieties even if they're allergic to others, so stick with those that don't cause a reaction.

Check labels - they can lurk in biscuits, cereals, cakes, chocolate, sauces and salads, and sesame oil is found in many Asian dishes.

Many products may have come into contact with nuts during manufacturing so need to be avoided.

Boost monounsaturated fats with a little olive oil, and vitamin E with a little sunflower or rapeseed oil. Avocado provides both.

WHEAT

Wheat-containing starchy carbohydrates provide energy and can be rich in fibre and B vitamins.

Wheat is hard to eliminate as it's in so many foods, including bread, pasta, couscous, many breakfast cereals and anything that contains flour, such as cakes, biscuits, pastry, pies, pizza, crackers, and even sauces and soup.

A wheat-free diet isn't the same as a gluten-free diet (gluten is a protein in wheat, rye and barley that can cause coeliac disease, which is an autoimmune condition rather than an allergy). But many gluten-free products are also wheat-free. Potatoes, rice, quinoa and porridge are good wheat-free alternatives.

EGGS

They provide protein, vitamins A, D, B2 and B12, and iron. "It's easy to avoid eggs in their simple form, but they're also found in cakes, biscuits, egg pasta and noodles, custard and some sauces," says Laura.

Other protein-rich foods, such as meat, provide similar nutrients. Quorn, tofu, beans, lentils and chick peas are good vegetarian options.

FISH AND SHELLFISH

"Fish and shellfish provide heart-healthy omega-3 fats," says Laura. "Fish, particularly oily fish, also contains vitamin D, and shellfish provides selenium, zinc, iodine and copper."

Most people are only allergic to certain varieties, so enjoy those that don't cause symptoms.

Otherwise, choose omega-3-containing plant foods, such as walnuts, flaxseeds or rapeseed oil.

Avoid oyster and fish sauces, and recipes containing them, such as Asian dishes, and ready-made sauces and stocks. Skip fish oil supplements too.

SOY

"This is a good vegetarian source of protein, which can be replaced in the diet by beans, lentils or eggs," says Laura.

But be aware that allergies to soy often go hand in hand with allergies to other legumes, including peanuts.

Check labels as many vegetarian dishes (veggie sausages, burgers and ready meals) as well as processed foods include soy protein. Meat, fish, poultry and dairy products are good protein sources for non-veggies.

Always read the label

Although you can be allergic to any food, by law, any pre-packed food sold in the UK must be labelled if it contains any of the following 14 allergens: milk, egg, cereals containing gluten, soya, sesame, fish, crustaceans, molluscs, lupin, celery, mustard, sulphites, tree nuts and peanuts.

Information must also be available for any non-packaged food, including meals from restaurants, takeaways, cafes and bakeries.

I've often seen children put on unnecessarily restricted diets based on tests that have no scientific evidence
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Title Annotation:Features
Publication:The Mirror (London, England)
Geographic Code:4EUUK
Date:Apr 25, 2017
Words:1521
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