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Questions and Answers
Why are young infants particularly vulnerable to food allergic reactions?
What is the primary mechanism by which hypersensitivity responses occur in food allergies?
What is the result of sensitization to an allergen?
What effect does the immaturity of the gastrointestinal tract have on allergen exposure in infants?
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What role does IgE play in food allergies?
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What characterizes a food allergy?
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Which of the following is an example of food intolerance?
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What is the primary cause of lactose intolerance?
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Which of the following conditions is NOT classified as food intolerance?
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What is a common symptom of food allergies?
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Which statement about food intolerances is accurate?
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What should be done in case of a food allergy emergency?
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Which food reaction can be identified as resulting from an adverse immunologic response?
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Which protein sources should be avoided for someone with a soy allergy?
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What role does a registered dietitian play in food allergy management?
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Which of the following should be consumed by someone with a tree nut allergy?
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What is a recommended action for managing a peanut allergy?
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Which food item is safe to consume for someone with a corn allergy?
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What is the primary cause of anaphylaxis in emergency departments?
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Which of the following chemical mediators is released by mast cells during an IgE-mediated allergic reaction?
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What is oral allergy syndrome (OAS) primarily induced by?
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What is the LEAP study's key finding regarding peanut consumption in infants?
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What type of reactions does anaphylaxis characterized by rapid onset usually involve?
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What symptoms are typically associated with milder allergic reactions?
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What condition requires prior sensitization to a cross-reacting inhalant allergen?
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Which foods are most commonly implicated in anaphylaxis for young children?
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What percentage of peanut-allergic children under age 2 may achieve tolerance by school age?
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How often should infants under 2 years with mild reactions be rechallenged to food?
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What is the recommended food introduction time for babies at high risk for peanut allergy?
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In which of the following conditions should restricted diets be continued indefinitely?
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How long should rechallenging sensitivities to certain food antigens like peanuts or tree nuts be undertaken?
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What is the common observation regarding sensitivity in children to food allergens?
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What is the correct approach to increase exposure during a food challenge?
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What conclusion can be made about breastfeeding and food allergies?
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Study Notes
Adverse Food Reactions
- Adverse food reactions can be the result of food hypersensitivity or food intolerance.
- Food hypersensitivity is an adverse immunologic response, while food intolerance is an adverse physiologic response.
- Examples of food intolerance include lactose intolerance, glucose 6 phosphate dehydrogenase deficiency, and galactosemia.
- Fava beans can cause a deficiency in NADPH, which can lead to oxidative stress and red blood cell lysis.
- The definition of food allergy is a specific immune response that occurs reproducibly upon exposure to a given food.
Food Allergy
- Food allergy occurs when the immune system reacts to a substance (allergens) that is usually harmless.
- The immune system mistakenly assumes the allergen is harmful and creates an immune response.
- Sensitization is exposure to an allergen, which can lead to hypersensitivity.
- Young infants are susceptible to food allergies due to their immunological immaturity and immature gastrointestinal tract.
- Infants lack IgA and IgM in exocrine secretions, and salivary secretory IgA is absent at birth.
- IgE-mediated mechanisms are the most well-characterized form of hypersensitivity response, often occurring immediately or within 2 hours.
- IgE attaches to a mast cell, causing the release of chemical mediators like histamine, serotonin, and kinins.
- Anaphylaxis is a rapid-onset, life-threatening allergic reaction.
- Food allergy is the #1 cause of anaphylaxis in emergency departments.
- Common foods implicated in anaphylaxis are peanuts, tree nuts, seafood, cow's milk, and eggs.
- Oral Immunotherapy, also known as oral desensitization, can promote tolerance to allergens by gradually introducing small amounts of the allergen.
Oral Allergy Syndrome/Pollen Food Syndrome
- Oral allergy syndrome is caused by cross-reacting allergens found in both pollen and raw fruits, vegetables, or some tree nuts.
- The immune system recognizes pollen and similar proteins in food, causing an allergic response.
- Unlike simple food allergy, OAS requires prior sensitization to a cross-reacting inhalant allergen.
- OAS manifests most commonly with pruritus (itching) of the lips, tongue, and mouth.
LEAP (Learning Early About Peanut Allergy) Study
- The LEAP study transformed the guidance on introducing peanut foods to children at high risk for food allergies.
- The study recommended introducing peanut foods between 4 - 6 months of age.
- Early consumption of peanut resulted in a 70-80% relative risk reduction of peanut allergy.
- The potential for preventing other food allergies through early life exposure is not as clear.
Food Allergy Management
- Registered dietitians play a critical role in food allergy management.
- The role of the dietitian includes providing education on food avoidance, suggesting alternatives, providing recipes and meal plans, evaluating compliance, and ensuring adequacy and enjoyment of the diet.
- While peanut and tree nut allergies are often considered permanent, studies show that some children can develop tolerance by school age.
- Food challenges are used to test for food allergies after resolution of symptoms.
- Food challenges typically start with a small amount of the food and gradually increase.
- Most reactions occur within 2 hours; however, non-IgE reactions may take longer.
- Infants under 2 years experiencing mild reactions may be rechallenged every 4-6 months to check for continued symptoms.
- Older patients may be rechallenged every 1-2 years depending on the difficulty of avoiding the food in question.
- Sensitivity to certain types of food antigens, such as peanuts, tree nuts, and seafood, can be lifelong; rechallenging should be done no sooner than every 5 years.
- Restricted diets for conditions like celiac disease or dermatitis should be continued indefinitely.
- Most children are only allergic to one to two foods.
Breastfeeding and Food Allergies
- Babies at high risk for peanut allergy should be introduced to peanut as early as 4-6 months of age.
- All babies should be introduced to peanut in their first year of life, regardless of allergy risk.
- There is no conclusive evidence that breastfeeding alone can prevent food allergies, but it may help prevent eczema.
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Description
This quiz covers the differences between food hypersensitivity and food intolerance, along with definitions and examples of each. It highlights conditions such as lactose intolerance and the immune responses involved in food allergies. Discover how the body reacts to allergens and the implications for individuals with sensitivities.
