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+ Food Allergies in the United States Module 1

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Page 1: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+

Food Allergies in the United States

Module 1

Page 2: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+

Module Content

Definitions Types and prevalence of food allergies in the United

States Types and prevalence of food allergies in foreign

countries Impact of food allergies

Page 3: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Definitions

Food “any substance—whether processed, semi-processed,

or raw—that is intended for human consumption and includes drinks, chewing gum, food additives, and dietary supplements”

“substances used only as drugs, tobacco products, and cosmetics (such as lip-care products) that may be ingested are not included” (Boyce et al., 2010, p. S8).

Page 4: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Definitions

Food allergy “an abnormal response to a food, triggered

by the body’s immune system” “an adverse health effect arising from a

specific immune response that occurs reproducibly on exposure to a given food”(Boyce et al., 2010, p. S8).

Page 5: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Definitions

Food allergens

“those specific components of food or ingredients within food (typically proteins but sometimes also chemicals) that are recognized by allergen-specific immune cells and elicit specific immunologic reactions, resulting in characteristic symptoms” (Boyce et al., 2010, p. S8).

Page 6: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Definitions

Allergic response “a reproducible adverse reaction to a substance

mediated by an immunological response. The substances provoking the reaction may have been ingested, injected, inhaled, or merely have come into contact with the skin or mucous membranes” (David, 2000, p. 34).

Page 7: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Definitions

Food intolerances non-immunologic adverse reactions Intolerance symptoms are usually caused by

an inability to digest or metabolize a food, resulting in gas production, cramping, or diarrhea.

Lactose intolerance (inability to digest milk sugar) is the most common type of food intolerance”(Boyce et al., 2010, p. S9).

Page 8: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Definitions

IgE (Immunoglobulin E) a unique class of immunoglobulin that

mediates an immediate allergic reaction (Boyce et al., 2010).

IgE is released from plasma cells in the mucosa of the GI (gastrointestinal) tract, respiratory tract, and tonsils when the immune system overreacts to an allergen, triggering the release of histamine, inflammation, and an allergic responses (Marieb & Hoehn, 2010).

Page 9: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Types of adverse reaction to food

Adverse Food Reaction

Immune- Mediated

IgE- Mediate

d

Non-IgE Mediate

d

Mixed IgE & Non-IgE- Mediated

Cell Mediated

Non-Immune- Mediated

Metabolic Pharmacologic Toxic

Other/Idiopathic/Undefined

e.g., Food

Allergy

e.g., Celiac Disease

e.g., Lactose

Intolerance

(Boyce et al., 2010)

Page 10: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Food Allergy Organizations

Food Allergy Research & Education [FARE] is: a newly formed organization which

combined two other groups, FAAN and FAI. FARE is “dedicated to food allergy research

and education with the mission of ensuring the safety and inclusion of individuals with food allergies while relentlessly seeking a cure” (FARE, 2014).

Page 11: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Big 8 Food Allergens in the United States

In the U.S., 90% of food allergies are caused by eggs, milk, shellfish, wheat, peanut, fish, soy, and tree nuts (e.g., walnuts, cashews, almonds, pecans, pistachios, hazelnuts, macadamia nuts) (Sicherer, 2010).

The estimated prevalence of allergies among the U.S. population (Boyce et al., 2010): Peanut: 0.6%-1.3% Tree nuts: 0.4%-0.6% Fish: 0.4% Crustacean shellfish (crab, crayfish, lobster, shrimp): 1.2% All seafood: 0.6% in children and 2.8% in adults Milk and egg: 1%-2% for young children and 0.2%-0.4% in the

general population

Page 12: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Big 8 Food Allergens in the United States

Eggs Albumin Eggnog Lysozyme Mayonnaise Meringue Ovalbumin Surimi

Page 13: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Big 8 Food Allergens in the United States

Milk Butter Cream Cheese Lactose Pudding Yogurt Margarine Casein Whey

Page 14: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Big 8 Food Allergens in the United States

Shellfish Barnacle Crab Crawfish Krill Lobster Prawns Shrimp

Page 15: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Big 8 Food Allergens in the United States

Wheat Bread crumbs Flour Pasta Wheat germ oil

Page 16: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Big 8 Food Allergens in the United States

Peanut Peanut oil Peanut butter Peanut flour

Page 17: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Big 8 Food Allergens in the United States

Fish Anchovies Bass Catfish Cod Salmon

Page 18: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Big 8 Food Allergens in the United States

Soy Edamame Miso Soya Soybean Soy sauce Tofu

Page 19: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Big 8 Food Allergens in the United States

Treenut Almond Cashew Chestnut Coconut Pesto Walnut

Page 20: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Food allergies among children

In 2007 about three million children under the age of 18 (3.9%) were reported to have a food allergy (Branum, 2008).

Reports of food allergies increased by 18% from 1997 to 2007 among children 18 years of age and younger (Branum, 2008).

From 2004 to 2006, children 18 years of age and younger represented approximately 9,500 hospital discharges per year after a diagnosis related to a food allergy (Branum, 2008).

It is more common for female than male adults to have food allergies, while male children typically have more food allergies than female children (Ben-Shoshan, Turnbull, & Clarke, 2012).

Page 21: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Ethnic groups and children in the U.S.

Less

than

5 y

ears

5-17

yea

rsMal

e

Fem

ale

Non-H

ispa

nic whi

te

Non-H

ispa

nic bl

ack

Hispa

nic

Tota

l0

1

2

3

4

54.7

3.7 3.84.1 4.1 4.0

3.1

3.9

Percentage of children under 18 years who has a re-ported food or digestive allergy in the past 12 months

Page 22: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Emerging and less prevalent allergens

The majority of studies have focused on the most common food allergens, even though more than 170 foods have been reported to cause IgE-mediated reactions (Boyce et al., 2010).

Page 23: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Emerging and less prevalent allergens

Examples of uncommon allergens (FARE, 2014): Corn: raw and cooked Meat: beef, mutton, chicken, and pork (heating

and cooking meat may reduce the allergenicity) Gelatin: a protein formed when connective tissue

or skin is boiled Seeds: sesame, poppy, or sunflower Spices: coriander, mustard, and garlic

Page 24: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Types and prevalence of food allergies in foreign countries Common allergens in other countries and regions

(Baumert, 2012) Canada: sesame, mollusks, mustard, sulfites, and gluten Europe: sesame, mollusks, sulfites, gluten, mustard,

celery, and lupin (a type of legume used in flour form) Codex (South Africa): gluten and sulfites Hong Kong: sulfites and gluten Japan: milk, egg, peanuts, and wheat Australia/New Zealand: sesame, mollusks, sulfites, and

gluten

Page 25: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Impact of food allergies

Hospitalization related to food allergies

1998-2000 2001-2003 2004-20060

2,000

4,000

6,000

8,000

10,000

2,6154,135

9,537

Years

Avera

ge n

um

ber

of

dis

ch

arg

es p

er

year

Page 26: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+Video Case StudyPeanut Allergy Causes Parental Outrage

Page 27: + Food Allergies in the United States Module 1. + Module Content  Definitions  Types and prevalence of food allergies in the United States  Types and

+SUMMARY

Food allergy is “an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food” (Boyce et al., 2010, p. S8).

Food allergies are common in U.S. and increased by 18% from 1997 to 2007 among children 18 years of age and younger (Branum, 2008).

In the U.S., 90% of food allergies are caused by big 8 food allergens: eggs, milk, shellfish, wheat, peanuts, fish, soy, and tree nuts (Sicherer, 2010).