Miami Herald:When food turns fatal

Posted on: Tue, 09/07/2004 - 4:27pm
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Posted on Tue, Sep. 07, 2004

When food turns fatal

BY HOWARD COHEN
[email]hcohen@herald.com[/email]

A 19-year-old in Manchester, England, takes his girlfriend out for a curry dinner at an Indian restaurant to celebrate the anniversary of their first date.

He's dead within two days. Peanuts.

Three students, one in middle school, two in high school, died in Massachusetts -- one after eating candy that contained cream, the other two munching on nuts.

Grace Fleitas of Hialeah noticed that her baby Amanda was more cranky than usual and had blood and mucous in her bowel movements. Milk protein allergy, the doctor said.

Food allergies. Nearly 11 million Americans suffer from them, up from about seven million a decade ago. The most common are allergies to milk and eggs, especially among children. Peanuts, tree nuts (i.e. almonds, pecans, walnuts), fish, wheat, soybeans and shellfish round out the top eight.

Symptoms often include nausea, vomiting, abdominal pain, skin rashes -- on the face and neck of children, on the inner elbows and behind the knees of adults -- and respiratory problems. In severe cases, anaphylaxis -- the swelling of the tongue and closing of the throat -- can occur and is life-threatening.

Among children, whose immune systems are not as mature, the rates are higher.

Peanut allergies, in particular, have been troublesome for children. ''There is a significant doubling or tripling in true allergies to peanuts in children in the past 10 to 15 years,'' said Nova Southeastern University professor Dr. Dana Wallace, citing the Journal of Allergy and Clinical Immunology.

Peanut allergies are among the most dangerous, often resulting in death. (Each year, about 150 people die from a food allergy and another 30,000 require emergency room treatment.)

There is no cure for food allergies and experts can only theorize on what's causing the increase.

Some suggest there's a lack of clarity in food labeling.

'At present, food allergic consumers are having a difficult time determining what is safe. Many terms are written in scientific languages . . . or the very ambiguous term `natural flavors,' '' said Amie Rappoport, administrative director of the nonprofit Food Allergy Initiative.

In August, Congress passed the Food Allergen Labeling and Consumer Protection Act of 2003, mandating that all food ingredients be labeled explicitly by January 2006.

Others suggest our ultra-clean lifestyles have contributed to the rise.

''Our immune system is designed to attack things,'' said Dr. Scott Sicherer, associate professor of pediatrics at Mount Sinai School of Medicine in New York. ''We lead clean lives and the immune system isn't having to fight bacteria.'' Quite simply, ''the immune system could be looking for something to do'' so it reacts to the food.

Infants are also born with immature stomachs, which allow food allergens to pass without protection. Wallace advises that parents refrain from introducing solid foods to babies until they are at least four months old or ''preferably one year'' when their stomachs mature. ''Three hundred years ago we were only breast feeding, we weren't preparing infant food,'' she said.

There is no evidence that food additives play a part. With peanuts, however, preparation could have an impact. Roasting could make peanuts more allergenic, Sicherer said.

The Journal of Allergy and Clinical Immunology reported that per capita consumption of peanuts in China and the United States is the same, but there is little peanut allergy in China. The Chinese opt for boiled or fried peanuts while Americans favor dry-roasted. The higher heat of dry roasting and the maturation and curing processes have been shown to increase the allergenicity of peanut proteins, the study found.

Most people are allergic only to a few foods, although they may complain of problems with any number of items. For reasons unknown to doctors, food allergies are more common in male children and female adults. Things even out around age 26 when the female adult starts to pull ahead. ''We don't know why,'' Wallace said.

Studies fluctuate because not every adverse reaction to food proves to be a true allergy and many studies are conducted by telephone rather than in clinics.

''When you go and put your food in a capsule and give [patients] a double-blind test the percentage of people who are truly allergic plunges dramatically,'' said Dr. Jos

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