With food allergies on the rise, research on causes, solutions still needed

In the U.S., estimated 15 million people have food allergies

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[Editor's note: This is part one of a two-part series on food allergies. Read part two here.]

Mercedes Turek's situation is a story becoming more and more familiar in the United States.

The sixth-grade student at Excelsior Middle School in the Linn-Mar Community School District is allergic to milk.

"She can be around dairy," her mother Sandra Fischer said, "It's just got to be in a controlled environment."

If milk touches Mercedes' skin, she can break out into hives, her mother said. And if Mercedes consumes milk, she can go into anaphylactic shock, a life-threatening allergic reaction, and stop breathing. When her family consumes milk, they have to be diligent while cleaning up lest they trigger Mercedes' allergic reaction.

Mercedes is one of the estimated 15 million Americans with food allergies, a number that is growing.

"The awareness has improved over the last few decades, but studies do show that food allergies are on the rise," said John Lehr, CEO of Food Allergy Research & Education (FARE), a Virginia-based group. The organization was formed in 2012 as the result of a merger between the Food Allergy & Anaphylaxis Network and the Food Allergy Initiative.

He pointed to a 2013 Centers for Disease Control and Prevention study showing that the number of those with food allergies has increased almost 50 percent between 1997 and 2011. Now, an estimated 4 to 6 percent of children in the United States have a food allergy, according the CDC.

However, discerning the number of Iowans with food allergies is more difficult as the Iowa Department of Public Heath, Linn County Public Health and Johnson County Public Health do not track this information. Area hospitals are also unable to give an accurate number of allergy-related admissions because often the allergic response is a secondary reason for admittance or the visit can be due to Celiac Disease or food intolerance.

What is a food allergy?

A food allergy is when the body mistakenly responds to a food protein as something that is harmful, said Judy Fitzgibbons, a dietitian for the Johnson Avenue Hy-Vee store. It often results in the body experiencing anaphylaxis, she said, which is life threatening.

Eight foods account for 90 percent of all allergic reactions — milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish. Even trace amounts of these foods can cause a reaction, which can range from a sore throat or ear infection to the swelling on the tongue and breathing issues.

"Allergens cause inflammation," Fitzgibbons said.

A food allergy is far more severe than a food intolerance — such as a lactose intolerance of wheat intolerance — which is when the body is unable to properly digest a carbohydrate, she said. A food intolerance is not life threatening, it simply produces discomfort and bloating.

People can develop food allergies at any stage in life, Fitzgibbons said, adding that the severity of an allergy can increase or decrease over time as well.

"Little boys are more likely to get an allergy young and outgrow it, while little girls aren't as likely but can develop them as women," she said. "There's no research on this, but I suspect some of this is hormone related. Women will develop them during pregnancy or menopause — it kind of makes you wonder."

Holly Brown, a doctor who specializes in allergy and immunology at Allergy Partners in Cedar Rapids, said that the media attention to peanut allergies has led to misunderstandings when it comes to other food allergies.

“I don’t get that skepticism with a peanut or a tree nut. I get it with other allergens,” said Brown, who is Mercedes’s doctor. “I have been questioned about the true severity because it’s milk and not peanuts.”

Brown said that her experiences working with area school nurses have been largely positive, and she encourages newly diagnosed children and their families to work with school staff and make them aware of the condition.

“They spend most of their time at school, so I find it pretty important to discuss with parents,” said Brown, who noted that school nurses contact her for guidance or additional information on students. “The schools do their best, and they try for the most part to accommodate all those kids.”

More research needed

Many mysteries still surround food allergies, why they develop and why they're becoming more severe, said FARE's Lehr.

"Typically, many children outgrow an allergy but what's been happening is, children are less likely to outgrow (an allergy) and those without allergies are more likely to develop one later in life," he said. "No one knows why this is, but there are lots of theories out there."

Lehr said a significant amount of research is underway compared with even 10 years ago, but there is still much to learn.

"What the triggers are, we're still trying to find," he said.

Researchers are looking at multiple theories, including how pollution has possibly dampened the immune system, making it more vulnerable to food allergies, how a mother's diet and the medication taken during pregnancy can affect her child and connections between the rising number of allergies in developed and industrialized countries when compared with underdeveloped ones.

FARE focuses on research, education, advocacy and building awareness. The organization helps fund food allergy research and clinical trials, Lehr said.

That's because treatment for a food allergy is limited to avoiding the problem foods and then treating an allergic reaction when it occurs with epinephrine or a visit to the emergency room.

Lehr pointed to research being done on immunotherapy, which desensitizes people to the offending food. This is done by introducing small amounts of the food, like a peanut, to the person and slowly increasing the dose over time.

A study conducted in Cambridge, England found that after six months of oral immunotherapy, up to 91 percent of children aged 7 to 16 could safely ingest about five peanuts a day, according to the New York Times.

This may not seem like much, but it could save someone's life if he or she is at a party and eats a cookie that may have touched a peanut without his or her knowledge, Lehr said.

"We still need a more permanent solution," he said, pointing out that America is still in the up curve or rise of people with food allergies. "So people can have the assurance that, if they bite into the wrong food, it won't lead to death."

"Other than breathing oxygen, food is one of the most essential things to life," he said.

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