Identifying & managing food allergy or intolerance

Physicians typically review past history and predisposition to allergies before treating a patient for food allergy or intolerance. “For instance, if both parents have some allergy, there is a 80% chance of a child developing an allergy while the probability drops to 40 % when only one parent is allergic," says Dr Prasad.

As specific allergens cannot always be readily identified, people who suffer from allergy symptoms are encouraged to maintain a food diary under medical supervision. “It is absolutely vital to carefully document the time and content of all the meals and the appearance and timing of subsequent symptoms," says Khosla. After a week or two, a pattern may emerge, at which point the food that is believed to be causing the symptoms should be dropped from the diet for at least a week before it is reintroduced. “If allergic symptoms develop, then chances are you have identified the offending food," says Khosla.

THE PROBLEM WITH LABELS

In the absence of precise labelling on food products in India, the safest way to prevent serious mishaps is for the affected person to stay well away from processed foods that are not labelled. “Current labelling standards are not informative enough for allergy or intolerance prevention," says Krishnaswamy, who feels it is important for food labels to carry a mandatory listing of the top eight allergens, as is done in the US.

“A person with allergic reactions must choose only branded products wherever possible, as they carry some labelling and in case of serious allergies, ensure you carry your own food with you," says Khosla, who feels foods such as soya sauce, cornflakes, whiskey, ketchup, baking powder and asafoetida also need labelling. Typically, the danger lies in processed foods carrying hidden allergens: for instance, peanut products (even oil) in biscuits, ice cream and pasta sauces, fish or shellfish as part of pizza toppings or salad dressings.

MANAGING THE CONDITION

However, the good news in food allergy management is that when problem foods are scrupulously avoided, people, particularly children, tend to outgrow the condition. A food allergy can develop at any age, but occurs in a smaller percentage of adults while 3–7% of children tend to have a food allergy diagnosed before they turn three. “It is good to have a food allergy diagnosed in time as it could otherwise impede absorption of proteins and minerals," says Dr Shukla.

“It is also important to understand the safe handling of food when dealing with allergies," says Khosla, who feels allergic people must be aware of handling methods (during preparation and serving of food). “For instance, while cooking, avoid cross-contamination by not sharing utensils, food containers, cutting boards and serving dishes, or even using the same cooking oil for allergenic and non-allergenic foods," she says.

EXPERT OPINION

“It is difficult to put your finger on why the immune system gets misdirected causing food allergies: there can be an allergy to white of an egg, vaccines can set it off," says Ashutosh Shukla, consultant, internal medicine, Artemis Health Institute, Gurgaon. “Often, food allergies and intolerances are overlooked as the symptoms tend to be misdiagnosed for other conditions," he adds.

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