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Celebrated by some, March is National Peanut Month

It takes about 540 peanuts to make a 12-ounce jar of peanut butter. But for someone who is allergic to peanuts, it takes just one peanut to create a life-threatening medical event. And avoidance of peanuts is very difficult because peanuts are commonly used as an additive in the preparation of foods.

The peanut is America’s favorite legume:

  • The world’s largest peanut butter factory churns out 250,000 jars every day.
  • Four of the top 10 candy bars manufactured in the U.S. contain peanuts or peanut butter.
  • Peanuts account for two-thirds of all snack nuts consumed in the U.S.
  • Peanuts contribute more than $4 billion to the U.S. economy each year.
  • Americans spend almost $800 million a year on peanut butter.
  • The average American consumes more than six pounds of peanuts and peanut butter products each year.
  • The average child will eat 1,500 peanut butter and jelly sandwiches before he/she graduates from high school.
  • Americans consume on average over 1.5 billion pounds of peanut butter and peanut products each year.
  • Peanut butter is consumed in 90 percent of American households.
  • The amount of peanut butter eaten in a year could wrap the earth in a ribbon of 18-ounce peanut butter jars one and one-third times.

How many people are allergic to peanuts?

“With the prevalence of peanuts in the American diet, it’s no wonder that there is increasing concern when there’s so much news coverage on peanut allergies in the past few years – leading people to think there is a growing trend of peanut allergies,” said Dr. Todd Levin, who is double-board certified by the American Board of Allergy, Asthma and Immunology and the American Board of Pediatrics.

However, he pointed out that the numbers released by the CDC (Center for Disease Control) show that only 0.6 - 1.0 percent of people have a mild to more severe peanut allergy, and studies show that about 20 percent of peanut allergies can be outgrown. (By comparison, about four times as many adults are allergic to seafood.)

Nearly 90 percent of food allergies are caused by these common foods: tree nuts (almonds, walnuts, pecans, cashews, pistachios, etc.), peanuts, milk, eggs, fish, crustacean shellfish, wheat and soy.

As with all allergies, those with a family history of allergy, asthma, or eczema, may be at increased risk.

What are the symptoms of peanut allergy?

Most allergic reactions are not life threatening – gastrointestinal, skin and respiratory symptoms – but some can lead to a more severe reaction known as “anaphylaxis,” where blood pressure drops abruptly and the airways and throat swell, which lead to breathing difficulties. When this is not controlled, unconsciousness and death can occur, so it is important to know how to manage severe allergies, whether they are food or non-food related.

Is there a cure?

There is no cure for peanut allergy and no therapies that eliminate or reduce the severity of peanut allergy. Current treatments only address the symptoms of an allergic reaction once it has taken place. (The American Peanut Council)

Strict avoidance of peanut and peanut-ingredient is the only way to prevent an allergic reaction. (National Institute of Allergy and Infectious Diseases, The American Peanut Council)

To prevent an allergic reaction, the best recommendation to those with peanut allergy is to avoid intake. To minimize the risk of being exposed to allergens, which may occur by accident, there are also important strategies that can be taken.

  • Read labels - which highlight allergens on the ingredient list.
  • Plan ahead - when dining out or attending a party. Call ahead to notify friends, talk with restaurant staff, or use a “chef card,” which lists ingredients to avoid and can be found at the Food Allergy Anaphylaxis Network (FAAN) website at www.foodallergy.org/downloads.html.
  • Practice proper sanitation - with common cleaning agents, such as hot, soapy water to remove cross contamination.
  • Carry medicine - such as epinephrine injector pens, which are also referred to as EpiPens. They must be used within 10 minutes but can provide the time necessary to seek medical attention. Epinephrine is a hormone that is released during stress. It boosts the supply of oxygen and glucose to the brain and muscles, while suppressing other non-emergency bodily processes, such as digestion.
  • Control asthma - with proper medical care since asthma is a main risk factor for death due to anaphylaxis.
  • Let people know – by wearing a bracelet or necklace identifying the allergy and its severity.

What Causes Peanut Allergy?

The major proteins Ara h1, Ara h2, and Ara h3 are the allergens in peanuts. Both genetic and environmental factors may be involved. Family history, occurrence of eczema-type skin rashes and exposure to soy protein were associated with the development of peanut allergy in childhood in one study. The most current data does not support the theory that if peanuts are eaten during pregnancy or infancy there is a greater chance that the child will end up with the allergy.

For more information on food allergies, contact your board certified allergist, who can test you. Food allergies affect between 4 percent and 8 percent of children and between 1 percent and 2 percent of adults. The majority of children outgrow their food allergies, and the foods can safely be reintroduced when they are older.

The diagnosis of a suspected food allergy begins with a medical history and a physical examination. It is confirmed with the detection of peanut-specific IgE, either by means of a skin prick test or fluoroenzyme immunoassay (Pharmacia ImmunoCAP-FEIA). When there is doubt about the diagnosis, oral food challenges can be performed.

In addition to getting a handle on your food allergies, the board-certified allergists at Chattanooga Allergy Clinic can help you get control of hay fever, asthma, pet allergies, chronic sinus infections, chronic hives, eczema, drug allergies, insect allergies and immune (IgG) deficiency.

Call 423-899-0431for more information or to schedule an appointment. LIKEus on Facebook and FOLLOWus on Twitter.

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Food Allergies 101

Think you have a food allergy? You might want to reconsider. No one can dispute that food allergies are serious business, and their incidence is on the rise. But while 20-25% of Americans think they have a food allergy, in truth only 2-3% of adults and 6-8% of children test positive for food allergies. For this reason, it’s crucial to get a diagnosis by a board certified allergist if you suspect sensitivity to a certain food.


“Food allergies can be very unpredictable – it’s impossible to know if your next reaction will be more or less severe than previous exposures,” says Dr. Lee Perry, allergist with Chattanooga Allergy Clinic. “You certainly never want to ‘test’ it on your own, but you also don’t want to avoid a food unnecessarily.”

Not only is Dr. Perry a double-board certified pediatric and adult allergy and asthma specialist, he also has personal experience with food allergies. His oldest son was diagnosed with a peanut allergy several years ago.

“When he was first diagnosed we were blown away – we thought ‘How do we deal with this?’” he admits. “But after a while it just becomes a part of your life.”

So, what do you do if you suspect food allergies? Here’s a quick breakdown on everything you need to know, from getting diagnosed to how to cope.

SYMPTOMS

“True food allergies almost always involve a cutaneous (skin) component such as hives, eczema, rash or itching,” says Dr. Perry. “Symptoms occur almost immediately after eating the food – usually within 15 minutes to 2 hours.”

Other common symptoms include:

  • Swelling of the lips, tongue or throat
  • Vomiting or diarrhea, usually within one hour of digestion
  • Shortness of breath, cough or wheezing
  • Anaphylaxis
  • See full list

ALLERGY VS. INTOLERANCE

Food intolerances are easy to confuse with allergies. Symptoms usually occur within 30 minutes to two hours of ingestion and can mimic allergic reactions like diarrhea and itchy skin rash. However, problems from intolerances remain in the gut and do not involve the immune system, so anaphylaxis can’t happen. The two most common intolerances are lactose and gluten, also called Celiac Disease. A board certified allergist at Chattanooga Allergy Clinic can accurately diagnose whether you have an intolerance or allergy.

OTHER FOOD DISORDERS

Other food disorders confused as allergies include:

  • Eosinophilic esophagitis (EoE) -A disorder that causes a large number of eosinophils (a type of white blood cell) to gather in the esophagus, making it inflamed and difficult to swallow certain foods.
  • Food protein-induced enterocolitis syndrome(FPIES) -A type of food allergy that affects the GI tract and does not show up in standard allergy testing. Symptoms include profuse vomiting, diarrhea and dehydration.
  • Oral Allergy Syndrome -Also known as pollen-food syndrome, OAS causes itchy or scratchy mouth symptoms caused by raw fruits or vegetables in people who also have hay fever. Generally, treatment is not necessary and symptoms subside quickly after exposure. Common food pollen associations include apples, carrots, peaches, plums, cherries, pears, almonds or hazelnuts for people allergic to birch; tomatoes for those allergic to grasses; and melons, zucchini, cucumbers, kiwis or bananas for those with ragweed allergies.

TESTING

As we mentioned above, diagnosing food allergies should be done by a board certified allergist. Testing can be done at any age, even infants. The first step is a detailed medical history. From there, doctors usually order a skin prick test, where your back is lightly “scratched” with the suspected food protein. Usually a large, red welt will appear if allergic. Sometimes blood tests are done, but they’re not a first resort because they’re more expensive and take longer to get results. If results from both tests are still inconclusive, your doctor may order an oral food challenge in which he/she feeds you the suspect food in measured doses, starting with a very small amount.

HOW TO COPE

It’s easy to feel overwhelmed after receiving a food allergy diagnosis, but do not despair. There are plenty of resources available, including websites likewww.foodallergy.org. You may also want to seek out local support groups.

The two main strategies are strict avoidance (your doctor can provide guidance) and always carrying two doses of epinephrine (EpiPen®) and/or Benadryl for milder reactions.

OTHER FASCINATING FACTS

  • You can develop food allergies as your get older, and science has not been able to determine why.
  • Many children outgrow allergies so doctors recommend retesting every year or two. Retesting in adults is rare – they’re likely to keep them for good.
  • Scientist recently discovered a new, unusual food allergy to meat called Gal Alpha Gal, which is caused by a bite from the Lone Star tick. Unlike other food allergies, the reaction occurs within 3 to 6 hours of ingesting any mammalian meat like beef, pork, lamb, goat, venison and buffalo. Symptoms include itching, hives, swelling and even anaphylaxis.
  • No one knows exactly why food allergies are on the rise, but most experts suspect diet restriction early in life. The American Academy of Pediatrics used to recommend not exposing kids to certain foods until age 2, such as peanuts. But in Israel, where 69% of babies are exposed to peanuts by 9 months old, the rate of peanut allergies is less than 1%.
  • There are promising studies at Duke University for a food allergy cure, called oral immunotherapy. However, Dr. Perry predicts we’re still probably 10 to 20 years away from implementing the therapy on a wide-scale.
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Fall Allergies

The beginning of fall means cooler temperatures, football games, and children going back to school. Unfortunately, this time of year is also particularly difficult for those suffering with allergies and asthma. According to the American College of Allergy, Asthma and Immunology (ACAAI), allergies and asthma account for more than 14 million school day absences annually. The back-to-school season is also associated with a 46 percent increase in asthma-related emergency department visits by grade school children. School children with asthma and allergies face challenges not experienced by their classmates, and parents are charged with helping these children identify potential triggers for these conditions.  

According to Dr. Lee Perry, a board certified adult/pediatric allergist at the Chattanooga Allergy Clinic, Chattanooga was recently ranked the 5th worst city in America for asthma sufferers. These rankings, performed by the Allergy and Asthma Foundation of America, were based on several factors including pollen counts, medication utilization, air pollution and ozone levels. “Children returning to school are at increased risk of infections and cold viruses, which are the most common trigger for asthma attacks, ” says Dr. Perry.  “Other potential exacerbants include ragweed allergy (hay fever) and exercise.” Dr. Perry says that avoiding germs at school is nearly impossible, but parents should make sure their children get a seasonal flu shot. “It is also important to teach your child how to properly wash his or her hands with soap and hand sanitizers, which can prevent the spread of infection,” says Dr. Perry. 

Dr. Perry states that over 80% of asthmatics experience exercise-induced symptoms. “If your child has difficulty breathing during or after exercise, see a board-certified allergist who can help you develop a treatment plan,” says Dr. Perry. “Also, be sure to make sure teachers are aware of your child’s condition so that medications can be available at school.”

In addition to being a challenging city for asthmatics, Dr. Perry says Chattanooga has annually been among the worst cities in the country for people with fall allergies. Ragweed is the most common fall-specific seasonal allergen, as well as other weed pollens. Other common allergy-related triggers include perennial allergens such as dust mites and pet dander. “These allergens can lead to asthma symptoms as well as allergy symptoms such as runny nose, nasal congestion, sneeze, itchy and watery eyes, and sinus infections,” says Dr. Perry. “If you or your children experience these symptoms during the fall, I would recommend allergy skin testing to help determine which allergens are the culprit(s).” Treatment for such allergies include over the counter antihistamines, prescription nasal sprays, and allergy shots. “The medicines we use are somewhat effective in controlling allergy symptoms—however, allergy shots are the only available cure,” says Dr. Perry. According to Dr. Perry, the goal of allergy shots is to eliminate allergies and decrease the need for medications.

Food allergies are another common concern for both parents and students at the beginning of the school year. The most common food allergies are associated with peanuts, tree nuts, milk, egg, wheat, soy and seafood. “School officials should be made aware of your child’s food allergies, and proper avoidance measures should be taken,” says Dr. Perry. “For most food allergies, it is wise to have emergency medications available at the school as well.” According to Dr. Perry, these medications might include antihistamines (such as Benadryl) and injectable epinephrine (EpiPen). 

Click here to view the article as it appeared in Live Well magazine.

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