Food hypersensitivity (allergy and intolerance)

Food hypersensitivity is the umbrella term for hypersensitivity reactions to food, such as food allergy and intolerance.

When you react violently to a certain food, we recommend not to experiment with omitting or using certain foods yourself. The best thing is to go to the doctor. He can determine whether it is an allergic reaction or intolerance and then refer you to a dietician.

What is food hypersensitivity?

Food hypersensitivity is the umbrella term for food allergy and intolerance.

What is food allergy?

If you have a food allergy, your immune system reacts to certain substances in your food. The immune system makes antibodies against proteins that occur in the diet. Proteins that can cause allergic reactions are called allergens. Known allergens are certain proteins in cow's milk or nuts.

What is intolerance?

The body can react to certain foods without having an allergy. This is a non-allergic food hypersensitivity. We call that intolerance. Think, for example, of lactose intolerance. In addition, people cannot digest the substance lactose properly. The substances that cause the symptoms in the event of intolerance are called ‘triggers’. These triggers occur naturally in foods such as lactose. They can also be added to foods, such as the preservative sulphite.

Read more about:
Lactose intolerance
Coeliac disease

How often does food allergy and intolerance occur?

Estimates of how often food hypersensitivity, food allergy and food intolerance occur often come to 1 to 4%.

For children, higher estimates are often given, around 4 to 6%. Children who have a cow's milk allergy in their infancy usually grow over it.

What is the cause of food hypersensitivity?

You may have a genetic predisposition to an allergy or intolerance. Then you are more likely to get an allergy or intolerance. By hereditary predisposition we mean that you have at least one parent or brother or sister with a proven food allergy or intolerance.

It is not easy to determine food hypersensitivity. The symptoms can be very different and vary from person to person. In addition, the complaints may also have other causes.

Health effects of food allergy and intolerance

What are symptoms of food hypersensitivity (allergy and intolerance)?

The symptoms of food hypersensitivity vary greatly. Skin, respiratory and gastrointestinal complaints are particularly common. Many of these complaints can also have other causes. It is therefore important that the doctor excludes all other possible causes.

Sometimes it is immediately obvious that a specific food is the cause of the complaints. More research is not necessary in this case.

Examples of symptoms of allergy and intolerance may include:

• An allergic reaction to the mouth and throat. This includes mild symptoms such as swelling, itching and redness in and around the mouth. The symptoms start within a few minutes after eating certain types of fruit, vegetables, nuts or crustaceans.
• Urticaria (hives) and angioedema. Urticaria is a common skin disease in which you suffer from bumps, severe itching and very occasionally pain. A special form of urticaria is angioedema in which extensive fluid accumulations can occur. Urticaria and angioedema can have many different causes, including food hypersensitivity.

What is anaphylactic shock? 

Anaphylactic shock is a life-threatening situation caused by an allergic reaction in the body. It can be the result of an allergic reaction to certain foods such as peanut or sesame, but medicines or wasp stings can also cause anaphylactic shock. If you don't intervene in time, it could be fatal.

The symptoms of anaphylactic shock can develop within a few minutes and sometimes last for hours. If it is not treated properly, shock may occur again after 6 to 8 hours. The sooner the symptoms develop, the more severe the reaction is usually.

One of the first signs of shock is a tingling sensation, itching or a metallic taste in the mouth. This is often followed by the following symptoms, which can also occur at the same time:

• urticaria (hives)
• feeling of warmth, sweating
• vomiting
• cramps, diarrhoea
• swelling of the mouth and throat
• difficulty breathing, difficulty in breathing

The most important substance released in an allergic reaction is histamine. This substance causes the blood vessels to widen. In the event of a violent reaction, the blood pressure can drop so much that you become unconscious. An asthma attack is also possible at the same time.

Anaphylactic shock requires an adrenaline injection to stop the reaction. Patients who are more likely to experience shock have adrenaline with them. In case of shock, the patient should be given the injection as soon as possible, whether or not by a doctor or ambulance staff. It is advisable to lay the patient flat on the back, with the feet up and to loosen tight clothing such as a tie.

Anaphylactic shock usually occurs as a result of a previously developed allergy. It is unlikely that a food that you could eat without problems at first suddenly causes anaphylactic shock. In most cases, previous allergic signs such as itching in the mouth or skin complaints have not been noticed.

Cross-reactions between foods

For example, if you are allergic to shrimp, you may also react to crab. This is because the allergens in these foods are very similar. When this happens, we call it a cross-reaction.

Cross-reactions in hay fever

Cross-reactions may occur not only between foods. With hay fever, you are allergic to certain pollen from trees, plants or grasses. Sometimes hay fever can also cause allergic reactions when eating certain products. That's what we call cross-reactions. Presumably this is because certain allergens in food and in pollen are related to each other.

The following overview shows the most well-known cross-reactions between pollen and plant-based foods. Not all of the cross-reactions mentioned occur equally frequently. Some cross-reactions are truly exceptional.

Cross-reactions in other allergies

In addition to the above-mentioned cross-reactions, cross-reactions can also occur with other allergies. Below is an overview:

By inhaling proteins from bird droppings when cleaning the bird cage, for example, someone may become hypersensitive to chicken egg protein. This is called Bird-Egg-Syndrome.

What is the dietary advice for allergy or intolerance?

Do you notice yourself reacting violently to a certain food? We recommend that you do not experiment with omitting or using certain foods yourself.

The best thing is to go to the doctor. He can determine whether it is an allergic reaction or intolerance and then refer you to a dietician. The dietician will look for the cause of the complaints together with you. He or she can give you advice on how to prevent allergic reactions. This will give you advice on how to avoid certain foods without a shortage of nutrients.

Can you prevent allergies in children?

Allergy prevention focuses on preventing or delaying an allergy. Children have an increased risk of allergy if at least 1 of the parents or 1 of the older children in a family have an allergy, such as hay fever, asthma or a food allergy.

• Breast-feeding for the first 6 months is preferred for children with an increased risk of allergy. Just like any other kid.
• If breastfeeding is not successful, artificial nutrition is a reliable and safe alternative. Hypoallergenic artificial food based on a partial protein hydrolysate does not help to prevent an allergy. We do not even recommend intensively hydrolysed artificial foods.
• The risk of developing a food allergy is lower when the baby starts between 4 months and 6 months with first snacks in addition to breastfeeding or artificial food.
• Start offering different types of food, including peanut butter and egg, as early as possible. From 4 months you can start with the first exercise snacks of fruit and vegetables. As soon as your child is used to this, you can add peanut butter or egg to these snacks. The advice is to start giving peanut butter and egg before your child is 8 months old.  That's how you start.
• Does your baby have severe eczema or a food allergy? Then it is especially important to start early with different types of food, such as egg and peanut butter. Start before the age of 6 months. Consult with your child's attending physician or dietitian first.
• In principle, it is also not necessary in children with food allergy to supplement the diet with additional vitamins and minerals, in addition to the usual vitamins D and K in breastfeeding and vitamin D in artificial nutrition.

Advice for a child at school

It is advisable to explain to the teachers about the allergy or intolerance and the foods involved. Some tips:

• Indicate which foods your child can eat. A stock of snacks and alternatives to treats are useful, provided you regularly check the stock and shelf life.
• If necessary, discuss an ‘emergency plan‘ with the teacher(s) that has been drawn up in consultation with the attending physician.
• Make sure that the information for the school is also on paper. Make the information striking, for example on coloured paper or with a photo of the child. Keep the information brief and note the phone number at the bottom of each page so that the reader can call with questions. Also mention the telephone number of the general practitioner.
• Make a short report of all agreements made with the school.
• If necessary: Ensure that an adrenaline syringe is available at school and regularly check the shelf life. Despite all measures, it may be necessary to administer adrenaline at school. This may require that the teacher also learns how this works.
• Organize, possibly together with other parents of children with an allergy or intolerance, an information evening at school for teachers and parents. If necessary, contact the school doctor's office.

Eating out with an allergy or intolerance

European legislation requires catering establishments to provide information about allergens when they are used in the preparation of the product or dish. To avoid misunderstandings, it is wise to consult with the cook well before the planned dinner and to go through the menu. On the website of Stichting Voedselallergie you will find all kinds of tips about eating out with a food allergy and reviews from restaurants.

On holiday with an allergy or intolerance

• It is possible that certain products are not available in the holiday country. That is sometimes difficult to estimate. You can also bring your essential food from the Netherlands. If you have a baby who is given special formula, it is wise to take enough of it with you on holiday. Some countries have rules on the import of foodstuffs. The ANWB website contains detailed information on each country.
• It is useful to bring a translated glossary. Sometimes pictures of the foods to be avoided can help in a conversation.
• If you're traveling with a travel company, let them know if they can accommodate your diet. However, bring an ‘emergency ration’ in case there is a delay on the way or the diet has not been taken into account on arrival.
• A meal is often served during the flight. Inform in advance whether the meal can be adjusted. For a number of diets, this is usually possible. If necessary, you can bring your own food supply. Then keep perishable products cool in a cool bag(you). Inform about the possibilities in the aircraft for cooling, storing or warming up. Make an estimate of the likelihood of a possible contamination with substances that you should avoid. Once on the plane, you can inform the flight attendant and instruct her on how to store or warm up.
• If you are staying at a hotel where you also use meals, it is useful to contact the hotel in advance. It is advisable to distribute any medication over several pieces of baggage, for example hand baggage and other baggage. Or part of your travel companion's luggage. If some of the luggage is lost, you still have some of the medication.
• A medical passport may be required if you are flying or need to go through customs. But even if something happens to you, it can be useful. In addition to personal data, a medical passport can also contain information about the nature of your condition, the substances that must be avoided, the symptoms and the name and details of the general practitioner.
• If there is an increased risk of life-threatening allergic reactions or other conditions with a risk of loss of consciousness, the White Cross Alarm badge can quickly provide essential information to the emergency doctor. The badge contains all the necessary information.

The general practitioner or specialist may, if necessary, give advice when completing the European Medical Passport and the alarm aids.

Bron: Voedingscentrum