Food allergies

Allergies are among the most common and increasing chronic conditions in Australia. According to the Australasian Society of Clinical Immunology and Allergy (ASCIA), allergies affect around one in 5 people at some point in their lives.¹

“Australia is known as the allergy capital of the world,” says Maria Said, CEO of Allergy & Anaphylaxis Australia and Director of the National Allergy Council.

“Since the 1990s, we have seen a tsunami of people with things like food allergies, allergic rhinitis (hay fever), allergic asthma and insect allergy. And it’s not just children. Adults who have eaten a particular food all their lives can develop an allergy to it.”

Food allergies are sometimes confused with food intolerances or food poisoning. A food intolerance can make you ill, but it’s usually not life-threatening. And food poisoning can cause serious illness and even be fatal in some cases.

If you have an allergy to a particular food, your body thinks that this food is trying to cause harm. When your immune system identifies a problem food as an invader, it overreacts and produces specific antibodies as a protective response. Almost always, it’s the protein in the food that triggers this reaction and, ironically, it’s the body’s response that is harmful.

Although there are rare occasions where a food allergy may not cause immediate symptoms, these antibodies mean your immune system is ‘sensitised’ to that particular food protein. Some people then go on to be allergic, with their immune system responding with signs and symptoms of an allergic reaction each time they eat even a small amount of the food.

Some food allergies result in immediate, severe and even life-threatening symptoms, whereas others cause symptoms which may take longer to develop.

Signs and symptoms of a mild or moderate allergic reaction may include:

• itching and/or swelling of your lips, face and eyes
• skin reactions (such as swelling and itching, hives, eczema and flushing)
• abdominal pain, diarrhoea, feeling nauseous and vomiting.²

It’s important to note that many of these symptoms can also be caused by problems other than a food allergy. See your GP if you experience any of them.

Anaphylaxis is the most severe allergic reaction and can be life-threatening.

Symptoms of anaphylaxis can include any one of the below:

• difficult or noisy breathing
• swelling of the tongue
• swelling or tightness in the throat
• wheezing or a persistent cough
• difficulty talking or a hoarse voice
• persistent dizziness or collapsing
• becoming pale and floppy (in young children).³

Anaphylaxis can occur very quickly and may result in loss of consciousness or even death. If someone around you has any of these symptoms, lay them on the ground or let them sit with their legs outstretched. If they have severe and sudden breathing difficulty, give them an adrenaline injector first, if available, then immediately dial triple zero (000) for an ambulance.

Almost any food can cause an allergic reaction, but the most common are:

• cow's milk (dairy)
• eggs
• peanuts
• tree nuts (such as cashew, almond)
• sesame
• soy
• fish
• shellfish
• wheat⁴

If you’re concerned that you or a loved one may have a food allergy, speak to your GP. They may recommend an allergy test and provide a referral to an allergy specialist.

They will also ask you questions, such as the foods that trigger your allergy and the kind of symptoms you experience.

If you have a severe food allergy, you may be prescribed an adrenaline (epinephrine) injector, such as an EpiPen® or an Anapen®, which can help reverse symptoms if you experience anaphylaxis. Your GP or allergy specialist will show you how to use this. It’s important to have your adrenaline injector with you at all times. Do not leave it in your car or a warm place, as heat can affect how well your injector works.

It’s not recommended that you buy online allergy tests as they are unreliable and inaccurate. If you want an allergy test, speak to your GP, who can refer you to an allergy specialist.

Avoiding the allergen (food trigger) is an effective way of preventing anaphylaxis, but accidents do happen, so always be prepared.

An accredited practising dietitian can help you remove staple foods like milk, eggs and wheat from your diet, and advise you on how to replace them so you don’t miss out on essential nutrients.

Support organisations like Allergy & Anaphylaxis Australia can help you understand what to look for on food labels, and help you develop strategies when eating out.

Some foods are hard to avoid completely. It’s important to note that your allergen could appear almost anywhere. Eggs and fish traces can be found in some wine, while nut oils appear in shampoo, moisturisers and other cosmetics.⁵

“Our food labelling laws help with this,” claims Said. “Any food that contains milk, egg, peanut, tree nuts, fish, crustacea, sesame, soy and wheat must be labelled, no matter how much of that food is in the product. So at least we can look at a food pack and know whether it has any of those allergens as an ingredient.

Symptoms of mild food allergies, such as a rash or runny nose, may be managed with the help of antihistamines. However, it’s important that you only take medicines for your allergy on the advice of your doctor or pharmacist. Always read any patient information leaflet available for your medicine. If you have any questions, ask your pharmacist or doctor for help.

Even if you tell food service staff about your food allergy and read labels carefully, it’s possible to eat a problem food by accident. For some people, a tiny amount of a food allergen can trigger a severe and sometimes life-threatening reaction. Anyone with a food allergy is at risk of anaphylaxis and needs to take the following precautions:

• Make sure your doctor counsels you on how to manage an allergic reaction.
• Wear a medical identification bracelet and carry your ASCIA Action Plan that gives details about your allergy.
• Carry 2 adrenaline injectors at all times. You and those around you, such as work colleagues, friends and family, must know how to use it in case you have anaphylaxis. Check regularly to make sure the device is within its expiry date. If you need to use it, you must always seek medical attention immediately afterwards by calling triple zero (000) or going to your local hospital, even if you feel better.
• Let your family, friends and work colleagues know about your allergy, and how they can help in the event of an emergency.
• If your child has a food allergy, you must make sure that all your child’s carers, teachers and sports coaches know how to recognise an allergic reaction and how to react quickly in an emergency. This includes laying your child down and administering their adrenaline injector before calling triple zero (000) for an ambulance.

The Australasian Society of Clinical Immunology and Allergy (ASCIA) provides a downloadable first aid plan for anaphylaxis.

Allergy & Anaphylaxis Australia has online support resources available, including information on how to read food labels and what to do in an emergency. You can also call for help and support on 1300 728 000.