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A food allergy is where the body’s immune system mistakenly thinks that the proteins in certain foods are a threat. As a defence mechanism, chemicals are released in an attempt to fight off this threat, and it is how the body reacts to the release of these chemicals that creates the symptoms associated with food allergies.

An estimated 2 million people in the UK suffer from a diagnosed food allergy. Symptoms can vary significantly between these sufferers; from the mild to the severe. Although the number of food allergy cases has sharply increased over the last 30 years, thankfully the number of deaths is relatively low; on average ten people die annually from a severe allergic reaction to food.*

Food allergies cannot be cured but may ease, or even disappear entirely, over time. The best and most common way to prevent an allergic reaction is to identify what type of food is the cause. This can be a long process and involves working with a medical professional to remove different types of food from the diet, one at a time until the allergic reactions cease. Once the type of food is identified, then the sufferer would need to avoid it entirely. However, this may lead to a feeling of alienation for the sufferer and they may risk exposing themselves to that food type in order to fit in; this is especially true with younger sufferers.

What are the symptoms?

Some of the milder symptoms are:

• A tingling, itchy, sensation in the mouth, throat or ear
• A rash, known as urticaria (or “hives”), that is itchy, red and raised
• Facial swelling, known as angioedema
• Vomiting
• Hay fever-like symptoms; such as a runny nose, sneezing or itchy eyes

There is no immediate threat to someone exhibiting these milder symptoms. However, if someone is prone to more severe reactions, then action should be taken when any symptoms are exhibited. If the person is not already aware of their allergy, then they should ask for a professional diagnosis from their GP.

Some of the more severe symptoms are:

• Struggling to catch a breath
• Struggling to swallow or speak
• Dizziness or fainting
• Swollen tongue
• Tightness in the chest
• Collapse

An allergic reaction, exhibiting some or all of these symptoms, is known as anaphylaxis, and is a medical emergency. Like any medical emergency, 999 should be called, and an ambulance requested as soon as possible. Without quick treatment, anaphylaxis can be life-threatening.

Common food allergies

Although someone could be allergic to any type of food, certain food allergies are more common than others. The 14 most common allergens are; celery; cereals that contain gluten; crustaceans; eggs; fish; lupine (or ‘lupin’); milk; molluscs; mustard; tree nuts; peanuts; sesame seeds; soya; sulphites.

It is important for sufferers to know which foods may contain the food type they are allergic to, and this has become somewhat easier due to EU regulation 1169, introduced in 2011, which says any food which may contain any of these common allergens must be clearly labelled. However, it is still important to call out some of the less obvious foods:

• Celery; canned soups, stock cubes or spice mixes
• Cereals that contain gluten; bread, pasta or cereals
• Crustaceans; crab, crawfish or langoustines
• Eggs; mayonnaise, salad dressing and cappuccino
• Fish; gelatine, Worcestershire sauce and salad dressing
• Lupine; is a bean used to make lupine flour and lupine protein
• Milk; chewing gum, baked goods and doughnuts
• Molluscs; mussels, scallops, oysters, etc
• Mustard; the mustard seed is common in sauces, such as ketchup and marinades
• Tree Nuts; walnuts, almonds, hazelnuts, cashew, pistachio and Brazil nuts
• Peanuts; cookies, Asian cuisine and many sauces
• Sesame seeds; baked goods, cereals and Asian cuisine
• Soya; common in many Asian sauces
• Sulphites; dried fruits, grape juices and wine

Food Allergy Treatment

There is no cure for food allergies. However, 2 main types of treatment can relieve the symptoms caused by an allergic reaction to food:

• Antihistamines – used to treat mild to moderate reactions

Antihistamines block the effects of histamines (chemical compounds found in foods) which are the cause of most symptoms of an allergic reaction.

Antihistamines can be bought over the counter at pharmacies, but some may not be suitable for very small children.

Alcohol should be avoided immediately after taking an antihistamine, as this may lead to drowsiness.

• Adrenaline – used to treat severe allergic reactions, known as anaphylaxis

Adrenaline narrows the blood vessels, which counteracts the effects of low blood pressure and eases breathing difficulties.

Those who have a severe food allergy, and are therefore at greater risk of suffering anaphylaxis, will be given an auto-injector of adrenaline in case of emergency. It is important that the person with the allergy, and other people who will be around that person, know how to operate the auto-injector so that the adrenaline can be applied swiftly and correctly.

In case of emergency, the following advice should be followed by those who are required to own an auto-injector:

• Carry the auto-injector on you at all times;
• Avoid keeping the auto-injector in extreme temperatures, such as in a fridge or the glove compartment of a car;
• Check the expiry date regularly to ensure the auto-injector is still offering full protection;
• Make use of the manufacturers’ reminder service (if they offer one), where an alert will be received close to the expiration date;
• If a child has an auto-injector, they will need to change to an adult version once they weigh 4.7 stone;
• Always apply the adrenaline when the symptoms begin, even if these are mild. Never wait for the symptoms to become more severe before acting.

Food Allergy Training

TutorCare Ltd offers a number of food safety training courses that are recognised by the Chartered Institute of Environmental Health (CIEH). These include the standard in-house Food Safety Awareness course, our Allergen Awareness course, CIEH Level 2 Award in Healthier Food and Special Diets and the mentor led CIEH Food Safety Train the Trainer programme.

For first aid emergencies we also the topics of auto-injectors, CPR and severe allergic reactions in our Anaphylaxis First Aid Training Course.

*Food Standards Agency report: Food Allergy and Intolerance Programme – https://www.food.gov.uk/sites/default/files/media/document/report-food-allergy-intolerance-research-programme-review

NHS: Food allergy – https://www.nhs.uk/conditions/food-allergy/