1. Living with life-threatening food allergies
3M Health Care
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    Living with life-threatening food allergies: What does the future hold?

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    Multigenerational family gathers around table for a healthy me

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    • Ashwin in doctor’s exam room

      Most of us look forward to restaurant outings and holiday gatherings with family and friends. We come together and bond over a table loaded with food. For some families, these get-togethers look very different.

      “We had to remove food-centered events from our gatherings,” says Danette Andley, mother of four-year-old Ashwin, who has multiple food allergies. “We can’t eat grandma’s delicious Indian food. I have to tell family members you can’t kiss my son and you have to wash your hands before you touch him because he could break out in hives.”

      Ash had his first allergic reaction to food when he was six months old, after eating a scrambled egg. “He started projectile vomiting and broke out in hives,” says Danette, who works for 3M Health Care. “I called the nurse line and she told me to hang up and dial 9-1-1.”

      They kept discovering more food allergies over the next year: Peanuts, sesame, chick peas, tree nuts, soy, lentils and fish. “We try not to scare him, but he knows he can’t have eggs, tree nuts or peanuts because he could have a severe reaction,” says Danette. “He knows he can’t have cake unless mom or grandma makes it.”

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    • teen in swim lane

      Don Ashton is further along in the journey of raising a child with life-threatening food allergies. His son, Liam, is in high school and has severe peanut and tree nut allergies. He’s at a point in his life where he can advocate for himself more. But, Don notes, he’s also a teen. “He’s at an age where he thinks he’s immortal,” says Don, who works on 3M’s finance team. “He’s a six-foot-tall swimmer and he likes to eat. He likes to try new foods.” That often means going out to eat with friends, which can be problematic.

      “He’s had four anaphylactic reactions in the past three years,” Don says. An anaphylactic response causes an immune response that can include narrowing of airways and difficulty breathing. It can happen within seconds or minutes and without immediate treatment it can be fatal. Don says Liam doesn’t necessarily want to call attention to his food allergies so he may not ask a lot of questions about food preparation and cross-contamination when he goes out to eat or visits friends.

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    • A growing trend

      These families are part of a growing trend. Food allergies have been on the uptick in the past few decades. According to National Institutes of Health, as many as 10 percent of people in developed countries report food allergies.

      The trend of increased food allergies – along with an increase in environmental allergies – is probably related to society’s increase in hygiene, known as the hygiene hypothesis, according to Dr. Doug McMahon, Allergist at the Allergy and Asthma Center of Minnesota. He says when we grow up in a very clean environment, our bodies aren’t used to fighting germs. Our immune system overreacts to when it is exposed to something it perceives as a threat.

      “Delaying the introduction of foods has not done us any favors either,” says Dr. McMahon. Medical experts have now reversed the recommendation to wait to introduce food until children are older. If babies have no eczema and no family history of food allergies, doctors now recommend introducing foods at four months. If children do have eczema or a strong family history of food allergies, they should go to an allergist for testing first, he says.

    • Current and future treatment options

      Dr. McMahon, who has a tree nut allergy himself, says there are currently two options for people with allergies – avoidance or desensitization treatment.

      People with food allergies need to worry about eating specific foods, and also about touching any surfaces where the food has been. “People with allergies should always carry two doses of epinephrine,” he says. “That’s the only treatment once an allergic reaction starts.”

      Dr. McMahon says that for children and young adults, desensitization can be a viable alternative. Patients allergic to peanuts, for example, would first receive a dose of 1/50,000th of a peanut. Then, they continue to take higher doses for the next eight months. “At the end of the eight months, they then need to continue to eat that food daily to maintain desensitization,” he says.

      “It can be very stressful on parents and on a young patient,” he adds. But Dr. McMahon says it’s worth it – he feels like it’s a better option than avoidance in the long run.

      What’s on the horizon for new treatments? Dr. McMahon says he’s developing a new epinephrine device. Companies also recently have introduced skin patches that can be used for desensitizing patients to peanuts. He believes biologic treatments, using immune cells to try to calm down the body’s response to allergens, will soon become available.

    • Better food labeling and safer food handling

      Both Danette and Don want to see more protections put in place to make it easier to avoid allergens. More diligence is needed in food labeling and food handling protocols.

      “I’d like to see food companies increasing their allergen policies and procedures,” says Danette. She says some progressive companies have information that is available by scanning a code on the label – where it was manufactured, if they process allergens, and what cleaning protocols they follow. “I want to make an educated decision,” she says. “If food manufacturers don’t share information clearly, they don’t just lose one consumer – they lose all five people in my household.”

      Don also would like to see clearer allergen information from both restaurants and food manufacturers. He doesn’t like the umbrella labeling of “may contain” because he worries that people may not take that seriously and will assume the allergen isn’t present. “I’d like to see better technology in testing food and surfaces,” he says. “The prep and cooking areas in restaurants should be tested for cross-contamination.”

      Dr. McMahon sums up what he tells his patients: “You have to be very diligent. Pay attention to labels and always carry epi devices. With a few deviations, like bringing your own cupcake to a birthday party, you can still live a normal life.”

    3M scientists work hard to simplify the complexity of allergen testing for food safety professionals. See how 3M has designed test kits for monitoring specific allergens for a wide variety of foods.


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    • Five things to know about allergens and what you can do

      1. Allergies can be life-threatening. People may associate allergies with minor symptoms that go along with seasonal allergies, like sniffling and itchy eyes. For some people, allergic reactions can cause difficulty breathing, a loss of blood flow, and, ultimately, death.

      2. Having food allergies can be isolating. Schools often have a peanut-free lunch table, so kids with allergies may eat lunch alone. Encourage children who don’t have peanuts, or other allergens, in their lunch to sit with students at the allergen-free table if they can. Adults and children alike often opt out of social events if they are food-centered.

      3. List ingredients. When you attend potlucks, list ingredients used in the recipe or keep the package labels on hand for people to review.

      4. Be aware of cross-contamination. For some people with food allergies, even a miniscule amount of an ingredient can lead to a severe reaction. Using a cutting board, utensils, mixers or an oven that contacted an allergen can lead to cross-contamination and an allergic reaction.

      5. Plan ahead. Whether you a planning a child’s birthday party or hosting an event for adults, let guests know what foods will be served. If you are serving pizza and brownies at a kid’s party, your child’s friends can bring their own and feel included in the festivities.

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    • Allergies and sensitivities: What’s the difference?

      It is not always easy to understand the difference between food allergies and intolerances or sensitivities.

      Allergies cause the immune system to react by producing antibodies, according to the American Academy of Allergy Asthma & Immunology. These antibodies travel to cells and cause them to react, which triggers allergic symptom like hives and swelling. With food allergies, even a small amount can trigger a serious reaction, including anaphylaxis. An anaphylactic response can include difficulty breathing and without immediate treatment it can be fatal.

      Food sensitivities and food intolerance are not life-threatening. Symptoms can include digestive distress, skin conditions, migraines and fatigue. Food intolerances can be caused by the absence of an enzyme needed to fully digest a food, or triggered by food additives like sulfites, according to Mayo Clinic. Celiac disease is an autoimmune disease that affects the digestive process of the small intestine – and is triggered by eating gluten. Symptoms are varied and can be severe, but often primarily gastrointestinal. People with Celiac are not at risk of anaphylaxis.

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    common allergens, dairy, eggs, peanuts, tree nuts, fish, shellfish, wheat and soy

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    • Common Allergens

      “The Big 8” refers to the eight most common food allergies. They are responsible for 90 percent of food allergies in the U.S. Globally, there are 21 food allergens recognized and regulated by 18 countries.

      The Big 8 include dairy, eggs, peanuts, tree nuts, fish, shellfish/crustacea, wheat and soy. Other countries regulate additional allergens including sesame, buckwheat, mustard, celery, tomatoes and oats.