- Food allergies aren’t always obvious.
- Food allergies aren’t always obvious but they’re worth taking seriously – especially since some of them can be life-threatening.
- Hives, coughing, and itching of the throat are all signs of an allergy.
- You could have a food allergy if you’re experiencing pain swallowing certain foods.
- Visit INSIDER’s homepage for more stories.
Food allergies can be tricky to detect. In many cases, they are severe enough that you’ll know the hard way if you have one, but some allergies may not be as clear.
Dr. David Cutler, a family medicine physician at Providence Saint John’s Health Center in Santa Monica, California, explained that although not all allergies are severe, it’s important to keep a watchful eye on any warning signs that suggest that you may be dealing with food allergies of any kind.
From hives to swelling of the throat, below are some signs that you may have a food allergy.
It’s worth noting that this is just a general outline of symptoms and that you should always speak with your healthcare provider to get a proper diagnosis.
You may experience hives
Itchy rashes and hives are some of the biggest signs of a food allergy, according to Dr. Clare Morrison, a medical advisor at Medexpress.
If you do experience hives, asking your doctor about an elimination diet can help you find out what food or food group is triggering you.
“Let’s say you’re not eating any of the hives foods and then you add back shellfish and you get the hives again. Then you can pretty much figure it out,” Dr. Debra Jaliman, a New York City-based dermatologist and the author of “Skin Rules,” told Health.
- Hives could be a sign you have a food allergy.
You may have itching and swelling in the mouth and throat
“Itching and swelling in the mouth and throat is particularly worrying,” Morrison told INSIDER. This is caused by the immune system reacting to proteins that are similar to those found in pollen such as fruits and nuts, she said.
According to Harvard Medical School, this is typically classified as an oral food allergy and is considered mild. Of course, if this turns severe or is coupled with other symptoms, seek help right away.
Wheezing, coughing, and experiencing shortness of breath are other symptoms to look out for
As VeryWell Health noted, being slightly short of breath when eating can have many different causes, one of which is a food allergy. But this can also be one of the first signs of anaphylaxis, a severe allergic reaction that can be life-threatening. If you’re feeling short of breath, especially when you’re eating certain foods, it’s best to speak with a doctor about it.
You’re experiencing unusual reactions after taking just one bite of something
Food allergies can be trigger by even a small amount of the food you’re allergic to, said registered dietitian Staci Gulbin. If you’re experiencing symptoms after simply taking a bite, that’s a pretty good sign that what you’re experiencing is a food allergy rather than simply an intolerance.
- You may have to cut out some foods.
You are experiencing pain when you swallow
“Less obvious symptoms include difficulty swallowing, painful swallowing, or sensation of food sticking in the chest,” said Dr. Omid Mehdizadeh, an otolaryngologist (ENT) and laryngologist at Providence Saint John’s Health Center in Santa Monica, California.
This is due to the allergic response within the esophagus or swallowing tube, he explained. He said that this type of food allergy is called eosinophilic esophagitis and it usually develops in childhood though it can present later on in life.
You have gastrointestinal distress
Dr. Sujan Patel, assistant professor of infectious disease and immunology and pediatrics at NYU Langone Medical Center, told Prevention magazine that like food intolerances, food allergies can cause gastrointestinal issues like nausea and vomiting. Unlike an intolerance, though, these symptoms may be more severe and accompanied by others on this list when you have an allergy.
You suddenly experience these symptoms, even as an adult
Though most food allergies develop while you’re a child, adult allergies are possible, so if you’re suddenly experiencing these symptoms, it could be a sign of an allergy.
“It’s possible to develop an adult-onset allergy,” said Dr. Janette Nesheiwat, who specializes in family and emergency medicine. “This means you may not have had allergies to something in the past (like shellfish), but it can happen later in life and the exact reason is unclear.”
It’s worth noting that many people may think they have an allergy though they actually have an intolerance
All of this in mind, food allergies are classified by a reaction by your immune system and allergies are generally life-threatening. Intolerances, which are often mistaken for allergies and are much more common, may simply cause gastrointestinal distress, per Cleveland Clinic.
As always, it’s best to speak with your doctor for an individual diagnosis especially if you are uncertain if you are dealing with an intolerance or allergy.
- The definition of “hypoallergenic” may not be what you think it is.
- Caroline Praderio/INSIDER
- “Hypoallergenic” products are popular for their perceived skin benefits.
- But the definition of “hypoallergenic” is not standardized or regulated by the US Food and Drug Administration.
- The term can mean whatever manufacturers want it to mean.
- And research shows some “hypoallergenic” products actually contain allergens.
People with skin allergies probably trust that “hypoallergenic” products will be free of ingredients that cause itchy, painful reactions. So they might be surprised to learn that the term “hypoallergenic” is essentially meaningless.
You don’t have to take our word for it – take the US Food and Drug Administration’s.
“There are no federal standards or definitions that govern the use of the term ‘hypoallergenic,’” the FDA writes on its website. “The term means whatever a particular company wants it to mean.”
And it might not mean much.
In a 2015 study, for example, scientists tested 135 children’s skin-care products labeled “hypoallergenic” and found that almost 90% contained at least one known skin allergen.
In an April 1978 issue of its “FDA Consumer” magazine, the agency explained that it did try to regulate the term during the 1970s. The agency wanted to allow the use of “hypoallergenic” only if human studies showed a product caused a significantly lower rate of allergic reactions compared to other products. But cosmetic companies fought the FDA in court and won. To this day, “hypoallergenic” is still unregulated, and manufacturers don’t have to offer the FDA any proof to back up the claim.
- Many children’s skin care products are labeled “hypoallergenic.”
- Oleg. / Flickr
This doesn’t mean that all companies who use the term are trying to deceive you. Some might voluntarily put their products through a barrage of high-quality allergy testing, but it’s hard to know that when you’re browsing store shelves in search of a new product. In the drugstore, when you see the term on two different products, it could mean two totally different things.
The bottom line: Don’t assume that “hypoallergenic” products will never cause an allergic reaction. If you see a company using the marketing term, you might want to check their website or contact customer service and see if they have additional information on their interpretation of its meaning.
Read more: 16 subtle ways you could be damaging your skin without realizing it
If you know you’re allergic to a certain ingredient or ingredients, it’s best to skip straight a product’s ingredients list. And if you’re getting allergic skin reactions and you’re not sure why, ask a doctor about getting patch testing, dermatologist Dr. Allison Arthur previously explained to INSIDER. The test exposes your skin to common allergens found in cosmetics so you’ll know which ones to avoid in the future.
Visit INSIDER’s homepage for more.
An inability to digest milk properly is not an uncommon occurrence and this condition is called lactose intolerance.
Lactose is a type of sugar found in milk and milk products. Unlike cow milk protein allergy (CMPA), which involves the immune system, lactose intolerance is a digestive problem.
This means that while lactose intolerance can lead to tummy discomfort, it will not produce life-threatening reactions such as anaphylaxis.
Another difference is that milk allergies tend to appear within the first year of life, while lactose intolerance can start in childhood and gradually become more obvious in adulthood.
A study of Malaysian adults found lactose intolerance prevalence was as high as 91%. (Asmawi MZ, Seppo L, Vapaatalo H, et al [The Indian Journal of Medical Research, Dec 2006]. Hypolactasia & lactose intolerance among three ethnic groups in Malaysia.)
How does lactose intolerance develop?
Your child’s body breaks down the lactose in milk with an enzyme called lactase, which helps break down lactose into glucose and galactose.
If his body does not produce enough lactase, it will lead to lactose intolerance, as his body cannot properly break down lactose in milk.
Do note that the symptoms of lactose intolerance will also vary depending on the amount of lactose that your child consumes, i.e. drinking more milk will result in either more severe symptoms and/or increase the number of symptoms experienced.
Often, signs and symptoms will occur anywhere between 30 minutes to two hours after drinking milk (or eating dairy products).
The severity may range from mild to severe, and is largely dependent on the amount consumed and how well he can tolerate lactose.
The common signs/symptoms of lactose intolerance are: wind, pain and swelling in the tummy, failure to gain weight and diarrhoea.
No matter what, if your child (especially in the case of infants) feels cranky or unwell, do everything you can to soothe and comfort him.
In the case of lactose-intolerant mothers, it is safe for you to breastfeed your baby as it does not increase his risk of becoming lactose intolerant.
Continue exclusive breastfeeding (unless advised not to by your doctor) for the first six months of life as studies have shown that this reduces the risk of cow’s milk protein allergy, compared to feeding using infant formula during that time.
A temporary case of lactose intolerance can also occur if your child suffers a viral infection or if he suffers from any digestive conditions that cause inflammation in his intestines (e.g. coeliac disease).
When diagnosing lactose intolerance, your child’s paediatrician will start off by taking a medical, family, and diet history.
A hydrogen breath test may be required – this is a simple test where your child breathes into a device that measures his breath’s hydrogen level before and after he drinks a sample containing a set amount of lactose.
The test should only detect a small amount of hydrogen in the breath if he is not lactose intolerant. An increase in detected hydrogen would indicate lactose intolerance.
Another test used by paediatricians is to check your child’s stools, especially if he is too young and cannot perform the hydrogen breath test correctly.
Stool acidity may indicate problems with lactose absorption, while another stool test checks for glucose in the stool, which points to undigested lactose.
Depending on the severity of his symptoms, a biopsy (tissue sample) may be required.
This is accomplished by a procedure called endoscopy, where a long, thin, flexible device is inserted via the anus to measure lactase levels in the intestines.
How you handle your child’s lactose intolerance will depend largely upon how severe his condition is.
If it is relatively mild, he may be able to tolerate small amounts of dairy or dairy products. Instead of giving him a full glass of milk, try giving him half a cup or a less each time.
If your child’s lactose intolerance is severe enough that he cannot drink any cow’s milk, he can still get enough calcium from lactose-free dairy products, dark green leafy vegetables (e.g. spinach, broccoli, kale), nuts, beans, fish (e.g. sardines, salmon) and calcium-fortified food products.
Do consult with his paediatrician before opting to give him calcium supplements as too much of it can cause constipation and may interfere with his body’s ability to absorb iron or zinc.
Alternatively, you may want to explore other milk substitutes such as soy, almond, rice and oat milk.
As a good source of calcium and protein, soy milk is a popular milk substitute, along with almond milk, which is a good source of calcium, but lower in protein when compared with cow’s milk.
Before giving your child any milk substitute, do check with his paediatrician first.
Dr Amir Hamzah Abdul Latiff is a consultant paediatrician and consultant clinical immunologist/allergist. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please e-mail firstname.lastname@example.org or visit www.mypositiveparenting.org. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Some may go on a veggie-juicing diet while others sing praises of detox teas, which use a concoction of herbs to cleanse and nourish the liver, an organ responsible for clearing toxins from the body.
One friend tried to sell me the wonders of colon irrigation as he lost three kilogrammes from removing all that gunk, resulting in a flatter stomach and clearer skin.
Many like him say stubborn pounds miraculously melt away after a few sessions. Sceptics like me tell him to eat healthier and accumulate less junk. It’s cheaper than flushing money down such procedures.
The truth is, your body can naturally get rid of toxins no matter what you eat, as long as you incorporate wholesome foods like fruits and vegetables, plus engage in regular physical activity.
However, there are many parts of the body that could do with some help in cleansing due to our food intake and the polluted environment we live in. The mind also needs to be purified for clarity of thought.
According to yogic science, certain cleansing processes are extremely important for a healthy body. Without regular cleansing of the bodily systems, one cannot gain maximum benefit from practising yoga.
This practice, comprising six purification techniques, is called the shatkarmas or shatkriyas, valued for healing all kinds of internal disorders. They are neti: nasal cleaning (including jala neti with salt water and sutra neti with a cotton thread); dhauti: cleansing of the digestive tract; nauli: abdominal massage; basti: colon cleaning; kapalbhati: purification and vitalisation of the frontal lobes; and trataka: blinkless gazing (which I talked about in one of my previous columns).
The shatkarma affect and activate almost all of the vital systems in the body, especially the digestive, respiratory, circulatory and nervous systems.
Every individual organ of importance, like the oesophagus, stomach, colon, lungs, eyes and ears, receive equal attention.
These purification processes are both preventive and curative.
Since sinusitis or allergic rhinitis affects about 20% of the population and up to 40% of children, one of the easiest methods to cleanse an adult’s nasal cavity is by doing jala neti.
Nasal hygiene is extremely important as it is linked to many conditions including migraine, headaches and other allergies.
Patients with sinus problems, often due to a hypersensitive immune system, suffer frequent and prolonged respiratory infections, as well as asthma, which is difficult to control.
Sinusitis or allergic rhinitis affects about 20% of the population and up to 40% of children, — AFP
Jala neti is a simple practice that can be done along with your daily routine, such as after brushing your teeth in the morning.
All it takes is some salt, warm water and a few minutes to help relieve many of the problems related to the nasal and sinus cavities.
But first, you need to purchase a neti pot – a container made of plastic or ceramic, designed to rinse “debris” or mucus from your nasal cavity. It can be purchased from selected pharmacies, yoga studios or online.
To prepare, make sure you only use boiled water that has been left to cool until lukewarm, so that it does not irritate the tissues inside the nostrils. You don’t want it too hot as it might burn the nostrils.
Or, if you’re as finicky as me, you can filter the tap water first, then boil it. Add a teaspoon of non-iodised salt (any salt is acceptable) to half a litre of water.
The method (stand over a sink):
• Pour the salt water into the neti pot and place the cone at the end of the spout inside the left nostril.
• Tilt your head gently to the right and open your mouth (breathing should be done through the mouth during the process). Adjust the tilt of your head up to a point where water starts flowing from your left nostril to the right nostril. Continue until the water in the pot is emptied.
• Fill the pot again with salt water and do the same procedure from the right nostril.
• Repeat this process two or three times. Then blow your nose.
When you first start this practice, it may seem daunting and you may get irritations in the nose, sneezing, coughing, runny eyes etc, which will disappear after few sessions.
If you’re suffering from sinus problems, it’s recommended that you carry out the jala neti daily. If you’re normal, then once a week is sufficient.
Do not practise if you are having a severe cold or chest infection. In such scenarios, it’s better to steam your head over a pot of hot water with drops of eucalyptus oil added.
After use, clean the neti pot thoroughly to clear away contaminants, and let it air dry completely before storing it away. Like toothbrushes, your pot shouldn’t be shared with anyone else. Be stingy about it!
The Western world has caught up with this cleansing technique, but instead of doing it the traditional yogic way, medical practitioners prescribe a saline spray or drops to alleviate congestion. Often, they refer to it as nasal irrigation.
The salt water causes the blood vessels in the nose to contract and dilutes mucus, which helps reduce swelling in the sinus area.
When the different systems of the body have been purified, the overall result is that energy can flow through the body freely. One’s capacity to work, think, digest, taste, feel, experience, etc, increases and greater awareness develops.
With boosted immunity levels, the occurrence of common colds and flus are greatly reduced.
For you and me, we don’t have to do all the cleansing techniques unless you aspire to be a yogi.
So, just do the ones necessary for the body part that needs it most as you’ll still get some benefits. With jala neti, you can breathe and sleep better.
Revathi Murugappan is a certified fitness trainer who tries to battle gravity and continues to dance to express herself artistically and nourish her soul. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
READ: Part 1 and Part 2
A curious aspect of non-coeliac gluten sensitivity (NCGS) is that this syndrome is usually acquired after childhood. It is odd because statistically, adults have a smaller percentage of allergy sufferers than children – one presumes childhood allergens are better tolerated as one grows older and develops a more rounded (or stronger) immune system.
It might be suggested that NCGS is akin to lactose intolerance, which develops after the body stops producing the enzyme lactase. The difference is the human body is innately unable to produce the enzymes to digest many complex carbohydrates at any age – it needs bacteria in the human gastrointestinal microbiota (HGM) to do this, and one supposes adults have a larger range of bacterial fauna than children.
To be clear, humans do produce enzymes to digest some common carbohydrates, especially starches (made up of amylose and amylopectin) and sugars – but most other carbohydrates need digestive help from the HGM. This is why FODMAPs may be allergens behind NCGS if the HGM is defective in some way. FODMAP stands for Fermentable, Oligo-, Di-, Mono-saccharides And Polyols, and are varieties of carbohydrates which humans cannot digest natively via enzymes – and they are often found in food where gluten is present, and also in foods where there is no gluten.
Old wheat vs new wheat?
As modern wheat is a hybrid derived from various grasses, it is worth determining if some change in wheat genes is a cause of NCGS. This was investigated by the University of Reading in 2017. Analysis of various ancient strains established differences in various compounds compared to modern wheat, in particular carotenoid lutein, a colourant mostly bred out of modern wheat (as people prefer white wheat flour). There were also minor differences in plant phytochemicals and dietary fibre content. Curiously, the profiles of FODMAPs are remarkably similar in both ancient and modern wheats. So if FODMAPs are a root cause of NCGS, then people have been suffering for thousands of years.
One mildly interesting outcome is there seems a lesser reaction to FODMAPs from a strain of khorasan wheat called kamut (also known as “mummy wheat” as it allegedly came from wheat grains found in Egyptian tombs). Symptoms of NCGS and irritable bowel syndrome (IBS) appear to be reduced with kamut wheat, and analysis of faecal samples suggested that kamut wheat has a different impact on HGM than normal bread wheat. However, the studies were on small groups and therefore not conclusive – also complicating matters is the fact that nutrition profiles of kamut grown in various countries have wide differences which may or may not be significant.
Gluten, FODMAPs and baking
Next was a look into the impact of modern processing of wheat flour, especially in commercial bakeries and food processing plants. Research in 2015 in Britain suggests that bread gluten becomes less digestible after baking (possibly due to structural changes) – in particular, baked gluten is even more indigestible in people deficient in producing the enzyme amylase (used for digesting amylose).
Furthermore, a 2014 Flinders University study researched the impact of baking on two major prebiotics in bread wheat flour: arabinoxylans (AX) and fructans – prebiotics are non-digestible food compounds which feed the HGM, and are also FODMAPs.
The study found slight variations in AX content after various stages of baking – which implies AX is not hugely affected by processing. More interesting is the impact on fructans; in particular, the use of yeast to ferment and leaven bread flour before baking can reduce fructan content in bread by 60% (though it is important to also note the baseline content and types of fructans vary widely depending on the source of the flour).
This is significant because most commercial bakeries do not proof (ferment with yeast) breads as it takes too long – instead they often use chemicals (eg. sodium bicarbonate, sodium aluminium phosphate, etc) to raise bread quickly in commercial ovens, and therefore the fructan content is significantly higher than for leavened breads.
Fructans are oligosaccharides (complex sugars consisting of polymers or chains of fructose-based molecules). There are several categories of fructans, delineated by different hydroxyl (radical –OH) bonds in their structure and the most well-known types are inulin and levan. They are interesting because a 2017 study at Oslo University claimed that fructans is a possible cause of NCGS. Although the study was small, it was a well-done double-blind exercise, though it is odd that the test fructans (inulin derived from chicory roots) are also sold as prebiotics to promote HGM health.
When test subjects did not know what they were eating, 22% reported intestinal issues with gluten while 46% reported the LEAST problems when ingesting gluten. With fructans, 41% recorded issues, almost double the number for subjects troubled by gluten. Moreover, the study suggested that issues with fructans may be dose-dependent – doubling the amount of fructans normally eaten provoked negative reactions which were absent with less consumption.
There are some considerations. The fructans used in the study were derived from chicory roots – which are different from fructans in wheat and other foods. The same fructans used are also sold commercially as prebiotic supplements to promote HGM health – presumably there are not many people reacting negatively to such supplements or else it would not be a business.
The gluten is based on the 19 most allergenic gliadins (out of around 890 types of known gliadins) – these proteins are 33-mer peptides, and as such not all the gliadins in a normal diet are covered.
It should therefore be noted that not all combinations of fructan and gluten compounds in normal diets were tested.
As an aside, durum wheat (found in good spaghetti and pasta) lacks the gene to produce 33-mer peptides so if you have a reaction to bread wheats, you might try eating some pasta instead to see if it helps.
In 1965, Bronstein’s research into the digestion of wheat gliadins indicated the resulting acidic peptides are a cause of coeliac disease (CD) as sufferers lack an enzyme to digest such peptides, which then circulate around the digestive tract. In response, the body produces antibodies to counter these peptides which are perceived as foreign pathogens. Later in 2000, Fassano showed that intestines also increase production of zonulin in such situations – this protein loosens the tight cellular linkages in the intestines, causing “leaky gut syndrome” where digestive substances permeate into the blood stream, provoking more severe reactions.
Then a 2015 US paper researched the effect of pre-digested wheat gliadins on intestinal tissues extracted from people with CD, NCGS and controls with no gluten sensitivity. The outcome was sobering – ALL tissue samples demonstrated increased permeability reactions to pre-digested gliadins. In addition, it was found that the controls produced significantly more of a protein called cytokine IL-10, which is an anti-inflammatory factor.
It should be noted that tests on tissue extracts with chemically pre-digested gliadins may not accurately reflect conditions in the body. Or it can be suggested gliadins in wheat gluten consistently provoke intestinal inflammatory issues and people who produce enough cytokine IL-10 do not feel the effects of such inflammation.
The probability that humans are reacting to chemical food additives used in modern processed foods also cannot be ignored. This is a long complex subject, covered in the six-part series, “How to count on food”.
If you’re not confused by now, you’re not paying attention
A summary is now in order.
Gluten (especially wheat gliadins) and FODMAPs are broad, complex groups of food substances which vary widely in quantity and types. Due to idiosyncratic differences in humans, it is difficult to pin-point exactly which compound or combinations in one or both groups cause NCGS.
FODMAPs are indigestible food compounds which need the HGM to help with digestion. As they can promote fermentation in the gut, some FODMAPs are associated with gas and distended bellies. They are not necessarily bad – but they do need a compatible, robust HGM to process them.
Ironically, a lot of commercial gluten-free food is bulked up with FODMAPs and often contain industrially-processed oils and added sugars – in short, gluten-free foods are not always inherently healthy.
Fructans are fructose-based FODMAPs which can trigger NCGS, though the reasons why are not known – maybe it is related to HGM. Fructan content varies widely by source and also by certain food processing steps, such as yeast fermentation.
Gliadins in bread wheat gluten, particularly 33-mer peptides, have been linked with intestinal permeability.
Food additives can trigger NCGS, though relevant impact analysis data is currently not available due to the wide range of additives in modern food processing.
Back to Taiwan
Based on the above, my incident in Taiwan in Part 1 of this series was likely due to over-consuming wheat flour in noodles and buns, pushing gliadin and FODMAP consumption past levels which overwhelmed the body’s anti-inflammatory response.
The same issue may apply for commercial breads using unleavened dough with high fructan content and textured with industrial additives.
Subjectively, although problems develop after consuming certain compounds (eg. gliadins, FODMAPs, additives) past a tolerance threshold, it does not mean I have NCGS – in the same way getting drunk does not mean an alcohol allergy.
So if you still consider NCGS a problem issue, you now have all the (currently known) facts before deciding to pay premium prices for gluten-free foods.