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For illustrative purposes only. Image Credit: Agency

Dubai: Two weeks ago, Myra, was celebrating her 14th birthday at a restaurant in Dubai with family when she suffered an allergic reaction to

prawns. Luckily a doctor was at the gathering and had an epinephrine or ‘epi’ pen, which enabled him to revive the teenager, who had collapsed and turned blue, before the ambulance arrived.

Tests at the hospital confirmed her allergy and she was advised to avoid crustaceans and always carry an epi pen.

Welcome to the frightening reality of food allergies and intolerances.

Food intolerances and allergies

According to guidelines issued by the Centre for Disease Control (CDC) food intolerances and allergies among children have increased by over 50 per cent since 1990.

With intolerances triggering inflammatory processes and weight gain, it is thought that as we urbanise rapidly and increasingly choose processed food products — as well as compel farmers to increase agricultural yields with the help of hybrid crops, fertilisers and pesticides — a new group of health conditions are manifesting themselves.

Food allergies need to be acted upon as these can be life threatening. Food intolerance on the other hand, is milder as it occurs due to a deficiency of certain digestive enzymes.

- Juliot Vinolia, Clinical nutritionist at Medeor Hospital, Dubai

Many seemingly edible foods are now being perceived by our bodies as an ‘enemy’ or invader triggering a negative response.

What is the difference between food allergy and food intolerance?

Juliot Vinolia, Clinical nutritionist at Medeor Hospital, Dubai explained: “A food allergy is the hypersensitivity to specific proteins in foods like milk, eggs, peanuts and seafood. These proteins are mistaken by the body as a threat like any bacteria or virus. As a result, antibodies are produced which trigger the allergic reactions and symptoms.”

Food allergies need to be acted upon as these can be life threatening.

Food intolerance on the other hand, is milder as it occurs due to a deficiency of certain digestive enzymes resulting in the malabsorption of carbohydrates.

Vinolia explained: “When partially digested foods enter the colon these trigger gastric disturbances leading to Irritable Bowel Syndrome (IBS) like symptoms.”

Though food allergies and intolerances share similar symptoms, food intolerances are not caused by the immune system and they are not life threatening. It only results in gastric discomfort affecting the quality of life.

Food intolerances can be rectified either by taking the easily digestible form of the food by modifying the cooking process or taking the commercially available allergen free products — for example lactose free milk or gluten free breads.

Vinolia added that allergies are usually common among children below the age of five due to an immaturely developed immune system.

Probiotics are live cultures of healthy bacteria found in yoghurt and fermented foods like khimchi, miso and sauerkraut that help in the repopulation of healthy gut flora.

- Ruba Al Hourani, Clinical dietician at RAK Hospital, Dubai

“With age, most kids eventually outgrow food allergies. The test confirmed allergic foods should not be experientally reintroduced in small or liberal quantities anytime later after an allergic episode without medical supervision as this can be life threatening. Recent immunological studies in 2017 have shown that adults with asthma or dermatitis (dry skin) showed more sensitivity to food proteins. Eliminating the allergic foods showed relief in both cases,” she said.

How to tell if you have an allergy or intolerance?

Food allergies are either done by a skin prick test — where a small amount of the allergen is exposed to the skin by a needle and if a reaction occurs this confirms an allergy — or a blood test, where a sample is taken and checked for levels of Immunoglobulin E Antibodies (IgE). Elevated levels confirm an allergy.

Food intolerances can also be detected by blood sample test. The sample is exposed to a range of food proteins and tested according to the levels of Immunoglobulin G Antibodies (IgG) this exposure produces. Identified foods are categorised as ‘not elevated’, ‘elevated’ or ‘highly elevated’, and with the support of a dietician these foods can be eliminated while following a balanced diet until IgG levels return to normal.

Who is at risk?

Anyone can develop intolerances if they are at genetic risk of allergy or have intolerance from excessive intake of processed carbohydrates, preservatives, additives, colourants, enzymes or taste enhancers like monosodium glutamate.

Causes

Vinolia said: “The increasing incidence can be attributed to commercial food production methods of instant or long life foods. The method of processing, addition of food additives can also alter the nature of proteins in our traditional foods during the production. Our body does not recognise these proteins as food but instead as a foreign substance resulting in immune flare ups.

One of the most common manifestation of lactose intolerance is Hydrogen breath that indicates intestinal bacterial growth following malabsorption of lactose and sugars.

- Dr Gaurav Diddy, Consultant gastroenterologist at Prime Hospital, Dubai

“Hybridisation of agriculture with the main aim of feeding the growing population is also a concern,” she added. “It may interfere with the DNA of the cells of our digestive system imposing a genetic risk for traditionally thought wholesome foods, which the bodies of our next generation might identify as an allergen thus imposing a genetic risk to traditional foods.”

What happens if food intolerance go undetected?

“Taking intolerant foods for a long period can damage or alter the absorptive surface of the intestine,” said Vinolia. “This directly affects the optimal absorption of other vitamins and minerals in the diet. It can also alter good bacteria in our colon making us easily prone to food poisoning. Any disturbance in the gut microbiome has shown a direct relation to chronic diseases like diabetes, cancer and obesity by several studies recently.”

Typical fall outs of long term intolerance is Celiac disease and IBS. Vinolia added that food intolerances left untreated could lead to deficiency of vitamins and minerals, trigger migraines, skin issues, respiratory tract infections, plus bone and joint inflammation.

Dos and dont’s to build a healthy immune system

■ Avoid too much processed grain and cereal-based food

■ Replace long life products with fresh products

■ Enjoy seasonal fruits and vegetables as they require less pesticides and fertilisers

■ Read ingredients labels and pick products with the least additives and preservatives

■ Choose healthy cooking methods

■ Include probiotic rich foods like yoghurt for good gut microbial count

■ Drink water to help digestion and the absorption of toxins

■ Include Omega 3 and healthy fats to combat unseen chemicals

■ Avoid refined sugars and artificial sweeteners

■ Include fibre for bowel health

How can pre and probiotics help?

Ruba El Hourani, clinical dietician at RAK Hospital, Diabetes Centre, Dubai advises intake of natural pre and probiotics to help counter the problem of food intolerance. “Live bacteria helps us digest food and keep us in good health. These are helped by prebiotic intake,” said El Hourani.

“Prebiotics are special kinds of fibres that act us fertilisers for healthy bacteria. These are found in the non-digestible parts on vegetables such as onion, garlic, artichokes that reach the intestine undigested, ferment and help eliminate harmful bacteria.”

El Hourani also recommended probiotics.

“Probiotics are live cultures of healthy bacteria found in yoghurt and fermented foods like khimchi, miso and sauerkraut that help in the repopulation of healthy gut flora to destroy harmful, unhealthy, disease-causing bacteria. Those who have lactose intolerance are advised to take probiotics such as lactobacilli, bacillus coagulants, and saccharomyces boulardii (available at local pharmacies) to allow healthy gut bacteria to counter the problem.”