There is evidence of allergic manifestations referring back to the days of the pharaohs, meeting in the Egyptian papyri descriptions of severe reactions to bee stings. (Adkinson et al, 1988).A high percentage of the population in non-industrialized countries are fed improperly, causing varying degrees of malnutrition, a fact that is particularly complicated in Venezuela by the high prevalence of allergic diseases 43% (Massicot et al, 1984) and therefore absorption Limited food macromolecules when patients with hypersensitivity to food. The current prevalence of adverse reactions to food in our country is unknown, while for other regions like the United States to 25% in children under four years and reacting only a third of these patients to the PPDC for food problems. It has been shown that a 2 to 3% of the pediatric population have food hypersensitivity, although certain group, such as those with mild atopic dermatitis express even higher frequency (Burks et al, 1988) 8% mint.Sometimes an adverse reaction is misinterpreted to food intolerance and allergy itself; to facilitate research in this area the European Academy of Allergy and Immunology along with the National Institute of Allergy and Infectious Diseases North America propose a publication for the purpose of standardizing the nomenclature.Food Sensitivity: those reactions that occur in response of the organism after ingesting a food or food additive.Food intolerance: is an adverse reaction that happens as a result of a variety of non-immunological mechanisms include contamination by toxins secreted by salmon (eg egg and chicken); pharmacological properties of food, for example caffeine in coffee; and enzyme deficiency or metabolic disorders, for example lactose deficiency (milk and dairy).Food hypersensitivity or Food Allergy: is an abnormal immune response, they are IgE-mediated reactions. It is the term used when food sensitivity is likely to immunological basis.SYMPTOMS OF FOOD ALLERGIESThe manifestations are multiple and can occur in any system of the body..- Gastrointestinal cramps, nausea, vomiting, constipation, or anal itching throat, abdominal pain..- Nasal: congestion, itching, rhinorrhea, sneezing..- Dermatologic: urticaria, eczema, angioedema, erythema, pruritus, papules, etc.Respiratory .- rhinitis, asthma, cough, bronchospasm, dyspnea, etc..- Ocular: edema, irritation, conjunctivitis, etc..- Systemic: headache, irritability, chronic fatigue, hypotension, anaphylaxis..- Oral-labial edema, edema of the tongue, palate itching and ringing in the ears.There are foods which act as triggers or immunological triggers allergic reactions (hypersensitivity) or immunological reactions (intolerance). Eg cow's milk, wheat, fresh eggs, nuts, chocolate, etc., nonimmunologic act as histamine releasers, inducing similar to IgE mediated reactions symptoms, these can be traced to toxic or pharmacological action caused by food or an enzyme deficiency to the food, eg lactose intolerance reactions to additives (tartrazine, sulfites, etc.)
In the case of an allergic reaction, of course, the first step is the history, which should include a food diary to identify the suspect food, the same amount ingested, time elapsed since ingestion and the onset of symptoms, frequency of the same, previous episodes with similar symptoms since the last time.For the demonstration of immune mechanism, the allergist will evaluate the results of clinical response through some tests.After sensitivity to food has been proven by the treating physician, you should start a diet plan designed and guided by a nutritionist.
Kilocalories provide sufficient and necessary to ensure proper growth and development in children and to achieve and / or maintain an ideal or recommended in adult body weight.
Ensure adequate nutrient foods removing and replacing an equivalent nutritional value, mainly during the evaluation of the patient as an adverse reaction to a food protein is suspected.
Analyze the curve of weight and height as a dietary regime is implemented, particularly in the evaluation and treatment of children.
Knowing the amount and quality of food that make up its core to provide adequate nutritional orientation or immunodeficient patient atopic diet.
Control the appearance of the protein after sensitization symptoms.
In addition it should be remembered immunological memory, ie, the time it takes the body, once recognized as harmful substance, to reintroduce in the diet without symptoms occur. This may be due to the molecular weight of the antigen of the food, therefore a higher molecular weight as long memory. For example: wheat and milk have immunological memory time of two years. The egg of 1-2 years, 6-8 shellfish years.Once rejoin food, food is important to rotate and maintain a balanced diet. Avoiding nutritional deficiency or sensitization by excessive consumption of a single food. Furthermore it is not always the food itself can sometimes be the form of preparation (additives, preservatives, etc.)In addition, you must identify the botanical family of food allergens can appear as a reaction to them, for example, if a patient is sensitive to peanuts, probably will be, peas and green beans. It may also be given because the body confuses a compound of equal or similar chemical composition, for example, aspirin and vegetables that contain salicylated (spinach).
Prevention StrategiesThe first step is to identify those infants who are at high risk of developing an allergic disease in early life (especially those whose one or both parents expressed some atopic process)The second step is to avoid exposure to potential allergens or adjuvants, therefore it is recommended:A. Encourage breastfeeding, the mother avoid major food allergens and taking supplements with hypoallergenic formula, if necessary during the first six months of life. It is recommended that nursing mothers avoid eating peanuts and nuts as these alergenitos protein foods can pass into breast milk and sensitize the childB. Wean with hypoallergenic protein hydrolyzate.c.- Starting with solid foods after six monthsd.- By age incorporate food every two weeks (cow's milk, soy, citrus and peanuts)E. Delay up to two years the addition of egg, fish, wheat and nuts to the child's diet.And finally avoiding exposure to specific environmental aids: parental smoking, environmental pollution, infant formula, delaying care attendance.
References:Adkinson NF. The basic immunology of allergic diseases. Allergy Proc, 1990; 11 (1): 5-6Bock SA, Sampson HA, Atkins FM, et al. Double-blind, placebo-controlled food challenge (DBPCFC) as an office procedure: a manual. J Allergy Clin Immunol 1988; 82 (6): 986-997.Burks AW, Mallory SB Williams LW, Shirrell MA. Atopic dermatitis: clinical relevance of food hypersensitivity reactions. J Pediatric 1988; 113: 447-451.Businco L, Benincori N, Cantani A. Epidemiology, incidence and clinical aspects of food allergy.Ann Allergy. 1984 Dec; 53 (6 Pt 2): 615-22Mahan K, Krause. Food, Nutrition and Diet Therapy, 1992JG massicot. SG Cohen. Epidemiologic and socioeconomic aspects of allergic diseases. J Allergy Clin Immunol 1986; 78 (2): 954-960Schellenberg RR Adkinson NF. Assessment of the influence of irrelevant IgE on two independent allergic sensitivity to allergens. J Allergy Clin Immunol. 1979 Jan; 63 (1): 15-22.Modern Nutrition in Samspson H. Heath and Disease, Chapter 92 Diagnosis and treatment of food allergies in Schis M 1994 1745 to 1754.Mataix J and J. Maldonado Capitulo55 food allergies. In Mataix J (editor) Food and Human Nutrition Volume 2. Globe Editions, 2002Warren Bierman Allergy Disease From Infancy to Adulthood, 1988Willens et al, Annals Allergy 1993; 71: 147-150
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