September 8, 2023

FOOD ALLERGIES

A food allergy occurs when the body’s immune system wrongly identifies a food as a threat. A food allergy is a hypersensitivity reaction that involves the immune system. These reactions are basically exaggerated or inappropriate immunologic responses occurring in response to an antigen or allergen.

The body releases chemicals, such as histamine, in response. It is the release of these chemicals that causes the symptoms. A food allergy can range from mild reactions to severe, life-threatening (anaphylactic) reactions and can occur even with tiny doses or cross-contamination.

An immediate (IgE-mediated) allergy may cause the following symptoms:

  • Itchy skin, a red rash, flushing and swelling of the skin around the eyes or other parts of the body.

  • Swollen, watering or itchy eyes.

  • Swelling of the lips or tongue, vomiting, diarrhoea or abdominal cramps.

  • Sniffing and sneezing, wheezing or asthma attacks, noisy or difficult breathing.

  • Anxiety, being withdrawn and a “feeling of doom”.

  • Fast heartbeat, low blood pressure, fainting or collapse.

When the allergic reaction is severe and the circulation or the airway is involved, the allergic reaction is known as anaphylaxis. This can occur very quickly and is a medical emergency. Anaphylaxis causes the immune system to release a flood of chemicals that can cause you to go into shock — blood pressure drops suddenly, and the airways narrow, blocking breathing. Signs and symptoms include a rapid, weak pulse, a skin rash and nausea and vomiting.

A food allergy is different from food intolerance. A food intolerance is caused by your body not being able to digest a certain food or an ingredient in food. The most common food intolerance is lactose intolerance. This is when your body is not able to digest lactose, a type of sugar mainly found in milk and dairy products such as cheese and yoghurts. A food intolerance is not life-threatening, and the person may be able to eat small amounts of the food and only have symptoms when eating larger amounts.

How is a Food Allergy Treated?

Currently, there is no “cure” for food allergies. People with an allergy need to avoid that food (or foods). It is essential that people who have an allergy read all food labels and understand the scientific words for the foods in case they are not labeled clearly. According to the current food labeling laws in South Africa, products containing allergens should have these allergens clearly indicated on their ingredient list.

People who have allergies must remember that, although they must avoid all food items that contain the ingredient that they are allergic to, it is still essential to consume a balanced diet with enough protein, energy, minerals and vitamins.

Key points to take note of:

  • Always be extra careful and double-check when you are around food.
  • Always check the small print on food packaging labels.
  • Being proactive when you are eating out such as making catering staff aware of your allergy.
  • Carry your prescribed medication with you everywhere you go.
  • Know how to use your adrenaline injection and when to use it in an emergency.

In South Africa, the food industry is regulated by several regulations, including the Regulation Relating to the Labelling and Advertising of Foodstuffs. According to this regulation:

  • The presence of common allergens in the product or its packaging material must be indicated on the food label. If the food producer cannot prevent allergen cross-contamination in the manufacturing environment, they are required to place precautionary allergen labeling statements (may contain) on their products.
  • For uncommon allergens, their presence or risk of allergen cross-contamination doesn’t need to be stated on the packaging. However, this information must be disclosed by manufacturers upon request by a consumer.

Common allergens that must be identified on packaging include:

  • Fish Shellfish (crustaceans and molluscs)
  • Soybeans (soya)
  • Wheat and gluten
  • Cow’s milk (goat’s milk should be labeled in the same manner)
  • Tree nuts and peanuts 

Uncommon allergens, which do not need to be specified on the packaging, include (but are not limited to) red meat, gelatine, corn, sesame seeds, and sulphites. Food at Empact Group’s allergen sign includes the following ingredients that are classed as allergens which we will be covering in further detail: eggs, fish, shellfish (crustaceans and molluscs), soya, wheat, gluten, cow’s milk, nuts, seeds and celery. In this article, we will be covering the first four allergens on this list.

1. Egg Allergy

Egg allergy is a type of food allergy, caused by proteins present in both egg white and yolk. Proteins that can cause allergy in egg white are ovomucoid, ovalbumin, ovotransferrin and lysozyme and in egg yolk is alpha-livetin. If you are allergic to chicken eggs, also avoid eggs from ducks, geese, quails or other birds because you might react to any egg.

Very rarely, people who are allergic to chicken eggs may not be able to eat chicken. Some very sensitive people may even suffer breathing problems when they inhale the fumes of cooked eggs.

How to avoid egg?

Egg can be found in a wide range of foods, including but not limited to:

  • Baked Items (cakes, pastries etc)
  • Desserts and mousses
  • Meat products and glazes
  • Mayonnaise and other salad dressings
  • Soups
  • Pasta and noodles
  • Battered and bread-crumbed foods
  • Ice cream, chocolates and sweets

To avoid eggs completely, read the ingredient lists on food packets carefully. Egg can be included in foods in different forms including as egg protein, dried egg white, egg yolk, egg solids/powder, globulin, lysozyme, ovalbumin, livetin, ovoglobulin, ovomucin, ovovitellin, egg albumin or egg lecithin (E322), but this will always be highlighted in the ingredients list of products. It is important to read all food labels and packaging. Always ask staff directly whether an egg is an ingredient in a food or whether there is a risk of cross-contamination.

For some people with an egg allergy, cooking and baking eggs may make them less likely to cause an allergic reaction. Egg proteins change when cooked to become much less likely to cause an allergic reaction.

What are the symptoms of egg allergy?

Symptoms usually occur immediately after eating the egg. They often consist of a rash (hives or “nettle” rash), swelling of the lips or around the eyes and itching.

Severe reactions (anaphylaxis) are much less common but include difficulty breathing (with wheeze or swelling of the mouth or throat), feeling faint or dizzy. These need urgent medical attention.

2. Fish Allergy

Fish allergy is a type of food allergy where a person is allergic to fish. Fish allergy refers to fish that have fins such as cod, plaice, haddock, herring, trout, salmon and tuna – as opposed to shellfish – and all types have the potential to cause allergic reactions. People who are allergic to one type of fish have a high chance of reacting to others as they contain similar proteins.

The main allergy-causing protein is called parvalbumin. If you have an allergy to fish, there is a chance you may have symptoms when you breathe in the vapours while fish is being cooked. This is because cooking causes allergic reaction causing proteins to be released into the air. Most people that are allergic to white fish can eat shellfish.

How to avoid fish?

Once you have been diagnosed with a fish allergy, you will probably be advised to avoid all fish (raw and cooked) and foods that contain it. This is because all fish contain similar proteins. There is also a high chance of cross-contamination, where one type of fish is contaminated with proteins from another. For example, in fish markets or supermarket counters where different types of fish are in close contact with each other. Always read ingredient lists carefully and importantly, always reread the ingredient list every time you buy a product as manufacturers change their recipes often.

By law, restaurants, cafes, hotels, takeaways and other catering businesses are required to provide information on major allergens, including fish. Ask staff directly if the food you would like to buy contains fish and if there is a risk of cross-contamination. Let them know that even small quantities can cause an allergic reaction.

Foods that often contain fish:

  • Fish sauce
  • Caesar salad and Caesar dressings sometimes contain anchovies.
  • Worcestershire Sauce contains anchovies.
  • Scampi is sometimes made with white fish instead of shellfish.
  • Crab sticks or seafood sticks – the imitation crab meat in seafood sticks is usually made from fish.
  • Kimchi is often made with fish sauce. Sushi

If you are allergic to fish or seafood, you must avoid eating those foods altogether. Avoid any possible direct or indirect exposure to fish including handling or inhaling cooking vapours. Take care when eating out, as your meal may be contaminated with fish if, for example, the fish and the chips are prepared in the same oil.

What are the symptoms of fish allergy?

  • Allergy to seafood/fish could result in almost any allergy symptoms and signs, but some are more common than others.
  • Common symptoms include skin rashes, swelling, nausea and vomiting. Severe reactions may cause breathing difficulty and collapse.
  • Chest symptoms may occur in very allergic people who inhale fumes from cooked fish.
  • Most symptoms develop within 2 hours after eating, smelling or handling fish.

3. Shellfish Allergy (Crustaceans and Molluscs)

Shellfish can be divided into two groups: crustaceans (including shrimp, prawns, crayfish lobster and crab) and molluscs (including squid, octopus, scallops and oysters). If you are allergic to fish, you don’t have a higher risk of allergy to shellfish. This is because they contain different proteins. Sometimes people are allergic to both, but this is probably a coincidence rather than cross-reactivity – where the proteins in one food are like the proteins in another.

People who react to one type of shellfish (such as crab) are likely to react to other members of the same group (in this case, other crustaceans). Some may react to molluscs as well. A special reason for being cautious is because of the relatively high risk of cross-contamination among different types of shellfish, for example on fish counters or in fish markets.

How to avoid shellfish?

Always make sure that you check the labels and ingredient lists of items before consuming. Ask staff directly if the food you’d like to buy contains shellfish and if there is a risk of cross-contamination. Let them know that even small quantities can cause an allergic reaction. Even if you think you have chosen a safe dish still query the ingredients, including those in stocks and soups.

Foods that often contain shellfish:

  • Scampi
  • Oyster sauce is used to flavour some savoury dishes. 
  • ish sauce can be made with shellfish as well as fish.
  • Worcestershire sauce, steak sauce, fried rice, egg rolls and salad dressings can have shellfish as a hidden ingredient.

What are the symptoms of shellfish allergy:

  • Allergy to seafood/fish could result in almost any allergy symptoms and signs, but some are more common than others.
  • Common symptoms include skin rashes, swelling, nausea and vomiting. Severe reactions may cause breathing difficulty and collapse.
  • Chest symptoms may occur in very allergic people who inhale fumes from cooked shellfish.
  • Most symptoms develop within 2 hours after eating, smelling or handling shellfish.

4. Soy Allergy

Soy allergy is a reaction to the proteins found in soybeans. Soy is a protein-rich plant source derived from soybeans. Soybeans are a member of the bean (legume) family. Most people who are allergic to soy do tolerate other legumes, however, a small number may react to other legumes such as beans and peanuts.

How to avoid soya?

If you are allergic to soy, you must avoid eating soya milk, soya yoghurt and all soy-containing products. Soy protein is present in a large number of everyday foods.

Items that often contain soya to look out for on labels:

  • Carob; Emulsifier; Lecithin (E322); Miso; Monosodium glutamate (MSG); Protein extender; soya; soybean; soybeans; cz soy isolate; soy concentrate; soy flour; soy fibre; soy albumin, soy oil, soy milk; soy nuts; soy sprouts; soy sauce; shoyu sauce; stabiliser; starch; tempeh; tofu (soya bean curd); hydrolysed or textured vegetable protein

What are the symptoms of soya allergy?

  • This type of reaction typically occurs within minutes but may present up to 2 hours after eating the food. Most allergic reactions to soy are mild, causing hives (urticaria), swelling or vomiting. Occasionally reactions are severe causing breathing difficulties or circulation issues.
  • Some reactions to soy are a ‘delayed type allergy’ which typically occurs several hours or even days after eating the soy. This usually manifests as skin rashes (usually eczema) or gut symptoms.

In conclusion, the importance of educating oneself about allergens cannot be overstated. It is an essential step towards personal health and safety, empowering individuals to take control of their well-being and to avoid potentially life-threatening situations.

This education extends beyond personal benefit, promoting a more informed society that can make inclusive choices and accommodate diverse needs. A heightened awareness of allergens encourages empathy and understanding in our communities, leading to the creation of safer environments for all.

Yours in Wellness
Thandi and the Empact Team

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