Food Allergies: The Immune War by Krisha Tripathy

Food Allergies: The Immune War Are you eating food, or is food eating you?

By: Krisha Tripathy

~Food Allergies in Children~

Food Allergies: The Immune War

Children who do not avoid the foods they are allergic to are more likely to suffer from health issues such as rashes, weight gain, and anaphylactic shock.

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A special thanks to Mrs. Kiszka, my teacher and guider, for always encouraging me to do my best. I wouldn’t have been able to do this without you!

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Table of Contents Part 1: The Nuts and Bolts................................................3 Chapter 1: The Definition of Food Allergies..................................................4 Chapter 2: Prevalence.........................................................................................7 Chapter 3: The Immune War..........................................................................10

Part 2: Causes............................................................15 Chapter 4: Non-rotational Diet......................................................................16 Chapter 5: GMOs and Additives....................................................................18 Chapter 6: Natural Birth vs. Caesarean Section........................................21 Chapter 7: Breastfeeding vs. Bottle-feeding...............................................24

Part 3: Effects............................................................27 Chapter 8: Anaphylaxis..................................................................................28 Chapter 9: Rashes, Hives, and Eczema........................................................31 Chapter 10: Weight Gain and Inflammation.............................................34

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Part 4: Diagnosis.......................................................37 Chapter 11: Symptoms.....................................................................................38 Chapter 12: Medical History...........................................................................41 Chapter 13: Skin Prick Test.............................................................................43 Chapter 14: Blood Test.....................................................................................46

Part 5: Management..................................................49 Chapter 15: Epinephrine Injection................................................................50 Chapter 16: School Management...................................................................53 Chapter 17: Elimination Diet/ Rotational Diet..........................................56

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Part 1: The Nuts and Bolts 5

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Chapter 1: The Definition of Food Allergies The immune system is held liable with the burdensome responsibility of protecting our bodies from “foreign invaders” and unwelcomed germs. While we enjoy eating our favorite sweets and sandwiches, the immune system is toiling non-stop, trying to detect which antigens are safe and which are harmful. A food allergy is an immune system reaction that occurs after eating an offending food.

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With a food allergy, the immune system mistakes a harmless antigen to pose a threat to the body, which results in an antibody and histamine response to the foreign invaders. The immune system, which is now confused, is unable to differentiate between the good

guys and the bad guys. Not only is the body confused and disturbed, but the histamine, which is a chemical released in the body to â&#x20AC;&#x153;protect,â&#x20AC;? is triggering overwhelming allergic symptoms. While many people look at food allergies and food intolerance to be closely similar, they both deal with very different parts of the immune system. Food allergies collaborate with IgE antibodies, or immunoglobulin E antibodies, while food intolerances collaborate

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with IgG antibodies, also known as immunoglobulin G antibodies. One other big difference is that food intolerances do not involve the acute hypersensitivity reaction and therefore lead to less instantaneous and dangerous reactions. Nevertheless, they do cause chronic health related issues such as obesity, headaches, gut disturbances, rashes, and joint pains.

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Chapter 2: Prevalence Food allergies among children have increased approximately 50% between 1997 and 2011, leaving us at a grand total of over 15 million Americans with food allergies. Compared to adults, it is much more common to find food allergies in children, especially from ages six to twelve. Adolescents have to be much more cautious with what goes in their mouths, because children’s young immune systems lack the necessary tolerance and prove to be extremely sensitive. Besides the stereotypical peanut allergy that most have heard of, there are 7 other foods that account for 90% of allergic reactions in children. These include milk, eggs, soy, wheat, tree nuts, fish, and 9

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shellfish. Generally, children with more IgG mediated allergies are able to outgrow their food allergies. This goes along with the concept that

most

children

develop food allergies because of their immune system’s sensitiveness and delicateness. Once the young body builds up enough tolerance for the food antigens, they are less reactive. Going back to the wide differences of food allergies in children and adults, certain allergies are more likely to be found in adults than children. While children are more prone to react to allergens in peanuts, milk, eggs, wheat, and corn, adults are more unsuited for fruits, vegetables, and shellfish. Although there is no obvious reason for the differences in the common allergies between adults and 10

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children, this could possibly be a result of limited exposure. If children were not as exposed to fruits or vegetables as a child, their immune system most likely never got the chance to build up tolerance for the food antigen. Therefore, as an adult, the body reacts negatively to the “foreign” food, just as it would in a child.

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Chapter 3: The Immune War While we fight the short battle of runny noses and headaches on the outside, the immune system is engulfed in an entire war. The immune system is a network of cells, tissues, and other biological structures that work together to protect the body from disease and infection. When we don’t listen to the immune system telling us what foods are unsuitable, the immune system is forced to fight the offending allergens and therefore becomes overwhelmed. As soon as the allergen enters the body, it finds its way to an antigen-presenting cell, where it then attaches itself. Once the T-cells, 12

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or helper cells, activate with the help of the antigen-presenting cell, they trigger an immune cascade in the body. This results in the production of IgE or IgG antibodies, which is custom-made by the Bcells.

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These antibodies then search around for some mast cells, which they will then attach to. After the antibodies attach to the mast cells, they eagerly wait for the next exposure to the offending food. When the next exposure occurs, the antibodies signal the mast cells to release the chemical called histamine, which is charged with the job of protecting the system. Now the immune system is completely engaged in destroying the antigen, or what the immune system knows as “the enemy.” With all of these antibodies and histamines responding to the invading allergen, the immune systems becomes confused. All of a sudden, it becomes hard for the immune fighters to differentiate between the good guys and bad guys, leading to utmost chaos. The connection between the immune war and the irritating symptoms that occur after ingestion comes along with the histamine released by the antigen activated mast cell. The histamine triggers the release of cytokines and inflammatory mediators near some local leukocytes. These chemicals then increase inflammatory response in 14

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the body, which is one of the many symptoms caused by food allergies. Still, the immune war is the reason for the vicious consequences having food allergies.

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Part 2: Causes

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Chapter 4: Non-Rotational Diet One of the most recognizable phrases, “An apple a day keeps the doctor away,” is now being challenged by one of the most common reasons for developing food allergies. Having a nonrotational diet is one of the easiest ways to develop a food allergy, even though it is a much harder task to fix. As a child who grew up with food allergies, I can also relate to having a non-rotational diet. Around the age of 6, I would drink four bottles of milk a day, thinking that milk is good for growth. However, I gradually noticed that I was getting rashes in my elbow and knee 18

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creases. Little did I know that I was showing one of the main consequences of food allergies, eczema, and the reason for my food allergies was none other than my excessive consumption of milk. When the food antigen enters the body, the immune system normally builds up tolerance to it. However, if the immune system fails to build up tolerance, then the antigen penetrates the barrier and enters the bloodstream. With the constant exposure of the antigen, the body becomes hypersensitive and develops a food allergy.

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Chapter 5: GMOs and Additives One cause of food allergies that is commonly overlooked, yet equally responsible, is GMOs and Additives. Although these might not have been as much of a problem a couple of decades ago, the increase in genetically modified and artificially adjusted foods has also contributed to the increase in food allergies. GMOs and Additives have also resulted in the addition of another common food allergy in children, which is corn. Since genetically modified organisms and additives were never meant to be in food, they prove to be very unsuitable for the body. Although, in many cases, it can satisfy our taste buds and eyes, the body was never built 20

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to handle such foods. That is where the disagreement starts. The immune system and digestive system have no tolerance for these foods because the body was never meant to build up tolerance for artificially changed food. Therefore, the body reacts to the GMOs and additives just as if they were any other harmful invader, and builds up an allergy to the specific food overtime. Another way that genetically modified foods disturb the digestive and immune system is through its indigestibility. One main fault in GMOs is that the modified food is not as digestible as the natural version. This is because the foods do not break down into the simplest form of protein, also known as an amino acid. The immune system reacts negatively to the undigested food particle, and therefore results in a chaotic antibody disturbance. 21

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While thousands of man-made substances are added to our foods, the real mystery is how our body is slowly responding to those additives. The most severe type of food additive reaction is anaphylactic shock. Although is uncommon to see with additives, as it would be more of a chemical allergic reaction, anaphylactic shock is known to occur within a couple of minutes after the ingestion of the additive. Although it is hard to identify the different additives that are put in foods during such an “artificial food” boom, it is still important to be aware of what additives cause disturbance in our bodies.

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Chapter 6: Natural Birth vs. Caesarean Section It is hard to believe that the development of food allergies starts right from birth, but that is the truth in some circumstances. The method that the baby is born has an important role of whether or not the baby will develop food allergies. When a baby is born through Csection rather than natural birth, they are put at more of a risk of developing food allergies.

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When a baby is born, he or she needs certain bacteria to survive in the world. Through natural birth, the baby is fully exposed to bacteria such as lactobacillus species and bifidobacterium species.

These bacteria help to inoculate the baby’s GI tract with healthy flora. This guarantees a more tolerant and less delicate immune system, which is helpful in avoiding the development of food allergies. However, when a baby is born through caesarean section, or Csection, the baby is no longer exposed to the necessary and healthy 24

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bacteria. Instead, it is exposed to a different set of bacteria. This makes the baby more vulnerable to the allergens, and more likely to develop food allergies, skin rashes, allergic rhinoconjunctivitis and asthma at an early age.

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Chapter 7: Breastfeeding vs. Bottle-feeding One aspect that comes into play with the development of food allergies at birth is breastfeeding vs. bottle-feeding. Although bottlefeeding is more convenient for many, it puts the baby at a higher risk for developing food allergies in the future. In 2000, the AAP's feeding guidelines suggested that breastfeeding mothers of infants at high risk for developing allergy should avoid cow's milk, egg, fish, peanuts and tree nuts. If they couldn’t breastfeed, it was recommended that 26

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the mother use a hypoallergenic formula as an alternative to breastfeeding. In infants, the gut contains more than 70% of immune system, suggesting that the gut is the foundation of health in children. Babies who are fed with breast milk are given the healthy bacteria that they need in order for immune balance, such as colostrum. Breast milk also contains immunoregulatory

Healthy Gut Flora

factors that help stimulate lactic-acid producing bacteria. This means that breast milk is helpful in balancing the baby’s immune system and producing good bacteria, such as lactobacillus species. This also promotes Th1 cytokine balance and oral tolerance, which suggests that breastfeeding allows the baby to have inflammatory balance and more tolerance to foods.

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On the other hand, bottle-feeding does not promote balance in the Â babyâ&#x20AC;&#x2122;s Â immune system. Instead, it leads to Th2, or T-helper 2, cell dominance. This imbalance between the Th1 and Th2 cells in the immune system leaves the baby to be more susceptible to the development of food allergies, skin rash, allergic rhinoconjunctivitis and asthma.

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Part 3: Effects

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Chapter 8: Anaphylaxis Anaphylaxis is the most severe reaction that one can get from eating a food that he or she is allergic to. This potentially life threatening reaction has results in over 300,000 ambulatory-care visits a year among children under the age of 18. According to The U.S. Centers for Disease Control, food allergy is the leading cause of anaphylactic reactions outside of the hospital setting. A fatal food allergy, such as anaphylaxis, occurs when an IgE antibody, or immunoglobulin E antibody, overreacts toward a normally harmless substance, such as food. Although the body may 30

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not react to the first exposure, the second exposure leads to the binding of the allergen to the antibodies. Not only does this result to minor symptoms such as hives, but it can also lead to a whole-body reaction, which is commonly marked by swelling, hives, tightness in throat, shortness of breath, drop in blood pressure, or dilated blood vessels. In severe cases, a person can go into anaphylactic shock,

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which, if not treated immediately with an epinephrine injection, can lead to fatalities. Anaphylaxis is triggered by foods that are known to be more IgE mediated. These foods include peanuts, tree nuts, shellfish, fruits, and fish. Usually, this life threatening reaction will strike a couple of minutes after ingestion, showing a clear and painful sign. If one does experience anaphylaxis, it is important to give immediate epinephrine injection and then go under a four-hour watch in the hospital. This will ensure that a second, more delayed reaction will not occur.

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Chapter 9: Rashes, Hives, and Eczema Skin irritations are the most common types of reactions caused by food allergies. In 2012, 12% or 8.8 million children reported skin reactions to food allergies in the past 12 months. Some of the most recognizable allergic skin conditions include rashes, hives, and eczema. Hives are an inflammation of the skin, which is caused when the immune system releases histamine. This triggers the small blood 33

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vessels to leak, ultimately leading to the swelling of skin. A common symptom of hives includes itchy, red and white welts, or bumps, on the surface of the skin. Although hives can be painful, they are definitely not contagious, and should be seen as warnings rather than diseases.

Atopic Dermatitis, or eczema, is the most common skin condition in children. This allergic reaction affects 1 out of every 5 infants, but only 1 out of every 50 adults. Although there is no clear answer to how or why eczema occurs, it is now thought that it is due to the “leakiness” of the skin barrier, which causes the skin to dry out 34

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and become prone to irritation. Just as any other food allergy, the eczema reaction starts when the IgE antibody reacts with the food antigen. After the histamine is released, symptoms such as itchy, red, or dry skin will indicate that one is having an allergic skin reaction, in this case eczema, to a food.

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Chapter 10: Weight Gain and Inflammation With obesity at an all time high in the past decades, it has become most nutritionists’ and dietitians’ goal to spot out the factors that contribute to the weight gain and inflammation. Shockingly, food allergies are one of them. Dr. Ashok Tripathy has proven that patients can lose 10-20 pounds by avoiding disagreeing foods. In an interview with Dr. Tripathy, a family medicine physician, he clearly stated that food allergies can cause weight issues, especially 36

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if the allergy is IgG mediated. Dr. Tripathy explains, “Weight gain is related to food allergies by increasing the inflammatory cytokines (Interleukin 6) and inflammatory biomarkers (C-reactive proteins, TNF-alpha, NF-kappa B).”

When food allergies are not properly avoided, the antigen and antibody respond in a way that leads to fluid retention and inflammation in the body. This inflammation will then lead to insulin resistance, resulting in higher insulin levels. Since insulin is a fat-

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storing hormone, an aging hormone, and a disease-promoting hormone, it makes it easy to gain the extra weight causing obesity.

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Part 4: Diagnosis 39

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Chapter 11: Symptoms The most important part of identifying food allergies lies in the identification of signs and symptoms. Food allergies can affect the skin, gastrointestinal tract, respiratory tract, or cardiovascular system. Some of the most commons symptoms of food allergies include rash, headaches, swelling, tingling in different parts of the body, and allergic conjunctivitis. The symptoms of food allergies can be split into the four different affected areas of the body. The skin symptoms include hives, eczema, swelling of the face, an itching in the mouth area. Overall, 40

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skin conditions are the most common reactions caused by food allergies. On the other hand, abdominal

pain,

nausea,

vomiting, and diarrhea can occur as a GI tract reaction. The respiratory tract is where one of the most severe symptoms of a food allergy takes place, which is shortness of breath. Lastly, the cardiovascular system is where the symptoms of lightheadedness and fainting occur. Headaches are commonly seen as a result of eating an offending food. As we discussed before, food allergies are known 41

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to increase inflammatory mediators and cytokines. The inflammation and high levels of cytokines then overwork the brain, resulting in bad headaches and possibly migraines. Another common symptom of food allergies is swelling. Swelling can occur in many spots of the body, especially in the face, lips, or rash-prone areas. The swelling is caused when the food antigen and antibody react together. This leads to fluid retention in the skin.

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Chapter 12: Medical History It is already bad enough that food allergies can start developing at birth, but studies also show that they can be inherited. This is why, when we are at the doctor’s office, it is common to hear the doctor ask to parents, “Have you had a family history of asthma?” or “Does anyone in your family have eczema?” During diagnosis of one’s food allergies, it is crucial to know the patient’s family history with food allergies and allergy related diseases. Eczema is one of the several conditions of food allergies that can be inherited through the family. In about half of patients with severe 43

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atopic dermatitis, the real reason for the development of this disease in youngsters was the inheritance of a faulty gene in the skin called filaggrin. Patients with faulty filaggrin are known to develop eczema on their hands and an excessive amount of little lines on the skin of their palms. Doctors often treat medical history as the critical link between the allergy test results and the allergic disease itself. If a patient’s allergy test results don’t match up with the patient’s medical history, then the doctor is most likely to use their experience, the medical history, and a physical examination – not the test results. While the allergy tests are valued for their accurate and reliable results, they are still just a confirmation of the information gathered in the medical history. 44

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Chapter 13: Skin Prick Test The skin prick test is one of the most commonly used tests by doctors during the diagnosis of a patient’s food allergies. An allergist will use the SPT to measure the presence of IgE antibodies for the suspect food. This will indicate whether or not the food has antibodies that are ready to fight with the antigen. During this test, the doctor will drop some solution containing the suspected food allergen on your forearm or back. Then, using a probe or small test needle, the allergist will gently prick or scratch the

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skin in order to allow a tiny amount of the solution to enter below the surface.

Results of the skin prick test usually appear within 30 minutes. If the food antigen is offending of the body, then a wheal, or a raised white bump surrounded by a circle if itchy red skin, will appear. This indicates a positive test result. Although a large wheal is more likely to suggest a true food allergy, size is not always the most accurate or reliable. If no wheal appears on the surface of the skin, then it is 46

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unlikely that you are allergic to the suspected food allergy. However, the skin prick test is not the only deciding factor. As stated before, the skin prick test is just a confirmation of the patient’s medical history, and together, they both must decide if a food is “harmful.”

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Chapter 14: Blood Test Another common test that doctors use to diagnose food allergies is a blood test. Just like the skin prick test, the blood test also measures the presence of IgE antibodies to specific foods in the blood. Nevertheless, the blood test and skin prick test are both very different from each other. While the skin prick test has almost instantaneous results, the blood test results could take several days to arrive. Also, unlike the SPT, any antihistamine that one takes does not affect the blood test. It

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can be performed for people with extensive rashes that may prevent using skin tests. One brand that is known for doing blood tests is ALCAT. In this test, the patient is allowed to choose from different panels of food that they want to have checked, based on suspicions of a possible allergy. The ALCAT blood test involves a phlebotomist drawing blood into as many tubes as necessary. The blood is then taken to a laboratory, where it is checked for the presence of IgG antibodies for certain foods. This lets the lab expert know if the immune system is producing antibodies that are waiting to react with a food allergen and cause disruption.

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The ALCAT test results then come back with a list of foods that the patient is severely, moderately, and mildly allergic to. The test results even have a specially allotted spot for allergies to gluten, casein/whey, and nuts. The allergist or physician will most likely direct you to which test is more suitable for your body, because each test is different in its own way.

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Part 5: Management 51

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Chapter 15: Epinephrine Injection In severe cases of food allergies, such as anaphylaxis, it is important to have a plan. An epinephrine auto-injection is used to treat anaphylaxis and other severe allergic reactions. EpiPens are selfinjectable devices that contain epinephrine, which, according to National Food Allergy Guidelines, is the first-line treatment for lifethreatening allergic reactions. Most allergists will suggest for patients with history of severe food allergies to carry at least two auto-injectors at all times, in case of a life threatening reaction. This will ensure protection from sudden 52

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waves of allergies, especially if the allergy is unknown. After using the EpiPen, it is strongly encouraged that the patient goes to the emergency room if still having bothersome severe symptoms, so that additional treatment can be given. In case of a biphasic reaction, or a second round of symptoms, doctors will observe the child for a minimum of four hours to watch for other signs, which is common in many cases.

While epinephrine injections are the only “self-use” device, they are to take caution with. EpiPens are not to be use more than two 53

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times without health care professional permission, and are not to be injected in veins, buttocks, fingers, toes, hands, or feet. Also, it is important to take epinephrine with caution if you are taking other disease-medicines in the side. Nevertheless, the epinephrine auto injection is still a very useful and necessary self-use device for patients with history of severe food reactions.

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Chapter 16: School Management One of the hardest parts of dealing with food allergies is having to worry about them at school. Although it may seem just as simple as taking care of food allergies at home, it is no less than a hassle to figure out emergency plans in a place that has so many little children to handle. This is especially true for elementary school students; however, there are still ways to smartly plan for a day of success without worrying about allergies.

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With the population of children affected by food allergies increasing, most elementary schools are taking the extra steps to caution children about others allergies. In the Clear Creek Independent School District, most elementary schools have adopted the habit of having a “Nut-Free Zone” in the cafeteria. This ensures that students with nut allergies are not accidentally exposed to the allergen. Also, it is common for elementary schools to hang up posters and send out letters informing parents about certain allergies in this classroom, once again ensuring that no children come to class with a harmful food to others. Along with the confidential forms that are sent out at the beginning of the year regarding students’ allergies, the elementary nurses are used to keeping allergy medicines in their clinics. The 56

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elementary school nurses in CCISD usually keep Benadryl and sometimes an epinephrine auto-injector in case of an emergency allergic reaction. They even send out a permission slip that allows students to keep a handy EpiPen if necessary. Thanks to the precautions that most elementary schools take, it is not as hard for students to deal with their allergies at school anymore.

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Chapter 17: Elimination Diet/ Rotational Diet Although there is no proven cure for food allergies, it does not mean that some food allergies can never go away. In general, about 80% of children with milk, wheat, or soy allergies will outgrow their allergies. Also, two thirds of those allergic to eggs and 20% of those allergic to peanuts are likely to outgrow their allergies. Nevertheless, an allergy cannot be outgrown simply with time, but instead with the help of an elimination diet or rotational diet. 58

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Severe IgE mediated allergic foods are suggested to be avoided for life, unless immunotherapy is given. Immunotherapy is low-dose food antigen given over a period of time in gradually increasing amounts. However, severely intolerant IgG mediated foods only have to be avoided for six months, and moderately intolerant IgG mediated foods only have to be avoided for 3-6 months. If one is mildly intolerant to an IgG mediated food antigen, then they have the option of following a rotational diet. A rotational diet is where the mildly offending food antigen is allowed to be eaten every fourth day. This gives the allergic person the freedom to eat more of a variety of foods, and still not have to ban one food forever. However, this diet is not the best option for a severely 59

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allergic person, because their body is still not tolerant enough to handle another exposure. Rotational diets and elimination diets are given along with the results of an allergy test. Although they are not required, they are highly encouraged for people who want to help build back their immune system, and live a healthy life once again.

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Food Allergies: The Immune War Works Cited Almageur, Ruben. Personal Interview. 14 March 2015. Bommanna, Vasudeva. Personal Interview. 19 February 2015. "Diagnosis & Testing - Food Allergy Research & Education." Diagnosis & Testing - Food Allergy Research & Education. Food Allergy Research and Education, Inc., n.d. Web. 17 Mar. 2015. "Food Allergies | AAAAI." Food Allergies | AAAAI. American Academy of Allergy, Asthma & Immunology., n.d. Web. 17 Mar. 2015. "Food Allergies." KidsHealth - the Web's Most Visited Site about Children's Health. Ed. Steven Dowshen. The Nemours Foundation, 01 Jan. 2012. Web. 16 Mar. 2015. "Food Allergy." ACAAI. American College of Allergy, Asthma, and Immunology, n.d. Web. 12 Mar. 2015. Hyman, Mark. "Are Your Food Allergies Making You Fat? - Dr. Mark Hyman." Dr Mark Hyman. N.p., 20 Apr. 2010. Web. 17 Mar. 2015. Lopez, Len. "CBN." The Danger of Hidden Food Allergies. N.p., n.d. Web. 17 Mar. 2015. "Main Differences Between IgE and IgG Allergies." Main Differences Between IgE and IgG Allergies (n.d.): n. pag. Great Plains Laboratory. Great Plains Laboratory. Web. 17 Mar. 2015. Motala, Cassim. "Disease Summaries." World Allergy Organization. Ed. Richard Lockey. N.p., n.d. Web. 17 Mar. 2015.

~Food Allergies in Children~ Rushlow, Amy. "The Surprising Way To Prevent Peanut Allergies: Feed Kids Peanuts." Yahoo. Yahoo HEALTH, 23 Feb. 2015. Web. 17 Mar. 2015. Salim, Amir. Personal Interview. 23 February 2015. "Skin Allergy Symptoms, Diagnosis, Treatment & Management | AAAAI." AAAAI. American Academy of Allergy, Asthma & Immunology., n.d. Web. 17 Mar. 2015. Tripathy, Ashok. Personal Interview. 22 February 2015. Tripathy, Krisha. Survey of Armand Bayou Elementary Nurse Jenkins Concerning Food Allergies. Houston, TX. 15 February 2015. Unpublished Survey. Tripathy, Krisha. Survey of Clear Horizons High School Nurse Cain Concerning Food Allergies. Houston, TX. 15 February 2015. Unpublished Survey. Tripathy, Krisha. Survey of Falcon Pass Elementary Nurse Swartz Concerning Food Allergies. Houston, TX. 15 February 2015. Unpublished Survey. Tripathy, Krisha. Survey of Landolt Elementary Nurse Winsor â&#x20AC;&#x201C; Bourda Concerning Food Allergies. Houston, TX. 15 February 2015. Unpublished Survey.

~Food Allergies in Children~

Food Allergies: The Immune War Works Cited for Pictures http://bizarro.com/wp-content/uploads/sites/172/2013/01/Bizarro-01-06-13-WEB.jpg http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url =http%3A%2F%2Fwww.baileydebarmore.com%2Fblog%2Fdo-i-have-a-foodallergy&ei=M6YeVdWpM8ywggTQ1IDQCg&bvm=bv.89947451,d.eXY&psig=AFQjCNFcUbLOINHob NIogUC6nSZ3nJY_oA&ust=1428158386641698 http://www.google.com/imgres?imgurl=http://thegoodnihilist.files.wordpress.com/2012/05/alcat2.jpg&imgrefurl=htt p://thegoodnihilist.com/2012/05/13/food-sensitivity-and-the-alcattest/&h=6560&w=5016&tbnid=VwrTTKi8VTd4zM:&zoom=1&docid=UKV8r4ZSsqYZ_M&ei=TqgeVeq zBMipNqS2g_gF&tbm=isch&ved=0CB8QMygDMAM http://www.google.com/imgres?imgurl=http://cwspi3qoj94m3t5a1dwwupr6z.wpengine.netdnacdn.com/files/2013/06/shutterstock_77060821600x685.jpg&imgrefurl=http://eatdrinkbetter.com/2013/06/05/5-things-you-want-to-know-aboutgmos/&h=685&w=600&tbnid=V5achmyLk8Q1XM:&zoom=1&docid=p1Dl2nQqfL1LHM&ei=qqgeVdXr OJGFNvP2g5gB&tbm=isch&ved=0CCQQMygIMAg http://www.gocomics.com/walthandelsman/2015/02/25#.VO8ehL3nQ3M.facebook http://www.google.com/imgres?imgurl=http://i.huffpost.com/gen/1806548/images/o-GUT-BACTERIAfacebook.jpg&imgrefurl=http://www.huffingtonpost.com/2014/05/21/autism-gutbacteria_n_5358690.html&h=1000&w=2000&tbnid=2dBT3Jo1roO_uM:&zoom=1&docid=jCSaIjM7GwQ _OM&ei=p6keVf2FG8XDggSW7oHwAg&tbm=isch&ved=0CGgQMyhBMEE http://www.google.com/imgres?imgurl=http://upload.wikimedia.org/wikipedia/commons/7/71/Signs_and_symptom s_of_anaphylaxis.png&imgrefurl=http://commons.wikimedia.org/wiki/File:Signs_and_symptoms_of_anap hylaxis.png&h=2742&w=3260&tbnid=1MxZbB5yDYufWM:&zoom=1&docid=gZq4mBS70t3ZM&ei=1qkeVd-RK4W_ggTjrIH4Dw&tbm=isch&ved=0CBwQMygAMAA

~Food Allergies in Children~ https://lh3.googleusercontent.com/ab5ka7DlMpeKk93oSJU5V8HftUjeK7VKvwayo0TGDAy2Cxnkm7Iy7HTCRBy76agFBqfEg=s165 http://www.google.com/imgres?imgurl=http://thumbnails-visually.netdna-ssl.com/can-you-blame-weight-gain-onfood-intolerance_538f4d4d19ed2_w1500.jpg&imgrefurl=http://visual.ly/can-you-blame-weight-gain-foodintolerance&h=852&w=1500&tbnid=xV26fjtC-CS9RM:&zoom=1&docid=4P9318Q87ChpM&ei=yqoeVaiyMoi4ggSn-4O4Dg&tbm=isch&ved=0CBwQMygAMAA http://www.google.com/imgres?imgurl=http://therealfoodguide.com/wpcontent/uploads/2013/08/food_intolerance_symptoms.jpg&imgrefurl=http://therealfoodguide.com/foodintolerancesymptoms/food_intolerance_symptoms/&h=1910&w=786&tbnid=45sbwUGB_HBEqM:&zoom=1&docid =aQTSxLIrU9tbMM&ei=46oeVcu2BcGjgwSxkIHICw&tbm=isch&ved=0CBwQMygAMAA http://www.google.com/imgres?imgurl=http://www.mykidsfoodallergies.com/wpcontent/uploads/2013/04/allergies-medical-idbracelet.jpg&imgrefurl=http://www.mykidsfoodallergies.com/blings-for-allergickids/&h=300&w=300&tbnid=Og1HZe0XoMUxuM:&zoom=1&docid=6WgS9GgHVLjGIM&ei=FaseVd K2MsykNtTkg9gI&tbm=isch&ved=0CB0QMygBMAE http://www.google.com/imgres?imgurl=http://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/m edia/medical/hw/h9991640_001.jpg&imgrefurl=http://www.webmd.com/allergies/skin-prick-allergytest&h=300&w=460&tbnid=VAf18QfKBMyj8M:&zoom=1&docid=cEdRCHxnfIAgqM&ei=LqseVZ3aII HagwSfp4KACA&tbm=isch&ved=0CBwQMygAMAA https://www.epipen.com/en/about-epipen https://lh3.googleusercontent.com/ekQJ4179AJ2BxV-s-VvLWKwxIU6vLhnOb4sQK1AThx4X_7jWmlf1fXVh01CrXsOx5fZYQ=s96 http://www.google.com/imgres?imgurl=http://www.womenshealthmag.com/files/wh6_uploads/images/foodallergies1_0.jpg&imgrefurl=http://www.womenshealthmag.com/weight-loss/eliminationdiet&h=514&w=644&tbnid=FWoKcf7CKAfI3M:&zoom=1&docid=KM_QN1U3c5rfVM&ei=X6weVab NBsSXNq2CgPgN&tbm=isch&ved=0CC4QMygSMBI

While most Americans underestimate the consequences of food allergies to be as minor as a runny nose, one mere allergen can stir up an entire immune war. Everyday, children with food allergies suffer from the risk of health issues such as rashes, weight gain, and anaphylactic shock. Whether it is obvious or not, the entire immune system is disturbed in this process. With the number of children affected by this disease increasing, there is still no clear cure. The best approach of eliminating food allergies is change in diet and avoidance of the offending foods.