Could Your Health Problem Be a Food Allergy?
Here's how to find out and how to manage food allergies
By the time you're over 50, you think you know which foods you can eat and which you can't. Because of this, you might be shocked if you develop a food allergy later in life. Actually, as we get older, changes in our bodies can lead to food allergies.
Aging can cause your stomach to produce less gastric acid, resulting in deficiencies in nutrients like zinc, vitamin D or iron. This can lead to an alteration in the immune system itself. In addition, “There is a higher usage of antacids and alcohol, both of which can change the pH (acidity) of the stomach over time," leading to food allergies, says Dr. Tania Elliott, spokesperson for the American College of Allergy, Asthma and Immunology.
About one in 10 people have food allergies, and half develop them as adults. And half of adults with numerous food allergies developed at least one of them as an adult, according to a study by Northwestern Medicine and Ann & Robert H. Lurie Children’s Hospital. A food allergy is an immune system response to a food, causing itching, hives, swelling, low blood pressure, anaphylactic shock or a respiratory reaction that can be life-threatening.
Diagnosing Food Allergies
To test for a food allergy, an allergist uses a skin prick test, pricking your skin with tiny allergen-laden needles to see if your skin reacts. A blood test can also be used. Testing is straightforward, yet many people with allergies remain undiagnosed, Elliott says.
"It may be hard to diagnose a food allergy because fewer adults with a true food allergy seek medical attention. They think they 'know how to handle it on their own' or 'it isn’t a big deal,’” she says.
Food Intolerance or Food Allergy?
Many people mistake a food intolerance for an allergy. One study estimated that 25 to 30 percent of adults self-diagnose themselves with allergies, said dietitian Larissa Brophy in an article on Today’s Dietitian. A food intolerance causes a digestive reaction to food, such as cramping, diarrhea, gas or bloating. Food intolerances are very common, but not life-threatening. Thirty- to 50 million adults in the U.S. have some level of lactose intolerance, for example.
Food Allergies in Older People Often Misdiagnosed
The most common allergen people develop as adults, according to the Northwestern Medicine study, is shellfish, affecting 7.2 million adults in the U.S. Other common adult-onset food allergies are to milk, peanuts, tree nuts, fin fish, eggs, wheat, soy and sesame.
Identifying a food allergy can be challenging in people 50 and older. The symptoms may not be as clear cut as when you're younger and can involve the respiratory system, skin, nose, mouth, ears, gastrointestinal tract or even the heart.
It's not uncommon for a health care professional to mistake food allergy symptoms in an older adult for problems with a medication, sleep issues, viruses, autoimmune diseases, general aging or gastrointestinal problems like irritable bowel syndrome. The longer a person continues to eat the allergen, the more serious the reactions can be, a particular concern in people with other health issues. Patients themselves may never consider a food allergy to be the root of their health issues, which can add to the difficulty in diagnosis.
Rhonda Adkins, of Great Falls, Mont., was stunned by her shellfish allergy diagnosis at 53. "The daughter of a shellfish fisherman, I literally grew up from age twelve eating shellfish almost five days a week,” she says. “We ate bay scallops like popcorn! When my allergist gave me information about shellfish allergies, I was surprised that it happens suddenly and in adults, typically in their fifties."
Living with a Food Allergy
The only way to manage a food allergy is to avoid the allergen. Sounds simple, right? Actually, living with a food allergy can be complicated and challenging. Your allergen could be an ingredient in foods you would never imagine finding it in.
"Even after I had my first reaction to shrimp, I was taking chondroitin and krill oil. No wonder I was still getting mild random hives,” Adkins says. Chondroitin, a supplement people take for joint pain and osteoarthritis, contains glucosamine, which is made of shellfish.
Eating out requires careful thought and questioning. "When going to dinner you have to tell people; they just don't think to ask,” Adkins says. “You have to think about the salt and pepper shakers in seafood restaurants. People handle them with fishy hands. Many Asian condiments have shellfish. Buffets are a nightmare."
Here are some helpful tips for managing your food allergy:
- Read the ingredient list on all foods.
- Avoid cross-contamination if others in your home continue to eat the allergen. Don't share the same unwashed cutting board, for example.
- Be clear with restaurant staff and verify that they can prepare your food allergen-free.
- Alert family and friends so food you consume from them is allergen-free.
- Don't cheat! Even one bite of your allergen can be life-threatening.
Elliott recommends patients talk to their allergists’ staff, who "can help you understand food allergy labels and what to avoid." She also recommends Food Allergy Research & Education and other online food-allergy resources.
The most important thing about a food allergy is to accept it is dangerous, Adkins says. "At first I didn't want to take it seriously. Hey, I can just take Benadryl and have my shrimp too. It wasn't until my allergist said I needed to carry an EpiPen that I learned that the reaction may be mild now, but the very next one could be life-threatening,” she says.
Food Allergies and Long-Term Care Communities
It's one thing to manage your food allergy when you're cooking or ordering your own food, but it's another if you're living in a long-term care facility where your food choices are not entirely your own. To manage your food allergy or your loved one’s, ask these questions:
- How does the staff track residents' dietary needs?
- Does the staff use separate preparation areas for food-allergic residents' meals?
- Is the staff well-versed in what you are allergic to and where allergens might be found?
- How does the staff keep food-allergic residents' plates separate from the rest?
- What methods help residents stay on track with their diets and prevent things like food swapping?
Pat Perotti is a registered dietitian at McKnight Place, an assisted living and skilled nursing community in St. Louis that holds itself out as a “food allergy-aware” facility. When choosing long-term care housing, Perotti recommends you ensure that food handlers have earned ServSafe certifications. She also stresses the importance of ensuring that "dietary managers have their CDM (certified dietary manager) certificates."
Living with a new food allergy requires attention to detail and careful food selection, but with some care, you can eat smart and stay healthy.