allergy to food additives
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Dr. fawzeia abo aliProf. Of int. medicine &clinical immunology
Ain shams faculty of medicine
Allergy to foodadditives
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'food additive
means any substance not normallyconsumedas a food by itself andnotnormally used as a typical ingredient of
food.
contaminants orsubstances added fornutritional qualities.
does notinclude
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Types of food
additives
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1) Preservatives(to give food a longer shelf-life)
The SulphitesThe Sulph
itesused to preserve processeed meats, and dried fruit
According to the FDA, about 5 percent of asthmatics
are sensitive to sulfites.
Sodium nitrite, &benzoic acid
These agents are added to food products and occur naturally in,cinnamon, tea and berries.They may cause urticaria, asthma and angioedema. (E 210 - E
219 )
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2) Colourings(make food visually more attractive).
(tartrazine) is used to color beverages,
candy and other foods.
Nitrates and Nitrites - give meat a pink colour tolook more attractive and found in frankfurters
They can trigger hives, urticaria, asthma and
generalized allergic reactions. ( E 100 - E 180 )
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3)3) Antioxidants Antioxidants: (prevent fat rancidity)
Synthetic phenolic antioxidants prevent this spoilage happening but can
trigger asthma, rhinitis and urticaria. (E320 321)
4) Flavour enhancers (to enhance palatability).
Aspartame: a low calorie sweetener can trigger urticaria and itchy hives.
Monosodium Glutamate (MSG) which can trigger the "Chinese RestaurantSyndrome" of headache and burning plus tightness in the chest.
( E 620 - E 635 )
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5) Emulsifiers and stabilisers
Stop oil and water componentsStop oil and water componentsseparating, as inseparating, as in
ketchup andketchup and
mayonnaise,mayonnaise,
Occasionally cause adverseOccasionally cause adverse
reactions.reactions.
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6)6) Naturally occurring substances inNaturallyoccurring substances in
foodfood
Vaso-active amines. Natural Histamine, Serotonin and Tyramine
occur in some cheeses, fish, sausage, red
wine, chocolate and pickled vegetables
can induce cramping, flushing, headacheand palpitations in a dose related manner.
Caffeine
found in foods, medication, tea, coffee andCoca-Cola
induces dose dependent agitation,palpitations, nausea and tremors.
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Salicylates (aspirin-like naturally occurring
chemicals).Salicylates induce urticaria, asthma
and nasal polyps.
They are found in Curry powder, paprika, driedthyme, oranges, apricots, honey, berries and
fruit skins, tea and almonds. Salicylate sensitive individuals also tend to
have adverse reactions to benzoates and
tartrazine
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E numbers
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E numbers are number codes for
food additives and are usually found on foodlabels throughout the European Union.
the 'E' prefix which stands for Europe.
If a food additive has an E number this showsit has passed safety tests and been approved
for use throughout the European Union.
http://en.wikipedia.org/wiki/Food_additivehttp://en.wikipedia.org/wiki/Foodhttp://en.wikipedia.org/wiki/European_Unionhttp://en.wikipedia.org/wiki/European_Unionhttp://en.wikipedia.org/wiki/Foodhttp://en.wikipedia.org/wiki/Food_additive -
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2.1 E100E199 (colours)
2.2 E200E299 (preservatives) 2.3 E300E399 (antioxidants, acidity regulators)
2.4 E400E499 (thickeners, stabilizers, emulsifiers)
2.5 E500E599 (acidity regulators, anti-caking agents
2.6 E600E699 (flavour enhancers)
2.7 E700E799 (antibiotics)
2.8 E900E999 (miscellaneous) 2.9 E1000E1999 (additional chemicals)
http://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_numberhttp://en.wikipedia.org/wiki/E_number -
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ALLERGIC REACTIONS TO FOOD
ADDITIVES
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(FDA) estimates 1 percent to 3 percent of adults
and 6 to 8 percent of children may experience
some sort of sensitivity to food additives.
Adverse reactions to food additives could be oftwo
different types:
Intolerance :
where no
immunological
basis is apparent.
allergy orhypersensitivity,
which results from an
immunologicalmechanism.
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Skin urticaria/angioedema
atopic dermatitis sweating itching flushing
Gastrointestinal abdominal pain nausea/vomiting diarrhea
Respiratory asthma symptoms cough rhinitis
http://allergies.about.com/od/skinallergies/a/urticaria.htmhttp://allergies.about.com/od/skinallergies/a/atopicderm1.htmhttp://allergies.about.com/od/glossaryofallergyterm1/g/rhinitis.htmhttp://allergies.about.com/od/glossaryofallergyterm1/g/rhinitis.htmhttp://allergies.about.com/od/skinallergies/a/atopicderm1.htmhttp://allergies.about.com/od/skinallergies/a/urticaria.htm -
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Musculoskeletal muscle aches
joint aches fatigue weakness
Neurologic behavior mood changes and bedwetting.
attention deficit and hyperactivity disorder migraine headaches mood swings, difficulty falling asleep, frequent night
waking, night terrors, restless legs
Cardiac palpitations arrhythmias
http://allergies.about.com/od/noseandsinusallergies/a/ar_migraines.htmhttp://allergies.about.com/od/noseandsinusallergies/a/ar_migraines.htm -
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Anaphylactic shock.
Can occur with sulfites. Without treatment, asevere reaction (anaphylaxis) may quicklyprogress to anaphylactic shock.
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1.adverse hyperactive behavioural changes in children
have been documented with excess amounts of artificial
food colourings and sodium benzoate preservatives .
2.Melkersson-Rosenthal Syndromea rare disorder
possibly triggered by sodium benzoate tends to occur in
atopic individuals.characterised by
c. lip granulomas,d. facial paralysis and
e. a fissured tongue.
.
Special consideration
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diagnosis of allergy to food
additives
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Diagnosis for additive sensitivity
1.HISTORY:Itis suspected when a person experiences
various reactions to prepared foods or when
eating at restaurants, but not from foods
prepared at home.
2.food diary The first step often involves an
individual creating a complete food diary withthe help of a physician.
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While keeping this diary, patients will be asked
to record all the foods they consume, the time
food is eaten and the time reactions occur.
By closely observing which foods trigger a
response, a physician can often pinpointadditives that are more likely to blame.
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3) Elimination diet
an elimination diet, which involvesavoiding any foods that may contain the
problem additives.
By observing the patients reactions orlack of reactions through this stage, the
physician can further determine theindividuals susceptibility.
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4) Provocative Tests for Food or Food
Additives
The method includes administration of thefood extract, followed by observation for any
of a broad variety of subjective and objectivesigns and symptoms that could be
interpreted as the presence of a food
allergy.
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Treatment
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Treatment and prevention of additive
sensitivity
there are no established treatment or preventionmethods for additive sensitivities.
However, if a person is diagnosed with anadditive sensitivity by a physician, the most basic
and effective way of preventing further reactions
is:
avoidanceavoidance
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Ingredient lists must be carefully.
Individuals with additive sensitivities should also learn toinquire at restaurants about cooking methods that mightpresent a problem.
A physician will often recommend anti allergic medications to
provide relief for reactions .
individuals who could potentially have an anaphylacticresponse should carry a syringe of epinephrine and know how
to self-administer the medication.
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Reactions against additives are rising .Reactions against additives are rising .
Additives are responsible of a lot of adverse effectsAdditives are responsible of a lot of adverse effects
They are mainly due to intolerance, yet true allergy areThey are mainly due to intolerance, yet true allergy areevident in atopic individualsevident in atopic individuals
No accurate diagnostic tests are yet available.No accurate diagnostic tests are yet available. Always read all packaged food labels, it is now FDAAlways read all packaged food labels, it is now FDA
ensured that additives must be clearly labeled.ensured that additives must be clearly labeled.
All additives used within the European Community mustAll additives used within the European Community must
have an E number.have an E number.
General rules for preservatives and additives:
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References:1.www.fedup.com.au
2.www.naturalstandard.com
3.A complete listing of food additives by E number isavailable at:www.food.gov.uk/safereating/chemsafe/additivesbranch/enumberlist. (Accessed on May 12, 2008).
4.Simon, RA, Bosso, JV, Daffern, PD, Ward, B. Prevalence ofsensitivity to food/drug additives in patients with chronicidiopathic urticaria (CIUA). J Clin Immunol 1998; 101:S154.
5.Asero, R. Food additives intolerance: a possible cause ofperennial rhinitis. J Allergy Clin Immunol 2002; 110:937.
6.McCann, D, Barrett, A, Cooper, A, et al. Food additives and hy
http://www.fedup.com.au/http://www.naturalstandard.com/http://www.uptodate.com/patients/content/abstract.do?topicKey=~IUUBAEgJzrr5Z&refNum=9http://www.uptodate.com/patients/content/abstract.do?topicKey=~IUUBAEgJzrr5Z&refNum=9http://www.uptodate.com/patients/content/abstract.do?topicKey=~IUUBAEgJzrr5Z&refNum=9http://www.naturalstandard.com/http://www.fedup.com.au/ -
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