Food Allergies: Facts, Myths, and Pseudoscience
Understanding Food Allergies
Is it true that if you are allergic to seafood, you should eat it often and the allergy will go away? Would it help if we took preventive medication before consuming food that we are allergic to? These are questions regarding food allergies that Thais often ask. Hence, these questions are a part of the exhibition "Uncensored: Perd Mod Plueak (Completely Uncensored)".
Organised by TCDC Commons MunMun Srinakarin, "Uncensored: Perd Mod Plueak" aims to provide information about food allergies. Pamuk Yukong, manager of TCDC Commons MunMun Srinakarin, explained that TCDC Commons is involved in innovative food development and focuses on wellness and sustainability.
The team -- Pamuk (manager), Patteera Jaturongsripat (assistant manager), Aranya Jangjaroonrot (content writer) and Rattiya Namuangrak (content writer) -- noticed an increase in alternative products for people with food allergies including more product labels that include warnings.
"We wondered if it was a trend, but were unsure of how much consumers know about food allergies. When we conducted research, we found that information regarding food allergies is quite scattered and often based on hearsay. Since there has never been an official exhibition about food allergies before, we wanted to create this exhibition to improve the lives of people," said Pamuk.
The exhibit is divided into four sections -- Revealing Most Common Food Allergens; Food Allergy vs Food Intolerance; Label Awareness; and Safe Alternative Food.
Suwitcha Chaiyong
The first section, Revealing Most Common Food Allergens, shows that the five most common food allergens in Thailand are cow's milk, eggs, wheat flour, soy milk and shellfish. Besides these common allergens, Thais are also allergic to peanuts, tree nuts and fish. These food allergens have been identified as the top eight which sometimes appear on food labels or food advertisements.
Since Thailand does not have enough food allergy information, the exhibition also includes information from other countries. Visitors will learn that the Food and Agriculture Organization of the United Nations (FAO) and World Health Organization (WHO) reported that approximately 220 million people worldwide have food allergies and the number is increasing. Additionally, in the US, on average, a patient experiencing food-related anaphylaxis is sent to the emergency department every six minutes.
To gain local information, TCDC Commons worked with Kitchen Player, a gluten-free brand which avoids the top eight allergens, and consulted Dr Pattara Tanticharoenwiwat of the Samitivej Allergy Institute at Samitivej Thonburi Hospital.
"It is difficult to find statistics about people with food allergies in Thailand, so we teamed up with Tum Sirasa, the founder of Kitchen Player. Her products were inspired by her child who has food allergies. This led to a group between families with members who have food allergies and entrepreneurs who create innovative products for people with food allergies," explained Pamuk.
According to research, Rattiya discovered that food allergies can be due to heredity.
The Revealing Most Common Food Allergens zone. Suwitcha Chaiyong
"Heredity is a possible cause of food allergies. If parents have food allergies, it is possible for their children to be allergic to the same or similar types of food. Additionally, eating too much, too little or never having eaten a particular kind of food can trigger the body to have allergies. It is better to consume a variety of different foods."
Many Thais believe their food reactions to be allergies, though it is really food intolerance. The second section of the exhibition, Food Allergy vs Food Intolerance, provides different symptoms of the two. While food allergies involve the immune system and can be life-threatening, food intolerance does not and the symptoms are less severe.
Aranya gave an example of lactose intolerance which many Thais experience.
"People without lactase, which is an enzyme that helps the body to fully digest lactose in milk, will lead to bloating, gas or diarrhoea after drinking milk. Many people assume those symptoms are due to allergies but they are not," explained Aranya.
"Another common case involves alcohol. People who lack the enzyme ALDH2, which is involved in alcohol metabolism, may have facial redness. Since this condition happens to many Asians, it is referred to as 'Asian Flush'. This is different from an actual alcohol allergy which causes more severe symptoms such as dizziness and difficulty in breathing."
Those who are not sure if they have food intolerance or food allergies should consult doctors for their own safety. Patteera explained there are three methods for food allergy testing -- skin prick test; blood test; and oral food challenge.
"Oral food challenge is to slowly consume allergens and increase its amount under close supervision of a doctor," said Patteera.
According to the Ministry of Public Health Notification No.383 B.E. 2560 (2017), food labels on product packages require entrepreneurs to specify the ingredients that may cause allergies. The label must provide information for people with food allergies. If there is contamination in the production process, they are required to specify "information for people with food allergy: may contain…".
"In case a factory produces a product with gluten and a snack made from peanuts, there is a possibility that the snack may have been contaminated by gluten. Therefore, the factory must label the peanut snack that it may contain gluten," explained Patteera.
The third section, Label Awareness, displays food labels that should be read carefully. Visitors may be surprised to learn that the ingredients of the French fry brand Mun Farang Sed include eggs, wheat flour, soy beans, fish, peanuts, sesame, sulfur dioxide, cow's milk and beef. Meanwhile, instant noodles contain shrimp and squid. It can be frustrating to discover that ingredient details often appear in very small text despite it being crucial information.
The final section, Safe Alternative Food, showcases innovative products designed to substitute food people are allergic to. Visitors may be surprised to learn that there are many local products available on the market.
On display, there are alternatives for cow milk such as oat milk, pistachio milk and soy milk. Trumkin is a cheese substitute made from pumpkin seeds which provides a salty flavour similar to cheese. Instead of using cow milk, Sweet William is a sweetened condensed milk made from plant-based ingredients including soy, corn and coconut.
The team admitted that some products do not provide the same flavours as the original, but they offer a somewhat comparable taste and are free from allergens.
Pamuk hopes that the exhibition will raise awareness of food allergies.
"Food allergies can occur to people around us, including family members and friends. It would be nice if business operators, restaurant owners and food factory owners come to see the exhibition and become interested in managing raw materials to prevent contamination of substances that can cause allergies.
Food Allergy Management Tied To Anxiety And Stress
FAMILIES managing food allergies often exclude allergens from their homes, a practice linked to greater psychosocial stress. Food allergy affects approximately 10% of children worldwide, posing significant challenges for families. Allergies to common foods such as peanuts, tree nuts, and sesame frequently result in anxiety about accidental exposure and emergency management. Many families adopt allergen exclusion practices in the home to mitigate these risks, but the psychosocial impacts of this approach have been less explored. Recent research examined the prevalence of allergen exclusion and its association with psychosocial functioning in families of children with food allergies.
A cross-sectional survey was conducted between April 2022 and November 2023, involving 919 parents of children diagnosed with food allergies. The participants, predominantly mothers (96.6%), represented diverse regions of the United States and Canada. Logistic regression analyses compared food exclusion practices by allergy type and assessed associated psychosocial outcomes. Among households, 63.8% excluded at least one allergen. Allergies to peanuts, tree nuts, and sesame were most commonly associated with exclusion, with 62.4%, 54.7%, and 51.3% of affected families respectively removing these allergens. In contrast, only 24.3% of families with egg allergies excluded eggs.
Parents who practised allergen exclusion reported higher mean scores for worry (2.6 vs 1.7), anxiety (34.3 vs 16.9), and lower self-efficacy (79.7 vs 84.8) compared to those who did not exclude allergens (all p < 0.001). Children in allergen-exclusion households were also more likely to have elevated anxiety scores, particularly among those aged 8 to 17 years (30.4% vs 15.6%, p = 0.03). These results suggest that allergen exclusion practices may exacerbate stress and anxiety in both parents and children.
While allergen exclusion may offer a sense of safety, this study highlights the unintended psychosocial burden it may impose. Clinicians are encouraged to ask families about their allergen management practices and provide guidance on reducing anxiety. Future research should explore strategies to improve psychosocial well-being in families managing food allergies, particularly those involving prevalent allergens such as peanuts and tree nuts. Addressing these concerns in clinical practice could enhance the quality of life for both children and their families.
Abigail Craig, EMJ
Reference
Ruran HB et al. Household food allergen exclusion practices and food allergy-related psychosocial functioning. JAMA Netw Open. 2024;7(12):e2452646.
8 Myths And Facts About Food Allergies In Children
Whether your child was recently diagnosed with a food allergy or has been living with one for years, you know how stressful it can be to manage.
More and more are being diagnosed with allergies: The number of children with food allergies grew by 50 percent between 2007 and 2021.[1]
As food allergies abound, so do misconceptions about them. Some myths can be dangerous, such as thinking Benadryl is just as good as an epinephrine auto-injector (EpiPen) when it comes to stopping an allergic reaction. (Spoiler: It's not.)
To keep your child safe, it's important to know all the facts around food allergies. Here are the truths behind some of the most common myths.
Myth 1: Food Allergies Aren't That SeriousFood allergies can be deadly.
They're more than just a mild irritation to certain foods. "Food allergies can lead to a severe, potentially life-threatening reaction called anaphylaxis, where your body goes into shock," says Amanda Lee Pratt, MD, a pediatric allergy and immunology specialist at Duke University School of Medicine in Durham, North Carolina.
With anaphylaxis, blood pressure drops and the airway narrows, making it difficult to breathe. Some children get a skin rash or hives, while others become nauseous and vomit. If it isn't treated right away — with an injection of epinephrine — it can be deadly.[2]
Myth 2: All They Need Is Benadryl, Not an EpiPenAntihistamines, such as diphenhydramine (Benadryl), do not stop anaphylaxis.
Epinephrine is "the first line of treatment," says Christopher Codispoti, MD, an allergy and immunology specialist at The University of Texas Health Science Center in Houston. For a severe reaction, epinephrine — usually in the form of an auto-injector, such as an EpiPen — is needed, because it can quickly treat the symptoms of anaphylaxis. It opens the airway, making it easier to breathe, and helps regulate blood pressure and heart rate. It can also help reduce itching and hives.[3]
"Antihistamines can be used as a supplement for more mild symptoms," he says, "like a runny nose or itchy mouth."
Myth 3: Eating a Little Bit of the Food Won't Be Harmful and May Lessen the AllergyEven a tiny amount of a food allergen can cause anaphylaxis.
You should help your child avoid all contact with the food. "Their body can still detect the allergen and have a reaction even in small amounts," says Dr. Codispoti.
The only time your child should be intentionally exposed to the allergen is under the supervision of a doctor. You or your child should never do this on your own. Known as oral immunotherapy, it involves slowly exposing someone to their allergen in small doses to train their immune system not to have a reaction.[4]
Myth 4: Food Intolerances and Food Allergies Are the SameFood allergies and intolerances are very different. Food intolerances can be uncomfortable, but they are usually not life threatening.
"A food allergy is an antibody-mediated immune reaction to food that could lead to life-threatening symptoms," Dr. Pratt explains. A food intolerance may or may not involve an immune system reaction and usually causes more mild symptoms, such as gastrointestinal issues, headaches, or skin problems.[5]
Myth 5: Food Allergy Tests Are Always AccurateSkin-prick and blood tests for food allergies can give false-positive results.
When it comes to diagnosing food allergies, the gold standard of testing is an oral food challenge, says Pratt. "We do it to see what happens when [your child puts] the food in question in [their] mouth," she explains.
Here's how it works: Under their doctor's supervision, your child would eat the suspected food in measured doses, and the doctor would wait and watch for a reaction. If your child were to start having symptoms, the doctor would end the food challenge and give them medication to stop the reaction and relieve their symptoms.[6]
Myth 6: Food Allergies Always Begin in ChildhoodFood allergies can develop at any age, anytime.
"I've diagnosed people in their 70s and 80s," Codispoti notes. The most common food allergies in adults are fish, shellfish, peanuts, and tree nuts.[7]
Myth 7: Your Child Will Always Have Their AllergyIt's possible that your child will outgrow their food allergy.
Children are more likely to grow out of certain allergies. "Around 80 percent of children who are allergic to eggs and milk will outgrow it," says Pratt. "Peanuts and tree nuts are the opposite: Only 20 percent of children outgrow those." The younger your child was diagnosed, the more likely they are to grow out of their food allergy, she notes.
Myth 8: If an Ingredient Isn't Listed on a Restaurant Menu, It's Safe to EatNot all ingredients are disclosed in the menu description, so you have to be extra careful when eating out.
Be sure to ask the server or manager not only for a list of every ingredient in the dish, but also exactly how it's prepared. "You need to be cautious of cross contact during preparation in the kitchen," says Codispoti.
Let the waitstaff know about your child's food allergy, so they can accommodate you. To be even more prepared, go online and check out the menu ahead of time, so you can see what may be safe for your child to eat.[8]
The Takeaway
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