ALLERGY: FOOD AND DRINK
The topic of food sensitivity – of allergy or intolerance to food and drink – is probably the most difficult area of this book. Not only is the subject the most controversial and the one which arouses most hostility from sceptics, but it is also the most demanding area to manage if you are trying to discover what upsets you. Futhermore, food sensitivity is one of the most difficult types of allergy or sensitivity to live with. Avoiding certain foods can affect your family life profoundly, particularly if children are involved. It impinges on your social life and your worklife, and engages you frequently on complicated endeavours of organisation and planning.
Working out a diet that suits you can often be a quite straightforward process if you go about it in an orderly fashion. The vast majority of people find that they can solve their problems by avoiding just one or a tiny number of foods – even if it takes them some time to work out which ones.
However, a small handful of people have much more severe problems, discovering that they are sensitive to a wide range of foods. Often such people do not suspect wide-ranging sensitivity before embarking, and only discover it in the process of eliminating and testing foods.
It is best to do any exclusion dieting under medical supervision, because the process of identifying food allergy and intolerance can occasionally be complicated, because some (rare) individuals can become quite ill in the process of sorting out their diet, and because specialist advice on nutritional balance is often necessary. This is especially important if you are working out a diet for a baby or child.
Some doctors, however, are unsympathetic or even hostile to the idea of reactions to food. Many GPs will not consider giving you any help in the process, let alone refer you to someone else who can help. If you meet this reaction from your doctor, remember that it is worth persisting in asking for a referral to a specialist. Your doctor may eventually agree, if only because he or she believes it will exclude food allergy or intolerance as a possible cause of your symptoms. You have also the right to change your doctor without giving a reason and, if you meet with real hostility, it may be necessary to do this. For how to find doctors who specialise in the field.
If, despite all your efforts, you cannot get satisfactory help from a doctor, you may decide to carry through a limited exclusion diet by yourself. If you do so, go gently. You should only exclude foods selectively, rather than go for a comprehensive exclusion diet (see below for full advice), and take your time, rather than to try to identify problem foods quickly. Never go on a fast or a one- or two-food-diet without supervision.
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ALLERGY: FOODS
Opinion among doctors and experts as to the degree of cross-reaction between foods varies widely; you will often encounter differing (sometimes conflicting) advice on which foods cross-react.
Foods, as all living things, are classified biologically into groups and sub-groups according to their inter-relationships. These categories include ‘family’ and ‘sub-family’ groupings. It is argued that cross-reaction is more likely to occur within a food family, and diets may be planned and managed on this basis. If you are on a rotation diet, for instance, you will often be advised to leave an interval of two days or more between eating foods that belong to the same family. This can be quite restrictive.
In practice, the family model is not always helpful. Some families, such as the legume family, which includes peas, beans, pulses and peanuts, are very broad. Some foods within such a family are very distantly related, and cross-reaction can be rare. Sometimes cross-reaction only occurs consistently within sub-families. The grass family includes the wheat sub-family, the corn sub-family, and the rice subfamily, and cross-reaction often occurs within the sub-families, but less commonly between them. If you react to wheat, for example, you are more likely to cross-react to oats, which is part of its sub-family, than to rice, which is related but belongs to a separate sub-family.
Like many aspects of allergy and sensitivity, the cross-reaction of foods can be very confusing, and you will probably have to work out for yourself, with expert guidance, what you tolerate and what causes cross-reaction in you.
The best way to deal with the question of food cross-reaction is probably to adopt a strict and conservative approach initially, when you are first working out what you react to. On an elimination diet (or on a rotation diet, if this is advised), start by being careful about the food families, and then relax gradually in order to find out what you can tolerate. You may not need to observe the families at all eventually. (For full advice on planning diets, a full list of food families.
Some foods contain moulds and can cause cross-reaction. Oils and terpenes in foods can also cause cross-reaction. Some foods cross-react with pollen.
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ALLERGY TO CLEANING PRODUCTS: WHAT CAUSES PROBLEMS?
Certain chemicals in cleaning products often cause sensitivity and allergy. Chlorine, ammonia and phenol are released from common bleaches, disinfectants and cleaners and can cause reactions if inhaled or touched. Fragrances and perfumes are added to virtually all cleaning products, either to add a pleasant fragrance, or as a masking chemical to block strong odours. Many products contain organic solvents, either used directly as cleaning agents, as in stain removers or dry cleaning fluid, or as solvents to carry other chemicals, as in polishes. Natural chemicals are not automatically safer. Some people are sensitive to chemicals, such as pine oil, coconut lemon oil, acetic acid (vinegar) and lavender oil, which are used in some cleaners. Nor are ‘green’ or environmentally safer products necessarily less likely to cause reactions. Most contain perfumes and some contain troublesome natural chemicals.
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ALLERGY BABYCARE: IF YOUR BABY IS TOTALLY BOTTLEFED
If your baby is totally bottiefed, make sure you have taken basic precautions against other things that the baby may be ingesting before you investigate its feed.
If your baby is on a cow’s milk formula feed, the first thing to try is giving smaller, more frequent feeds. This may help babies who are intolerant of lactose, the sugar found in milk, for the reasons explained on page 250 in connection with breastfeeding.
If this does not work, you can try alternative formula milks, with your doctor’s advice. Soya-based milks (e.g. Wysoy, Nutrition Soya) are most people’s first option; these are readily available in chemists’ shops, and are sometimes a good solution for babies sensitive to cow’s milk. Use a soya milk formula for at least a week to see if your baby settles – if he or she is clearly worse straightaway, see your doctor at once – but if the baby has been having colic, diarrhoea, or other gut disturbance, it can take a couple of weeks for these symptoms to clear.
Some babies also start to react to soya formulas, either straightaway or after some time. If this happens, there are other special formula milks that you can try. These are available on a doctor’s prescription. One type is based on chicken, highly processed to make it digestible (e.g. Chix). Another type is called hydrolysed formula, and is based on cow’s milk and corn, treated with digestive enzymes in order to break down and pre-digest allergens. Examples of these are Pregestimil and Nutramigin. These are sometimes tolerated by even highly allergic babies.
If you have a lot of problems with bottle-feeding, it is worth working your way through these alternative formulas, as one may suit where others do not. Each time you try a new one, give it a week to show effects if you can, unless the baby reacts strongly against it early on. Consult your doctor as you try each one.
A goat’s milk formula milk for babies has recently been introduced in the UK. There is no current evidence that it is of benefit to babies sensitive to other milks. Do not use it without consulting a doctor.
Other so-called hypoallergenic brands of cow’s milk formula are soon to be marketed in the UK. Hypoallergenic does not mean they are ‘safe’, only that cow’s milk allergens have been modified to make them better tolerated. These may not be tolerated by extremely allergic babies and have been known in the United States to cause anaphylactic (shock) reactions. Always consult your doctor before using any of these to be sure it is advisable for your baby. Only use them on prescription and under supervision. Do not buy over the counter.
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HOUSE DUST MITES ALLERGY: DRAWBACKS AND BENEFITS OF ANTI-DUST TREATMENTS
Apart from the need for follow-up vacuuming, the major disadvantage of chemical products is the need to re-apply (recommended between fortnightly and every six months, depending on make, except for the anti-mite paint) and the consequent cost. The cost of re-applying the treatments runs at somewhere between £100-£200 a year, depending on how extensively you do it, and on which chemical you use. You could pay for an increase in your heating bills to keep things dry, several vacuum filters or a large share of an allergy vacuum cleaner with the same amount of money. You can treat soft toys with sprays, but being often an awkward shape, the treatment does not always reach every part of the surface. If you treat furniture and mattresses, make sure they dry off thoroughly. Light or delicate fabrics can stain.
The nitrogen gas treatment is done by a contractor but is expensive, needs follow-up vacuuming, and has to be repeated frequently if you take no other precautions. It could be useful if you moved into a new home and wanted a once-off treatment to get rid of mites, then followed it up with basic avoidance measures.
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