AUTO - B. FOOD ALLERGY AND FOOD TOLERANCE-COVERED

Question 1

toxic adverse reaction to food

Answer 1

toxin in food

Question 2

non-toxic adverse reaction to food

Answer 2

food intolerance = non-immune mediated
food tolerance = immune medicated = food allergy

Question 3

food intolerance

Answer 3

• reproducible (≥1) adverse reaction to a specific food

*abnormal immunological reaction = food allergy

Question 4

food allergy

Answer 4

• only 2%
• before age 5
• antibody response to allergen
• rapid reaction after ingestion (minutes-hours)
• nausea, vomiting, abdominal pain, diarrhoea, dermatitis, asthma, rarely anaphylactic shock

Question 5

infants and cows milk allergy/lactose intolerance

Answer 5

• formula milk containing cow’s milk protein or
• mother’s milk contains cow’s milk proteins from diet
• soya-based formula?
• nutramigen (cow’s free milk), peptic-junior (cow’s free milk)

*intolerance: don’t have enzyme/reduced activity of lactase

Question 6

coeliac disease

Answer 6

• allergy as involves abnormal immune response to food (gluten in flour)
• IgE antibodies not produced so not classic
• autoimmune disease: body produces antibodies against tissue protein - inflam response in GIT which causes flattening of villi, decreased absorption area for nutrients and less energy and lower weight

gluten = gliadins and glutenins

Question 7

symptoms of coeliac disease

Answer 7

• weight loss
• abdominal distension
• flatulence
• steatorrhoea (fat in diarrhoea)
• micronutrient deficiencies (calcium - osteoporosis or iron - anaemia)
• Vit C def = gingivitis (inflam of gums) + joint pain
• constipation - lack of fibre

avoid
- wheat
- rye
- barley (oats)
- some processed food and medicines
- thickening agents - gravy

on prescription
- plain biscuits
- bread
- pizza bases

OTC
- luxury items - chocolate biscuit

Question 8

risks with coeliac disease

Answer 8

• lymphoma and adenocarcinoma of small bowel
• need to adhere to GF diet

Question 9

Gluten ataxia

Answer 9

• antibodies have effects on brain proteins
• neurodegeneration in brain
• balance impairment
• neuronal cells can’t regenerated
• 2 out of 7 have neurological problems
• due to immune repose rather than micronutrient deficiency

Question 10

non-immune mediated reaction

Answer 10

• defects in enzymes
• pharmacological reaction to substance in food - naturally occurring (caffeine)
• alcohol dehydrogenase deficiency
• lactase deficiency

Question 11

phenylketonuria

Answer 11

• defective breakdown of amino acid phenylalanine into tyrosine
• requires special diet and supplements
• avoid aspartame (aspartic acid and phenylalanine) and high protein foods
• calcium-containing foods also contain protein so need calcium supplements
• need iron supplements due to little meat in diet
• still require protein diet but limit Phe intake
• pregnant - Phe-free diet as Phe can cross placenta
• supplement with Phe free amino mix for adequate protein
• failure to treat in 20 days: neurodevelopment delay
• epilepsy may occur
• every baby born has blood test 6-10 days

Question 12

lactose intolerance

Answer 12

• deficiency of lactase
• can’t digest and absorb lactose
• leaves as diarrhoea
• flatulence
• diarrhoea
• bloated stomach
• stomach cramps and pains

Colief - lactase drops for infants
Enfamil lactofree powder

Question 13

diagnosis of allergic reactions or intolerance

Answer 13

• skin prick tests
• elimination diets (harder for non-immune)

children
- failure to thrive
- skin rashes
- eczema
- asthma
- urticaria
- mood
- GI disturbances (allergic reaction)

adults
- allergic symptoms
- migraine
- IBS
- rule out psychological food allergy