Can we prevent food allergy? Can we treat food allergy?
The short answer to these questions is – YES.
Yes- it is possible to prevent food allergy. Yes- it is possible to treat food allergy.
How? This is exactly what we will discuss in detail in this article.
Table of Contents
How To Prevent Food Allergy?
In the previous article I explained in detail how food allergies develop and how- to everyone’s surprise- globalization is the main reason why the number of cases with food allergies is exploding globally like a pandemic. If you haven’t read that article, please click HERE.
We cannot avoid globalization. We are in it now. So, we are all prone to develop food allergies. However, we can still take some steps which may help prevent these allergies. Although- please remember- such outcome cannot be guaranteed.
There are two key principles here.
The first principle towards preventing food allergies is to keep the inflammation level in the body as low as possible. Now the first step is to recognize our own ancestry and stick to the practices of our ancestors. Eat what they eat. Or at least try matching. Live where they lived. Or at least try living in similar climatic conditions.
I will give you my example. I am a Bengali. So ideally I must keep eating fish and rice and other ancestral Bengali dishes. I must eat vegetables and fruits that grow in the soils of Bengal. I must respect the seasonal variations in the diet that were followed by my ancestors. I must continue living near Bay of Bengal. Genetic evolution that shaped Bengali bodies over thousands of years has resulted in a unique biology in my body that allows ancestral Bengali diet and the climate in Bengal to be optimal for my body.
If you are a Punjabi, the same Bengali specific climatic and dietary conditions will not be optimal.
In the previous article (here is the LINK) I explained how this mismatch between- what our bodies are adapted to face and what we face- leads to chronic inflammation. This chronic inflammation then triggers food allergies. In the current fast paced globalized world, we cannot avoid this mismatch. We cannot avoid getting chronic inflammation. This is the main reason why not only food allergies, but other diseases of chronic inflammation such as diabetes, high blood pressure, cancer etc are rising exponentially.
For an immigrant who is moving from one country to another, it is nearly impossible to match his/her ancestral conditions. I myself migrated from Kolkata to Boston a few years back. But, if I am to somehow prevent development of food allergies, I must try to maintain a diet that is close to what my ancestors traditionally ate. This will minimize the mismatch. More importantly, we need to somehow control the mismatch driven inflammation.
This is where the second step features- we need to start adopting practices like regular fasting and meditation. We need to adopt these practices as a part of our routine life. Earlier these used to be labelled as blind superstitious practices. Now there is enough published research to show that fasting and meditation significantly bring down inflammation. (1) (2) (3) (4)
Learn and practice meditation regularly. Slowly increase the length of meditation time.
Adopt fasting practices. Make your own rules in terms of fasting. If you struggle with such rules, just follow the fasting practices followed in your religion and culture. All religions and cultures recognized power of fasting since thousands of years, and they all have developed their own rules to get maximum benefit out of fasting. With fasting- remember not to push too much. If you are uncomfortable with the hunger pangs, eat something. But keep practicing fasting. Fasting is like a muscle- it will grow slowly as you keep practicing.
The other practice we must all adopt is to make and follow a routine. Decide when you will eat, when you will sleep, when you will wake up, when you will meditate, which days of the week you will fast etc. Constant changes in these routines significantly increase inflammation. Also, try matching these routines with sunlight and sunset. Sleep early at night, wake up early in the morning, do not eat anything after sunset.
Next- we need to reduce mental stress. Here too meditation helps. Do what you are passionate about. Be kind to everyone including yourself. Be compassionate to everyone. Don’t push yourself too much. Now, I know it’s easily said than done. But- remember- mental stress is a key driver of chronic inflammation and often triggers food allergies.
So, in short, the first principle towards prevention of food allergies is all about reducing inflammation.
We read in the previous article that food allergies occur when the immune system mistakenly identifies a certain food or a substance in food as harmful and starts fighting against them.
So, the second principle towards preventing food allergies is to train the body to accept that the food that is being consumed is not harmful.
The only way to do this is to regularly expose the body to food substances against which allergies are frequent. This actually can be initiated right from the time when the kid is in the mother’s womb. Mothers should be encouraged to eat proteinaceous food regular during pregnancy and lactation. Studies show that children born to such mothers have significantly lower chances of developing food allergies. (5) (6) I really believe that our ancestors knew about this. In several cultures traditionally pregnant women are made to eat dry fruits and nuts.
There are compelling evidences that show that in populations where nut exposure is actively avoided, there appeared to be more nut allergy cases than in populations that encourage early introduction of nuts. (7)
There is a very interesting study on this which compared food allergies amongst two Libyan groups and a UK native group. First Libyan group was settled in Libya and mostly followed traditional practices and fed pregnant and lactating mothers with nuts. Other Libyan group were settled in UK, but they also mostly followed their traditional practice of feeding nuts during pregnancy and lactation. The non- Libyan UK native group in general avoided nuts during pregnancy and lactation. The study showed that the prevalence of nut allergy was 0.4% for Libya based Libyans, 0.4% for UK Libyans, and a whopping 4.5% for UK native group. (7)
Scientists in UK found that Jewish children who avoided peanuts in the first year of life had a 10-fold higher risk of peanut allergy compared to Jewish children in whom peanuts were introduced early in infancy. (8)
Similarly, researchers reported that infants in Israel who were exposed to cow’s milk in the first 14 days of life were less likely to become cow’s milk-allergic compared to those who had their first exposure beyond the first 14 days. (8)
The Australian HealthNuts study also had similar findings- the researchers discovered that early introduction of cooked egg into infants’ diets between the age of 4 to 6 months reduced the risk of egg allergy, while delayed introduction after 12 months of age was associated with higher rates of egg allergy. (8)
On similar lines, there was another study conducted in UK. This study was called LEAP- “Learning Early About Peanut Allergy”. This study compared two groups of children between the ages of 4 and 11 months- one group consuming 6 grams of peanut protein at least 3 times a week and the other group completely avoiding peanut products for the first 5 years of life. At the end of this study, 17.2% of children in the peanut avoidance group developed challenge-proven peanut allergy by age 5 years, compared to only 3.2% in the peanut consumption group, translating to a risk reduction of 86.1%. (8)
A recently conducted study of food allergies called STOP II trial has demonstrated that children who are highly sensitive to peanut allergens could have their sensitivity reduced by repeated exposure to the allergen. (9)
Now, after reading about all these studies and findings, you shouldn’t get surprised to hear that food allergy is more common in families which are better educated and well to do.!! (10)
And this intriguing statistic has its roots in an international recommendation that was made in an attempt to curb food allergy. In the year 2000, the World Health Organization (WHO) recommended that complementary foods be introduced no earlier than 6 months of age. The American Academy of Pediatrics (AAP) further recommended maternal restriction of peanuts and tree nuts, and the elimination of cow’s milk, eggs, and fish during lactation to reduce the risk of food allergy in their children. It also recommended that solid foods not be introduced into the diet of high-risk infants until 6 months of age and dairy products delayed until 1 year, eggs until 2 years, and peanuts, nuts, and fish until 3 years of age. This recommendation was widely adopted by “educated” families worldwide, and is continued to be followed today. Today we know that these recommendations were flawed and actually contributed to the rise in food allergies. In fact, later the AAP & the National Institute of Allergy and Infectious Diseases (NIAID) subsequently replaced these guidelines with new recommendations that solid foods not be delayed beyond 4–6 months of age and that the introduction of allergenic foods into infants’ diets should no longer be delayed. A joint consensus communication was released by several Allergy organizations worldwide in 2015, recommending introduction of peanut-containing products into the diets of “high-risk” infants early in life (between 4 and 11 months of age) in countries where peanut allergy is prevalent because delaying the introduction of peanut can be associated with an increased risk of peanut allergy.” (8)
But, this came a bit too late- and the current fad amongst “so called” educated families is still towards avoidance. And this practice of educated parents is fueling the rise in food allergies globally.
How To Treat Food Allergy?
So, till now we discussed about prevention. Let us now discuss about how food allergies can be treated.
The traditional approach to managing food allergies has been strict avoidance of food one is allergic to. But this approach is incorrect. But avoidance, you are simply telling the body’s immune system that it was correct in recognizing that the allergic food was harmful to the body. If you want to really treat food allergy, you will have to train the body to recognize the allergic food as harmless and tolerate the same.
This training process to make body tolerate to allergic food substances is known as Oral Immuno-Therapy or OIT. Remember- OIT should be attempted by a trained physician. There are risks involved, and hence I do not recommend anyone to try this at home without medical supervision.
So, how to perform OIT?
Simply introduce extremely small quantity of the allergic food substance. If there is any reaction, stop and manage the reaction. Then, once the reaction is controlled and everything looks ok, introduce even smaller quantity of the same food. Continue this process until you reach a quantity in which body does not react. Now slowly, gradually, increase the amount of food in extremely small proportions. If there is any reaction, again manage the reaction and lower the quantity of food. But do not stop this process. Slowly you will be able to slowly increase the food quantity without body reacting to it. Eventually you will reach a point where body will not react at all to consumption of that food. This entire process can take 3 months to a year. Trick is to be patient and not give up. Another important point one must remember is that once you have been treated completely, you must ensure that you are consuming that food on a regular basis- else the food allergy can start again.
To reduce the chances of reaction while performing OIT, one can also overcook the allergic proteins before ingestion. Heat denatures proteins and break the molecular structures that make proteins so tough. It is known that children with milk and egg allergy may tolerate extensively heated forms of these proteins like hard boiled eggs and boiled milk.
My kid was around 2 years old when he was diagnosed with cow’s milk allergy. We were recommended to avoid cow’s milk completely. I am a trained physician and I knew that avoidance will simply make cow’s milk allergy a permanent thing for my kid. So, I started introducing extremely small quantities of highly diluted cow’s to my kid. Over next 6 months I gradually increased the quantity and concentration. My kid got cured of that allergy and till date easily drinks two glasses of cow’s milk without any allergic reaction.
I will repeat once again- OIT should be attempted only by a trained physician.
There is a secret sauce that might improve success with OIT. And that secret sauce is meditation. Meditate before consuming allergic food during OIT. Meditation calms the body, controls inflammation and helps the body to accept and tolerate allergic food.
OIT has been studied extensively by many scientists. There are numerous published research papers demonstrating how effective OIT is in treating food allergies.
For example, in Apr 2014, scientists at NHS UK presented their study on the effectiveness of OIT for treating peanut allergy. This study was published in the prestigious Lancet journal. In this study, the scientists treated 39 patients with peanut allergy using OIT for 6 months. In 46 other patients, peanuts were avoided. Of those 39 patients who underwent OIT, 24 got successfully desensitized to peanuts and were able to tolerate 1400 mg of peanut proteins. However, in the other group where peanuts were avoided, none of the patients could tolerate peanuts at the end of 6 months. (11)
Similarly, in Jan 2022, Elizur et al published their findings from the famous NUT CRACKER study. In this study 50 cashew allergic patients underwent OIT for cashew proteins. 15 additional patients did not undergo OIT- they were kept away from cashew. After 6 months, 47 out of 50 patients who underwent OIT could eat 1200 mg cashew without any reaction. All the 15 patients who did not undergo OIT and avoided cashews continued suffering from cashew allergy. (12)
Based on these evidences, several countries and medical associations now recommend use of OIT primarily for treating food allergies. In Canada, OIT is recommended for all food allergies in children and adults. Spain recommends OIT for treatment of food allergies in children. The European Academy of Allergy and Clinical Immunology (EAACI) recommends OIT for all children who are more than 4 years old. (13)
Kids respond to OIT extremely well . They get treated quite fast without much reactions. Issues happen while treating adults. It takes pretty long time to treat an adult. Adults react often, and their reactions are generally more severe. But the key is not to give up.
In Oct 2022 Epstein-Rigby et al published a marvelous study that how food allergies can be treated using OIT. In this study there were 1704 patients with various food allergies. 96 patients were adults over the age of 17 years, 309 were adolescents aged 11–17 years and 1299 were children aged 4–11 years. (14) As expected, overall OIT was extremely successful in treating food allergies. But the treatment success is more if the age is lower. OIT is a bit challenging while treating food allergies in adults. Adults reacted more and responded less compared to children. Again- the key is not to give up.
The only scenario where OIT might not be used is in those unfortunate patients who react violently even to the smallest possible amount of food they are allergic to. These are generally rare cases who have extremely high degree of inflammation. Most often these are adults who had food allergy for a very long time. And only in these rare cases there is no other option but to completely avoid allergic food.
So, let’s summarize key take-away points on how to prevent food allergies.
Remember 8 steps.
- Don’t migrate away from your land of ancestors if you don’t have to.
- Stick you your ancestral food habits and practices. If you are a Punjabi follow the seasonal dietary habits of your ancestors back in Punjab. If you are Bengali, eat what your ancestors ate back in Bengal.
- Learn and practice meditation regularly. Slowly increase the length of meditation time.
- Adopt fasting practices. Make your own rules in terms of fasting. If you struggle with such rules, just follow the fasting practices followed in your religion and culture. All religions and cultures recognized power of fasting since thousands of years, and they all have developed their own rules to get maximum benefit out of fasting. With fasting- remember not to push too much. If you are uncomfortable with the hunger pangs, eat something. But keep practicing fasting. Fasting is like a muscle- it will grow slowly as you keep practicing.
- Set routines and follow them. Define when you will sleep, when you will wake up, when you eat etc.
- Sleep early at night, wake up early in the morning. Do not eat after the sun sets.
- Pregnant and lactating women must be encouraged to eat nuts.
- Introduce solid foods in newborns as early as possible. Introduce nuts in their diet at the earliest.
Follow these 8 steps and most probably you will not get food allergies. But the biological and mental stress caused by today’s globalization leads to chronic inflammation that actually cannot be prevented. This chronic inflammation has put us under tremendous risk of developing food allergies.
We can control the inflammation using that the 8 steps we discussed. With these 8 steps we will substantially decrease the risk of developing food allergies. Unfortunately, we cannot prevent globalization. So, despite what we do, there will be cases where food allergies will appear.
So, let’s now summarize key take-away points on how to treat food allergies.
- When faced with food allergy, never resort to avoidance.
- Take help of a trained physician and go for OIT.
- Children respond to OIT faster. In adults, OIT takes time and reactions are quite frequent and sometimes severe. But eventually, in most cases, OIT will treat food allergies.
- Although there will be a small subset of patients who have such a high degree of inflammation in their body that they cannot be treated with OIT. These patients have no option but to avoid the allergic food substances completely.