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What causes food allergies?

The number of people with potentially deadly food allergies in the U.S. has risen steadily in recent years, and according to Food Allergy Research & Education, as many as 15 million people now have such allergies. But one thing remains unclear: why?
There are several theories on why the number of food allergy cases is rising, but no clear-cut explanation. FARE CEO John Lehr said that despite ongoing research, "...we don't actually know why there's an increase."
Dr. Lisa Roth, an allergist based in Lynbrook, said that over the last five to seven years, she has seen a significant increase in food allergy patients.
According to a Centers for Disease Control and Prevention study released this year, the number of food allergies increased approximately 50 percent between 1997 and 2011. One in every 13 children under 18 now has a potentially deadly allergy.
Lehr and Roth support a theory, known as the hygiene hypothesis, that people's immune systems are being negatively impacted by excessive cleanliness. "In the developed world, we're almost too clean," Lehr said. "Our immune systems are maybe being downgraded, and that makes [them] more vulnerable to things like food, which should be harmless but are now viewed as a potential threat."
Roth said that while hygiene is important in preventing other diseases, our bodies need a certain level of microbes and bacteria in order for our immune systems to develop normally. "We need balance," she said. "If something isn't quite right, there becomes an imbalance."

A reaction can come at any time

A food-allergic body, Roth explained, misreads a food, normally a nourishing source of energy, as something harmful and reacts negatively. In the U.S., a reaction to a food allergy sends someone to an emergency room every three minutes, according to FARE, and every six minutes that reaction is anaphylaxis — a severe, potentially fatal condition.
When a person with a food allergy tastes, touches or even smells the wrong food, the respiratory system, the skin, the gastrointestinal tract and the cardiovascular system can be affected, Roth said. The most common way a reaction is triggered is by taste, and when it occurs, it is important to administer epinephrine quickly. Roth called epinephrine the "gold standard" for stopping the progression of anaphylaxis brought on by food allergies.
"There is nothing more important to anyone with a food allergy," Lehr said, "or even an environmental allergy, than making sure you're carrying epinephrine ... at all times, because an accidental exposure to a food allergen can happen anywhere, any time."

A cure on the way?

Food Allergy Research & Education, a nonprofit that was formed in 2012 after the merger between Food Allergy & Anaphylaxis Network and the Food Allergy Initiative, raises millions of dollars each year to fund research into possible cures, spread awareness, encourage government advocacy and educate people about food allergies. FARE is the largest private funder of food allergy research in the world.
The most promising treatment for food allergies, which is still in clinical trials, is oral immunotherapy, or OIT. During OIT, the food allergen — in powder form, mixed with a harmless food — is administered gradually, in small but steadily increasing doses, until the patient is desensitized to it.
Studies show, Lehr said, that between 70 and 80 percent of people with food allergies can be desensitized, which is why OIT is so promising — although it is FARE's goal to desensitize 100 percent of food allergy sufferers.
Roth said she hopes to one day treat patients with OIT, but she added that the treatment is a long way away from being approved by the Food and Drug Administration.

Go to www.liherald.com and search "food allergies" for the first and second installments of this series.

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Lisa Roth, MD
10 Union Ave. Suite 11A&B
Lynbrook, NY 11563
Office: 516-599-6910
Fax: 516-612-3402

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