Food to avoid with allergies

For confirmed IgE-mediated food allergy, the only universal safety prevention and control method currently recognized in the global clinical field is to 100% avoid foods containing allergens. There is no universal recipe of "eat a small amount and adapt". All "tolerance exercises" that are separated from clinical monitoring are risking life safety.

A while ago, I helped my best friend sort out her baby's three-meal-a-day diet. The baby was three years old and had a severe allergy to cow's milk protein. Previously, her grandma secretly fed her a mouthful of Wangzai steamed buns with whole-fat milk powder. She gasped in the middle of the night and her lips turned purple. She was taken to the emergency room overnight and received a hormone infusion before she recovered. The old man was quite aggrieved and said, "The kid next door is also allergic. Just drink a couple more mouthfuls of yogurt. I don't want him to build up his resistance." I broke into a cold sweat after hearing this.

Many people have a very superficial understanding of food avoidance and think that as long as they avoid eating visible allergenic foods, in fact there are too many pitfalls to count. Take milk protein allergy as an example. Do you think it will be over if you don’t drink pure milk or eat cheese? Whey protein, casein, skimmed milk powder, and margarine in the ingredient list may contain milk allergens, and even the leavening agent of some breads and the water-retaining agent of ham may be added. When ordering food at a restaurant, don't just say "I'm allergic to mangoes". You have to emphasize "don't put mangoes on all dishes, don't touch the knife and chopping board that cut the mangoes, and don't put dried mangoes on drinks as decorations." A friend of mine only said the first half of the sentence and ended up in the hospital because of a piece of dried mango stuck in the rim of the cup. Oh, yes, many products from online celebrity handicraft stores now have incomplete ingredient lists. If you have severe allergies, don’t touch them. Last year, I met a blogger who was allergic to nuts. He ate an unlabeled handmade snowflake cake and went to the emergency room. The boss secretly added chopped almonds to add flavor.

However, in recent years, there have been different opinions in the academic circles regarding whether to absolutely avoid food. One group of scholars who studies oral immune tolerance believes that for patients with mild to moderate anaphylactic shock and no history of severe anaphylactic shock, they can gradually increase their intake from microgram-level allergen doses under the strict supervision of an allergist. Long-term persistence may induce long-term tolerance. Currently, some hospitals in Europe and the United States have used this program for the intervention of children with peanut allergy. However, the opposition is also clear: the long-term success rate of this therapy is only about 40%, and it is easy to relapse during the process. Moreover, if the dosage is not well controlled, the risk of inducing severe allergic reactions is very high, and it is definitely not suitable for ordinary people to try it at home. The clinical conservative point of view is still more stable: Unless you can ensure that the intervention is under the supervision of professionals throughout the entire process, avoiding food honestly is the option with the lowest cost and least risk.

Oh, by the way, there is another point that many people confuse. Don’t mistake food intolerance for food allergies. For example, many people who have diarrhea after drinking milk are lactose intolerant. The lactase deficiency is not a problem with the immune system. This does not require complete food avoidance. Drinking Shuhua milk or eating a small amount of yogurt is no problem. It is completely different from a milk protein allergy that requires strict food avoidance. Don’t scare yourself, and don’t apply food avoidance rules randomly.

Among the allergy patients I have come into contact with, the most cautious one is a sister who is allergic to peanuts. She always carries an epinephrine first-aid pen with her when she goes out. She never touches a bite of the cake served at dinner parties with friends. She said, "I can't afford to bet on whether there are half a peanut in this cake that I didn't pick out carefully." To be honest, I quite agree. If the allergy attacks quickly, it can cause laryngeal edema and suffocation in a few minutes. It is really not worth taking the risk just to eat in one bite. If you really want to try to lose tolerance, first go to the allergy department of a regular hospital for a complete set of allergen assessment and risk screening. It is 10,000 times more reliable than the "eat less and more to practice tolerance" folk remedies you read online.