Ways to be food safe over Christmas: Allergies are more common than you think

BAVINA SOOKDEO

A Trinidadian Christmas is synonymous with food and drink, from pastelles to ponche-a-creme, ham, rum-soaked fruit cake with nuts, these are the flavours that make a TT Christmas lime real nice.

However, the lime isn’t always so nice for people with allergies.

Paediatrician, adult allergist and immunologist Dr Ari Heffes-Doon said it was important for Trinidadians to recognise that food allergies were far more common than people think, even if local statistics were limited.

“Food allergies are a global issue affecting an estimated 220-250 million people worldwide. “While we don’t know exactly how many people in TT have food allergies, I can confidently say that they are quite common,” he said in a recent interview.

Dr Heffes-Doon recently returned to TT after completing his medical degree at Grenada’s St George’s University as well as completing his paediatric residency at New York University Grossman Long Island School of Medicine. He now operates out of his private practice AHD Allergy and Immunology Med in Woodbrook.

He drew a distinction between food allergies and food intolerance. The latter occurred, usually, when people ate too much of a particular food or as a result of an enzyme deficiency. While reactions to food were common, most of them were not true allergic reactions, he said.

“In general, food intolerances are uncomfortable and inconvenient, but they are not life-threatening.”

True food allergies, however, involved the immune system interpreting a harmless food as if it were dangerous leading to allergic-type symptoms.

Symptoms typically occurred within an hour of eating a particular food and might include hives, runny nose, itchy eyes, wheezing or vomiting, Heffes-Doon said.

“In small children who can’t express themselves yet, some early signs of an allergic reaction may be tongue thrusting or using their fingers to scratch their tongue, which may indicate having an itchy mouth.

“Children tend to experience milder symptoms, while adults can have more severe reactions.”

Everyone with food allergies could have a severe reaction known as anaphylaxis.

He said, “This is a potentially life-threatening reaction and it can involve difficulty breathing, throat swelling or a significant drop in blood pressure affecting the body’s ability to deliver oxygen to all its vital organs.”

Food allergies were more common during the holidays because it involved eating at other people’s homes and this could result in the accidental ingestion of a food allergen or cross contamination of prepared food, he said.

Those with food allergies often hesitated to ask about how the food was prepared, worried that they might appear fussy, he added.

“They may be reluctant to ask as many questions as they should about ingredients in the food, again highlighting just how easy accidental ingestion of an allergen can be.”

For their own safety, Heffes-Doon said people with food allergies should have their epi pens (epinephrine autoinjector). This device administers the exact amount of epinephrine the person would need in the event of a reaction, he said.

While antihistamines may help with itching or mild swelling, he added that they do not stop the allergic reaction from worsening.

“If someone is experiencing anaphylaxis the first line medication that should be administered before any other medication is epinephrine.”

In the event of a severe reaction, Heffes-Doon said even people without medical training could help by simply asking someone for their epi pen.

“Ask if they have epinephrine and offer to get it for them. One of the most significant, but preventable risk factors for fatal anaphylaxis is delayed administration of epinephrine if the person does not have epinephrine, offer to take them to the emergency department or to call for an ambulance so they can be treated as soon as possible.”

Heffes-Doon also stressed the importance of following up with their doctors/allergist. He recommended people find an allergist if they believed they might have food allergies.

Tips for guests and invitees to be food safe this Christmas:-

For invitees, he suggested:

1. Ask questions: “The rule of thumb for every person with a food allergy is ‘read the ingredients.’ In the case of a Christmas lime, ask the chef. If food is catered, Heffes-Doon suggested calling the restaurant to clarify the ingredients of each dish.

2. For anyone, children or adults, suspected of having a food allergy, Heffes-Doon recommended they be assessed by a board-certified allergist to accurately identify their food allergy and obtain a food allergy action plan.

3. For children old enough, Heffes-Doon recommended having conversations with them on the importance of always asking what ingredients are in a food, advising them not to eat everything they are given and recognising potentially unsafe foods. He also recommended informing the host about the child’s allergies as well as asking what was likely to be served.

For hosts, he suggested:

1. Ask guests about allergies beforehand.

2. For chefs, read ingredients on packets to identify any hidden or unexpected allergens.

3. Cook allergen-free dishes first and store them separately.

4. Label all dishes clearly with allergens included.

5. Use separate serving utensils for each dish.

6. Keep allergen-containing foods on a different table.

7. Normalise conversations around allergies, reminding guests to state any food allergies they may have.

8. Learn about the basics of food allergies and what allergic reactions look like.

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