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STUDY: Food allergy and food intolerance in childhood.
JOURNAL: Indian J Pediatr 1999;66(1Suppl):S37-S45
AUTHORS: Sullivan PB., University of Oxford, Oxford, UK.
ABSTRACT: Food intolerance is a reproducible adverse reaction to a specific food ingredient that is not psychologically based. Food allergy is a form of food intolerance in which there is evidence that the response is caused by an immunological reaction to food. Other mechanisms of food intolerance include enzyme defects (e.g. lactase deficiency), pharmacological effects (e.g. histamine), toxic properties (e.g. haemagglutinating lectins) and irritants (e.g. spices). Food allergy in children is a highly contentious subject and there is often a striking lack of published evidence from which to base clinical decisions. The true prevalence of food allergy in children is unknown, although there is evidence of an increasing incidence of allergic reactions to some foods, especially peanuts. Our understanding of why some children are unable to tolerate certain foods (e.g. cow's milk, egg), or how they grow out of this intolerance, is very poor. Symptoms of food allergy in children are diverse and include vomiting, poor weight gain, abdominal pain, malabsorption, cough, wheeze, rhinitis, atopic eczema, urticaria and angioedema. Despite the lack of objective data to support the notion that food intolerance contributes to behaviour in children, this is a belief firmly held by many parents and some professionals.
COMMENTARY: I find it amazing that despite ample evidence that dietary lectins are an important provocative influence in both food allergy and intolerance, many professionals, includinbg the vast majority of hematologists, continue to deny their biological activity. However, the simple truth is that they are in the diet, have biological effects, and we best get used to that notion.