Abstract
Adverse reaction of food some time mimic with other health hazards that are not directly contributed by food. The present review work was under taken to identify various aspects of food adverse reaction including etiology, epidemiology, clinical feature, disease mechanism, diagnosis, treatment and preventive measure with the greatest potential for novel therapeutic approaches from personal knowledge of the subject.
The information sources for the article are pre-reviewed reports of original observation and reviews of recent literature from websites, newspaper, journal, books etc where study for this purpose.
Adverse reaction of food may be three types: Food allergy, Food intolerance and Food toxicity. Food allergy is immediate immune system (IgE) mediated or delayed T-cell mediated hypersensitivity reaction. Food allergy may be life threating as in case of anaphylaxis. Food intolerance is non-allergic hypersensitivity that may due to enzyme deficiency, individual hypersensitivity to certain food, food additives intolerance or natural histamine & salicylate present in food. Food toxicity is the direct toxic effects of some naturally occurring toxicant in food.
Introduction
Health is closely related to food consumption and habits. Health hazards and clinical disorder can arise from unsafe and faulty food habits. A number of factors influence the food habits that include: geographical variation, religious beliefs, traditional beliefs, food taboos, education, economical situation of the community, availably and cost of food and social & cultural practices.
Adverse reaction of food means any undesirable reaction in the body after consume a particular food due to presence of substances (allergen or toxicant) that gives allergic, hypersensitive and other toxic reaction. Normally food gives energy and supply nutrient essential for life. But some foods give allergic reaction, some contain toxic or carcinogenic substance, some contain mutagen and others give individual hypersensitive reaction.
Summary of Literature Reviews
Allergens present in some food are responsible for allergic reactions. Allergens are proteins that usually resist the heat of cooking, acids in stomach and intestinal digestive enzymes. As a result the allergens survive to cross the gastro-intestinal lining, enter the blood stream and go to target organ causing allergic reaction throughout the body. Allergens are present in various food such as peanuts, almond, walnuts, soy-bean, poppy, Sesame Seed, Brinjal or Eggplant and in several food pollen i.e. apple, cherry, tomato and peach. Food allergy may be of several types such as cross-reactivity, exercise induce, allergy during pregnancy and infantile colic etc.
The biochemical mechanism of food allergy involves three stages that are initiated by allergen: 1) Sensitization, 2) Mast cell activation and 3) Late phage inflammatory response. Symptoms of food allergy includes: itching in the mouth, difficulty in swallowing & breathing, nausea, light headedness, weakness etc.
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Signs & symptoms of food allergy are sometimes confused with that of Candida hypersensitivity syndrome, Post-viral fatigue syndrome & Mercury toxicity etc.
Diagnosis of food allergy involves two stages i.e. first differ the food allergy from some other physical disorder that are similar to food allergy (differential diagnosis) and then diagnosis of allergy to specific food. Differential diagnosis include: histamine toxicity, food additives intolerance, food poisoning, lactase deficiency, gluten-sensitive enteropathy, and some other gastro-intestinal disorder. Diagnosis to specific food allergy comprises- dietary history, dietary dairy, elimination diet, skin test, and food challenge method.
Anaphylaxis is a serious individual sensitive reaction that is rapid in onset and may cause death, some people are so sensitive that breathing in the food essence can trigger an anaphylactic reaction, as in a restaurant when the person at the next table is eating fish or kissing a person who was recently eaten peanuts. Various conditions such as systematic mastocytosis hereditary angioedima, Carcinoid Syndrome mimic anaphylaxis. Anaphylaxis is usually diagnosed by blood RAST test.
Common food intolerances are celiac disease or gluten-sensitive enteropathy, lactose intolerance, food additives intolerance etc. Other may due to present of lectin in kidney bean, histamine, serotonin, tyramine, dopamine present in certain foods. Food additives intolerance i.e. tartrazine (used in soft drink), acetyle salicylic acid, monosodium glutamate (a flavor enhancer) etc. causes adverse reaction in some individual.
The most prevalent food toxicity in India, Pakistan, Nepal, Bangladesh, andchina, is lathyrism that results from long time and excessive consumption of grass pea lathyrus sativus. The toxic substance in grass pea is glutamate analogue beta- N- oxalylamino- L- alanine acid (BOAA). The disease is characterized by paralysis of lower limbs. The treatment of lathyrism include: avoidance of grass pea and administration of bactofen and tizanidine. Three possible approaches for the eradication of the disease: 1) Treatment of seed by leaching out the toxicant in hot water both on home scale and factory scale. 2) Education of the public on the danger of consuming untreated lathyrus sativus 3) cultivation of other pulses in place of lathyrus sativus.
Goitrogen (linamarine) present in bitter cassava causes paralysis, iodine deficiency disorder (goitre) and growth retardation in children. Cassava can made safe to eat by the processing i.e. grating, soaking, fermenting and drying etc. Other food toxicity includes mushroom poisoning, solanine poisoning (glycoloid present in potato/ green part of potato), and epidemic dropsy (that is caused by accidental or deliberate contamination of cooking oil seeds i.e. mustard seed or rape seed by toxic argemone seed). Sea food poisoning is caused by the consumption of fish contaminated with various toxic pollutants. The common shell fish poisoning are Amnesic Shell fish Poisoning, Ciguatera Poisoning, Paralytic Shell fish Poisoning, Scomboid, Puffer fish Poisoning, Hallucinogenic Fish Poisoning, Diarrhoeal Shell Fish Poisoning and Sardine Poisioning etc. The preventive measure for sea food poisoning include: processing, treating the sea food before or during cooking and awareness among people about the toxicity.
Discussion
In case of food allergy when a food is implicated, all products of this particular food should be avoided. As for example- if milk is implicated, then all sources of milk such as butter, cheese, butter milk, chocolate, cream, ice-cream, yoghurt and casein should be avoided and the diet should be supplemented with calcium and vitamin-D.
All allergic foods are a good source of protein, for this reason another source of protein should be replaced. If you are allergic to beef, pork or turkey, then game meats are a good alternative.
Exclusive breastfeeding, which is, excluding all other foods, for the first 6-12 months of life is suggested to prevent allergies to milk or soy from developing within that time. Breast milk contains less protein that is foreign to the infant and therefore less allergic than cow’s milk or soy formula. As they grow older, some children may tolerate foods that previously caused allergic reaction and the severity of reaction may decrease by the late childhood.
The use of food additives has increased enormously in the last few decades. Food additives are added to food to increase their attractiveness especially to children and that is another challenge to prevent food adverse reaction.
Prevention of food toxicity is a greatest challenge in developing country. In India, Bangladesh and Nepal some turbulent people to get more benefits in business, mix toxic argemone seed with mustard seed that are look very similar. Although the government of Bangladesh banded the cultivation and consumption of grass pea (local name- khesari dhal), in some extent grass pea are cultivated and consumed secretly due to poverty as its cultivation require very low cost. Thus the best measure for the prevention of food toxicity in developing countries is building of people awareness.
Recommendation
As the adverse reaction of food is a public health problem, government of the state, ministry of health, public health department, administrative institutions, nutrition research institute, nutritional worker, physician, dietitian, food & nutrition faculty of universities and food industry all should work together from their own field to prevent and to build up awareness among people about adverse reaction of food.
A young Nutritionist.
Have completed M.Sc degree in Applied Nutrition & Food Technology in 2009.
Working for insuring Nutrition Security in Bangladesh.
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