THE BASIC CONCEPTS OF ALLERGIES: WAXES
Although many shoppers are unaware of the fact, certain fruits and vegetables are sold with a coating of paraffin wax. The wax on parsnips and rutabagas is so thick that you can scrape it off with your fingernail. But other so-called fresh produce, such as cucumbers, green peppers, and apples, are often sprayed with a light coating of paraffin to improve their appearance and shelf life. Not surprisingly, this petroleum-derived wax can contribute to the health problems of susceptible persons.
Some people think it is safe to eat such foods if they simply peel the wax away. But wax particles stick to the cut surfaces of waxed fruits and vegetables. To prove this, you simply have to peel a parsnip or other heavily waxed vegetable and then dip it into boiling water. Wax droplets may rise to the surface of the water, despite the fact that you supposedly removed the wax through peeling.
Peeling a commercial cucumber or apple is more effective in removing the wax. But these produce may still contain other chemical residues that can cause problems.
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APPENDICES: PAIN-KILLERS
(Trade names are not given in this section, as the common pain-killers are used in a great number of different preparations. The ingredients are shown on the packet for those bought without a prescription.)
These are drugs that can block pain sensations. Our main interest in them is in connection with headache and migraine.
Aspirin and other salicylates (see Section 7A) reduce pain and damp down inflammation. They also have some effects on the blood platelets, and this may help to abort a migraine attack. Regular, prolonged use of salicylates can irritate the stomach lining and have other adverse effects, so this should be avoided. Paracetamol reduces pain but has very little anti-inflammatory effect. It has no ill-effects on the stomach, and as long as the maximum dose is strictly observed it is a very safe drug. However, it should not be taken long-term at the maximum dosage, nor should it be taken by anyone who has kidney or liver disease. There are rare instances of paracetamol causing skin rashes.
Codeine is a very mild opiate (a morphinelike drug) used in some migraine preparations. It is a fairly safe drug.
Caffeine is added to some pain-killers to speed up absorption and improve the effectiveness of the drug. Caffeine can also produce headaches, so heavy use of this type of pain-killer is not advisable.
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FOOD INTOLERANCE: PLANT FOODS
Potato family, Solanaceae: potato (but not sweet potato), tomato, aubergine, sweet peppers (green, red and yellow peppers), paprika, chilli peppers, tobacco, cape gooseberry.
Bean and pea family, Leguminosae:
peas, haricot beans (kidney beans, whether white-, red-, brown- or black-skinned, also baked beans and flageolets), peanuts, soya beans, lentils, split peas, broad beans, butter beans, mung beans, lima beans, chickpeas, black-eyed peas, carob, runner beans, green beans, snap beans, string beans, mangetout peas. Different kinds of haricot beans and their green forms (snap beans, string beans and green beans, including those sold as a frozen vegetable) are all the same species and should be regarded as the same food. Peanuts belong to a separate tribe from other members of the family, and experience with patients who are allergic to peanut suggests that cross-reactivity with other legumes is generally low, but peanut-sensitive people may react to soya beans. Patients sensitive to soya beans are
likely to react to a wide range of legumes. Anyone with these sensitivities is usually advised to avoid peanut and soybean oils as well, but this may not be necessary – such oils contain no detectable protein, and tests with allergic individuals showed no reaction to the relevant oil. But there might be a reaction if someone were intolerant of a non-protein component.
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NUTRITION SUPPLEMENTS: AN ELIMINATION DIET SHOULD TAKE A NUTRITIONAL SUPPLEMENT
Doctors who are concerned about possible nutritional defects suggest that anyone embarking on an elimination diet should take a nutritional supplement. They argue that many are likely to have deficiencies anyway, especially if they number diarrhoea among their symptoms, and that the restrictions of the elimination diet will only make the situation worse. Such doctors also recommend a special type of nutritional supplement to anyone coming off the Pill -and certainly to anyone staying on it. It is quite easy to overdo things with both vitamins and minerals, particularly with the fat-soluble vitamins, A and D, because these are stored by the body if taken in excess – water-soluble vitamins such as vitamin C can be washed out of the body in the urine. So grabbing a handful of ordinary vitamin pills is not the answer – they can be dangerous if the body already has an excess of vitamin A.
Ideally, anyone who is concerned about their nutritional status should have a full analysis done, so that a supplement can be tailored to their specific needs. Unfortunately, testing itself is a contentious issue. The traditional method of just testing a blood sample is now considered inadequate by many doctors. It appears that some nutrients – zinc for example – can be deficient as a whole but show normal levels in the blood. The suggestion is that the blood ‘needs’ the mineral more than other parts of the body, so there are mechanisms that ensure a good supply, scavenging the mineral from other tissues to keep the blood level high. A more extensive method of testing, using hair and sweat samples, as well as blood, often shows up nutritional defects that are not revealed by the blood alone. This form of testing seems to be vindicated by the results in individual cases – correcting the deficiencies shown by hair or sweat tests often does wonders for patients with previously intractable health problems. This Ts not hard, scientific evidence of course, and some carefully designed trials are needed to test these new approaches to nutrition.
In the meantime, what can be advised? Extensive nutritional testing is only available privately, but for those who can afford it there is little to lose, and. For anyone corning off the Pill, a special supplement is probably advisable.
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WHAT CAUSES FOOD INTOLERANCE? IS THE IMMUNE SYSTEM INVOLVED?
At the beginning of this book, we defined food intolerance as ‘any adverse reaction to food, other than false food allergy, in which the involvement of the immune system is unproven because skin-prick tests and other tests for allergy are negative. This does not exclude the possibility of immune reactions being involved in some way, but they are unlikely to be the major factor producing the symptoms.’ Because food intolerance has long been thought of as an ‘allergy’, most research into its causes has centred on the immune system. It is only in the last ten years or so that other possible reasons for intolerance have been investigated.
Despite extensive research, the evidence for immune-system involvement is fairly limited. The general consensus of opinion now is that immune reactions may have some role in food intolerance in some people, but they are only part of the story – something else must be going wrong as well.
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IN WHAT AGE MOST ALLERGIES ARE APPEAR?
Although most allergies first appear in childhood, particularly the acute types of food allergy, there are a few adults who suddenly develop an allergy for no obvious reason. Dr AW. Frankland, formerly of St Mary’s Hospital in London, describes the case of a woman of 50 who suddenly became allergic to sesame seeds, which she had previously eaten without difficulty. One day while eating a biscuit containing sesame, her mouth and throat began to tingle, and urticaria (nettle-rash) developed on her skin. These symptoms disappeared after an hour. When she ate another such biscuit two weeks later the reaction was far more severe. Her lips and eyelids swelled, urticaria developed all over her body, and she collapsed unconscious on the floor. Only prompt medical attention saved her life. This is an unusual, but not an isolated case, and is difficult to explain in terms of what we now know about allergies as inherited disorders.
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FIBERS ALLERGY: WHERE FIBRES ARE FOUND
COIR
Coir is a fibre made from the outer husk of the coconut. It is used to make doormats (the bristly type), floor matting and ropes. It is also used as a filling in mattresses and can be used in upholstery. It gives off few particles and rarely causes reactions. Unless you have significant exposure* to handling it, say at work, it is an uncommon cause of allergy.
Horsehair
This is hair taken from the mane and tail of horses. It used to be a common material in upholstery and furniture-making but is now much less used. If you are allergic to horses , you may be sensitive to horsehair used in furniture. Generally, older furniture is more likely to contain it than modern furniture. For most people, however, exposure to horsehair is low and allergy uncommon.
Jute, Sisal and Hemp
These fibres come from three plants and are commonly used in rope-making. Hemp has been recorded to cause allergy among workers handling it in production. Otherwise, sensitivity is not common.
Kapok
Kapok is a fibre that surrounds the seeds of a tropical tree. It looks and feels rather like a pink-coloured cotton wool. It is used for filling cushions and soft toys. Children are sometimes allergic to kapok in soft toys that they cuddle closely, although sensitivity to house dust mites and other types of filling material is more common.
Also known as flax, linen is a cellulose fibre in common domestic use for tea-towels. It can also be used for clothing (often in a blend with cotton), tablecloths and napkins, and for sheets. It is an expensive fabric, which creases easily and so exposure to it, apart from tea-towels, is low. Allergy to linen is rare.
Starches and resins are sometimes applied to linen, and these can cause sensitivity reactions. However, linen without finishes, as in tea-towels, rarely causes allergic reactions. Despite its creasing, it is hard-wearing and can be a useful fabric for people with multiple allergies.
Ramie
Ramie is a yarn made from a plant with fibrous leaves. It is used in clothing, especially knitted garments, often in blends with cotton or linen. It is uncommon and most people never wear it, so allergy is not reported.
Silk
Like linen, silk is an expensive and often impractical fabric in daily life. Silk has few everyday uses, apart from clothing, ties and accessories. It is a protein fibre, like wool, and is known to cause allergy, but because so few people have any significant exposure to it in everyday life, allergy to silk is uncommon.
Resins are not used on silk at all, since they accentuate the fibre’s natural tendency to break and abrade. Silk is therefore a very useful fibre for the chemically sensitive. Starches and sizes are sometimes applied, but these usually wash out.
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WHICH SUBSTANCES CROSS-REACT? ASPIRIN
Acetylsalicylic acid is the active chemical in aspirin. It was originally extracted from the bark of willow trees and occurs naturally as methyl salicylate, oil of wintergreen. Synonyms for acetylsalicylic acid are salicylate and salicylic acid. If you react to aspirin, you may cross-react to other drugs and painkillers containing salicylates. Your doctor or pharmacist will be able to advise you on what to avoid.
Oil of wintergreen (methyl salicylate) is used in many over-the-counter liniments, antiseptics and medicines (including sinus decongestants, sinus inhalers and rectal suppositories). Your pharmacist will be able to tell you whether a product you are using contains oil of wintergreen. It is also used as a flavouring in some toothpastes. Contact the manufacturer if you want to check any toothpaste you use.
Many foods naturally contain salicylates, especially certain fruits, spices, herbs and nuts. If you react strongly to aspirin, and still have reactions after avoiding it, it may be worth trying a diet that avoids foods rich in salicylates. However, such a diet would need to be very restrictive so it is only worth doing if you have strong motivation. It should only be undertaken with medical supervision. The foods shown in Table 2 (overleaf) are low in salicylates and should form the core of a low-salicylate diet. Those listed in Table 3 are high in salicylates and should be avoided if possible.
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ALLERGY IN CHILDREN: SCHOOL-LIFE
You may need special help and collaboration from staff at school if your child is made ill by things he or she encounters there. The best way to achieve this is, again, to be matter-of-fact, combined with offering staff as much practical help as you can in sorting things out. If you want them not to use certain polishes or cleaners in your child’s vicinity, for instance, it helps to be able to propose or even give them an alternative. If you want your child not to wear certain parts of the uniform, for example, it helps to offer them an alternative which is likely to be acceptable. Be assertive, but not aggressive or over-emotional. The staff may privately consider you over-fussy, but if your child genuinely will be better for something being done or avoided, you are right to insist. Do not ask for things which are not strictly important, and try to get the staff not to differentiate your child – to treat him or her as normally as possible.
Your child’s needs will vary according to his or her allergies or sensitivity. Some of the things over which you may need to take care are food and drink. It may be easier for a child sensitive to foods to take a packed lunch each day, rather than eat school lunches, and to take his or her own water or juice for break-time drinks.
If your child is sensitive to chemicals, he or she may be sensitive to cleaning products, polishes or disinfectants used in the school. If you suspect these, either ask for them not to be used in the places where your child goes, or offer substitutes.
If your child is sensitive to solvents, check that paints and glues used in schools are not solvent-based. Oil paints should be avoided, but water-based paints will be no problem. PVA adhesive rarely causes problems. Ask that felt-tip pens are water-based, rather than solvent-based.
Swimming can cause a child sensitive to chlorine and other disinfectants to react, and may be best avoided if your child appears unwell or worse afterwards. Other sports activities may affect your child – on damp days outside in winter if allergic to moulds, or on summer days if allergic to pollens. Ask for alternatives to outdoor activities if your child is severely ill. If pollens are the problem, exam time in summer can be difficult for your child.
If school pets or animals are kept, or allowed to roam, in schoolrooms, these can affect a child highly allergic to pets. See if this can be changed or controlled.
If your child goes on any school trip or holiday, make sure that staff have details of any medication, special diet or other requirements. Send supplies of unusual foods with the child, if necessary.
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ALLERGY BABYCARE: IF YOU HAVE SEVERE PROBLEMS
If your baby is very severely affected, or if you get no results from selective exclusion dieting by the mother, a doctor may recommend that the mother goes on to a full exclusion diet. This is rarely done during breastfeeding, because it can affect the mother’s wellbeing and strength, and should only ever be done under close medical supervision.
If nothing helps your baby, and you and your doctor are still confident that breastmilk is at the root of the problems, it is probably better nonetheless for the baby to keep breastfeeding, and to delay weaning off the breast for as long as possible. A food-sensitive baby has a higher probability of having problems on infant formula feeds (even non-cow’s milk-based) and on solids than on breastmilk.
If you have to give a supplementary bottle feed, or want to wean from breast on to a milk formula, it may be better to give a soya milk formula feed than a cow’s milk-based formula to help prevent sensitivity. Soya is not totally free of problems, but it is less allergenic than cow’s milk formula. Your doctor will be able to advise you on what best to do.
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