Children and Food Allergies Children in the 21st century are developing more allergies and food intolerances. This may be due to less exposure to a wide range of bacteria needed to help the immune system mature and a fundamentally different diet. Also, problems with exclusively breastfeeding up to 6 months increases risk of developing food allergies. Here I examine the more common symptoms of childhood allergies, from asthma to ADHD.
The ADHD epidemic
ADHD has become a household name and is estimated to occur in a quarter of a million children under the age of 17. In the US the figure is rapidly approaching 3 million.
ADHD affects five times as many boys as girls. A third or more ADHD children will grow up to be ADHD adults. There is no laboratory or clinical test available yet that definitively diagnoses the condition; a diagnosis is based on observations of inattention, hyperactivity and impulsivity so serious they impair a child’s ability to function. Many children with ADHD take medication under a doctor’s prescription, usually the amphetamine-like drug Ritalin (methylphenidate) to help them pay attention, calm down, become less disruptive and perform better in school. More than 250,000 prescriptions for Ritalin are written each year.
Largely ignored, however, is the role that food allergyA food allergy occurs when the body’s immune system reacts abnormally to a specific food as it is perceived as a threat. In the most… and chemical food additive sensitivities play in children with ADHD. In a classic study by Dr Joseph Egger and colleagues at the University of Munich in Germany, 76 children with severe ADHD were kept on a strict hypoallergenic (very low allergic potential) diet for 4 weeks.1 The results were amazing: 82 per cent of the children got better on the hypoallergenic diet. One out of four children with severe ADHD recovered completely. Even more remarkably, most of the other non-ADHD symptoms improved with the diet, as well. Here’s what happened.
|Symptom||Before diet change||On diet|
|Abdominal pain or discomfort||54||8|
Egger then gave the children foods with artificial food colours and preservatives. He found the most problematic common substances were the chemical additives tartrazine and benzoic acid (E102 and E210). However, no child reacted to these two food additives alone. A total of 46 different foods provoked allergic symptoms. Soya, cow’s milk, wheat, grapes, chocolate, oranges, eggs and peanuts were the most common food allergens. Foods that did not cause symptoms included cabbage, lettuces, cauliflower, celery – and duck eggs!
Having identified which foods each child was allergic to, he then ran a test, giving the children either a placebo or a tiny amount of the food allergenAn allergen is a substance that is foreign to the body and which can cause an allergic reaction in certain people. Pollen is an example… without either the child or the researcher knowing which was given (in other words, a placebo-controlled double-blind test). This showed these children definitely were reacting to specific foods and chemicals.
In the UK, the leading child psychiatrist Professor Eric Taylor was somewhat sceptical about the reports he was getting from parents saying their children were behaving better on diets excluding chemical additives and/or common food allergens. He decided to investigate with another double-blind trial.2 He took 78 hyperactive children and placed them on a ‘few foods’ elimination diet. Fifty-nine of the children showed improved behaviour during the trial.
Among autistic children the evidence for food allergy, especially allergy to glutenGluten is a protein found in the cereals wheat, rye and barley. Obvious sources of gluten in the diet are bread, pasta, breakfast cereals and… grains and milk, is even higher than for children with ADHD. Much of the impetus for recognising the importance of dietary intervention has come from parents who have noticed vast improvements in their autistic children after changing their diets.
Wheat and dairy products – and the proteins they contain, gluten and casein – are the foods linked most strongly to autism. These proteins are difficult to digest and, especially if introduced too early in life, may result in an allergy. Fragments of them, known as peptides, can mimic chemicals in the brain called endorphins, so they’re often referred to as ‘exorphins’.
By mimicking the body’s own endorphins, which is what heroin does, the body becomes less sensitive to its own natural endorphins, which leads to cravings for even more of these ‘exorphins’ found in milk and wheat.3
The most common food allergies and chemical intolerances in autistic children are:
- Wheat and other gluten-containing grains
- Milk and other dairy products containing casein
- Citrus fruits
- Salicylates (as in aspirin)
- Foods in the nightshade family (potatoes, tomatoes, aubergines, peppers)
- Tartrazine (E102), benzoic acid (E210) and monosodium glutamate (MSG/E621).
If you have a child with autism or Asperger’s syndrome, I strongly recommend you investigate food allergy as a contributory cause. If you’d like to find out more about the nutritional approach to autism, see Optimum Nutrition for the Mind
Ear, nose and throat infections
Almost every parent is aware of the agony their child experiences with ear infection, which can also often involve the nose and throat as well. This also include rhinitis. The most common and serious is middle ear infection, of which there are two types: acute otitis media, and otitis media with effusion (also called serous otitis media, and nick-named ‘glue ear’), which involves fluid build-up in the middle ear.
Signs and symptoms of acute otitis media include:
- Severe and persistent pain in one or both ears
- Ear tugging or pulling
- Fever up to 104°F (fever with chills or fever with a headache may be a sign of more serious complications)
- Irritability, lethargy
- Loss of appetite, nausea, vomiting and/or diarrhoea , and concurrent signs of allergic rhinitis (frequent sneezing, runny or congested nose, nose rubbing, eye burning), catarrh and recurrent tonsillitis may also appear in as many as 80 per cent of otitis media sufferers.
In otitis media with effusion, the signs and symptoms are:
- Ear discomfort (ear popping, ear pressure, earache, hearing loss)
- Behavioural or emotional changes (poor sleeping, irritability, underachieving in school, many of the signs and symptoms of ADHD), and speech or language problems.
More often than not, the immediate ‘solution’ is antibiotics,4,5,6 despite the well-published evidence that the routine, repetitive use of antibiotics in treating otitis media increases its recurrence three to sixfold. Eighty per cent or more of this epidemic of ear problems could be avoided simply by identifying and avoiding food allergens, as at least four out of five of these children are food allergic.
What happens is this: the allergic reactions cause the eustachian tube that drains the middle ear to swell and close. Identify and stop eating allergic foods, and the eustachian tube will open and drain, and infection and/or fluid build-up will disappear. No more monthly visits to the doctor’s office, or prescriptions for antibiotics that don’t work very well. It’s that simple.
In my opinion, every single child suffering from repeated bouts of otitis media should be tested and treated for food allergy or intolerance.
Food allergies or intolerances often result in diseases of the airways, the most serious of which is asthma.7 In England, 1 in 5 children now have asthma, compared to just 1 in 25 adults – in fact, asthma is now the leading cause of school absenteeism for children under 15.
Allergic reactions can cause the airways to become irritated or to constrict, leading to a cascade of symptoms that can have sufferers wheezing, coughing, or even fighting to breathe. In children, this can be a real blow to their confidence and leave them in fear of the next attack. But an over reliance on inhalers isn’t the answer. They can be a huge health risk – and if corticosteroids are involved, your child’s growth in height can actually be slowed by about an inch a year.
Trying to treat the wheezing and coughing rather than the underlying cause is too limited a solution. I recommend that every child with asthma be checked for food allergy.
Sleeping problems and bedwetting
Many parents struggle to get their child to sleep, not realising that food allergies may be making them hyperactive. That glass of milk before bed may make matters worse, not better.
A study of 71 babies, 50 of them poor sleepers, showed that milk is a common allergen in infants. The babies with sleep problems showed raised levels of antibodies to milk, and when milk was eliminated from their diet, their sleep pattern became normal. When milk was then reintroduced to their diet, their sleeplessness returned.8 In another study, 17 under-fives were referred to a sleep clinic for their continual waking and crying during sleep times. To determine if a food allergy could be contributing to their insomnia, cow’s milk was excluded from their diet. Within six weeks, the children were falling asleep more easily, and slept more solidly and for longer – on average, from 5.5 to 13 hours. Reintroducing cow’s milk into their diets caused their insomnia to recur.9
There can, of course, be other allergies behind sleeplessness, so the best course of action is to have your child tested.
Bedwetting is another problem for families with young children – tens of thousands of them, in fact. Between 10 and 15 per cent of children wet their beds regularly, and 5 per cent of them will still have the problem in adulthood.
Bedwetting children can be consumed by feelings of guilt and low self-esteem as they see how ever-present piles of laundry and odours of urine affect their parents. Bed wetters are often reluctant to stay overnight with friends, or engage in a number of activities children normally do. And there can be related problems. ADHD – commonly a food allergic condition – is more prevalent in bed wetters.10 So on top of the bedwetting, many children with the condition have to cope with a range of typical ADHD symptoms.
In the early 1990s Dr Joseph Egger – then at London’s Great Ormond Street Hospital for Sick Children – studied 21 children with migraines or hyperactivity who were also bed wetters, and who had previously responded well to a ‘few foods’ diet (a diet free from the most allergenic foods). He identified which of the foods provoked migraines or hyperactivity in each child and removed these from their diets. The bedwetting stopped altogether in over half the children and decreased in a further fifth of them.11
In my experience, most bed wetters have hidden food allergies. Allergic reactions can irritate the bladder wall, and also provoke sleep disorders – of which bedwetting is one. When the food allergy is solved, the child sleeps more restfully, and is able to wake up to make it to the toilet in time.
Type 1 diabetes
Diabetes is a chronic disease in which the human body either doesn’t produce enough insulinInsulin is a hormone made by the pancreas. It is responsible for making the body’s cells absorb glucose (sugar) from the blood…. – the hormone that helps regulate blood sugar and turn it into energy – or is unable to use it properly. The high levels of sugar in a diabetic’s blood mean they have low energy.
There are two primary types of diabetes. About 90 per cent of diabetics have type 2, which used to be called ‘maturity-onset’ diabetes because it usually sets in in adulthood. Type 1 diabetes is always detected in childhood. People with type 1 produce very little or no insulin, and need daily injections of the hormone to prevent their blood sugar levels from getting dangerously high. Hence its other name, ‘insulin-dependent’ diabetes. In the UK alone, type 1 diabetes affects over 100,000 people and accounts for 8000 deaths a year.
Type 1 diabetes tends to run in families, suggesting a genetic predisposition to developing it. But its cause is still unknown. So what’s the link with food allergy? In this kind of diabetes, the child’s immune system attacks insulin-producing cells in the pancreas. It is therefore classed as an ‘auto-immune’ disease. There is increasing evidence that what might be happening is that the child becomes allergic to a particular food proteinProteins are large molecules consisting of chains of amino acids. Proteins are essential nutrients for the human body – they are a building block of…, and that the immune system reacts not only to this, but to a similar protein in the pancreas. This ‘cross-reaction’ theory is gaining credence and suggests that, in children who may be genetically susceptible to developing the condition, the major trigger might be introducing allergy-provoking foods too early – before the gut and immune system are fully mature.
These so-called diabetogenic foods, in order of importance, include:
- Gluten grains
- Soya products12
- Cow’s milk.
Growing evidence is linking type 1 diabetes to an allergy to bovine serum albumin (BSA), a substance found in dairy products.13 Genetically susceptible children who had been breast-fed for at least seven months or exclusively breast-fed for at least three or four months were found to have a significantly decreased incidence of type 1 diabetes, which suggests that another factor is involved. Children who have not been given cow’s milk until four months or older also show the same substantially reduced risk. The highest incidence of type 1 diabetes is found in Finland, which is also the world’s biggest consumer of dairy products.
Animal studies show that rats bred to be susceptible to diabetes have a much higher risk of getting the disease if their feed contains either milk or wheat gluten. In one study, even the addition of 1 per cent skimmed milk to their diet increased the incidence of type 1 diabetes from 15 to 52 per cent.
Dr Hans-Michael Dosch, Professor of Immunology at Mount Sinai Hospital in New York, identified BSA as the specific factor in dairy produce that increases the risk of diabetes, and showed that it cross-reacted with the cells of the pancreas. He and his fellow researchers theorised that diabetes-susceptible babies introduced to BSA earlier than around four months, a period when the gut wall is immature and more permeable, would develop an allergic response to BSA. As a result, their immune cells would mistakenly destroy not only the BSA molecules but also pancreatic tissue. He went on to show that, of 142 newly diagnosed type 1 diabetic children, 100 per cent had antibodies to BSA, compared to 2 per cent in normal children. Dosch believes that the presence of these anti-BSA antibodies indicate future type 1 diabetes in 80 to 90 per cent of cases.
He also thinks that keeping children off dairy products for at least their first six months halves the risk. BSA can, however, pass from the mother’s diet into her milk. So if breastfeeding mothers avoid beef and dairy products, the risk can be completely removed in genetically susceptible children. The current opinion is that about one in four children are genetically susceptible.
International research indicates that early and long-term avoidance of allergenic, ‘diabetogenic’ foods, combined with a highly varied diet of wholesome and nonallergenic foods, can reduce a diabetic child’s need for insulin by as much as two-thirds. So it’s well worth having an IgG food intoleranceFood intolerance is not the same as a food allergy. Food intolerances tend to cause digestive symptoms such as bloating, cramps and diarrhoea, but are… test to find out if you or your child are eating any offending foods.
Testing for allergy and intolerance
Conventional IgE based food allergies are best tested with a skin prick test, arranged by referral to an allergy specialist. This kind of allergy usually produces immediate and often severe symptoms. Harder to detect are hidden or delayed food intolerances which are most commonly a result of IgG based food intolerances. These can be reliably tested using a small sample of blood, often taken using a home test kit. The laboratory I favour, because they have done the most thorough research, are www.yorktest.com. Their FoodScan test tests for IgG sensitivity for 113 foods.
To find out more on this topic read Hidden Food Allergies by Patrick Holford & Dr James Braly
- Egger, J et al. (1985)
- Carter, C M et al., Effects of a few food diet in attention deficit disorder, Arch Dis Child, vol 69, pp 564-8 (1993)
- Whiteley, P, Sunderland University Autism Unit, presentation to ‘Autism Unravelled’ conference, London, May 2001
- Rosenfeld, R M, What to expect from medical treatment of otitis media, Pediatr Infect Dis J, vol 14, pp 731-738 (1995)
- Van den Broek, P et al., Letter to the editor. Lancet, vol 348, pp 1517 (1996)
- Williams, R L et al., Use of antibiotics in preventing recurrent acute otitis media and in treating otitis media with effusion. JAMA, vol 270, pp 1344-1351 (1993)
- Soutar, A, Bronchial reactivity and dietary antioxidants, Thorax, vol 52, pp 166-170 (1997)
- Rebuffat, E et al., Difficulty in initiating and maintaining sleep associated with cow’s milk allergy in infants, Sleep, vol 10, pp 116-121 (1987)
- Kahn, A et al., Milk intolerance in children with persistent sleeplessness: A prospective double-blind crossover evaluation, Pediatrics, vol 84, pp 595-603 (1989)
- Robson, W L et al., Enuresis in children with attention-deficit hyperactivity disorder, SC South Med J, vol 90, pp 503-5 (1997)
- Egger, J, et al., Effect of diet treatment on enuresis in children with migraine or hyperkinetic behavior, Clin Pediatr (Phila), vol 31, pp 302-307 (1992)
- Kitts, D et al., Adverse reactions to food constituents: Allergy, intolerance, and autoimmunity. Can J Physiol Pharmacol, vol 75, pp 241-54 (1997)
- The Immunology Review, vol 2 (1994)
Join the Conversation on our Facebook Page