Memorandum by Professor Jonathan O'B Hourihane,
Professor of Paediatrics and Child Health, University College
Cork, Ireland
Nearly half of the population are now vulnerable
to developing allergic conditions, including food allergy. Allergic
conditions are usually chronic and low intensity but have a significant
impact on quality of life of both the patient and their families,
whose lifestyle may often be very restricted. The prospects of
unexpected allergic catastrophe or anaphylactic death are real
issues for many families and should not be underestimated. Similarly
the seasonality and short duration of high intensity symptoms
may not be elicited by a casual medical enquiry. Many modalities
of treatment that are still common are very outdated and put sufferers
at significant risk of side effects, when modern, safe treatments
are more effective but not widely available.
Food allergy is widely thought of as merely
an early step on the "Allergic March", where eczema
and food allergy merely precede rhinitis and asthma. This is to
underestimate food allergy's critical impact on health and quality
of life of affected children and its potential to cause fatalities,
usually in older children and adolescents. However there are few
or no known lifestyle factors that are uniquely associated with
food allergy and it must be considered therefore in the context
of known or suggested risks for allergic diseases. Biparental
atopy is now common and appears to be a strong predictor of allergic
disease in offspring. Allergen avoidance while pregnant is not
effective. Being first born is linked with higher allergy rates.
Housing conditions/location and parental occupation are also influential
eg lower allergy rates in farming families in Germany. The role
of mode of delivery (vaginal delivery or caesarean section) is
controversial. Changing weaning practices and the impression that
organic or exotic fresh food is better for children than traditional
staple foods may be linked to the appearance of allergies to foods
that would have appeared bizarre to previous generations.
|
