Food Allergy Awareness and Asthma: Navigating the Allergy Maze

Food allergies and asthma are both atopic diseases that can coexist and predispose to having another. While food allergies are not a common trigger for asthma, certain allergens can lead to food-induced asthmatic episodes.

The coexistence of asthma and food allergies has been well-researched, but the exact reason is not fully understood. However, individuals who have asthma are more likely to develop food allergies, just as those with food allergies are at a higher risk of asthma.

Understanding The Connection Between Food Allergies and Asthma

Atopic diseases are a group of allergic conditions, including asthma, food allergies, and eczema. Food allergies and asthma have been increasing in prevalence in both children and adults in the US and worldwide. Bronchial asthma (asthma) is one of the most common long-term conditions in children, affecting more than five million children in the US.

Asthma is an atopic disease affecting the lungs that can be identified as intermittent and persistent. The two types of bronchial asthma are based on the cause, whether allergic or non-allergic, and the symptoms’ severity. Specific allergies, including foods, can trigger an asthma attack, also known as food-induced asthma.

Food allergies, also called food hypersensitivities, are immune system reactions that occur after consuming an allergen. The top nine food allergens are wheat, soy, milk, eggs, sesame, fish, shellfish, peanuts, and tree nuts. Asthma and food allergies have been shown to coexist due to shared risk factors, such as a family history of atopic conditions like allergies or asthma.

How Food Allergies Can Trigger Asthma Symptoms

Food allergies and anaphylaxis are common comorbid conditions with asthma. If someone has a food allergy, asthma can worsen allergic reactions and even be fatal. Food-induced asthma is when someone’s condition is triggered by specific foods, which only affects 2.5% of people with asthma.

When someone with food allergies consumes an allergen, their immune system releases histamines, which causes inflammation. This release of inflammatory chemicals in the bloodstream triggers a cascade of symptoms, including:

• Airway swelling and constriction
• Increased mucus production
• Bronchospasms

During an allergic reaction, especially a severe one like anaphylaxis, the airways swell and close, making breathing difficult. Increased mucus production during an allergic reaction can cause coughing and wheezing, similar to that of an asthma attack. Bronchospasms from food-induced anaphylaxis are a sudden tightening of the airway muscles, symbolizing asthma.

Recognizing Symptoms of Food-Induced Asthma

Specific food allergens, especially those associated with severe reactions, are more likely to trigger food-induced asthma symptoms. These foods include peanuts, tree nuts, and eggs. Studies show that individuals with a severe history of asthma were at a higher risk of life-threatening bronchospasm occurring after consuming nuts.

The symptoms of food-induced asthma can appear within minutes or hours after consuming an allergen, including:

• Shortness of breath
• Wheezing or persistent coughing
• Chest tightness
• Hives or swelling
• Anaphylaxis

Anaphylaxis, a severe allergic reaction, and asthma are both life-threatening hypersensitivity conditions that cause difficulty breathing and a persistent cough. If both food-induced anaphylaxis and asthma are present, life-threatening symptoms can escalate quickly. When experiencing an anaphylactic reaction or asthma attack, seek emergency medical care immediately.

Managing and Preventing Food Allergy-Triggered Asthma

The connection between food allergies and asthma lies in the increased risk of comorbidities and food-induced asthma attacks. Just as individuals, especially children with food allergies, are more susceptible to developing asthma, they are also at risk for food-induced asthmatic episodes. Understanding the risk of coexisting asthma and anaphylaxis is crucial for awareness, avoidance strategies, and emergency preparedness.

Identifying Triggers Through Allergy Testing

Working with an allergist can help determine all potential triggers for asthma and food allergies. Allergy testing, such as skin pricks or blood tests, will identify specific food triggers for anaphylaxis or asthma. These test results allow for better avoidance of triggers and management techniques.

Avoidance Strategies for Food-Induced Asthma

Implementing avoidance strategies for food allergy-related asthma can help those at risk improve their safety and peace of mind surrounding their condition. Here are just a few prevention strategies:

• Read labels carefully
• Inform restaurants about allergies
• Be cautious with new food items
• Educate friends, family members, teachers, and coworkers/employers

Food packaging is required to list common allergens, but cross-contact is still a risk in certain facilities. Carefully reading labels helps to identify when certain products are produced in a facility with other allergens, such as tree nuts, peanuts, wheat, or milk. This practice can prevent even a small amount of allergen from triggering anaphylaxis or food-induced asthma.

When eating out at a restaurant, ask about food preparation methods and ingredient lists to reduce allergen exposure and cross-contact. If you’re unsure about a specific food item or ingredient, avoiding consumption is best until confirmed safe.

Informing family members, friends, teachers, and coworkers about your allergies and asthma is critical for at-risk people. Educating them can minimize allergen exposure and prepare them for how to respond in an emergency.

Emergency Preparedness for Anaphylaxis and Asthma

If you have food allergies or asthma, always being prepared for emergencies is critical. Epinephrine is the first-line treatment for anaphylactic reactions from food allergies. Always carry two epinephrine auto-injectors to ensure timely treatment and intervention. While epinephrine is not the first-choice treatment for asthma attacks, it can help minimize asthmatic symptoms such as airway constriction.

Prepare an asthma action plan by always having prescribed inhalers on hand. Inhalers help mitigate respiratory symptoms triggered by common food allergens. Ensure those around you, including friends, family, teachers, and coworkers, understand your condition and emergency procedures.

Awareness of Food Allergies and Asthma

Raising Awareness about the connection between food allergies and asthma helps enhance safety measures in schools, public places, and restaurants. Increasing advocacy efforts can push stricter food labeling laws and affordable access to life-saving medications. By staying informed and proactive in advocating for food allergies and asthma, those at risk can live in a safer and healthier environment.

Click here to help support research efforts for anaphylaxis treatment and #stopanaphylaxis®. The KeepSmilin4Abbie Foundation funds research to detect the early signs of an anaphylactic reaction, enabling early intervention and treatment.

References:

• Frontiers in Pediatrics, 2017. Asthma, Food Allergy, and How They Relate to Each Other.
• Cleveland Clinic, 2024. Atopy.
• Current Opinion in Allergy and Clinical Immunology, 2012. Food allergies and asthma.
• Cleveland Clinic, 2022. Asthma.
• Mayo Clinic, 2024. Food allergy.
• Asthma and Allergy Foundation of America, 2018. Asthma Triggers.
• Better Health Channel. Asthma and food allergies.
• Current Opinion in Allergy and Clinical Immunology, 2019. Asthma and anaphylaxis.
• Healthline, 2023. Can You Use Epinephrine (or an EpiPen) to Treat an Asthma Attack?