Health and Remedies For All That Ails You

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It is estimated that
One out of three Individuals is currently suffering from some form of Allergy.

On the global scene, it is estimated that asthma, a form of airway allergy, affects as many as 300 million people with another 100 million expected in 20251.

In Malaysia, according to Assoc Prof Dr Ranbir Kaulsay (President of Malaysian Society of Allergy & Immunology, MSAI ), one out of three Malaysians is currently suffering from some form of allergy. By 2020, it is expected that half of the population will be allergic to something if the current trend continues. But sadly, allergy is still not accorded the attention and priority that it needs.

Why? Perhaps it is because allergy seldom kills or maims. Yes, life does go on for allergy sufferers, but unless you have an allergy yourself or live with someone who has it, you will never fully understand the impact of allergy on the quality of life. The physical suffering, the mental torment, the emotional struggles, the financial strain and the endless limitations in many aspects of life, ranging from food to sports or vacation to vocation.

In a nutshell, allergy rarely kills but often steals your zest for life.

As 60% of all allergies appear during the first year of life 2, it is only logical for allergy prevention to be focused on infants and young children. In fact, it is estimated that 35% of children are affected by allergy 3,4.

The most common manifestations of allergy in children are food allergy, atopic dermatitis, asthma and allergic rhinitis/conjunctivitis.

As if the misery of one form of allergy, say dermatitis, is not enough, allergies may come in a series called the “Allergy March”. Leading this march is atopic dermatitis which is often accompanied by food allergy. A large proportion of children with atopic dermatitis then progress to rhinitis or asthma later in life. Thus, the development of allergic diseases can be life-long.

Up till now, there is still no cure for allergy and prevention remains the only way to stop the allergy march. But before we can put the brakes on allergy, we must know what drives it.

Genetic link

Allergic diseases run in families. If you and your spouse both suffer from allergies, your children will have a 40-60% risk of developing allergies. If only one of you is allergic, then the risk falls to 20-40%.

However, even if both parents are allergy-free, the offspring will still run a 5-15% risk. So, allergy prevention is justified for all infants.

Environmental factors

Besides genes, environmental factors also contribute to the development of allergy. At present, genetic and environmental factors each account for 50% of allergic diseases (Host 2001).

The major environmental risk factor is exposure to foreign food proteins in early life and the main culprit is cow’s milk protein. In unmodified cow’s milk, there are more than 32 types of proteins with great potential to trigger food allergy5.

Similarly, plant proteins, like soy protein, also possess the potential to spark off food allergy. While any food can cause food allergy, the more potent ones are eggs, milk, peanuts, tree nuts (for example, almond, walnut, cashew, hazelnut, etc), fish, shellfish and soya bean 6. The state of the digestive tract and age of the child when first exposed to the offensive food are equally important.

Halting the Allergy March

If we cannot change our genes, we have to change the environmental factors. Here are some measures that can help halt the allergy march:

Exclusively breastfeed your child for at least the first six months of life. ****** milk proteins are not considered as foreign proteins by your child’s immune system. In fact, ****** milk has a long-term preventive effect against non-food allergies7. However, nursing mothers are advised to abstain from highly allergenic foods themselves as traces of offending proteins from these foods may reach the ****** milk.

If you are unable to breastfeed due to medical reasons, use a scientifically proven hypoallergenic formula that helps to prevent the development of allergy. Although this formula contains cow’s milk, the proteins have been modified with gentle heat and enzymatic treatment so that they are now safe and do not trigger allergies.

However, if your child has already been confirmed with cow’s milk protein allergy (CMPA), he would need another type of hypoallergenic formula, which is specifically designed for treating allergy. Do not use goat’s milk or similar milks as the proteins are very closely related to cow’s milk and as such may provoke allergic reactions.

Soy protein formulas have no role in the prevention of allergic diseases8, so do not use them for prevention. Moreover, 15-50% of infants who are allergic to cow’s milk are also allergic to soya milk9.

Delay the introduction of solid foods until your baby is at least six months old, when his digestive tract and immune system are better developed. Stay away from highly allergenic foods like shellfish, eggs and nuts during the first year. Introduce only one new food at a time to allow any adverse reactions to be traced easily.

Stop smoking during pregnancy as it may have adverse effects on infant lung development10. Children should also not be exposed to cigarette smoke at all, especially in confined spaces.

Parents should make every effort to prevent allergy in their children because once triggered, the allergy march might just go on, and adversely affect your quality of life.

References:
1. Masoli et al. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy 2004;59:469-78.
2. Liptay et al. Natural history of atopic disease in early childhood: is cord blood IgE a prognostic factor: Clin Pediatr 1992;4:241-6
3. Dean T. Prevalence of allergic disorders in early infancy. Ped Allergy Immunol 1997;10:27-32
4. Strachan et al. World wide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: The International Study of Asthma and Allergies in Childhood (ISSAC). Pediatr Allergy Immunol 1997;8:161-7
5. Exl BM. A review of recent developments in the use of moderately hydrolysed whey formulae in infant nutrition. Nutrition Research 2001;21 (2/1): 355-379.
6. Taylor. Chemistry and detection of food allergens. Food Technology 1992;39:146-152.
7. Saarinen K. Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Lancet 1995;346:1065-1069.
8. ESPGHAN Committee on Nutrition: Agostoni et al. Soy Protein Infant Formulae and Follow-On Formulae: A Commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr 2006; 42 (4): 352-361.
9. Kjellman et al. Soy versus cow’s milk in infants with a biparental history of atopic disease: development of atopic disease and immunoglobulins from birth to 4 years of age. Clin Allergy 1979;9:347.
10. Stick et al. Effects of maternal smoking during pregnancy and a family history of asthma on respiratory function in newborn infants. Lancet 1996;348:1060-1064.