Allergy

Allergies

Novalac is a pioneer in the management of Cow’s Milk Allergy (CMA).

We provide several solutions for babies either at risk of developing allergies or with a diagnosed allergy.

What is allergy?

Non-toxic adverse reaction to food can be classified in two categories: Immunologic reactions (allergy) and Non-immunologic reactions (intolerance/aversion). The two should not be confused.

Food intolerance

In case of food intolerance (e.g. enzyme deficiency), the immune system is not (or almost not) involved in the reactions. “Allergy to lactose” is therefore an improper wording, adverse reaction to lactose (diarrhea, etc.) should be named “lactose intolerance”.

Lactose intolerance is due to the absence or a metabolic deficiency of the lactase enzyme (disaccharidase of the intestinal brush border). If not hydrolyzed, lactose cannot be absorbed in the intestine. Therefore, the bacterial flora transforms this disaccharide, through a fermentation process, in short chain organic acids and gas.

This fermentation can lead to abdominal pain, flatus, bloating, loose stools or watery diarrhea. To manage lactose intolerance, lactose should be avoided in the diet1.

So, for infants who are suffering from a lactose intolerance, it is recommended to feed them with a lactose free formula, and as such a rice-based formula can also be used in the management of lactose intolerance.

  1. Heine R.G., et al., Lactose intolerance and gastrointestinal cow’s milk allergy in infants and children –common misconceptions revisited . World Allergy Organization Journal 10:41 DOI (2017)

Allergies

Allergies are the expression of an adverse reaction of the organism that does not tolerate foreign elements (food elements, dust, insect bites…). Food allergy is defined as an immunologic reaction to a harmless substance in food. This type of reaction is called an allergic reaction. There are several types of immunologic reactions depending on whether it implies Immunoglobulin E (IgE) or not. IgE-mediated reactions occur usually a few minutes or a few hours after the ingestion of the allergen whereas non IgE-mediated reaction can take place a few days after1.

Classification of adverse reactions to food (issued from2)

diagramme-product-allergy

Allergy may lead to several symtoms 1-4

several-symptoms-of-allergy
  1. Luyt D., et al. BSACI guideline for the diagnosis and management of cow’s milk allergy. Clin Exp Allergy. 44(5):642-72 (2014).
  2. Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes. EFSA Journal 12, 3894 (2014).
  3. Fiocchi A., et al. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guidelines. Pediatr Allergy Immunol Suppl 21, 1–125 (2010).
  4. Koletzko S., et al. Diagnostic approach and management of cow’s-milk protein allergy in infants and children: ESPGHAN GI Committee practical guidelines. J. Pediatr. Gastroenterol. Nutr. 55, 221–229 (2012)

Prevalence of food allergy

Several studies indicate that 75 % of allergic reactions among children are due to a limited number of foods, namely egg, peanut, cow’s milk, fish and various nuts1.

There is evidence that the prevalence of food allergy has been increasing in recent decades, particularly in westernised countries2.

On which data rely to see that food allergy prevalence has increased?

The best would be to rely on data provided by oral food challenge procedure, but conducting food challenges in large populations induces high costs and includes potential risks.

Therefore, data showing an increase in food allergy prevalence mainly comes from changes in hospital anaphylaxis admission rates derived from national government databases in westernised countries.

For example, the food anaphylaxis admission rates per 100,000 population per year rose:

  • from 1.2 to 2.4 between 1998 and 2012 in the United Kingdom3
  • from 5.6 in 2005-2006 to 8.2 in 2011-2012 (a 1.5-fold increase over 7 years) in Australia4; the highest rates occurred in children aged from 0 to 4 years, 21.7 in 2005-2006 and 30.3 in 2011-2012, a 1.4-fold increase.
  1. Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes. EFSA Journal 12, 3894 (2014).
  2. Tang M. L. K. & Mullins R. J. Food allergy: is prevalence increasing? Intern Med J 47, 256–261 (2017).
  3. Turner P. J. et al. Increase in anaphylaxis-related hospitalizations but no increase in fatalities: an analysis of United Kingdom national anaphylaxis data, 1992-2012. J. Allergy Clin. Immunol. 135, 956-963.e1 (2015).
  4. Mullins R. J., Dear K. B. G. & Tang M. L. K. Time trends in Australian hospital anaphylaxis admissions in 1998-1999 to 2011-2012. J. Allergy Clin. Immunol. 136, 367–375 (2015).