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Food Fight

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Jacqueline Pongracic
Pediatric Allergy & Immunology, Children’s Memorial Hospital

Reflecting on her childhood in North Aurora, Jacqueline Pongracic recalls two of her friends. One, a schoolmate suffering from severe asthma, was frequently hospitalized. Another, her next-door neighbor, was beset by multiple food allergies. “It shocked me how it affected her ability to lead a normal life,” says Pongracic, 45. Today, by combining her clinical practice with academic research—the Children’s Memorial Food Allergy Study and a federally funded look at asthma among inner-city children—she is trying to find remedies for both of those afflictions.

Q. Is there a greater frequency of food allergies today?
A. Of the most common food allergens—cow milk, egg, wheat, soy, peanuts, tree nuts, seafood—there has been great interest in learning about peanuts, because they tend to be associated with more severe, life-threatening reactions. And studies have shown that peanut allergy is increasing, and at a pretty significant pace.

Q. What is behind these increases?
A. We don’t think genetics alone is the answer. Genes can mutate, but they tend to do it slowly over a long period of time. People have questioned whether or not it has something to do with what we’re eating, but I don’t think we have adequate proof to say it’s the food supply.

Q. What about lifestyle and the environment?
A. There have been a lot of changes in the way we live, and I think that when you look at places outside of the United States that are adopting more of a Western lifestyle, it appears that their allergy rates are increasing, too. Maybe it’s the exposures we have because we spend a lot of time indoors. There are some people who believe that we don’t have enough ventilation in our homes.

Q. Are there any preventive methods people can adopt?
A. In families where there is a parent or sibling who already has a diagnosed allergy, we will suggest for subsequent offspring the mother consider breastfeeding and delay the introduction of solid foods until after the age of four months. We counsel them about delaying introduction of the highly allergenic foods. We will suggest no cow milk until your child is one year old, no eggs until they are two, and no peanuts, tree nuts, or seafood until after age three.

Q. What should parents watch for if they suspect a food allergy?
Look for rashes, gastrointestinal problems, or for the development of any sudden breathing difficulties or swelling after a meal. Typically a food allergy reaction occurs within minutes of eating the food, and almost always within two hours. Food allergy doesn’t wax and wane; it occurs with each exposure.

Q. Are there any cures or vaccines on the horizon?
Both are in development right now, and both have looked promising in the animal models. I think in ten years it might be feasible that we would have something that would have a significant impact.

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