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Menu options shrink as Indians become more prone to allergies

Fast-changing diets and weakened immunities are forcing some to eliminate peanuts, seafood, even rice.

health and fitness Updated: Jan 09, 2017 19:30 IST
Allergies

Imagine never being able to eat a samosa. That’s life for Mumbaiite Rashna Panthaki, who is allergic to potatoes.(Aalok Soni / HT Photo)

Shirin Gadbade can’t remember what a rasgulla tastes like, and says she doesn’t know where to look when dessert time rolls around and everyone helps themselves to ice-cream.

Gadbade, 37, a Mumbai-based communications manager, is lactose intolerant, which means no Indian sweets or paneer or chocolate with greater milk content.

“The only time I drank milk without throwing up was probably when I was breastfed,” she says.

People with lactose intolerance can’t digest this form of sugar, found in milk and dairy products, and experience bloating, stomach cramps, diarrhoea or nausea when they consume any.

It may not make Gadbade feel any better, but she’s among a growing number of Indians with food allergies.

A food allergy is a condition where the body’s immune system reacts abnormally to certain chemicals in food, leading to redness, rashes, swelling and in extreme cases even anaphylactic shock and death.

“By rule of the thumb, about 5% to 8% of any population has some kind of food allergy, but most do not get tested because of the cost involved, with the tests costing between Rs 7,000 and Rs 14,000,” said Dr Shubnum Singh, clinical allergist at Delhi’s Max hospital.

Communications manager Shirin Gadbade at her office canteen in Powai, Mumbai. Gadbade is allergic to peanuts, and her lactose intolerance is so bad that she has developed an aversion to all ‘white foods’. (Aalok Soni/ HT Photo)

Lately, the numbers have been rising in India.

“I have seen a two- to four-fold increase in the number of children coming in with food allergies over the past decade,” says Dr Krishan Chugh, director of paediatrics at Fortis Memorial Research Institute, Gurgaon. “The rise in numbers is likely a result of more people getting tested, and the fact that our food habits are changing faster than our bodies can cope with.”

Then, there is the hygiene hypothesis used to explain growing allergies across developed populations. “According to the hypothesis, when the body is not exposed to enough bacteria, the immune system starts fighting whatever it is exposed to, which, in this case, is food. This is highly likely because food allergies are higher in Indian children who have spent their initial years abroad — they account for half of my patients with food allergies,” said Dr Chugh.

Faulty self-diagnosis is another probably cause.

Gadbade, for instance, had not seen a doctor or technically been diagnosed with lactose intolerance until two years ago. Instead, she had deduced from trial and error that she could not digest lactose, and along the way had also developed an aversion to white foods, at which point she stopped eating bread and potatoes too.

“Perceiving a food allergy, people stop eating some foods and miss out on proper nutrition. For instance, one of my asthma patients looked very weak and when I asked her mother whether she was eating well, the mother said that she had stopped giving her rice, milk, curd, egg and banana because she thought she had an allergy. It turned out she didn’t. It is best to go to a doctor and get it tested,” says Dr Raj Kumar, head of the department of respiratory allergy and applied immunology at Delhi’s Vallabhbhai Patel Chest Institute.

ARE YOU ALLERGIC?

Faridabad boy Piyush Bhadana (seen here being fed by his mother) is only 15 months old and has been diagnosed with a milk allergy. (Ravi Choudhary / HT Photo)

Unlike in the West, where peanut allergies are the most common, Indians tend to be allergic to pulses (mainly black gram), rice (odd but true), citrus fruits, bananas, eggs and shellfish, doctors say.

Gluten has recently emerged as a rather popular allergy.

“It has become a fad,” says Mumbai-based nutritionist Samreedhi Goel, “fuelled by the fact that most people don’t know the difference between intolerance and aversion.”

Gluten is a component found in wheat, rye and barley and gluten intolerance, also known as celiac disease, is a rare condition caused by the deficiency of an enzyme that aids in the digestion of this component.

In a time of gluten-free diets fuelled by celebrity cleanses and organic lifestyle aspirations, the number of gluten-free products on the market has risen.

“This leads to intolerance for gluten in the long-term, hence allergic reactions, and a rise in the number of cases of gluten allergies,” says Dr Altaf Patel, director of medicine at Mumbai’s Jaslok hospital.

If you suspect a food allergy, a simple test at home is a good first step. “Completely stop eating the food you think you are allergic to for a week, then reintroduce it in one meal and again abstain for four days. After doing this two or three times, you will know whether you are really allergic to it,” said Dr Singh of Delhi’s Max hospital.

Your next step should be to consult a doctor. “A survey we did showed that 60% of our patients thought they had food allergies, but only 4% did,” says Dr Kumar.

Testing for allergies has evolved and you can now not only check for a specific allergy but also test your immune system against thousands of common allergens from your environment.

Once you are diagnosed, there is, sadly, no cure. So rasgullas are out for Gadbade.

“The best treatment for allergy,” says Dr Kumar, “is to avoid that particular food”.

A BABY WHO CAN’T DRINK MILK

Fifteen-month-old Piyush Bhavana is frail and underweight. His weight loss started when he was a month old and he developed diarrhoea, which did not stop.

“We went to several doctors but for five months, no one was able to tell us what was wrong with him,” says his father, Pramod, a salesman with an automobile company. “Some said the diarrhoea was because he was teething. Others asked us to stop giving him milk and chapatis, the only solid food he used to eat. One doctor even asked us to stop breastfeeding him.”

While the doctors debated, Piyush grew weaker. He was finally diagnosed with milk and wheat allergies at Fortis Memorial Research Institute, Gurgaon.

“Now he is gaining weight and has become active. We give him besan chapatis and dals recommended by the doctor,” says Pramod.

SHE CAN’T STAND NEAR A STEAMING SPUD

When Rashna Panthaki’s colleagues head out for their daily samosa / vada pav break, she is forced to eat a fruit instead — something that is infinitely healthier, but nonetheless makes her sad. You’d be sad too, if you could never eat potato again.

The 49-year-old secretary from Mumbai is allergic to spuds. Even lifting the lid on a boiling potato can cause her throat to start closing, prompt a dizzy spell and lead to a fall in blood pressure.

She was diagnosed 16 years ago. “I can’t even eat anything fried in the same oil as potatoes were. I develop an immediate and severe reaction,” she says.

As a result, her physician, Dr Beheram Bunshah, has advised her to always keep a set of anti-allergen tablets in her bag, car, office and home. “In case of a severe and unchecked reaction, there are steroids that can be injected, but it’s best not to reach that stage,” he says.