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The Fruit and Vegetable Section

OAS – When Raw Fruit is Forbidden

Diagnosing OAS
Since it occurs mainly in people with allergies to birch, grass or ragweed pollen, “the key to diagnosis is the history of hay fever and positive skin tests to relevant pollens,” says Mazer.

“As well, a history of eating the food with typical mouth and throat symptoms without other symptoms, plus the ability to eat the cooked variety of the fruit or vegetable makes the diagnosis fairly certain.”

However – I don’t react to any vegetables sharing allergenic proteins with birch tree pollen, only to fruits. Keith explains that this could be due to a lower level of offending proteins in some of the cross-reacting foods. As well, freshness makes a big difference to the potency.

“The peel also tends to have more protein than the fruit itself,” he says. “So if you peeled an apple and ate it, you might not react as if you ate one with the peel on.”

Like any food allergy, both Mazer and Keith espouse avoidance as the primary means of coping. Mazer also mentions microwaving raw fruit before eating, but agrees the suggestion is not the most appetizing solution. Sprinkling the cut-up fruit with lemon juice and letting it sit for a few minutes may also work.

Given the unpredictability of “true” food allergy, even I have to be on the lookout. “If someone gets hives or worse with the fruit, vegetable or nut; or gets symptoms with both fresh and cooked varieties; or has prolonged symptoms (hours instead of minutes), this may be the sign of a true food allergy,” says Mazer.

In those cases, he emphasizes the importance of seeing an allergist for diagnosis and testing, and then to “strictly avoid the substance and carry self-injectable adrenaline.”

Seeds of Control
If the problem is genuinely OAS, “the key is to manage the hay fever,” Keith says. He suggests using an intranasal steroid two weeks before the season and throughout, to stave off a seasonal rise in the allergic IgE antibodies.

“We want to turn off your nose’s production of IgE locally to the pollen, so when you eat a protein that is very similar, you won’t get the symptoms,” he says. Immunotherapy or allergy shots has not proved particularly helpful for this syndrome, though it can be effective for the hay fever itself.

Some natural therapies may provide some relief. Keith finds that nasal rinsing with a saline spray can be effective in reducing inflammation, while wearing glasses lessens pollen exposure in eyes. He also recommends keeping windows closed, especially in the bedroom and the car, during the specific allergy season.

Keith and his colleagues have recently completed a novel study on a mint tea high in rosmarinic acid, which is believed to have anti-allergic properties. Trials were conducted with sufferers of severe chronic rhinitis.

The results, which Keith allows “are interesting” were to be released at the American Academy of Allergy, Asthma & Immunology annual meeting in March. He thinks it’s important to undertake proper studies “to see if natural therapies do have a benefit.”

Given that a third of Canadians suffer from hay fever, the experts actually find it surprising that so few people experience OAS. “A major question is not why people get this problem, but why more people don’t – since the pollen-protein link is always there,” says Mazer. It tends to be those who have more severe hay fever who get OAS.

“If you get OAS symptoms, see your doctor,” says Keith. “What you’re experiencing is really a side effect of your hay fever not being controlled.” So it’s off to the specialist for me to make sense of my hay fever symptoms. There may be a chance yet for my love affair with peaches. One can only hope.

First published in Allergic Living magazine, Spring 2009.
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Allergic Living acknowledges the assistance of the OMDC Magazine Fund, an initative of the Ontario Media Development Cooperation.