Britons are now chugging 898 million litres of fruit juices and smoothies each year, according to the British Soft Drinks Association (stock image)
Walk down any suburban high street and you’ll see at least one slender gym-bunny clutching a brightly coloured fruit juice or smoothie. And these days, it’s not just exercise fiends who enjoy guzzling their five-a-day down in one.
Britons are now chugging 898 million litres of fruit juices and smoothies each year, according to the British Soft Drinks Association.
Now a supermarket staple, shoppers are tempted with all manner of exotic combinations; from mango and passionfruit, to pomegranate and coconut. All this is no doubt spurred on by the desire to hit our five-a-day target – after all, fruit and veg are packed with all the beneficial vitamins, minerals and antioxidants we know keep us fit and healthy.
But, according to some allergy experts, our fruit and veg obsession has come at a cost.
As the year-round demand for exotic fruits and vegetables has increased, so too has the number of people suffering from a new type of severe food allergy. Once unique to Spain and Italy, this allergy to the very foods meant to be keeping us healthy has landed on our shores – and the number of victims is increasing.
SWELLING, ITCHY EYES… STRUGGLING TO BREATHE
Mother-of-one Jodie Jackson, from Luton, had suffered with inexplicable attacks after eating random fruit since her teens. Within a minute of eating, her eyes would become so swollen she ‘looked like an alien’.
There appeared to be no obvious reason for her symptoms. Triggers that affected others such as nuts and dairy were harmless, but other fruits and vegetables would cause her to ‘blow up’. Antihistamine tablets seemed to fix the problem, yet she admits: ‘I knew I was allergic to something, but I couldn’t work out the cause.’
Then, last summer, the hairdresser ate a kiwi in Portugal and immediately started vomiting and gasping for breath. She recalls: ‘I knew it was the fruit that had caused it. Antihistamine tablets helped with the sickness but the swelling was still there next morning and took a while to go down.’
Jodie went to her GP, who carried out an allergy test. The results were inconclusive, so she was referred to London’s Royal Brompton Hospital, a leading centre for allergy treatment. In January, experts there diagnosed her with an unusual allergy, known officially as lipid transfer protein allergy, or LTP. The condition was thought to affect only people from Mediterranean countries such as Italy and Spain who eat diets packed with the allergy triggers.
But now experts have seen cases appearing across Britain. The question is: why?
Allergies only occur in the presence of so-called allergens, the substance that triggers an unexplained reaction in sufferers
Previously, a limited variety of fruit and veg was available in Britain, and fewer of us ate them. But now, with more Britons exposed to fruit allergens than ever before, reactions are increasing.
Walk down any suburban high street and you’ll see at least one slender gym-bunny clutching a brightly coloured fruit juice or smoothie (stock image)
Allergy specialist Dr Isabel Skypala from the Royal Brompton & Harefield NHS Trust, who has been studying the phenomenon, says: ‘Whilst we don’t know the cause, the fact that we consume far more concentrated forms of fruits and vegetables, such as juices and smoothies, could be relevant.’
Indeed, Britons now spend more than £1.2 billion a year on berries – a smoothie staple – alone.
Stephen Till, an allergy professor at London’s King’s College and a consultant allergist at Guy’s and St Thomas’ hospitals, agrees that changing eating habits may play a role. ‘For many years we’ve known about this allergy in other southern European countries. We’re now seeing patients with it here – and numbers are increasing, as with all food allergies. The increased incidence might be related to dietary habits changing. Tomatoes and strawberries are much more available now than they were decades ago so LTP allergic people may be more exposed to triggers.’
A NEW, POTENTIALLY FATAL, REACTION
Most common allergic reactions cause minor, hay-fever-like symptoms such as streaming eyes and runny nose. But for those with LTP allergy, an attack can be life-threatening if they suffer anaphylactic shock, which causes swelling to the throat, difficulty breathing and, for some, stomach pain and vomiting. A lifesaving shot of adrenaline is often needed to open up the airways. Also setting LTP apart from other common food allergies is the way it can present in different forms.
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Dr Skypala explains: ‘People with this allergy react whether an ingredient is cooked, raw or in a processed food. For example, those with the most common form of fruit and vegetable allergy, pollen food syndrome, will only react to raw tomato. But those with LTP allergy might react to raw tomato and tomato puree on a pizza, for example.’
As with all allergies, LTP is caused by the immune system over-reacting to a normally harmless compound such as pollen from plants or a protein in a food. This over-reaction releases a cascade of chemicals intended to fight the perceived intruder.
The most potent chemical, histamine, triggers the telltale symptoms of an allergic reaction: coughing, wheezing, sneezing and itching eyes, mouth and nose.
In the case of LTP, this can extends to the extreme swelling of the face and throat, restricting breathing.
Experts are still unsure as to what causes some people’s immune systems to over-react in this way.
Today, at least 44 per cent of adults suffer an allergy of some sort, and there are two million living with a diagnosed food allergy in the UK. The most common form of food allergy, pollen-linked food allergy, affects two per cent of the population – mostly of whom have hay fever. The body mistakes a fruit or vegetable for pollen, as they contain some of the same proteins.
Dr Skypala and Prof Till recently published the first study of British LTP cases. The researchers tested a number of patients they’d diagnosed with the allergy. As expected, they found their reactions were identical to a group of patients from Italy who were known to have the sensitivity.
They also compared them to people with other food allergies and proved that their reactions were distinct. Dr Skypala says: ‘Our study proves it is happening here and now experts know to look for LTP, diagnoses will become far more common.’
EXERCISE CAN MAKE REACTIONS WORSE
Another unique characteristic of this bizarre allergy is that certain circumstances can make it worse. For reasons currently unknown, exercise, painkillers and alcohol can all exaggerate the reaction. Dr Skypala says: ‘Often those who have this allergy might grab some fruit to eat, go dancing, have a drink and only then suffer a reaction. It could be that these co-factors might lead to a faster absorption of the food, which is why those with the allergy have a more severe reaction.’
Jodie Jackson’s case is a classic example. She says: ‘In my mid-20s, I started exercising – I like army bootcamps – and it seemed to happen during or after. I didn’t realise it was the banana I would eat beforehand that was causing the problems.’
Sufferers are advised to limit consuming known triggers and to avoid doing so before exercising, drinking alcohol or taking painkillers. Many are also advised to carry antihistamines and an injecting device that delivers an adrenaline shot, such as an EpiPen, which can reverse a severe anaphylactic reaction.
Since being diagnosed earlier this year, Jodie avoids fruit before exercising. ‘I stick to porridge,’ she says. ‘I eat fruit, but never on an empty stomach, which seems to avoid the reaction. I’ve not had to use my EpiPen yet, luckily. It’s very scary when you first have a reaction and struggle to breathe. I hope others who might have this allergy can now find out more about it too.’