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He adds that in some instances, “medications (e.g., aspirin) can trigger asthma” but that “this is by a different inflammation pathway”. “Allergy usually implies a particular process with specific processes involved. These can be targets for treatment,” Dr Claxton said. “Other allergies, e.g., food allergies such as peanut allergy, can have asthma symptoms as part of the allergy response, but it’s often more systemic than just inflammation in the lower airways.” Nutrition and allergic asthma: is there a link? Lisa Renn, Accredited Practising Dietitian and spokesperson for the Dietitians Association of Australia says that “food rarely triggers asthma”, adding that “only a very small percentage of people have asthma from food allergies”. “It’s certainly not a big trigger for asthma in the majority of people,” she said. “Asthma symptoms can present with other generalised allergy responses like ... hives, nausea and vomiting. Certainly, asthma can be part of that generalised allergy response, but whether food is actually triggering that is less common.” Ms Renn points out that while some people might have “asthma as a symptom of food allergy”, others might be exposed to the same allergen and have a different reaction, such as hives. However, while food is “highly unlikely to be the cause of asthma”, Ms Renn says that for people with a food chemical allergy or intolerance, symptoms can include asthma. A preservative found in food that may trigger an asthma response in some people is the sulphite, which she says is “a preservative found in dried fruit, beer and wine, \[and also in some\] medicine”. “The other one that has a \[small\] likelihood of causing asthma is MSG ... there’s also tartrazine, which is food additive 102 \[it’s also known as E102\] – it’s a food colouring. It’s likely to be very minimal in causing asthma,” Ms Renn said. “The other one is salicylate, which is a naturally occurring food chemical in stone fruit, dried fruits and berries, and concentrated tomato products ... it will ALLERGIES 39 likely very minimally trigger asthma, but the food chemical group, salicylates, may, in some small cases be a problem for people.” Ms Renn cautions that if someone suspects a food allergy or intolerances, it’s important that this is confirmed through diagnosis rather than “just avoiding food without having that medical confirmation \[about\] what’s going on”. “If someone is avoiding food, that can lead to a poorly balanced diet. For example, when someone is avoiding wheat, or having gluten free when they don’t need to, then that will lower the fibre content of the diet. It’s not dangerous but the diet won’t be as well balanced as it should be.” Additionally, Ms Renn warns that medical supervision is imperative when doing “food trials” as a way to test what triggers an allergic response and what doesn’t. “That obviously can be dangerous, as anaphylaxis can involve complete restriction of the airways, so you want to be doing these sorts of challenges with medical supervision,” she said. TO PAGE 40 RETAIL PHARMACY ASSISTANTS • JUN 2020