Food Allergies: Growing in Numbers and Understanding
Odds are you have a food allergy or know someone who does. Up to 15 million Americans have food allergies, and 1 in every 13 children under 18 in the U.S. has a food allergy, according to Food Allergy Research & Education (FARE). That’s roughly two in every classroom!
What’s puzzling is that the number of people who have a food allergy is growing, but researchers are unclear as to why. One benefit to these numbers is society’s increased understanding of food allergies and how to accommodate them.
Food allergies and reactions vary, so arm yourself with information:
Common Food Allergies
There are eight foods that account for over 90 percent of all food allergies, says Dr. David Stukus, a pediatric allergist and spokesperson for the American College of Allergy, Asthma and Immunology (ACAAI). These include cow’s milk, egg, wheat, soy, peanut, tree nut, fish, and shellfish. Milk, egg, and peanut are most common in children, whereas peanut, tree nut, and seafood are more common in adults, says Dr. Stukus.
It’s important to note that a wheat allergy isn’t the same as celiac disease, which is an autoimmune disease in which the body can’t digest gluten (which includes more grains than just wheat).
Most children with food allergies develop symptoms before school age, Dr. Stukus says, but adults can develop food allergies as well – even in foods they’ve eaten for years without problems. This mostly occurs with peanut, tree nut, and seafood. These particular food allergies tend to persist throughout life, with approximately 20 percent developing a tolerance over time, says Dr. Stukus. “Most, but not all, children with milk, egg, wheat, or soy allergies will be able to tolerate these foods at some point, typically before adolescence,” he adds.
Symptoms and Reactions
Symptoms of a food allergy can range from mild to severe, says the ACAAI. And not all reactions will be similar. “The most severe allergic reaction is anaphylaxis – a life-threatening whole-body allergic reaction that can impair your breathing, cause a dramatic drop in your blood pressure, and affect your heart rate,” says the ACAAI web site. It can come on within minutes of exposure and can be fatal, so it must be treated immediately with an injection of epinephrine, which is basically adrenaline.
The ACAAI lists symptoms of an allergic reaction that can include one or more of the following:
- Vomiting and/or stomach cramps
- Shortness of breath
- Repetitive cough
- Shock or circulatory collapse
- Tight, hoarse throat; trouble swallowing
- Swelling of the tongue, affecting the ability to talk or breathe
- Weak pulse
- Pale or blue coloring of the skin
- Dizziness or feeling faint
Food allergies don’t discriminate; they affect children and adults of all races and ethnicities. Your risk is higher, however, if you have a parent who suffers from any type of allergic disease (asthma, eczema, food allergies, or environmental allergies), says FARE. The organization also says that children with food allergies are 2-4 times more likely to have other related conditions like asthma and other allergies. Also, sometimes food allergies can trigger or be associated with other allergic conditions, like atoptic dermatitis.
If you suspect a food allergy, see an allergist. Dr, Stukus wants to emphasize how essential this is. A proper evaluation by a board certified allergist to ensure proper diagnosis, education, and training is important in “maintaining quality of life and effective self-management,” he says.
In this office visit, your family and medical history will be taken. You’ll likely be asked what and how much you ate, how long it took for symptoms to develop, and what symptoms you experienced and how long they lasted, describes the ACAAI. Skin tests and/or blood tests may be ordered. An oral food challenge is also considered an accurate way to make a diagnosis. This is when food is eaten slowly, in graduated amounts, under medical supervision.
An undiagnosed food allergy can have serious consequences, says Dr. James Baker, CEO and Chief Medical Officer of FARE, because if anaphylaxis occurs, the first-line treatment of the prescribed epinephrine auto-injector won’t be on hand.
Food allergies rarely cause any form of chronic symptoms, or symptoms that last once the allergen is eliminated says Dr. Stukus.
Tips for living with food allergies
Dr. Stukus likes to educate people to control what they can control. The goal for anyone with food allergies should be to live a happy, fulfilling life with limited restrictions as long as they have proper education and understanding, he says. “Living with food allergies entails communication and preparation,” he adds. Encounters involving food can be very anxiety provoking for some, especially if they have experienced prior anaphylactic reactions.
However, “learning effective ways to communicate their food restriction to others can help alleviate stress and reduce chances of accidental ingestion,” Dr. Stukus says. Unfortunately, accidents still occur, which is why it’s important to have immediate access to epinephrine, he says, and to use it as soon as a severe reaction takes place.
In fact, Dr. Baker recommends having two epinephrine auto-injectors because reactions are unpredictable.
Being cautions about the information you receive will also help, because there is a lot of misinformation that exists about food allergies, which can lead to unnecessary restrictions and heightened anxiety, says Dr. Stukus.
Dr. Baker says that positive strides have been made. More restaurants are catering to families managing food allergies, some airlines have improved policies to accommodate travelers with food allergies, and school staff have become more educated about how to keep students with food allergies safe and included.
Indeed, most schools and restaurants have interacted with someone with food allergies by now, says Dr. Stukus. They may not completely understand all that is necessary to properly avoid and manage a food allergy reaction, but the awareness is there, he says.
“The advancement of legislation to allow schools to stock epinephrine without a prescription and treat any student with anaphylaxis is a big step, but most of the states have passed [only] voluntary legislation,” says Dr. Stukus. “Mandatory stocking laws in every state are the only thing that will ensure adequate access to epinephrine for all students.”
Still Room for Improvement
Food allergies result in an immediate response to a food. People need to understand that there is no safe amount that someone with food allergies can eat, says Dr. Stukus. “Cross contact with shared baking equipment or surfaces can result in reactions for some people,” he says. “Having food allergies is not a choice someone makes. The only effective treatment is complete and strict avoidance.” This means reading labels on all packaged foods, notifying all food handlers about allergies, and always having self-injectable epinephrine immediately available in case of accidental ingestion causing anaphylaxis, he says.
Seasonal allergies or food intolerances are often confused with food allergies, says Dr. Baker. But having a food allergy means always being extremely vigilant about avoiding allergic triggers. As a result, many people with food allergies still feel stigmatized or excluded from certain activities, says Dr. Stukus, and we need to continue to help to educate others and provide necessary accommodations to help reduce risk of accidental ingestion.
The ultimate message should be that food allergies aren’t a lifestyle choice. “They’re life-altering and potentially life-threatening,” says Dr. Baker. Part of FARE’s mission is to educate the public about the fact that food allergy is a serious and growing public health issue and it’s nothing to take lightly.
The 2016 theme for May’s Food Allergy Month is “Food Allergies: React with Respect.” A kids’ poster asks how to respect food allergies, and the answers apply to us all: “Know that food allergies are very serious, wash your hands after eating, don’t share your food with friends who have allergies, get help right away if a friend gets sick, and show kindness.”
To learn more about food allergies visit: American College of Allergy, Asthma and Immunology and Food Allergy Research and Education, FARE.