For Food Allergy Action Month 2021, we’re excited to announce our new Ask the Allergist series featuring our Chief Allergist and Board Certified Allergist Katie Marks-Cogan, M.D., to answer your most commonly asked questions on food allergies. In our first installment, Dr. Marks-Cogan will discuss common food allergies, childhood food allergies, food allergy testing and more.
The Most Common Food Allergies
1 in 10 in the US suffer from a food allergy and there are 9 allergenic foods/food groups that are responsible for a majority of food allergies. These foods/food groups are:
- Tree Nut
However, it’s important to note that any food can cause a food allergy and one reaction can vary widely from the next in the same person. Allergic reactions can be unpredictable and one type of reaction from one exposure is not always the same as another reaction from another exposure. Food allergies are most common in children, but a food allergy can occur at any age.
Common Childhood Food Allergies
In children, most food allergic reactions are caused by three allergens: milk, egg and peanut.
- Most common food allergy found in infants and young children under 5.
- Severe reactions in children most often linked to milk allergy
- Can significantly impact quality of life as it’s difficult to avoid
- 2% of children are allergic to egg
- Egg protein can be found in surprising foods, always check food labels
- Also very difficult to avoid, and can impact social activities
- Rates have tripled in recent years, most common food allergy in children under 18
- Only food allergy with an approved oral immunotherapy, Palforzia
- Only 20% of children with peanut allergy will outgrow it
Less Common Food Allergies
While the top 9 allergens account for over 90% of food allergies, any food can cause a food allergic reaction. Some less common allergens include (but are not limited to):
- Fruits and vegetables (including apples, avocados, bananas, carrots, corn)
- Spices (including coriander, garlic, mustard)
Food Allergy Testing
Validated food allergy tests like skin prick tests or blood tests look for the presence of IgE antibody. If the tests are positive, they show that a person produces IgE antibodies to food allergens. But blood and skin tests alone cannot be used to diagnose food allergy. A person does not have a food allergy unless they also have clinical symptoms. There is also a chance that a person could have a "false positive" on their skin or blood test.
An oral food challenge which exposes a person to their potential allergenic food in small doses, slowly increasing over time with careful observation in a medical facility to watch for signs of an allergic reaction, is the only way to definitively diagnose a food allergy.
However oral food challenges can be risky, thus many times they are avoided and a diagnosis is made based on the other tests above plus the person’s medical history. A patient’s medical history (their reported experiences after exposure to the specific food) is the most important part of the evaluation for a food allergy diagnosis.
Food Allergy Management: Avoiding Allergens
Because there is no cure for food allergy, avoidance is an essential part of managing a food allergy. In addition to avoiding allergens, food allergic families should be educated on the following:
- Hidden ingredients (that may contain allergens)
- Cross contamination
- Early signs of anaphylaxis and when to use epinephrine
Strict avoidance and a high level of knowledge of these important steps to treating a food allergy is critical to maintaining safety and avoiding accidental exposure to allergens.
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