Food Allergies On The Rise

It happens at least once a week in my office. A parent or grandparent will ask “Why are there so many more children with peanut allergy these days?” This is typically followed by the statement, “When I was growing up, I didn’t know anyone who had food allergies.”

It is true – peanut and food allergies are on the rise. Most estimates are between 1 in 25 to 30 children in the United States that have a diagnosis of peanut allergy. That’s roughly one child with peanut allergy in every classroom in America, in every grade level.

There is no consensus as to why this is the case, but there are several theories. Part of the rise in diagnosis comes from increased awareness from families and physicians, as well as more easily accessible testing, either through skin prick testing at an Allergist’s office, or blood testing that can be ordered by any physician. Another theory is called the “Hygiene Hypothesis”, which basically states that as our society has shifted from living on farms into cities, we have less exposure to microorganisms. Our immune systems no longer have to practice fighting off infections, and instead turns its attention to harmless proteins/allergens.

Another thought concerns the production of peanuts for mass consumption. In the United States, peanuts are mostly dry roasted and perhaps this process alters the protein and increases its allergenicity. Lastly, it is possible that prior recommendations to avoid peanuts and tree nuts until 3 years of age did more harm than good. There is ongoing research that suggests earlier introduction may promote tolerance, whereas we used to think avoidance prevented allergy.

Bottom line, the rise in food allergies, and allergies in general, can be attributed to several different phenomena and there does not appear to be one clear link. Thus far, there is no effective way to prevent the onset of allergy as one’s DNA, or genetic makeup, is the most important part of the equation. Some of us are just programmed to be allergic, starting in the womb. And to complicate matters more, there is likely a complex interaction between genes and environment which may result in a variety of different outcomes, depending upon early life exposures, which are currently not well understood.

Believe it or not, but this blog was the short answer to this question. I am hopeful that we’ll have more concrete answers someday soon, which may help provide clues towards a cure. But for now, those with food allergies can only treat their condition with strict avoidance and vigilance for hidden sources of exposure. However, I can provide at least one piece of sound advice to the families I care for: There is nothing that you could have done to prevent this from happening.

David Stukus, MD
Dr. David Stukus is an Associate Professor of Pediatrics, Section of Allergy and Immunology, at Nationwide Children’s Hospital. Dr. Dave, as his patients call him, is passionate about increasing awareness for allergies and asthma. His personal life is filled with fun and chaos as he is married to a Pediatric Emergency Room physician and they have 2 energetic children. His rare free time is spent following his beloved Pittsburgh and Ohio State sports teams. Follow Dr. Dave on Twitter @AllergyKidsDoc for great allergy/asthma tips!

3 thoughts on “Food Allergies On The Rise

  1. Dianne Bowman on said:

    I am interested in hearing what you know about eczema. My almost four year old grandson is on a peanut, tree nut, milk and egg free diet. He was diagnosed with all of these and wheat when he was two years old. After his last skin prick and blood work up, his allergist let him go back to eating wheat. The outbreaks of bad eczema is what started us with an allergist. His body is doing really well, but his neck, head and face are constantly itchy and red. Every once in a while it will clear up a good bit, and then boom, it’s back to being red and itchy. We have had him on so many different meds and none seem to help the head. The symptoms on the face and head are so different from the body. The body just gets little bumps, and they do itch, but the face does not get the bumps, only the very red skin. We have seen several allergists and dermatologists and no one can seem to help that much.
    I would love to hear what you have to say or might recommend. We live in the Atlanta GA area. So sorry to go and on, but it is heartbreaking to see this beautiful child so uncomfortable all the time. What I would give for him to go twenty four hours with out having to scratch himself.
    Thank you for your time.

    Dianne Bowman

    1. Dianne,

      I’m sorry to hear of your grandson’s troubles. Eczema can be very persistent and difficult to treat. The hardest part is the lack of a cure and inability to find a ‘cause’, although there may be contributing factors. It sounds like he has been evaluated by many specialists and I’m sure has received excellent care. Unfortunately, I can’t offer any quick fixes but will reinforce the need to have a good daily regimen to maintain skin hydration and also a plan to activate during flares. In a general sense, foods typically do not trigger eczema symptoms as children get older, especially on only one part of the body, but it is definitely worthwhile working with his allergist to help sort out any dietary interventions. Many children with eczema have ‘false positive’ allergy tests that may not have any clinical significance, so I always recommend caution in interpreting allergy test results, especially for foods.

      The best I can offer is a sympathetic ear and my best wishes.
      Good luck.
      David Stukus, MD

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