Incidence of Food Allergies Rising? Don't Jump to Conclusions, Says Report

Do you believe the prevalence of food allergies is soaring? Hold on, says a report issued by the National Academies of Sciences, Engineering, and Medicine.

The report, entitled “Finding a Path to Safety in Food Allergy: Assessment of the Global Burden, Prevention, Management and Public Policy” urges changes in US labeling guidelines to better protect consumers with food allergies. But it also asserts that there is insufficient evidence to gauge the prevalence of food allergies in the US, let alone determine whether it is rising.

Committee member, Dr Hugh Sampson, professor of pediatrics, Icahn School of Medicine at Mount Sinai stated that it is “clear that we have no real good prevalence data”, and that an assessment is a “major need for the country because this helps us prioritize food allergy as a public health problem and helps direct appropriate resources towards the problem and also really helps us assess the risk of various food allergic reactions in different populations.”

The lack of definitive, easy to administer diagnostic tests often leave health providers to misinterpret the symptoms of food allergies because they have difficulty differentiating between true allergy and intolerances to foods like lactose and gluten, complicating treatment and prevention.

The report also states that there is insufficient evidence to determine whether these practices have any bearing on the prevalence of food allergy: allergen avoidance diets for pregnant or lactating women; allergen avoidance in infancy; vaginal delivery; breastfeeding; use of infant formulas containing partially or extensively hydrolyzed protein; and supplementation with specific nutrients, such as vitamin D, in children or adults.

The committee called on an authoritative agency, such as the CDC, to conduct a comprehensive study.

“Prevalence should be assessed in a systematic fashion in a sufficiently large population, with consideration given to using stratified sampling for cost-efficiency, with frequency-weighting used to obtain population-wide estimates,” the group wrote. “Prevalence estimates should be conducted in both children and adults and in groups defined by race, ethnicity, and socioeconomic status to determine differences in diagnosis and prevalence within these subgroups.”

The committee also recommended that physicians use evidence-based, standardized procedures to make food allergy diagnoses, and avoid non-standardized and unproven procedures, such as kinesiology, immunoglobulin G panels and electrodermal testing.

“Food allergy evaluation procedures include a medical history and physical examination, and also may include food-specific skin prick test, food-specific serum immunoglobulin E test, diagnostic food elimination diet, and oral food challenge,” the committee wrote. “Selection of the specific tests need to be individualized based on the medical history of each patient.”