A recent study to be presented at the 2026 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting found that multi-food allergy is highly prevalent among children with food allergies. The research, which tracked over 1,300 children, suggests that the traditional approach of testing for one allergy at a time may be insufficient. Instead, the findings support more targeted screening and intervention to better manage the complex health profiles of pediatric patients.
The scope of the issue is striking: researchers found that 75.5% of the children studied with at least one food allergy had multiple current food allergies. Meanwhile, 23% had a single food allergy — and among those children, 43% were allergic to peanuts. This high prevalence of multi-food allergy suggests that for many allergic children, the immune system is reacting to more than one trigger rather than an isolated ingredient.
One of the most significant takeaways for parents and healthcare providers is the identification of comorbidity patterns — specific pairs of allergies that frequently occur together. The study found a very high probability of co-occurrence among specific tree nut allergies, including cashew-pistachio and walnut-pecan (>0.9). In practical terms, this means that if a child is allergic to cashews, there is a very strong likelihood they may also be allergic to pistachios, making simultaneous screening for these pairs clinically important.
To better understand these patterns, researchers identified three distinct clusters of allergic profiles. The first group primarily includes children with peanut and tree nut allergies. The second cluster includes children with peanut, egg, and milk allergies. The third, more complex group is broadly multi-food allergic, with reactions to a wide variety of common foods. These categories may help clinicians anticipate additional allergies based on a child’s existing diagnosis and characteristics.
The study also found that multi-food allergy risk is associated with specific demographic and clinical factors. According to the report, “Multi-food allergy was predicted by race, ethnicity, age, socioeconomic status, comorbid atopy and Total IgE.” Identifying these predictors may help clinicians recognize which children are at higher risk for developing multiple food allergies and guide earlier evaluation.
Conversely, some allergies were less likely to co-occur. The researchers observed that the lowest rates of co-occurrence were between seafood and milk or egg allergies (<.2). This suggests that while certain allergies cluster closely together, others are less likely to occur in combination.
Ultimately, the research underscores the need for a more comprehensive approach to pediatric food allergy management. As the AAAAI noted, “distinct phenotypes and comorbidities associated with multi-food allergy may require additional allergy screening for pediatric patients.” Moving toward more targeted evaluation may help identify additional allergies that might otherwise be missed, providing families with clearer guidance on safety and long-term management.
