Food Allergy Education

Module 1. Food Allergies in the United States

Learning Objectives

After the module, students will be able to:

  1. Define food allergies
  2. Discuss the prevalence and current trends of food allergies in the U.S.
  3. Identify the most common food allergens in the U.S.
  4. Identify other food allergens that affect individuals in different countries

Module Content

 

Definitions

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Types and prevalence of food allergies in the United States

The Big 8 is a list of the top eight allergens in the U.S.: eggs, milk, shellfish, wheat, peanuts, fish, soy and tree nuts (USDA, 2012).

Big 8 statistics

In the U.S., 90% of food allergies are caused by eggs, milk, shellfish, wheat, peanut, fish, soy and tree nuts (e.g., walnuts, cashews, almonds, pecans, pistachios, hazelnuts and macadamia nuts) (Sicherer, 2010).

The estimated prevalence of allergies among the U.S. population (Boyce et al., 2010):

  • Peanut: 0.6%-1.3%
  • Tree nuts: 0.4%-0.6%
  • Fish: 0.4%
  • Crustacean shellfish (crab, crayfish, lobster, shrimp): 1.2%
  • All seafood: 0.6% in children and 2.8% in adults
  • Milk and egg: 1%-2% for young children and 0.2%-0.4% in the general population

According to research conducted at a university referral hospital, most infants who had a milk allergy developed this condition before their first birthday, and about 80% of them developed tolerance before they were five years old. Of these children with milk allergies, nearly 35% of them had other food allergies (Boyce et al., 2010).

Food allergies among children

In 2007, about three million children under the age of 18 (3.9%) were reported to have a food allergy (Branum, 2008).

Reports of food allergies increased by 18% from 1997 to 2007 among children 18 years of age and younger (Branum, 2008).

From 2004 to 2006, children 18 years of age and younger represented approximately 9,500 hospital discharges per year from a diagnosis related to a food allergy (Branum, 2008).

It is more common for female than male adults to have food allergies, while male children typically have more food allergies than female children (Ben-Shoshan, Turnbull, & Clarke, 2012).

Figure 1.1 graph
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Figure 1.1. Percentage of children under 18 years of age who reported a food or digestive allergy in the past 12 months, by age, sex, race and ethnic group in the United States, 2007. Adapted from "Food allergy among U.S. children: Trends in prevalence and hospitalizations," by A. M. Branum, and S. L. Lukacs, 2008, HCHS Data Brief, 10, p.1. Copyright 2008 by the U.S. Department of Health & Human Services.

Emerging and less prevalent allergens

The majority of studies have focused on the most common food allergens, even though more than 170 foods have been reported to cause IgE-mediated reactions (Boyce et al., 2010).

Uncommon allergens include the following (FARE, 2014):

  • Corn: raw and cooked
  • Meat: beef, mutton, chicken and pork (heating and cooking meat may reduce allergenicity
  • Gelatin: a protein formed when connective tissue or skin is boiled
  • Seeds: sesame, poppy, or sunflower
  • Spices: coriander, mustard and garlic

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Types and prevalence of food allergies in foreign countries

For many individuals, food allergies depend on their geographical location and tend to be staple foods eaten on a regular basis rather than foods eaten sporadically.

Common allergens in other countries and regions (Baumert, 2012):

  • Canada: sesame, mollusks, mustard, sulfites, and gluten
  • Europe: sesame, mollusks, sulfites, gluten, mustard, celery, and lupin (a type of legume used in flour form)
  • Codex (South Africa): gluten and sulfites
  • Hong Kong: sulfites and gluten
  • Japan: milk, egg, peanuts, and wheat
  • Australia/New Zealand: sesame, mollusks, sulfites, and gluten

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Impact of food allergies

Hospitalization related to food allergies

Figure 1.2, graph
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Figure 1.2. Percentage of children under 18 years of age who reported a food or digestive allergy in the past 12 months, by age, sex, race and ethnic group in the United States, 1998-2006. Adapted from "Food Allergy Among U.S. Children: Trends in Prevalence and Hospitalizations," by A. M. Branum, and S. L. Lukacs, 2008. Copyright 2008 by the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.

Between 2001 and 2006, 31 fatalities due to food-induced anaphylaxis occurred. Eight of these fatalities occurred in restaurants. (Bock et al., 2007)

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Video case study for class discussion

CNN:Peanut allergy causes parents' outrage

Includes controversial viewpoints about provisions for children with food allergies in schools.

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