Why food allergies are on the rise: Are we too clean?

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By Madelyn Fernstrom

Why are food allergies on the rise?

Nearly 15 million Americans have food allergies, with an estimated 1 in 13 children under the age of 18 affected by them, according to the Centers for Disease Control and Prevention. Some argue that the nearly 50 percent rise in food allergic kids between 1997 and 2011 is a problem caused by Americans being too clean. Others argue we’re weakening children’s immune systems by delaying foods linked to allergies when babies start eating. Unfortunately, the science really isn’t clear when it comes to the cause of food allergies — it could be a combination of genetics and the environment —but there are many things we do know.

TODAY answers your burning questions about the culprits, warning signs and how to protect your family when traveling.

What are the biggest culprits and are they clearly labeled on packaged foods?

The major food allergens come from just 8 foods: 

  • milk
  • soy
  • wheat
  • peanuts
  • tree nuts 
  • shellfish 
  • eggs, 
  • fish 

But food allergies can be found for any food, including seeds, fruits, and meat. Government regulations mandate the labeling of the top 8 food allergens in their product. 

By law fresh produce, eggs, fresh meat, and certain highly refined oils don’t require listing on the labels. The “may contain” labeling is voluntary, and not regulated. Testing shows products can have zero, or sometimes contain dangerous amounts of the allergen. Careful label reading is always essential.   

What are the warning signs of a food allergy?

According to pediatrician Dr. Gary Pien, a New Jersey board certified allergist/immunologist, the symptoms of an allergic response can vary but the most common signs are:

  • tingling or itching in the mouth, nose, or throat
  • swelling of the lips face, tongue or throat
  • nasal congestion or trouble breathing
  • feeling faint, dizzy or lightheaded
  • a sense of impending doom

What is the difference between a food sensitivity/intolerance and a food allergy?

A food allergy is an immune system-mediated reaction. The majority of food allergies are triggered by specific protein found in a particular food. A food sensitivity is not connected to the immune system, but can still provoke troublesome — but not life-threatening — symptoms. Food sensitivity/intolerance responses are often associated with food ingredients like gluten and lactose.

What does it mean to have a severe food allergy?

“Severity can mean that only a tiny amount of food is enough to trigger a reaction, or it could mean that the reaction is severe and leads to life-threatening symptoms," says Pien. "People diagnosed with a severe food allergy of either type need to be extremely careful, and always carry an epinephrine auto-injector in case of a severe reaction."

Do different foods provoke different severity of response?

More severe allergic responses, including breathing difficulty and anaphylaxis, have been associated with ingestion of peanuts, tree nuts, fish, and shellfish. However, any food could trigger a potentially anaphylactic reaction if a person is allergic to it.

When should an EpiPen be used?

According to Dr. Pien, every person diagnosed with a severe food allergy should carry an EpiPen, or other epinephrine device like an Auvi-Q (that gives verbal directions of how to use it). He says that “while fatal anaphylaxis is rare, delayed administration of an EpiPen is associated with an increased risk of fatality.” After an accidental ingestion of the allergen, if a person has a prior history of severe food allergy, is far from medical help, or has any symptoms of difficulty breathing, feeling faint, or throat swelling, an epinephrine injector must be immediately used.

How should you introduce foods to your child to avoid food allergies?

Earlier guidelines from the American Academy of Pediatrics had a recommended delayed pattern for introducing high allergen foods. Because there were few scientific studies to support the delayed introduction of allergenic foods, revised guidelines introduced in 2008 recommend introduction of all foods, around the age of 4-6 months, when the infant appears ready for them. Some studies suggest that earlier introduction might actually be a positive step, and help reduce food allergies,

What precautions can a family take to avoid an allergic response at a restaurant or when traveling?

It’s important to make sure the allergic child and adult does not feel like a social outcast due to more restricted eating of high allergen foods. Call ahead for ingredient lists, and stick with chain restaurants, where ingredients are standardized. Avoid buffets where cross-contamination is more likely. Always alert your server to the food allergies, to make sure the chef or other food preparers are focused on what to keep off the plate. 

Remember to take some tolerated foods on the road, including fresh or dried fruit, sunflower butter sandwiches and hummus for dipping veggies.