Why Do So Many Kids Have Food Allergies?

If you are new to the parenting scene, or if you grew up in a time when allergies weren’t that prevalent, you might be wondering why so many kids have food allergies? If you take a child to daycare or any group function today, allergy alert signs are posted everywhere, and entire schools are nut-free zones. When I was a child, peanut butter and jelly sandwiches were lunchbox staples. Today they are strictly banned, and the topic of food allergies is not one to be discussed lightly, especially if you are a parent with an allergic child.

Food Allergies Can be Life or Death for a Child

Some allergic children respond to certain foods with itchy skin or a scratchy throat. Others are deathly allergic, meaning they can develop anaphylaxis (pronounced an-uh-fil-LAX-is), a medical emergency that requires treatment with an epinephrine (pronounced ep-in-EF-rin) injector, or EpiPen, and a trip to the emergency room for constriction of the throat, severe drop in blood pressure, and loss of consciousness. For friends and parents living with an allergic child, the smallest piece of food on the table at the park could be an allergic reaction waiting to happen.

Protecting Kids in School: It Takes a Village

Protecting children in schools is critical to the fight against food allergies.

25% of food-induced anaphylaxis reactions in schools occur among students without a previous food allergy diagnosis.¹¹³
16-18% of children with food allergies have experienced reactions to accidental ingestion of food allergens while in school.¹¹⁴

Food Allergies on the Rise: Food Allergy Statistics

Between 1997 and 2008, the prevalence of peanut or tree nut allergy appears to have more than tripled in U.S. children. ¹¹¹
The Centers for Disease Control & Prevention reports that the prevalence of food allergy in children increased by 50 percent between 1997 and 2011.
The largest study to ever track food allergies surveyed 38,000 children and concluded that food allergies are more prevalent and more dangerous than previously thought—8% of children under age 18 (about two kids per classroom) were found to be allergic to at least one food and 39% of the allergic children had severe reactions.¹¹⁰
Children’s food allergies cost an estimated $24.8 billion each year ($4,184 per year per child), and much of that cost is out of pocket in the form of co-pays, special foods, medications, and child care required to avoid allergens. Time missed from work and caregivers needing to leave or change jobs are also major issues, since many allergic children require weekly testing and shots.¹¹²

How Many Kids Have Food Allergies?

Researchers estimate that 32 million Americans have food allergies, including 5.6 million children under age 18. That’s one in 13 children, or roughly two in every classroom.

Understanding food allergies

A food allergy is when your body mistakes food as something harmful. When something harmful is identified inside your body, your immune system sends signals to your cells to release something called immunoglobulin E (IgE) to neutralize the culprit. Eating the smallest amount of an allergenic food can trigger IgE antibodies, which release histamine into your bloodstream. Histamine, a chemical found in some of your body’s cells, increases the production of mucus, affects nerve cells in the skin, and causes blood vessels to swell. Histamine and other immune-response chemicals are responsible for allergic reactions and symptoms, such as a rash, itchy throat, dripping nose, nausea, difficulty breathing, and anaphylactic shock.

These eight types of foods account for 90% of all allergic reactions in children:

Eggs
Cow’s milk
Peanuts
Tree nuts (like walnuts, pecans, hazelnuts, almonds, cashews, and pistachios)
Soy or soybeans (primarily in infants)
Fish (like tuna, salmon, cod)
Shellfish (shrimp, crab, lobster)
Wheat

Note: The FDA estimates that 80 to 90% of children with allergies to milk, eggs, wheat, and soy should outgrow them by age five, while only 20% will outgrow a peanut allergy and 10% will outgrow tree nut allergies.

**What is causing the increase in food allergies?**

There is no single cause for the rise in food allergies; however, there are some theories about what might be contributing to the increase.

Hygiene Theory

This hypothesis asserts that we are “clean freaks.” Clean water, antibiotics, and vaccines have eliminated challenges to our immune systems, which are designed to fight foreign things like parasites, viruses, and infection. When our immune system is less busy attacking germs, it goes after the next best thing: food proteins (like eggs, wheat, and peanuts.)
The following list includes interesting research supporting the hygiene theory:
- Early exposure to bacteria is good: Though inner city kids have higher allergy rates overall, a study of 516 children in Baltimore, Boston, New York, and St. Louis found that infants under age one with the highest exposure to specific cockroach, mouse, and cat allergens, as well as dust bacteria, were less likely to suffer from allergies, asthma, and wheezing.¹¹⁵
- Dirt doesn’t hurt: Children raised on farms have fewer allergies and less asthma.¹¹⁶
- Helpful bacteria in the gut: In 2014, researchers found that mice raised in a sterile environment and given antibiotics early in life did not have common gut bacteria, Clostridia, which may prevent food allergies. Supplementing with probiotics containing Clostridia could reverse or lessen the allergy.¹¹⁷

Vaccine Theory

In the peanut allergy debate, some think the introduction of the Hib (Haemophilius influenze type B) vaccine in the early 1990s may have contributed to a rise in peanut allergies. They note that in countries such as Indonesia and China, where large quantities of peanuts are eaten and the Hib vaccine is rarely given, peanut allergies barely exist. Others believe that yeast used in the Hib vaccine is causing asthma and breathing difficulties in some children.

GMO Theory

Food allergies shot upward in the late 1990s. Coincidentally, Genetically Modified Organisms (GMOs) were introduced into the food system in 1996, and some are concerned that transferring genes between all types of plants and foods can bring unintended consequences, including cross-pollination of allergenic proteins.¹¹⁸

Food Additives Theory

Some doctors speculate that children may be having allergic reactions to food additives, rather than to specific foods themselves. For example, sulfites used to preserve wine, soft drinks, and dried fruit have been known to trigger asthma and other allergic symptoms. Artificial food colorings and preservatives also show similar results.¹¹⁹

Limited Diet Theory

Some suspect that limited, processed food choices of westerners may also be a culprit. Americans do not eat seasonally anymore. In fact, we eat about 20 of the same foods over and over in different combinations each day. Therefore, by focusing our diets, the immune system is less able to deal with the constant influx of the same foods. For example, nuts and nut byproducts are found in more foods and consumer goods than ever before, especially in processed foods and skincare products.
Further supporting the limited diet or inundation theory, Asian scientists studied 25,692 school children in Singapore and the Philippines, and found that peanut and tree nut allergies are relatively low, while shellfish allergies are predominate.¹²⁰

Vitamin D Theory

This theory acknowledges that pregnant women and children receive less vitamin D from sunlight because they are indoors more often, and they use more sunscreen. Evidence shows that food allergies in children are higher in regions further from the equator. Vitamin D deficiencies can alter immune system responses.¹²¹

Detection Bias Theory

Although most experts agree that a combination of factors is causing the increase, some believe that doctors are more aware of symptoms and are better able to diagnose food allergies than in the past.

Don’t be Snarky, Give a Hug to Parents Living with Food Allergies

Hopefully, we all feel a little more educated about food allergies and will have a heart for the moms and dads in our class who must be vigilant every day, who have no choice but to put the fear of God into anyone caring for their child. Perhaps we might grab an extra gluten-free, dairy-free cupcake at the bakery, so an allergenic child can enjoy birthday treats with the class. Or just acknowledge that parenting is exhausting enough without reading food labels on everything while constantly worrying about your child. Just a little understanding will go a long way in helping us navigate a changing food allergy landscape.

Sources

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109. Jackson, K.D., L.D. Howie, and L.J. Akinbami, Trends in allergic conditions among children: United States, 1997-2011. NCHS Data Brief, 2013(121): p. 1-8.

110. Gupta, R.S., et al. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics, 2011. 128, e9-17 DOI: 10.1542/peds.2011-0204.

111. Sicherer, S.H., et al., US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up. J Allergy Clin Immunol, 2010. 125(6): p. 1322-6.

112. Gupta, R., et al., The economic impact of childhood food allergy in the United States. JAMA Pediatr, 2013. 167(11): p. 1026-31.

113. Sicherer, S.H., et al., The US Peanut and Tree Nut Allergy Registry: characteristics of reactions in schools and day care. J Pediatr, 2001. 138(4): p. 560-5.

114. National Institute of Allergy and Infectious Disease, Food Allergy: An Overview. July 2007, NIH Publication No. 07-5518.9: Bethesda, MD.

115. Lynch, S.V., et al., Effects of early-life exposure to allergens and bacteria on recurrent wheeze and atopy in urban children. J Allergy Clin Immunol, 2014.

116. Holbreich, M., et al., Amish children living in northern Indiana have a very low prevalence of allergic sensitization. J Allergy Clin Immunol, 2012. 129(6): p. 1671-3.

117. Stefka, A.T., et al., Commensal bacteria protect against food allergen sensitization. Proc Natl Acad Sci U S A, 2014. 111(36): p. 13145-13150.

118. Herman, E.M., Genetically modified soybeans and food allergies. J Exp Bot, 2003. 54(386): p. 1317-9.

119. Asthma and Allergy Foundation of America. Adverse Reactions to Food Additives. November 13, 2014; Available from: http://asthmaandallergies.org/food-allergies/adverse-reactions-to-food-additives/.

120. Shek, L.P., et al., A population-based questionnaire survey on the prevalence of peanut, tree nut, and shellfish allergy in 2 Asian populations. J Allergy Clin Immunol, 2010. 126(2): p. 324-31.

121. Allen, K.J., et al., Vitamin D insufficiency is associated with challenge-proven food allergy in infants. J Allergy Clin Immunol, 2013. 131(4): p. 1109-16.