Summary: A new study reveals 10% of the adult population in the US suffers from a food allergy, yet 19% of people believe they are allergic to specific foods, despite their reported symptoms being inconsistent with true food allergies.
Source: Ann & Robert H. Lurie Children’s Hospital of Chicago.
Over 10 percent of adults in the U.S. — over 26 million — are estimated to have food allergy, according to a study published in JAMA Network Open that was led by Ruchi Gupta, MD, MPH, from Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University. However, researchers found that 19 percent of adults think they are currently food allergic, although their reported symptoms are inconsistent with a true food allergy, which can trigger a life-threatening reaction. Results are based on a nationally representative survey of over 40,000 adults.
“While we found that one in 10 adults have food allergy, nearly twice as many adults think that they are allergic to foods, while their symptoms may suggest food intolerance or other food related conditions,” says lead author Ruchi Gupta, MD, MPH, from Lurie Children’s, who also is a Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “It is important to see a physician for appropriate testing and diagnosis before completely eliminating foods from the diet. If food allergy is confirmed, understanding the management is also critical, including recognizing symptoms of anaphylaxis and how and when to use epinephrine.”
Researchers discovered that only half of adults with convincing food allergy had a physician-confirmed diagnosis, and less than 25 percent reported a current epinephrine prescription.
Researchers also found that nearly half of food-allergic adults developed at least one of their food allergies as an adult.
“We were surprised to find that adult-onset food allergies were so common,” says Dr. Gupta. “More research is needed to understand why this is occurring and how we might prevent it.”
The study data indicate that the most prevalent food allergens among U.S. adults are shellfish (affecting 7.2 million adults), milk (4.7 million), peanut (4.5 million), tree nut (3 million), fin fish (2.2 million), egg (2 million), wheat (2 million), soy (1.5 million), and sesame (.5 million).
“Our data show that shellfish is the top food allergen in adults, that shellfish allergy commonly begins in adulthood, and that this allergy is remarkably common across the lifespan,” says Dr. Gupta. “We need more studies to clarify why shellfish allergy appears to be so common and persistent among U.S. adults.”
Source: Ann & Robert H. Lurie Children’s Hospital of Chicago
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Original Research: Open access research for “Prevalence and Severity of Food Allergies Among US Adults” by Ruchi S. Gupta, MD, MPH; Christopher M. Warren, BA; Bridget M. Smith, PhD; Jialing Jiang, BA; Jesse A. Blumenstock, BS; Matthew M. Davis, MD, MAPP; Robert P. Schleimer, PhD; and Kari C. Nadeau, MD, PhD in JAMA Network Open. Published November 6 2018
Prevalence and Severity of Food Allergies Among US Adults
Food allergy is a costly, potentially life-threatening condition. Although studies have examined the prevalence of childhood food allergy, little is known about prevalence, severity, or health care utilization related to food allergies among US adults.
To provide nationally representative estimates of the distribution, severity, and factors associated with adult food allergies.
Design, Setting, and Participants
In this cross-sectional survey study of US adults, surveys were administered via the internet and telephone from October 9, 2015, to September 18, 2016. Participants were first recruited from NORC at the University of Chicago’s probability-based AmeriSpeak panel, and additional participants were recruited from the non–probability-based Survey Sampling International (SSI) panel.
Demographic and allergic participant characteristics.
Main Outcomes and Measures Self-reported food allergies were the main outcome and were considered convincing if reported symptoms to specific allergens were consistent with IgE-mediated reactions. Diagnosis history to specific allergens and food allergy–related health care use were also primary outcomes. Estimates were based on this nationally representative sample using small-area estimation and iterative proportional fitting methods. To increase precision, AmeriSpeak data were augmented by calibration-weighted, non–probability-based responses from SSI.
Surveys were completed by 40 443 adults (mean [SD] age, 46.6 [20.2] years), with a survey completion rate of 51.2% observed among AmeriSpeak panelists (n = 7210) and 5.5% among SSI panelists (n = 33 233). Estimated convincing food allergy prevalence among US adults was 10.8% (95% CI, 10.4%-11.1%), although 19.0% (95% CI, 18.5%-19.5%) of adults self-reported a food allergy. The most common allergies were shellfish (2.9%; 95% CI, 2.7%-3.1%), milk (1.9%; 95% CI, 1.8%-2.1%), peanut (1.8%; 95% CI, 1.7%-1.9%), tree nut (1.2%; 95% CI, 1.1%-1.3%), and fin fish (0.9%; 95% CI, 0.8%-1.0%). Among food-allergic adults, 51.1% (95% CI, 49.3%-52.9%) experienced a severe food allergy reaction, 45.3% (95% CI, 43.6%-47.1%) were allergic to multiple foods, and 48.0% (95% CI, 46.2%-49.7%) developed food allergies as an adult. Regarding health care utilization, 24.0% (95% CI, 22.6%-25.4%) reported a current epinephrine prescription, and 38.3% (95% CI, 36.7%-40.0%) reported at least 1 food allergy–related lifetime emergency department visit.
Conclusions and Relevance
These data suggest that at least 10.8% (>26 million) of US adults are food allergic, whereas nearly 19% of adults believe that they have a food allergy. Consequently, these findings suggest that it is crucial that adults with suspected food allergy receive appropriate confirmatory testing and counseling to ensure food is not unnecessarily avoided and quality of life is not unduly impaired.