While it’s clear that food allergies are on the rise, especially among children, it’s not as clear the extent to which this is true. Part of the challenge is that there hasn’t been a standard for defining and diagnosing food allergies.
It’s estimated that 50% to a whopping 90% of food allergies are not true food allergies, rather food sensitivities. There’s a difference, and it matters.
In 2008, the National Institute on Allergy and Infectious Diseases (NIAID) set out to standardize how doctors diagnose and treat food allergies. Their (non-binding) guidelines were released yesterday. One of the co-authors and Chief of the Asthma, Allergy and Inflammation branch of NIAID, Dr. Matthew Fenton, said, “We are trying to get everybody to use a common set of tools to diagnose food allergy and best practices for managing them.”
Um. Yes, please.
The new NIAID guidelines acknowledge that no single food allergy test is reliable on its own and that the most reliable test is the food test, where a doctor watches the patient eat the food in question. The recommendations advise that, ideally, all four food allergy tests be administered to diagnose a true allergy: a report of an adverse reaction including a rash, intestinal difficulties, difficulty breathing after consuming a particular food; a blood test; a skin prick test; AND the food test mentioned above.
By scientifically distinguishing true food allergies from food sensitivities, the NIAID hopes to move health care providers away from thinking about food elimination as an end treatment. Rather, as Dr. Hugh Sampson, guidelines co-author and a pediatrician at Mount Sinai School of Medicine’s Jaffe Food Allergy Institute, explains, food elimination should be just one step in the diagnosis process. The guidelines also encourage ongoing testing since several food allergies, especially those to milk and eggs, tend to disappear as children get older.
My hope is that the NIAID research and recommendations reduce anxiety around nutrient dense foods like peanuts and eggs. These higher allergen foods are a staple in non-allergic kids’ diets. I personally can’t live without them: eggs are my go-to quick, nutritious dinner and peanut butter makes an easy, healthy lunch that I know both my kids will always eat. But the fear around these foods has reached a fever pitch even though some research shows that, when it comes to peanuts, only 1% of allergic people have acute reactions to being near or smelling them.
So why are peanuts banned from so many schools? Back in November, when Sami Bahna, president of the American College of Allergy, Asthma and Immunology, got to peek at the now public NIAID guidelines, even he said that banning peanut butter in schools is an overreaction.
And why are pregnant and breast feeding women avoiding nuts and eggs? The NIAID guidelines reiterate the most recent recommendation from the American Academy of Pediatrics that there is no scientific evidence to support the avoidance of high allergen during pregnancy or breast-feeding.
Read more about yesterday’s released food allergy guidelines and, if you’re feeding a baby, how the latest research impacts the way you introduce solids. You can also hear from a peanut-butter loving mom raising a peanut allergic child: Peanut Allergy Fears & Risks — Raising a child with food allergies.
What do you think of the changing POV on food allergies? Will they change the way you feed your pregnant/breast feeding self and your kids?